Tiered Model of Nurse Staffing for Critical Care and Emergency Departments in the Wake of a Pandemic.

AIM: To identify strategies that increase hospital bed capacity, material resources, and available nurse staffing during a national pandemic. BACKGROUND: The COVID-19 outbreak resulted in an influx of acutely ill patients requiring critical care. The volume and acuity of this patient population increased the demand for care and stretched hospitals beyond their capacity. While increasing hospital bed capacity and material resources are crucial, healthcare systems have noted one of the greatest limitations to rapid expansion has been the number of available medical personnel, particularly those trained in emergency and critical care nursing. EVALUATION: Program evaluation occurred on a daily basis with hospital throughput, focusing on logistics including our ability to expand bed volume, resource utilization, and the ability to meet staffing needs. CONCLUSION: This article describes how a quaternary care hospital in New York City prepared for the COVID-19 surge in patients by maximizing and shifting nursing resources to its most impacted services, the emergency department (ED) and the intensive care units (ICUs). A tier-based staffing model and rapid training were operationalized to address nurse-staffing shortages in the ICU and ED, identifying key factors for swift deployment. IMPLICATIONS FOR NURSING MANAGERS: Frequent communication between staff and leaders improves teamwork and builds trust and buy-in during normal operations and particularly in times of crisis.

Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement.

BACKGROUND: A 245-bed community hospital established patient fall prevention as its patient safety priority. PROBLEM: The hospital's fall prevention program was not consistently effective. The baseline fall rate was 3.21, higher than the National Database of Nursing Quality Indicators' median of 2.91. APPROACH: An interprofessional fall prevention team evaluated the hospital's fall program using the evidence-based practice improvement model. A clinical practice guideline with 7 key practices guided the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment, purposeful hourly rounding, and video monitoring for confused and impulsive fall-risk patients. OUTCOMES: The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage. CONCLUSIONS: An interprofessional team successfully reduced falls with an evidence-based fall prevention program.

Emotional Intelligence and Transformational Leadership in Nurse Managers.

OBJECTIVE: This study describes the relationship between emotional intelligence (EI) and transformational leadership (TL) in nurse managers (NMs). BACKGROUND: Effective NM leadership is important as they have direct influence over RN performance and patient outcomes. Research has demonstrated that a TL style generates greater commitment from followers than other leadership styles. EI is 1 potential characteristic of TL. METHODS: A descriptive exploratory research study was conducted to correlate EI and TL practices of NMs. RESULTS: EI was significantly positively correlated with TL and outcome measures of extra-effort, effectiveness, and satisfaction and significantly negatively correlated with laissez-faire leadership. A positive relationship was found between TL and NMs with advanced education and administrative certification. CONCLUSION: Nursing administrators should consider EI characteristics when hiring NMs and lead efforts to advance education to align with organization needs for business and strategic essentials necessary for NM effectiveness.