Published Aug 1, 2005
From Advance for Nurses:
By Barbara Wright Engram, MSN, RN, CPUR
For decades, the assignment of patients to nursing staff has been based upon quasi components of team nursing, primary nursing, functional nursing and other methodologies that have yet to be titled.
Nursing management has devoted countless hours to develop improvements, yet little attention has been given to the method of patient care assignments.
Most hospitals today assign nurses to patients by dividing the number of patients on the unit by the number of nursing staff on duty.
But the crescendo of the quality wave is upon us. It's time for nursing to ride that wave to improve the process by which nurses are assigned to patients.
By using the nursing squad practice model, an innovative method administrators and managers can use to improve the process of patient assignments....
Inside a Nursing Squad
A nursing squad is a small fixed group of nursing staff composed of RNs, patient care technicians and/or LPNs.
The skill mix of a squad will vary depending upon the philosophy of the hospital and the nursing unit. However, each squad must contain RNs.
The number of staff on each squad should be sufficient to provide 24-hour coverage. The patient load for a squad is 6-8, depending upon acuity.
The nursing squad is responsible for providing clinical care, discharge planning and utilization review for patients assigned to their rooms.
Because squads are geographically fixed, patients would have the same caregivers from admission through discharge.
Discharge planning could truly begin upon admission.
A very interesting concept. Kind of like primary nursing weds team nursing, with modifications. It sure sounds like a much more realistic and innovative way to practice nursing. If anyone has actually practiced under this model please post your experiences.
I agree this sounds interesting...until administration begins to play with the mix, replacing RNs and LPNs with unlicensed staff, pulling nurses to unfamiliar departments, adding even more tasks to the list, etc. It will go down like all the previous "staffing patterns" unless there is an appropriate nurse:patient ratio.
llg, PhD, RN
It sounds just like a minor variation of team nursing to me. Dressing up some old ideas and trying to "sell" them as something totally new. I'm not totally against re-visiting old ideas and looking for ways to use the best aspects of them, but I hate it when people try to sell their ideas by trying to tell us that they are totally new when they are not and/or saying that people in the past have never looked at care delivery models. She even contradicts herself, saying first that there are lots of care delivery models (some even as yet "un-named") and then saying that little attention has been paid to how we do assignments!
What happens when people get sick ... or take vacation... or have more vacancies (or higher acuity) than the other squads? Wouldn't staff have to be redistributed?
There may well be some merit in the methodology she is suggesting. But I hate the salesmanship.
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