ADT rates and NHPPD

[laa83]

Hi

I have been a manager of a observation/PCU/Med/Surg (catch all) overflow unit for about 18 months. My unit sees an ADT rate of 100% in a month based on the midnight census. We have a capacity of 19 patients on our unit but turn over as many as 23 admssions, discharges or transfers in a day. We run the floor with 4 RNs and 2 LPNs if we are full. This amount of turn over is burning out my nurses. Does any one out there manage a unit like this and if so have you used your ADT rates to challenge your NHPPD? I have been looking for articles and have not found much support on how to make this happen. My unit struggles with low census on weekends which hurts my nursing hours. We staff to our numbers and cut back as much as possible. Any help would be appreciated. Also my director does not know how to help me since she barely understands NHPPD and the ADT rate of my unit. Thanks in advance!

[NurseLatteDNP, MSN, DNP, RN]

There is a published Advisory Board standard on staffing across various units and US areas. It is a book that you can order for free from their site. I got mine in 2015.

[jrt4]

This is the world of pediatrics. We typically staff a charge out of staffing to help facilitate admissions and discharges. The challenge is that either the charge nurse takes a minimal assignment or everyone else takes a larger patient load. If you have someone who can help with admissions and discharges though it makes the ADT a little more manageable. If you have 4 patients/nurse and you get 4 new patients by the end of the shift that is difficult. If you have 5 patients per nurse and turn around 5 of them in a shift but 3 of them the charge nurse admitted...thats a little bit more manageable particularly in a smaller unit where there are less hands around.