Seeking feedback on alternative staffing to utilize CNAs

[Vickytheangel]

Hello,

I am trying to collect information from anyone that has worked on a unit that uses a "unique" approach in how they utilize CNAs on the unit they work on.

Some examples of unique utilization would be assigning only certain tasks to CNAs from the standard assignment of doing VS, bed baths, ambulation, toileting, feeding, repositioning, and collecting I&Os. Or, assigning CNAs to RNs rather than to room numbers.

If you think you have a unique situation, please respond and let me know if there has been any noticable changes in patient satisfaction scores, quality of patient care, and/or a fluctuation in patients' length of stay?

Also, did you notice any changes the amount of staff sick calls?

And lastly, how was this transition made? What went smoothly in the transition to this model and what did not?

Thanks in advance to anyone and everyone that responds!!

[kool-aide, RN]

At my hospital the charge nurses make CNA assignments just as they would make RN assignments, by acuity level.

The CNAs are assigned a group of pts, 6-8 on days and 10-12 on nights, and these pts are at a high acuity for CNA care and require things like Q4 hour v/s, AC&HS(or more frequent) Accucheks, total care, frequent trips to BR, confused, etc.

Basically, the charge nurse doesn't assign CNAs to pts who are "easy."--ie: walkie talkies… She lets a nurse take those types of pts primary care to better utilize the CNAs.

As a hospital CNA, I must tell you, that I have worked on units where they were exploring "creative CNA staffing changes" and have been told that I don't have an assignment and that I should just take v/s, accucheks, and answer lights for the whole unit. I completely resent this and I think it's unsafe.

[mamaxmaria]

The units it my previous hospital would divide the pt's equally between the techs. There were two halls on the unit so their were ideally 4 techs... 2 for each hall. One tech would do all the v/s for their hall and the other would do all the accuchecks.

this system seemed to work out very well. They tried at one point to assign the techs to nurses but it eventually got complicated with all the admissions and discharges. The techs hated it because they were assigned to multiple nurses and had to keep track of their the nurses pt's which were sometimes on completely different sides of the unit.

The admissions worked they same as they did with the nurses...1 ..2..3...4..5 You were assigned a number. That number admission was yours..

When it came to the techs it was never assigned based on acuity or total care. The nurses know their pt's and were expected to help the techs with their total care pt's