Date of Graduation

Summer 8-9-2019

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Department/Program

Interdisciplinary Studies

First Advisor

Jeremy Yves Vergara

Abstract

Due to the lack of reliable and valid infusion nurse suggestive acuity-based staffing model, ambulatory infusion settings are burden with potentially compromised patient safety, poor quality of patient care with over-scheduling of unexpected complex patients, limited resources related to nurses and infusion chairs, the dissatisfaction of patients and family members, and infusion nurses’ burn out. This project seeks to determine the appropriate nurse to patient acuity-based point ratio in staffing and scheduling factors that influence nurse staffing model, and established nurse staffing strategies. This three-month project was conducted with the infusion nurses, a nurse manager, a nurse supervisor, an assistant nurse manager, an infusion scheduling leader, and patient advisers to create a safe and high-quality of patient care in ambulatory infusion settings. Patients were classified by using both current existing staffing, scheduling system and nurse suggestive acuity-based points tool. Data analysis related to daily encounter numbers, daily nurse staffing, assignments comparison between nurse to patient’s acuity-based point ratios and nurse to patient ratio, patient satisfaction, nurse over time, and job-turnover was collected by an infusion nurse who is enrolled in a clinical nurse leader (CNL) program through independent observation. A total of 1,218 patients who received care in two ambulatory infusion settings in May, were analyzed for this project. Based on the evidence-based practice and literature, on average, infusion nurse suggestive sixteen acuity-based points per nurse per day and appropriate levels of infusion nurse staffing are defined with minimal over time in ambulatory infusion settings. In conclusion, implementation of acuity-based staffing model provides consistent staffing, improves safety, quality, and efficiency, reduces nurse over time, and results in patients, family members, and staff satisfaction.

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