Addressing Patient Acuity and Nurse Staffing Issues in the Acute Care Setting: A Review of the Literature

Sobaski, Tanya

doi:10.20849/ijsn.v3i3.431

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…In line with these examples, there is growing recognition that mobility should be included as part of patient acuity assessments. Several recent studies have begun to explore the inclusion of patient mobility or general descriptors of level of assistance required to mobilize patients (Chiulli, Thompson, & Reguin‐Hartman, ; Firestone‐Howard, Zedreck Gonzalez, Dudjak, Ren, & Rader, ; Sobaski, ). For example, nurses from Duke Raleigh Hospital developed and validated a comprehensive patient acuity tool that included clinical severity indicators and nurse workload indicators (Chiulli et al, ).…”

Section: Discussionmentioning

confidence: 99%

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

et al. 2019

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Aim: Characterize the relationship between patient ambulatory status and in-hospital call bell use.Background: Although call bells are frequently used by patients to request help, the relationship between physical functioning and call bell use has not been evaluated. Methods:Retrospective cohort study of 944 neuroscience patients hospitalized in a large academic urban medical centre between April 1, 2014 and August 1, 2014. We conducted multiple linear regression analyses with number of daily call bells from each patient as the primary outcome and patients' average ambulation status as the primary exposure variable. Results:The mean number of daily call bell requests for all patients was 6.9 (6.1), for ambulatory patients 5.6 (4.8), and for non-ambulatory patients, it was 7.7 (6.6).Compared with non-ambulatory patients, ambulatory patients had a mean reduction in call bell use by 1.7 (95% CI 2.5 to −0.93, p < .001) calls per day. In a post hoc analysis, patients who could walk >250 feet had 5 fewer daily call bells than patients who were able to perform in-bed mobility.Conclusion: Ambulatory patients use their call bells less frequently than non-ambulatory patients.Implications for Nursing Management: Frequent use of call bells by non-ambulatory patients can place additional demands on nursing staff; patient mobility status should be considered in nurse workload/patient assignment. | 55CAPO-LUGO et AL.

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Section: Discussionmentioning

confidence: 99%

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

et al. 2019

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“…7 Lack of adequate staff resulted in missed nursing care, insufficient time for critical thinking, an unsafe nurse-to-patient ratio increasing length of stay, and complications that could lead to adverse events. 7 Factors addressing patient acuity P atient acuity is defined as the nursing time needed to meet the care requirements of a patient. 1 Differences in nurse workload are related, in part, to the amount of care a patient requires and the patient's physical location.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Results revealed an increase in knowledge, use, and satisfaction with staffing equity using the revised PAT. 6 Sobaski 7 conducted a literature review to identify resources addressing patient acuity and nurse staffing issues on medical-surgical units. 7 Lack of adequate staff resulted in missed nursing care, insufficient time for critical thinking, an unsafe nurse-to-patient ratio increasing length of stay, and complications that could lead to adverse events.…”

Section: Literature Reviewmentioning

confidence: 99%

Implementing a patient acuity tool

Johnson

Haines

Woock

et al. 2023

Nursing

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This study aimed to assess the acceptability, relevance, and effectiveness of a patient acuity tool (PAT) among part-time and full-time RNs. Methods: A pre-and post-test intervention was used to evaluate a PAT among part-time and full-time RNs on a 28-bed telemetry unit at a Magnet ® -designated hospital. An eight-item PAT questionnaire measured nurse acceptability. Relevance was evaluated using the RN Opinion of Relevance of Concepts of the PAT Questionnaire, and effectiveness was evaluated using the RN Opinion of Effectiveness of the PAT Questionnaire. Results: A total of 22/33 (66.6%) RNs participated and completed the PAT questionnaire that measured nurse acceptability of the PAT assessment process. Statistically significant differences were demonstrated between two out of eight variables pre-post intervention; "the way we currently evaluate patient acuity assists the charge nurse in making nurse-patient assignments" (t 3.070, df 22, P = .006), "the way we currently evaluate patient acuity is an accurate assessment of acuity" (t 2.390, df 22, P = .026). Conclusion: Acuity tools should be specific for a nursing unit and adapt to staffing and patient needs, which can include a change in a patient's condition, unexpected discharges and/or admissions, and psychosocial components.

