Boarding ICU patients: Are our rounding practices subpar?

Nunn, Andrew M.; Hatchimonji, Justin S.; Holena, Daniel N.; Seamon, Mark J.; Smith, Brian P.; Kaplan, Lewis J.; Martin, Niels D.; Reilly, Patrick; Schwab, C. William; Pascual, José L.

doi:10.1016/j.amjsurg.2017.04.019

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…This structure can lead to delays which patients may perceive as a lack of communication. Previous studies have demonstrated that there are often difficulties in communication between nursing and inpatient teams for boarded patients [11][12][13][14]. Another possibility regarding the lack of impact of an NHT on patients' perception of boarding in the ED is that certain inpatient comfort strategies are not feasible in the ED.…”

Section: Discussionmentioning

confidence: 99%

The Effect of a Nursing Hold Team on Patient Satisfaction for Admitted Patients Discharged Directly From the Emergency Department

Choe

Basile

Cambria

et al. 2021

Cureus

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Objectives: Emergency departments (ED) across the United States face challenges related to patient volume, available capacity, and patient throughput. Patient satisfaction is adversely affected by crowding and lengthy boarding times. This study aimed to determine whether the implementation of a dedicated nursing hold team (NHT) would improve patient satisfaction scores for admitted patients discharged directly from the ED. Methods: This was a retrospective, observational study with a pre-/post-test design. All admitted adult patients who returned a Press Ganey (PG) survey were included in the study. There were two twelve-month study periods before and after implementing an ED NHT. The primary outcome was the percentage of patients who gave top box scores for all questions in the Nursing Communication Domain. Results: During the pre-implementation period, 108 patients (59%) gave an overall top box rating for the Nursing Communication Domain versus the post-implementation period, where 99 patients (66%) provided a top box rating (OR 1.375, p = 0.16). There was a trend toward increased satisfaction for individual categories. However, these differences were not statistically significant. Conclusions: Implementing a dedicated NHT showed an increase in the overall top box PG Nursing Communication Domain score and several of the individual domain questions. Future studies should examine other potential benefits from a dedicated NHT, such as the rate of adverse events and medication delays.

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Section: Discussionmentioning

confidence: 99%

The Effect of a Nursing Hold Team on Patient Satisfaction for Admitted Patients Discharged Directly From the Emergency Department

Choe

Basile

Cambria

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…Familiarity with tasks associated with trauma patient care also increased, though it was not found to be statistically significant. Moreover, it has been shown that cohorted surgical ICU patients are seen earlier and longer on rounds than those boarded on non-surgical ICUs [ 18 ], which may result in a higher quality of care.…”

Section: Discussionmentioning

confidence: 99%

Ventral hernia patient outcomes postoperatively housed on surgical vs non-surgical units

et al. 2020

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Background Inpatient hospital units vary in staffing ratios, monitoring, procedural abilities, and experience with unique patients and diagnoses. The purpose of this study is to assess the impact of patient cohorting upon ventral hernia repair outcomes. Methods An IRB-approved retrospective review of open ventral hernia repairs between August 2013 and July 2017 was performed. The information of all patient locations during hospitalization, time at location, post-anesthesia care unit duration (PACU), and intensive care unit (ICU) duration was collected. Patient demographics, comorbidities, operative details, cost, and patient outcomes were analyzed. Multivariable analysis of log length of stay (LOS) was assessed with adjustment for clinical and operative factors. Results 235 patients underwent open ventral hernia repair. 179 patients were admitted to surgical units, 33 non-surgical units, and 23 stayed on both units. Clinical characteristics including patient age, gender, BMI, and medical comorbidities were similar between patients boarded on surgical versus non-surgical units. Hernia, wound, and operative data were also statistically similar. Patients admitted to non-surgical units for any duration experienced longer hospital stay (4 vs. 6 days, p < 0.001). Patients housed on a non-surgical unit were more likely to transfer rooms than patients on surgical units, 42.9% vs. 10.1% ( p < 0.001), respectively. Multivariable analysis of natural log-transformed LOS showed any stay on a non-surgical unit increased LOS by 1.0 days (95% Cl 0.9–1.2 days, p = 0.026). There were no differences in ICU or PACU stay, cost, or postoperative complications in patients housed on surgical versus non-surgical units. Conclusions Postoperative surgical patients had an increased length of stay when admitted to non-surgical units. More frequent room transfers occurred in patients admitted to non-surgical units. Evaluation of patient outcomes and LOS in open ventral hernia repair patients based on hospital unit is unique to this study.

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“…Additional concerns regarding patient safety pertain to the physical plant and/or the geographical location of the healthcare team in relation to specific "points of care" [60][61][62]. Many hospitals and other healthcare facilities have expanded or branched to many communities, effectively making geography a barrier to direct communication [63,64].…”

Section: Focus On Challengesmentioning

confidence: 99%