Inpatient bedspacing: could a common response to hospital crowding cause increased patient mortality?

McAlister, Finlay A.; Shojania, Kaveh G

doi:10.1136/bmjqs-2017-007524

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…However, optimal bed utilization means that nursing the outlier patient is and will continue to be a common experience for many frontline nurses in acute care settings [ 1 , 2 , 3 ]. Nursing patients in a ward that is not addressing the specific needs of the outlier patients has implications on the nurses’ professional roles and responsibilities, consequentially affecting patients’ health outcome and nurses’ morale [ 4 , 5 ]. In this paper, findings from a hermeneutic phenomenological study conducted in New South Wales, Australia, are reported.…”

Section: Introductionmentioning

confidence: 99%

The Frontline Nurse’s Experience of Nursing Outlier Patients

Cheung

West

Boughton

2020

IJERPH

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The frontline nurses’ experience of nursing with overstretched resources in acute care setting can affect their health and well-being. Little is known about the experience of registered nurses faced with the care of a patient outside their area of expertise. The aim of this paper is to explore the phenomenon of nursing the outlier patient, when patients are nursed in a ward that is not specifically developed to deal with the major clinical diagnosis involved (e.g., renal patient in gynecology ward). Using a hermeneutic phenomenological approach, eleven individual face-to-face in-depth interviews were conducted with registered nurses in New South Wales, Australia. The study identified that each nurse had a specialty construct developed from nursing in a specialized environment. Each nurse had normalized the experience of specialty nursing and had developed a way of thinking and practicing theorized as a “care ladder”. By grouping and analyzing various “care ladders” together, the nursing capacities common to nurses formed the phenomenological orientation, namely “the composite care ladder”. Compared to nursing specialty-appropriate patients, nursing the outlier patient caused disruption of the care ladder, with some nurses becoming less capable as they were nursing the outlier patient. Nursing the outlier patient disrupted the nurses’ normalized constructs of nursing. This study suggests that nursing patients in specialty-appropriate wards will improve patient outcomes and reduce impacts on the nurses’ morale.

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Section: Introductionmentioning

confidence: 99%

The Frontline Nurse’s Experience of Nursing Outlier Patients

Cheung

West

Boughton

2020

IJERPH

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“…Since the launch of Choosing Wisely in the United States,1 efforts to raise awareness about avoiding low-value care have spread internationally,2 prompting numerous commentaries,3–7 descriptive studies and improvement interventions,8–10 as well as inspiring new hospital job descriptions (eg, Chief Value Officer), journal sections11 and conferences devoted to the ‘Less is More’ paradigm. Low-value clinical care refers to services or interventions that provide little to no benefit to patients in specific clinical scenarios, may cause harm and/or incur unnecessary cost 6 12 13…”

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confidence: 99%

Education as a low-value improvement intervention: often necessary but rarely sufficient

Soong

Shojania

2019

BMJ Qual Saf

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“…Cohorting along both of these dimensions is frequently employed on intensive care units (ICUs), surgical services, and internal medicine subspecialties. It has been associated with improved clinical outcomes and process measures (10,11), although dispersion is common when hospitals reach capacity (12). Cohorting is inconsistently applied, however, to general medicine services.…”

Section: Introductionmentioning

confidence: 99%

Geographic cohorting by clinical care team: a narrative review

Bressman¹,

Kohn²,

Song³

et al. 2023

Ann Palliat Med

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Background and Objective: Geographic cohorting refers to localization of inpatients to designated hospital areas (typically a unit or a set of beds) based on specified criteria. One such criterion that has been commonly discussed and studied since the early days of the hospitalist movement in the US is a patient's assigned clinical care team. Because implementing cohorting of this type requires substantial operational investment, it is important to understand the benefits and the tradeoffs associated with bringing patients into closer spatial proximity with their full team of providers and allowing clinicians to work within a defined clinical space.Methods: We conducted a narrative review of the evidence around geographic cohorting of patients by clinical care team. We performed a comprehensive search of the PubMed, Embase, Cinahl and Scopus databases, identifying relevant English language articles. We used an inductive approach to developing thematic domains for categorization of article content.

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Inpatient bedspacing: could a common response to hospital crowding cause increased patient mortality?

Cited by 5 publications

References 15 publications

The Frontline Nurse’s Experience of Nursing Outlier Patients

The Frontline Nurse’s Experience of Nursing Outlier Patients

Education as a low-value improvement intervention: often necessary but rarely sufficient

Geographic cohorting by clinical care team: a narrative review

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