An innovation to improve Nursing care or Procedure. Or a Project proposal based on identified issue.

Increasing “TIME TO CARE” is to enable nurses and other hospital staff to spend more time with patients, thereby improving the safety, quality of nursing care and efficiency of the ward (ICU).

First let’s define ICU:

An Intensive Care Unit (ICU), also known as a Critical Care Unit (CCU), Intensive Therapy Unit or Intensive Treatment Unit (ITU) is a special department of a hospital that provides intensive-care medicine.

Intensive Care Units cater to patients with the most serious injuries and illnesses, most of which are life-threatening and need constant, close monitoring and support from specialist equipment and medication in order to maintain normal bodily functions.

Patients may be transferred to an Intensive Care Unit from a ward if they require constant monitoring.

Quality of care

Higher ICU staffing was significantly associated with lower ICU and hospital mortality rates.

A ratio of 2 patients to 1 nurse is recommended for a medical ICU or on a 1:1 basis for patients requiring very intensive support and monitoring; for example, a patient on a mechanical ventilator with associated anaesthetics or sedation, which contrasts to the ratio of 4:1 or 5:1 typically seen on medical floors.

PROBLEM:Actual Staffing in ASTMMC in ICU Department

Nurse Staffs and patients ratio =

1. patient census of the ICU dept for the month of November, then get average census. Including the paywards and NICU, PICU2. Average nurse staffing in every shift for the whole month of November

Example: 2 nurses : 14 patients

1 medicating nurse and 1 charge nurse

In 8 hrs shift, how much time the nurses spends in each patient?

What are tasks of the nurses each shift: Nurses notes, medicating, carry out doctor’s order, referral to the physicians, endorsements, bedside care, even bed making

“patients were sometimes afraid to call the nurse because they saw the nurses were so busy”

Purpose of health policy or idea

The program aims to empower ward teams to identify areas for improvement by giving staff the information, skills and time they need to regain control of their ward and the care they provide. They do this by looking at processes such as drugs rounds, ward rounds and discharges, and then finding ways of streamlining these processes so that the ward staff can spend more time on direct patient care.

Main points

Main objectives

Increase the proportion of staff time spent with patients Improve safety Improve staff morale

Results of evaluation

Very positive results are being reported from the program, including:

Nurses are getting back at least 10 per cent of their time to spend on patient care. In some wards, time spent with patients has doubled from around 28% to over 50%

Calmer wards and fewer patient complaints Increased patient safety, including reduced medication events Improved staff morale Barriers broken down between frontline staff and managers between

disciplines.

“The nurses appear happier and the ward seems less rushed and the patients feel like they’re getting better care,” says one nurse.

e story talks about how nurses were spending on 33% of their time with patients at the bedside. It’s such a systemic problem – the interruptions and waste – that the number is almost always between 30 and 33% in studies done around the world. Before, patients were sometimes afraid to call the nurse because they saw the nurses were so busy. That changes with RTtC.

“The nurses appear happier and the ward seems less rushed and the patients feel like they’re getting better care,” says one nurse. One hospital also reports a 10% shorter length of stay, as a result.

TESTIMONIAL: At uni our Facilatators were constantly going on about paperwork and how you should never let that get in the way of patient care, very true but how is it posible when you have lots of it to do and your manager is kicking your backside if it's not done. I'm still writing my notes at the end of my shift because I personally believe I'm not gonna put it in the way of patient care...maybe we should all start doing this lol!!

Then the other problem is Staff shortages, it all comes down to money, we are a few staff members down

ERRORS:

s. Eight categories

of nursing errors representing a broad range of possible errors and contributive or causative factors

were identified: lack of attentiveness; lack of

agency/fiduciary concern; inappropriate judgment;

lack of intervention on the patient’s behalf; medication errors; lack of prevention; missed or mistaken MD/healthcare provider’s orders; and documentation errors. Causes for the error, at the system

and practice responsibility levels, were identified in

each case.

Nurses take responsibility for mitigating and managing fatigue while at work, including using

professional approaches to decline work assignments.When deciding to work extra shifts or

when planning work or non-work related activities, nurses act on their ethical obligation to

maintain fitness to practice.

The nurse demonstrates experiential learning,as a result of a tragic error. It is doubtful that she will

ever make a similar error again.

Problem StatementDescribe the existing situation in the community/area.Summarize the specific problems, needs, or opportunities to be addressed directly by theproject.2.2 Discuss how these problems and needs can be addressed

PROJECT PURPOSE3.1 State clearly what the project intends to do, its impact on the environment and beneficiariesand its expected outputs

PROJECT DESCRIPTION

State the general and specific objectives of the project.Briefly describe what the project is all about and how it shall be implemented and managedand eventually sustained.Indicate what the project intends to do, its expected outputs, outcomes and impact on theenvironment, poverty reduction and local empowerment of communities.Describe the existing condition/situation of the proposed sites.

4.2 Planned Actions and Activities