The health care industry continues to be challenged by daily patient turnover due to the number of admissions, transfers, and discharges (Spader, 2008). The increase in number of admissions, in turn, puts a high demand on nurses in keeping up with the pace resulting in nurse frustration and dissatisfaction. According to Lane (2009), a thorough and comprehensive admission process is critical in providing quality patient care. Completing the admission process in a timely, efficient, and comprehensive manner has been a challenge for nurses due to the increase number of admissions, and also the fact that the nurses still have to provide ongoing care to the other patients. Creating a new position as the role of an admission nurse will help to combat some of the challenges associated with the admission process.
Purpose of the Project
The purpose of this project is to streamline the admission process. This can result in a decrease in nurse workload and improve patient flow. A reduction in nurses’ workload and demands can contribute to a decrease in nurse turnover and promote positive patient outcomes. The role of the admission nurse provides an opportunity for a dedicated nurse to gather the pertinent information in order to complete a comprehensive admission process.
The targeted population for this project is the direct care nursing staff. This nursing staff is currently responsible for the admission process. It is not unusual for a nurse to be interrupted several times while trying to admit a patient. It is also not unusual for a patient to be admitted and discharged from the hospital with an incomplete admission process. Regardless of what line of service, all nurses can benefit from streamlining the admission process
Benefits of the Project
An admission assessment in the admission process provides important details that are relevant to patients’ need. That is why it is critical that this information is completed thoroughly and accurately. Unlike the staff nurse, an admission nurse will have the necessary time to spend with patients and families. The role of an admission nurse can help to provide the comprehensive assessment associated with the admission process and also help to alleviate the nurses ‘stress associated with increased patient turnover. In addition to the benefit of the nurses, the hospital can benefit as well by potentially having a decrease in nurse turnover, increase patient flow, and an increase in patient satisfaction.
The expense of losing an experienced nurse can be costly to the hospital. Not to mention the nursing knowledge and skills. Estimates of the actual dollar amount incurred by nurse turnover range from 10 to 20 thousand dollars per nurse to as much as well over the nurse’s yearly salary. According to Anderson (2004), Nurse Executives estimate that “…visible costs represent only 24 percent of total costs for medical/surgical nurses and only 18 percent for specialty nurses. A true total cost of $42,000 per medical/ surgical RN and $64,000 per specialty nurse is more close to reality.” Turnover costs, average approximately $47,403 per medical/surgical RN and $85,197 for specialty RNs. “A 400-nurse hospital with a 20 percent turnover rate is replacing 80 nurses per year. The direct costs might average $800,000 per year, but the true total costs are closer to $4 million.”
Currently there is not sufficient evidence -based data to on admission models. But, there are still a number of ways to evaluate the success and or outcome of this project. One way is to do a pre and post survey of the nursing staff regarding the admission process. Another way is to survey patients pre and post implementation of the proposed admission process to evaluate success. In addition, evaluating the costs associated with nurse retention would also be another mechanism in evaluating this project.
Working in a fast paced environment such as the hospital setting can be stressful. The number of daily patient turnover, admissions, and discharges are continues to be a challenge for nurses working in the hospital setting (Spader, 2008). The role of the admission nurse to streamline some of the challenges associated with the admission process. In essence, this will free up the staff nurse to provide ongoing care to the other patients. This will also result in increased satisfaction for both nurses and patients. Mechanisms and process improvements that can be put in place to help alleviate the stress and strain associated with the admission process due to increased daily turnovers can be proven beneficial.
Anderson, R. (2004). Complexity science and the dynamics of climate and communication: reducing nursing home turnover. Gerontologist, 44, 378-388
Lane, B. (2009). Nurse satisfaction and creation of an admission, discharge, and teaching nurse
position. Journal Of Nursing Care Quality, 24(2), 148-152.
doi:http://dx.doi.org.library.gcu.edu:2048/10.1097/01.NCQ.0000347452.36418.78 Spader, C, (2008). Admission RNs Make Fast-Paced Admits Less Stressful. Retrieved on January 24, 2013 from http://news.nurse.com/apps/pbcs.dll/article?AID=2008108110080
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