Sunday, Sep 26 - Expo Hall Opening
Sunday, Sep 26 - Job Fair
Monday,
Sep 27 - AWHONN's Block Party
Sunday, September 26, 2010
Title: Improving Patient and Staff Satisfaction with the Implementation of Admit Nurse On a Gynecology Unit
Discipline: Women’s Health (WH)
Learning Objectives:
Submission Description:- Identify strategies to improve overtime hours
- Describe how implementation of admit nurse program improved employee satisfaction
- Describe how flexible, overlapping shifts improved patient safety
In any organization paying premium overtime to employees negatively impacts the budget. This overtime may be a result of staff working extra shifts or incremental overtime where employees routinely stay late to complete the work on the current shift. The overtime may also contribute to employee dissatisfaction and increased turnover.
On the gynecology unit we explored ways to decrease the incremental overtime staff routinely worked to complete their work. A retrospective study was conducted to evaluate the most frequent times admissions arrived on the unit. The data collection involved a three week time frame. From the data obtained, a plan was formed to implement an admit nurse program.
In the process of implementing this admit nurse program we utilized our current part time and per diem registered nurses who were interested in shift flexibility due to child care or family work-life balance. Several of our nurses were returning from maternity leave and expressed interest in the program. We incorporated this 4 to 8 hour shift into our staffing grid for our high surgery/admission volume days. The ideal time to have the admit nurse for our unit was between 2pm to 10pm. The admit nurse had specific responsibilities a few of which include: assisting the transport team to settle the new patients into bed, assessing the patient, completing admission documentation on the patient, reviewing and signing off orders and conducting a handoff to the RN that is assigned to the patient. These responsibilities incorporated the most time consuming part of the admission process. The admit nurse worked in a support role capacity and not as a primary caregiver for the admitted patients. Each patient admitted was assigned to a nurse and the admit nurse completed the above mentioned responsibilities and handed back the patient to the assigned nurse. This process allowed for the primary nurses to continue caring for their current patients without interruption. The overlapping of the admit nurse shift with the day and night shifts also allowed the admit nurse to monitor the newly admitted patients closely while the other nurses completed their handoff report to the next shift.
After a year of implementing this program, our gynecology unit experienced many positive outcomes: (1) overtime hours have decreased by 50%. This decrease has primarily been in our incremental overtime when staff had to stay approximately 30 to 45 minutes past their scheduled shift time to complete the admission process for a patient arriving towards the end of their shift. (2) Gallop Employee Engagement Survey Results increased by .26 points in one year. Comments from staff include that the admit nurse is the best investment the unit has made. (3) Patient Satisfaction scores increased by 40% and have maintained a percentage of excellence in the 85th percentile. We have also experienced a higher level of patient safety with the admit nurses having one patient to focus on and the ability to pay closer attention to detail.
On the gynecology unit we explored ways to decrease the incremental overtime staff routinely worked to complete their work. A retrospective study was conducted to evaluate the most frequent times admissions arrived on the unit. The data collection involved a three week time frame. From the data obtained, a plan was formed to implement an admit nurse program.
In the process of implementing this admit nurse program we utilized our current part time and per diem registered nurses who were interested in shift flexibility due to child care or family work-life balance. Several of our nurses were returning from maternity leave and expressed interest in the program. We incorporated this 4 to 8 hour shift into our staffing grid for our high surgery/admission volume days. The ideal time to have the admit nurse for our unit was between 2pm to 10pm. The admit nurse had specific responsibilities a few of which include: assisting the transport team to settle the new patients into bed, assessing the patient, completing admission documentation on the patient, reviewing and signing off orders and conducting a handoff to the RN that is assigned to the patient. These responsibilities incorporated the most time consuming part of the admission process. The admit nurse worked in a support role capacity and not as a primary caregiver for the admitted patients. Each patient admitted was assigned to a nurse and the admit nurse completed the above mentioned responsibilities and handed back the patient to the assigned nurse. This process allowed for the primary nurses to continue caring for their current patients without interruption. The overlapping of the admit nurse shift with the day and night shifts also allowed the admit nurse to monitor the newly admitted patients closely while the other nurses completed their handoff report to the next shift.
After a year of implementing this program, our gynecology unit experienced many positive outcomes: (1) overtime hours have decreased by 50%. This decrease has primarily been in our incremental overtime when staff had to stay approximately 30 to 45 minutes past their scheduled shift time to complete the admission process for a patient arriving towards the end of their shift. (2) Gallop Employee Engagement Survey Results increased by .26 points in one year. Comments from staff include that the admit nurse is the best investment the unit has made. (3) Patient Satisfaction scores increased by 40% and have maintained a percentage of excellence in the 85th percentile. We have also experienced a higher level of patient safety with the admit nurses having one patient to focus on and the ability to pay closer attention to detail.