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“…Examples of these variabilities include staffing levels and patient acuity. 8,9 The FRAM deconstructs a health care process into discrete activities or functions to describe ''what a system does'' rather than describe ''what a system is.'' 10(p.2) For instance, in exploring the transition of older adults from hospital to home, rather than identify a hospital discharge, Laugaland et al 7 described the activities necessary for the discharge to occur, such as notifying family of the pending discharge, organizing post-discharge services, and arranging transportation between settings of care.…”

Section: Introductionmentioning

confidence: 99%

“…The FRAM also identifies variabilities in everyday activities that require individuals or organizations to adjust their performance for the process to occur. Examples of these variabilities include staffing levels and patient acuity 8,9 …”

Section: Introductionmentioning

confidence: 99%

The Functional Resonance Analysis Method as a health care research methodology: a scoping review

McGill

Smith

Morris

et al. 2021

JBI Evidence Synthesis

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Objective:The objective of this review was to examine and map the literature on the use of the Functional Resonance Analysis Method (FRAM) in health care research.Introduction:The FRAM is a resilient health care tool tat offers an approach to deconstruct complex systems by mapping health care processes to identify essential activities, how they are interrelated, and the variability that emerges, which can strengthen or compromise outcomes. Insight into how the FRAM has been operationalized in health care can help researchers and policy-makers understand how this method can be used to strengthen health care systems.Inclusion criteria:This scoping review included research and narrative reports on the application of the FRAM in any health care setting. The focus was to identify the key concepts and definitions used to describe the FRAM; the research questions, aims, and objectives used to study the FRAM; the methods used to operationalize the FRAM; the health care processes examined; and the key findings.Methods:A three-step search strategy was used to find published and unpublished research and narrative reports conducted in any country. Only papers published in English were considered. No limits were placed on the year of publication. CINAHL, MEDLINE, Embase, PsycINFO, Inspec Engineering Village, ProQuest Nursing & Allied Health were searched originally in June 2020 and again in March 2021. A search of the gray literature was also completed in March 2021. Data were extracted from papers by two independent reviewers using a data extraction tool developed by the reviewers. Search results are summarized in a flow diagram, and the extracted data are presented in tabular format.Results:Thirty-one papers were included in the final review, and most (n = 25; 80.6%) provided a description or definition of the FRAM. Only two (n = 2; 6.5%) identified a specific research question. The remaining papers each identified an overall aim or objective in applying the FRAM, the most common being to understand a health care process (n = 20; 64.5%). Eleven different methods of data collection were identified, with interviews being the most common (n = 21; 67.7%). Ten different health care processes were explored, with safety and risk identification (n = 8; 25.8%) being the most examined process. Key findings identified the FRAM as a mapping tool that can identify essential activities or functions of a process (n = 20; 64.5%), how functions are interdependent or coupled (n = 18; 58.1%), the variability that can emerge within a process (n = 20; 64.5%), discrepancies between work as done and work as imagined (n = 20; 64.5%), the resiliency that exists within a process (n = 12; 38.7%), and the points of risk within a process (n = 10, 32.3%). Most papers (n = 27; 87.1%) developed models representing the complexity of a process.Conclusions:The FRAM aims to use a systems approach to examine complex processes and, as evidenced by this review, is suited for use within the health care domain. Interest in the FRAM is growing, with most of ...

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Addressing Patient Acuity and Nurse Staffing Issues in the Acute Care Setting: A Review of the Literature

Cited by 4 publications

References 17 publications

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

Association between ambulatory status and call bell use in hospitalized patients—A retrospective cohort study

Implementing a patient acuity tool

The Functional Resonance Analysis Method as a health care research methodology: a scoping review

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