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Discussion

Staff assignments

:confused: I am seeking information on staff assignements. Do you have guidelines? Do you assign a nurse to only IMCN infants or only NICU infants or a combination? Do you do "primary nursing?" What is your ratio of staff to infant? How is your unit set up? Do you have Pods, individual rooms or one large area?

We have Pods and it really makes assignments difficult at times...esp when there is ebb and flow in census. We do a lot of moving.

Thanks for your time.

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    • Featured Replies

    Our unit is sectioned in Pods and I must agree with you that is better from a developmental point of view to have rooms instead - less traffic=less noise. In level 3 assignments are 2:1 for a stable vent and an unstable CPaP or 1:1 if the ventilated babe is on high settings AND inotrops, chest tubes etc. In level 2 nursery is usually 3:1 as they are mainly feeders and growers and/or some cannula O2. Very seldom a nurse in level 2 would get the 4th assignment - a babe lodging with mom overnight, before discharge.

    And yes we shuffle babies around a lot, especially when busy.

    I hope this helped.

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    There are a couple of other threads about this too :)

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    • Expert

    There are threads about this everywhere. What there is not is any sort of consensus about how best to assign patients to nurses. I've found several research articles with great information, unfortunately, they often tend to discount the time actually spent performing procedures considered "easy" and "quick". I would love to actually get printed guidelines for staffing from other units so that I can add it to my research to improve acuity based staffing.

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    • Author

    Do you know the reference for the research articles?

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    • Expert
    Do you know the reference for the research articles?

    This is what I have so far

    Gray, J. E., Richardson, D. K., McCormick, M. C., Workman-Daniels, K., & Goldmann, D. A. (1992). Neonatal Therapeutic Intervention Scoring System: A Therapy-Based Severity-of-Illness Index. Pediatrics, 90(4), 561-567. Retrieved from http://pediatrics.aappublications.org/cgi/content/abstract/90/4/561.

    Mullinax, C., & Lawley, M. (n.d.). Assigning patients to nurses in neonatal intensive care. J Oper Res Soc, 53(1), 25-35. Palgrave Publishers Ltd. Retrieved from http://dx.doi.org/10.1057/palgrave.jors.2601265.

    Richardson, D. K., Gray, J. E., McCormick, M. C., Workman, K., & Goldmann, D. A. (1993). Score for Neonatal Acute Physiology: A Physiologic Severity Index for Neonatal Intensive Care. Pediatrics, 91(3), 617-623. Retrieved from http://pediatrics.aappublications.org/cgi/content/abstract/91/3/617.

    SPENCE, K., TARNOW-MORDI, W., DUNCAN, G., JAYASURYIA, N., ELLIOTT, J., KING, J., et al. (2006). Measuring nursing workload in neonatal intensive care. Journal of Nursing Management, 14(3), 227-234. Blackwell Publishing Ltd. Retrieved from http://dx.doi.org/10.1111/j.1365-2934.2006.00609.x.

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    • Author

    Thanks so much:yeah:

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