Efficacy of a Standardized Process in Optimizing Appropriate Use of Progressive Care Unit Beds in a Tertiary Care Facility.

IF 1.4 Q3 NURSING

Dimensions of Critical Care Nursing Pub Date : 2024-09-01 DOI:10.1097/DCC.0000000000000657

Susan B Stempek, Michael S Rosenblatt, Nelson Repenning, John Sterman, Janice R Morrissette, Susan E Flanagan, Lindsey Sallese, Yuxiu Lei, Timothy N Liesching

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引用次数: 0

Abstract

Background: Poor patient progression from the progressive care unit (PCU) beds has been recognized as a bottleneck, limiting the hospital's ability to optimize capacity for the sickest patients. Improving nurse management on PCU admission and discharge criteria could avoid PCU bottlenecks.

Local problem: Our institution lacked a standard process to identify clinically appropriate patients ready for transfer out of the PCU, causing delays in vacating PCU beds.

Objectives: The aim of this study was to determine if creating a standard process to empower bedside nurses and unit nursing leaders to push readiness information to the provider team improves the appropriateness of PCU stay and transfers patients out of the PCU earlier.

Methods: The most common causes of delayed transfer out of the PCU were discussed among stakeholders. A process was designed to empower the bedside nurses to partner with a physician leader to send information to the provider team requesting evaluation of the patient's readiness to leave the unit. The improvement of meeting the criteria for PCU was evaluated by comparing 60 patients prior to the intervention phase with 139 patients during the intervention.

Results: The primary outcome, percentage of patients meeting PCU criteria, was 53% during the audit phase and 68% during the intervention phase (P = .05). The PCU transfer time was pushed 1 hour earlier in the day.

Conclusions: The standard process of empowering bedside nurses to partner with physician leaders to push readiness for transferring patients out of the PCU resulted in a significant improvement in the percentage of patients meeting PCU criteria and earlier discharge of appropriate patients.

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在一家三级医疗机构中，标准化流程在优化渐进式护理病房床位合理使用方面的功效。

背景：进展期护理病房（PCU）病床上的病人进展缓慢已被公认为是一个瓶颈，限制了医院为病情最严重的病人优化容量的能力。改善护士对 PCU 入院和出院标准的管理可以避免 PCU 瓶颈。当地问题：我们医院缺乏一个标准流程来识别临床上适合转出 PCU 的病人，导致 PCU 床位空置延迟：本研究旨在确定创建一个标准流程，授权床旁护士和科室护理领导将准备就绪信息推送给医疗团队，是否能提高 PCU 留观的适当性，并使患者更早转出 PCU：方法：相关人员讨论了导致患者延迟转出 PCU 的最常见原因。方法：相关人员讨论了延迟转出 PCU 的最常见原因，并设计了一套流程，授权床边护士与医生领导合作，向医疗团队发送信息，要求对患者是否准备好离开 PCU 进行评估。通过对干预阶段前的 60 名患者和干预阶段中的 139 名患者进行比较，评估了符合 PCU 标准的患者的改善情况：主要结果：符合 PCU 标准的患者比例在审核阶段为 53%，在干预阶段为 68%（P = .05）。PCU 转运时间在一天中提前了 1 小时：结论：授权床边护士与医生领导合作，推动将患者转出 PCU 的准备工作，这一标准流程显著提高了符合 PCU 标准的患者比例，并使合适的患者提前出院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dimensions of Critical Care Nursing NURSING-

CiteScore

2.40

自引率

5.90%

发文量

102

期刊介绍： The primary purpose of Dimensions of Critical Care Nursing™ is to provide nurses with accurate, current, and relevant information and services to excel in critical care practice.