ABSTRACT
BACKGROUND: Staff shortages, reduced budgets, and high acuity of violent psychiatric patients can create challenges in psychiatric intensive care units (PICUs). LOCAL PROBLEM: Staffing of the psychiatric unit was based on patient census rather than evidence-based practices. METHODS: A pre-/postintervention design was used to examine changes in nursing satisfaction and patient outcomes as measured with the National Database of Nursing Quality Indicators (NDNQI) survey results. INTERVENTIONS: A psychiatric specific acuity tool was implemented on the PICU of a Veterans Administration hospital. RESULTS: After an initial decrease related to the COVID-19 pandemic, total acuity and the total number of nurses remained relatively stable while the unit census declined. NDNQI survey results improved with the largest being a 52-percentile increase for the quality-of-care summary measure. CONCLUSIONS: An acuity tool can help standardize practice, determine fair patient assignments among staff, increase nurse satisfaction, and promote best practices for patient safety.
Subject(s)
COVID-19 , Nursing Staff, Hospital , COVID-19/epidemiology , Humans , Intensive Care Units , Nursing Staff, Hospital/psychology , Pandemics , Patient Safety , Personnel Staffing and SchedulingABSTRACT
Two primary care clinics in rural and urban settings implemented a 9-hour nursing shift schedule. The purpose of this project was to use a quasiexperimental mixed-methods research design to assess outcomes for a 1-year implementation of nursing staff maintaining 9-hour shifts. Pre- and postdata were collected before and after implementation. The rural clinic demonstrated significant improvements in nurse satisfaction, overtime, compensatory time, and postacute follow-up. The urban facility showed significant decreases in sick leave. Patient satisfaction scores did not show significant changes for either clinic.
