Patient safety and staffing in emergency departments

Nurse and patient;Emergency Nursing -- organization & administration;Nursing;Safety measures;Nursing Staff;Hospital

Ecklor, NekoleCollier, Jill ;

University of Wisconsin

关键词: Nurse and patient;    Emergency Nursing -- organization & administration;    Nursing;    Safety measures;    Nursing Staff;    Hospital;   

Others  :  https://minds.wisconsin.edu/bitstream/handle/1793/34330/Ecklor_Thesis_08.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: University of Wisconsin

【 摘 要 】

The purpose of this study was to investigate and describe nurse staffingmethods, nurse skill mix, and patient safety in emergency departments (EDs) in order toaddress the question: How does nurse staffing impact patient safety in EDs? Althoughstudies have revealed an association between nurse staffing and patient safety forinpatient populations, there is limited research on the relationship between nurse staffingmethods, nurse skill mix, and patient safety in EDs.The question was evaluated by examining the ED as a system using Katz andKahn;;s Open Systems Theory. In this framework, patients enter the ED department(system) and their outcome (patient safety) is influenced by nurse staffing (throughput).A descriptive cross-sectional design was used to investigate nurse staffingmethods, nurse skill mix, and the impact on patient safety. The setting was EDs in thestate of Wisconsin that were listed with the American Hospital Association (AHA). All EDmanagers on the AHA;;s list received the Emergency Department Survey (EDS). TheEDS is a 12-item survey that investigated the nurse staffing method, nurse skill mix, andmeasured patient safety by examining the frequency of patient safety incidents in EDs.Fifty-seven usable surveys were returned out of the 115 distributed. With a researchstandard of 95% confidence level, 89 surveys were needed to produce meaningfulfindings.The statistical analyses used to analyze the collected data and answer theresearch question were descriptive, analysis of covariance (ANCOVA), qualitativeanalysis, and multiple regressions. Findings from the statistical analysis are: (a)Industrial engineering method of nurse staffing had a higher level of errors than othermethods; (b) Emergency medical technician-paramedics (EMT-P) were four times morelikely to have a correlation of medication errors and sentinel events combined; (c)Registered nurses (RNs) have an inverse association with a positive impact on patientsafety; (d) Incorrectlabeling comprised 13.5% of total errors; (e) The largest category inthe variable of patient safety was elopement, with 40% of reported errors; (f) Patient fallshad an inverse correlation. with licensed practical nurses (LPNs) and EMT-Ps; (g)Elopement had a positive correlation with RNs and EMT-Ps and an inverse correlationwith LPNs; (h) Incorrect identification was inversely correlated with LPNs and unlicensedassistive personnel (UAPs) and positively correlated with EMT-Ps; (i) Incorrect specimenlabeling was inversely correlated with LPNs and EMT-Ps.