Putting the Patients Needs First THE ROLE OF ACUITY MEASUREMENT IN - - PowerPoint PPT Presentation
NURSING INFORMATICS AUSTRALIA CONFERENCE MONDAY 6 AUGUST 2017 - BRISBANE CONVENTION AND EXHIBITION CENTRE Putting the Patients Needs First THE ROLE OF ACUITY MEASUREMENT IN REDEFINING NURSING WORKLOADS AROUND PATIENTS REQUIREMENTS FOR
THE ROLE OF ACUITY MEASUREMENT IN REDEFINING NURSING WORKLOADS AROUND PATIENTS’ REQUIREMENTS FOR NURSING SERVICE
NURSING INFORMATICS AUSTRALIA CONFERENCE MONDAY 6 AUGUST 2017 - BRISBANE CONVENTION AND EXHIBITION CENTRE
Historic nursing labour hours per patient day
Usually based on census calculation of patient days May be broken down on DRG
Nurse:patient ratios
Luke Hutley - support@trendcare.com.au
Generally divided between nurses based on number and proximity
Variable inclusion of clinical judgment of the person constructing
the workload allocation
Luke Hutley - support@trendcare.com.au
Historic expenditure
Assumes that supply and demand were well-matched, historically Assumes that each of the patients in the relevant cohort have the
same nursing requirements
Generally based on a census-point method of counting patients
Luke Hutley - support@trendcare.com.au
“When patient needs vary significantly, staffing is more difficult to predict and can result in an increased workload for nurses because staffing may fail to match patient needs.” (Duffield et al, 2009)
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Bed Census vs Bed
Utilisation
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➢ Average LOS – Surgical
Luke Hutley - support@trendcare.com.au
2002 2012
Total Episode of Care (36.9hrs) Av 4.1 HPPD LOS 9 days Total Episode of Care (18.8hrs) Av 4.7 HPPD LOS 4 days
Workload 4 days = 18hrs / bed + 2hr disc day 1 + 6hr Adm day4
Increase of .6 HPPD for 27 patients = 16.2 hrs/day = 5913 hrs / year = 3.6 FTE (productive)
➢ Average LOS – Post
Natal Mother with Baby
Luke Hutley - support@trendcare.com.au
2002 2012
Total Episode of Care (17.2hrs) Av 4.3 HPPD LOS 4 days
Av workload 4 days = 17.2hrs / bed
Total Episode of Care (10.4hrs) Av 5.2 HPPD LOS 2 days
Workload 4 days = 20.8hrs / bed +dis 4.6 hr + adm 5.8
Increase of .9 HPPD for 28 patients /day =25.2hrs 9,198hrs / yr = 5.6FTE
Establishes the number of nurses required due to the number of patients Based on evidence that a higher ratio of nurses to patients provides better
May be useful for setting minimum staffing requirements No evidence for an “ideal” ratio Considers only the number of patients, assumes care requirements are
equivalent
Seems simple, but has hidden complexity
Luke Hutley - support@trendcare.com.au
Number of patients certainly has an impact Wards will still experience fluctuations in workload despite stable patient
and staff numbers
Luke Hutley - support@trendcare.com.au
The most variable driver of nursing workload is patient acuity “Nursing care intensity can vary widely among patients on the same unit,
cognition, etc.” (Welton, 2007).
Measuring patient acuity is essential for including the patient in nursing
resource decisions
Patient acuity measurement should consider patient variables that impact
Luke Hutley - support@trendcare.com.au
TrendCare acuity tool
➢
Medical patient type
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TrendCare acuity tool
➢
Maternity patient type
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TrendCare acuity tool
➢
Mental Health patient type
Luke Hutley - support@trendcare.com.au
197 patient types allow for very specific acuity measurement Data is predictive and utilised to inform nursing resource decisions for
coming shifts, based on individual patient requirements
Data is actualised, and analysed retrospectively to identify trends in
acuity
Allows rosters to be re-engineered around identifiable trends in acuity,
ensuring that the ward is planning for a close balance between supply and demand
Data can be used to project resource requirements on the basis of
changes to clinical profile, number of beds / size of ward, etc.
Luke Hutley - support@trendcare.com.au
Measuring patient acuity enables nursing services to include consideration of each,
individual patient into workload distribution, daily staffing decisions and higher-level nursing workforce decisions, to safely and efficiently manage nursing resources. Luke Hutley Nurse Consultant Trend Care Systems Pty Ltd support@trendcare.com.au 07 3390 5399
Luke Hutley - support@trendcare.com.au