Patient Care Delivery

  1. Hi,
    I am looking for any information on restructuring nursing staff for efficient, safe and cost effective patient care delivery. Specifically nurse patient ratio on a general Med-Surg unit. We are currently using a modified primary assignment with skill mix of RN, LPN and NT. There is a Charge or Desk Nurse. Our LPN's are IV certified and able to deliver care within the full limit of their licence. We are faced as all hospitals with down sizing our FTE's. We utilize walking rounds, and are in process of moving away from the Kardex system. This is a 22 bed unit;, can anyone share their experiences with staff numbers for the 3 shifts? I am new to this BB and would appreciate any response. Thanks in advance.
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    About SueM

    Joined: Jul '99; Posts: 5


  3. by   floridaRN
    A lot would depend on your budgeted manhours per stat, productive versus non-productive and the total stat. We run differently in the summer than winter, because of the seasonality of where i live. We are in the process of looking at winter staffing right now and it varies so much from summer. But i would say before you make any changes it would depend on what you are expected to run and make the decisions from there.

  4. by   peck13
    it depends on your # of rn's/lpn's. I work in a tele unit. we have a "pod" system with an RN, LPN, and 2/3 of an aide for 6 pts on D/E and 8 pts @ noc. (a lot for med-surg). we have had really good outcomes, as the RN is able to teach, assess, and "care manage" the pt. on other units, the pods have more pts (6 on d/e and 12 on nocs). the lpn does meds and treatments, the aide does vitals/bedpans/etc. I LOVE IT!
  5. by   mirn
    We recently shifted from a primary care model to a team model of care delivery. But our patient-nurse ratio is much different. On night shift (12 hour shifts 7p-730a)an average "team" is an RN, LPN, PCA for 12-18 patients, RN and LPN for 8-12 pts, RN and PCA for 8-10 patients. Staffing is a bit more generous on day shift; three teams on days and two on nights. This is a 36-bed Neurosurgical/Urosurgical/ETOH detox unit. Our experience has been frustrating. We are feeling a loss of control over care and feeling "lost" trying to remember crucial details. We are working to improve this new system, but for now this is all I can contribute: WE MISS PRIMARY NURSING!!