Patient Assignment Plan ED

My ED has:

9 "front rooms" (where our "sick", critical patients go),

15 "side rooms" (where urgent, possibly sick patients go),

9 "express" beds,

8 wall beds (only when absolutely needed),

1 psych room and

1 large trauma room.

We are a level II trauma center.

The assignment works like this:

1 nurse to 4 rooms.

1-2 nurses out at triage.

1-2 "float" nurses who are also assigned to the trauma room.

2 nurses in the express wing.

Charge nurse.

And that's it.

Our day shift charge nurse does a great job of rotating nurses through all the rooms so that we don't get the front room all the time and get burned out. I typically get a "break" in the express wing about every 4 days I work.

I hope that helps and wasn't too confusing. Lol did that help some?

I'm not telling you it's going to be easy, I'm telling you it's going to be worth it.

Author: Art Williams

How many nurses do you have per shift? Any mid shift nurses?

My facility had 3 major rooms, 4 acute rooms, 1 isolation room, 8 "quick care" rooms (all these have monitors), 1 fast track rooms, 2 triage rooms, 8 hallway beds and a results pending area.

6 nurses start the morning shift with 1 more at 10a and another at 1p.

1 "free" charge, 1 nurse in triage (sometimes with a tech), 1 nurse in results pending/fast track (helps with quick care rooms also till 10 a, also sometimes has a tech assigned to them), 1 for the quick care rooms (till the 10a nurse comes in, then 2), 2 split the major rooms and 4 acute care room (1 major room and 2 acute care rooms each). 2 techs that float around everywhere.

1 open major room at all times if possible for unannounced EMS or walk-ins that need it (charge will usually cover that). When the 1 p nurse shows up, they are either a floater or cover the hallway beds.

The isolation room is not used except for sometimes hallway patents need a rectal/lady partsl exam, so they are in and out of there for that. It is also used for a suture room if it can't be done in the hall, usually a free nurse helps with those since they only take a few minutes. If the isolation room is used for isolation, a nurse that has been trained in isolation will work that and that only (protocol is to call in another nurse to work). That room is sometimes used as an exam room by a SANE nurse too, but they do their own thing and don't need us for much.

Ideally we have 8 nurses.

1 charge

1 triage

1 desk/fast track

1nurse=3monitor beds+1hallway bed

1nurse=3monitor beds+1hallway bed

1nurse=2isolations+1monitor bed+1hallway bed

1nurse=trauma room+1monitor

We don't have break or relief nurses. We work 8 hours/shift and have on calls among ourselves.

We do have 3 techs equally assigned by beds

I wanted to see how other EDs would do their pt/bed assignments

Our ER has 2 "trauma" rooms (we are not a trauma center but these beds get typically get high acuity patients or lacs that need stitches/staples) 2 intake/triage rooms, 8 express beds, 2 psych rooms, and usually 11 monitored beds, although we can expand to 15 monitored beds. Express gets 1 nurse, with the intake nurse floating between intake rooms and express care. 1 trauma, 1 psych and 3 monitored beds for 2 nurses, other nurse gets 5 monitored beds. 1 charge nurse, 2 medics (one stays in triage and the other floats to help w/ ekgs). We have been looking for a while at how to redistribute assignments because our trauma and psych rooms are on opposite sides of the ER. If you have a critical patient in a trauma room and an SI in a psych, it's impossible to keep an eye on the SI pt. sometimes we get sitters but that's rare. It can be a real mess!!!