179212 Investigation of the demand of patients' nursing care in emergency department

Tuesday, October 28, 2008

Shan-Ru Shih , Department of medical quality and patient safety, Taipei Medical University Hospital, Taipei, Taiwan
Ching-Hsiang Chang , Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan
Dorji Harnod , Surgical Intensive Care Unit, SHIN KONG WU HO-SU MEMORIAL HOSPITAL, Taipei, Taiwan
Background: The allocation of nurses is not only related to hospitals' operation, but also related to quality of medical service and patient care. Previously, many researchers record nurses' actions to calculate the frequencies and time of nurses' patient care motions. Few observed the time that patients received direct nursing care (DNC).

Objectives: To investigate the demand and supply of DNC in the emergency department in a district teaching hospital, and to propose recommendations in nurse staffing.

Data source: Data of patients in the emergency department from 10/7/2005 to 16/7/2005, were collected from the database of Hospital Information System, included patients' basic data, medical management received, arrival and leave time. Furthermore, the time demanded for DNC were estimated by consulting senior doctors and nurses according to each patient's diagnosis.

Methods: Descriptive statistics was used to examine the patients' demand for nursing care of each triage category, and the time demanded for DNC by every hour and every nursing shift were presented. Then the discrepancy of demand and supply time of DNC were examined. Appropriate time interval of nurse shift was obtained by calculating Move Average of demand/supply nursing care time ratio in different time periods.

Results: By analyzing demand and supply time of DNC, the result shows that the supply is usually unable to meet the demand from sixteen o'clock to midnight everyday. And we found that there were more than twelve hours in each of the seven days, the supply time of DNC was less than demand.

Conclusion: We suggest that the emergency department should arrange nurse staffing every four hours, instead of every eight hours, to decrease the discrepancy between demand and supply time of DNC in the emergency department.

Learning Objectives:
By the end of the session, the participant will be able to realize the discrepancy of the demand/supply of patients' nursing care in ED. And the participant will comprehend how to solve such problem. Moreover, we demo a method of management science, Linear Programming, to the audience, to let them know how to apply it in the future researches.

Keywords: Emergency Department/Room, Quality of Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Current Position: (1) Assistant professor of Department of Health Care Administration in Chang Jung Christian University in Taiwan. (2) Director of RFID Research Center in Chang Jung Christian University in Taiwan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.