Using an Acuity Tool to Maintain Productivity While Adhering to AWHONN's Perinatal Nurse Staffing Guidelines. Issue 1 (June 2015)

• Record Type: Journal Article
• Authors: St Laurent, Dana; Santovasi, Holly; MacDonald, Karen
• Is Part Of: Journal of obstetric, gynecologic, and neonatal nursing. Volume 44:Issue 1(2015)
• Page Start: S34
• Page End: S35
• Publication Date: 2015-06
• Subjects: Maternity nursing -- Periodicals; Gynecologic nursing -- Periodicals; Newborn infants -- Care -- Periodicals; Pediatric nursing -- Periodicals; Genital Diseases, Female -- nursing; Obstetrical Nursing; Pediatric Nursing; 618.2
• DOI: 10.1111/1552-6909.12713
• Languages: English
• ISSNs: 0884-2175

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jogn12713-sec-0010" sec-type="section"> <title>Poster Presentation</title> <sec id="jogn12713-sec-0020" sec-type="section"> <title>Purpose for the Program</title> <p>The art of scheduling perinatal nursing staff in a small community hospital is challenging in a specialty where census and acuity are highly unpredictable. This challenge on a women and children's (WMCH) unit is particularly complex because of five specialties: labor and delivery, postpartum/newborn, pediatrics, Level‐II nursery, and cesarean birth operating room. The hospital was facing decreasing revenue, increased cost because of health care reform, fluctuations in volume, and uncompensated costs. The hospital took this opportunity to reevaluate productivity and used a health care analytics company to adopt a new productivity benchmark for all departments.</p> </sec> <sec id="jogn12713-sec-0030" sec-type="section"> <title>Proposed Change</title> <p>The hospital's operations excellence process utilized the Lean and Six Sigma methods to improve performance, which required that frontline staff of all levels creatively develop solutions. The WMCH department used the Lean and Six Sigma methods to determine a plan to meet this goal while maintaining quality care and patient satisfaction. Previously the staffing assignments were done every shift based on charge nurse predictions not on evidence. This method was unreliable and generated frustration when there were discrepancies. To staff for patient census, varying acuity levels, and maintain staffing ratios recommended by AWHONN, the department incorporated an acuity tool into the daily nursing assignment sheet.</p> </sec> <sec id="jogn12713-sec-0040" sec-type="section"> <title>Implementation, Outcomes, and Evaluation</title> <p>The sheet yielded a productivity standard that clearly demonstrated whether each nurse assignment was appropriate and the unit was staffed safely every 2 hours. Charge nurses were able to make staffing decisions based on real‐time data. Department leaders could look at retrospective long‐range acuity and productivity data that allowed them to analyze trends and make departmental decisions. The staffing decisions were based on the acuity tool were clearly and objectively displayed to staff nurses, which allowed the nurses to feel confident with their assignments because of the alignment with AWHONN guidelines. After 6 months of utilizing the acuity tool, the department reduced the hours worked per equivalent patient days from 23 hours to 18.7 hours. This reduction was projected to save $800, 000 a year, although it actually resulted in hospital savings of $1, 300, 000.</p> </sec> <sec id="jogn12713-sec-0050" sec-type="section"> <title>Implications for Nursing Practice</title> <p>These metrics demonstrate the benefits of an acuity tool in a daily nursing assignment sheet for safe patient care, improved nursing satisfaction, increased productivity, and financial savings.</p> </sec> </sec> </abstract>