ABSTRACT
OBJECTIVE: To compare the time taken and steps completed by nurses in the process of insulin preparation and administration using the pen device compared to the vial and syringe method. METHODS: Observational and exploratory study utilizing a time-motion analysis of nurses' administration of insulin using the pen versus vial and syringe delivery methods. Nurses were observed, video-recorded, and timed during insulin preparation and administration using each delivery method. The steps performed by nurses were observed against recommended processes for preparing and administering insulin, and the percentage of nurses completing each step was noted. RESULTS: A total of 137 (94%) nurses participated. Nurses took less time preparing and administering insulin with the pen device compared with the vial and syringe method (79 ± 18 seconds vs 88 ± 20 seconds, respectively, P < .001). The overall average completion rate of steps with the pen device was 90% ± 7% compared to 88% ± 7% with the vial and syringe method. CONCLUSION: The time taken by nurses to prepare and administer insulin was lower with the pen device compared with vial and syringe. Furthermore, areas were identified for potential nursing education to enhance safe and appropriate use of insulin with both delivery methods.
Subject(s)
Drug Delivery Systems/nursing , Insulin/administration & dosage , Time and Motion Studies , Drug Delivery Systems/methods , Humans , Injections, Subcutaneous/nursing , Inpatients , Nurses , Simulation Training , SyringesABSTRACT
Use of outsourced nurses is often a stop-gap measure for unplanned vacancies in smaller healthcare facilities such as long-term acute-care hospitals (LTACHs). However, the relationship of utilization levels (low, medium, or high percentages) of nonemployees covering staff schedules often is perceived to have negative relationships with quality outcomes. To assess this issue, the authors discuss the outcomes of their national study of LTACH hospitals that indicated no relationship existed between variations in percentage of staffing by contracted nurses and selected outcomes in this post-acute-care setting.
Subject(s)
Leadership , Nursing Staff, Hospital/statistics & numerical data , Outsourced Services/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Quality Indicators, Health Care/organization & administration , Skilled Nursing Facilities/statistics & numerical data , Acute Disease/therapy , Cross-Sectional Studies , Humans , Long-Term Care/organization & administration , Medication Errors/statistics & numerical data , Nursing Administration Research , Nursing Staff, Hospital/supply & distribution , Outcome Assessment, Health Care , Outsourced Services/organization & administration , Personnel Staffing and Scheduling/organization & administration , United States , WorkforceABSTRACT
When staffing effectiveness is not maintained over time, the likelihood of negative outcomes increases. This challenge is particularly problematic in long-term acute care hospitals (LTACHs) where use of outsourced temporary nurses is common when providing safe, sufficient care to medically complex patients who require longer hospital stays than normally would occur. To assess this issue, the authors discuss the outcomes of their survey of LTACH chief nursing officers that demonstrated LTACH quality indicators and overall patient satisfaction were within nationally accepted benchmarks even with higher levels of outsourced nurses used in this post-acute care setting.
