nurses’ floating experience
DESCRIPTION
Nurses’ Floating Experience. Catherine Hennessy, RN, BSN Nyack Hospital. Nyack Hospital. Located approximately 25 miles northwest of New York City 373 Bed Community Hospital (Licensed) Types of Patient Care Units Medical Intensive Care Unit (11 beds) - PowerPoint PPT PresentationTRANSCRIPT
Nurses’ Floating Nurses’ Floating ExperienceExperience
Catherine Hennessy, RN, BSN Catherine Hennessy, RN, BSN
Nyack HospitalNyack Hospital
Nyack HospitalNyack Hospital Located approximately 25 miles northwest Located approximately 25 miles northwest
of New York Cityof New York City 373 Bed Community Hospital (Licensed)373 Bed Community Hospital (Licensed) Types of Patient Care UnitsTypes of Patient Care Units
Medical Intensive Care Unit (11 beds)Medical Intensive Care Unit (11 beds) Surgical Intensive Care Unit (11 beds)Surgical Intensive Care Unit (11 beds) Cardiac Stepdown Unit ( 30 beds)Cardiac Stepdown Unit ( 30 beds) Pulmonary Stepdown (23 beds)Pulmonary Stepdown (23 beds) Oncology (36 beds)Oncology (36 beds) Medical/Surgical (37 beds)Medical/Surgical (37 beds) Orthopedics (31 beds)Orthopedics (31 beds) Pediatrics (23 beds)Pediatrics (23 beds) Mother/Baby/Newborn Nursery (46 beds)Mother/Baby/Newborn Nursery (46 beds)
What is ‘floating’?What is ‘floating’?
Nursing staff members are assigned to Nursing staff members are assigned to work on a patient unit other than their own work on a patient unit other than their own in order to provide staffing to:in order to provide staffing to: Cover sick callsCover sick calls Increase staffing to ensure safe assignmentsIncrease staffing to ensure safe assignments Meet emergency staffing needsMeet emergency staffing needs Provide flexibility in staffingProvide flexibility in staffing
Who can ‘float’?Who can ‘float’?
All nursing staff members who provide All nursing staff members who provide patient care can float to any patient care patient care can float to any patient care area in the hospital within their scope of area in the hospital within their scope of practicepractice Registered NursesRegistered Nurses Patient Care AssociatesPatient Care Associates Administrative AssociatesAdministrative Associates
Where staff ‘float’?Where staff ‘float’?
Nurses ‘float’ within ‘clusters’ (determined Nurses ‘float’ within ‘clusters’ (determined according to scope of practice)according to scope of practice) Critical care clusterCritical care cluster Medical/Surgical clusterMedical/Surgical cluster Mother/Baby OB/GYN clusterMother/Baby OB/GYN cluster
Governed by Union ContractsGoverned by Union Contracts New York State Nurses Association (NYSNA)New York State Nurses Association (NYSNA) 1199 (Ancillary Staff)1199 (Ancillary Staff)
BackgroundBackground
Floating to unfamiliar units common Floating to unfamiliar units common practice in many healthcare settingspractice in many healthcare settings
Staff dissatisfaction/morale problems Staff dissatisfaction/morale problems related to floatingrelated to floating
Breaches in standards of practiceBreaches in standards of practice Patient safety and liability for staff member Patient safety and liability for staff member
and facilityand facility Affect on patient satisfactionAffect on patient satisfaction Increased turnoverIncreased turnover
Task Force ParticipantsTask Force Participants Task Force Leader Task Force Leader Associate Chief Nursing OfficerAssociate Chief Nursing Officer Nursing Supervisor/Nurse ManagerNursing Supervisor/Nurse Manager Day/Night Shift RNsDay/Night Shift RNs Representatives from all patient care unitsRepresentatives from all patient care units
MethodsMethods
““Floating Task Force”Floating Task Force” Literature Review to determine best practiceLiterature Review to determine best practice Reflective JournalingReflective Journaling SurveySurvey ““Floating Tool”Floating Tool” ResurveyResurvey
Task Force RecommendationsTask Force Recommendations
Determining the need to floatDetermining the need to float Who needs to float??Who needs to float?? Continuity of patient careContinuity of patient care Patient safetyPatient safety
Float ExperienceFloat Experience Float is greeted on assigned unit by Nurse Manager Float is greeted on assigned unit by Nurse Manager
or Charge Nurseor Charge Nurse Float tool is reviewed togetherFloat tool is reviewed together
Floating SurveyFloating Survey
The last time floatedThe last time floated Name of nurse in ChargeName of nurse in Charge Nurse Manager Nurse Manager Co-workersCo-workers AA AA PCAPCA Case Manager Case Manager DietitianDietitian Patient Meal TimePatient Meal Time
Lounge Lock CombinationLounge Lock Combination Code Cart LocationCode Cart Location Medication Room Lock Medication Room Lock
CodeCode Clean Utility Room Lock Clean Utility Room Lock
CodeCode My Break TimeMy Break Time Acuity of AssignmentAcuity of Assignment Unit Floated toUnit Floated to Primary UnitPrimary Unit
Staff ParticipantsStaff Participants
Day / Night ShiftDay / Night Shift Representatives from Representatives from
all patient care unitsall patient care units Positive and negative Positive and negative
attitudesattitudes
Results of Survey: CommentsResults of Survey: Comments
PositivePositive Greeted by staff on Greeted by staff on
receiving floorreceiving floor Felt needed on floorFelt needed on floor Made difference on Made difference on
floor felt part of a teamfloor felt part of a team Had assistance from Had assistance from
staff on receiving floorstaff on receiving floor Assignment Assignment
‘reasonable’‘reasonable’
NegativeNegative Assigned most difficult Assigned most difficult
patientspatients Did not get break or Did not get break or
lunchlunch Got first admissionGot first admission Did not know where Did not know where
anything was locatedanything was located Told ‘This is what we Told ‘This is what we
deal with all of the time deal with all of the time on this floor’on this floor’
Results of Survey (Pre)Results of Survey (Pre)
0
5
10
15
20
25
30
35
40
45
50
Today Yesterday Last Week Last Month Last Year
Last Time Nurse Floated
Last Year
Last Month
Last Week
Yesterday
Today
0
10
20
30
40
50
60
Yes No No Response
Floated Nurse Knew Change Nurse Name
No Response
No
Yes
Results of Survey (Pre)Results of Survey (Pre)
0
2
4
6
8
10
12
14
16
18
1
Units Floated To
5D
4D
4M
ICCU
3M
MICU
2D
Mother Baby
ICN
L&D
SICU
0
2
4
6
8
10
12
14
1
5D
4D
4M
ICCU
3M
MICU
2D
Mother/Baby
ICN
L&D
SICU
Name___________________ Unit______________ Ext______ Nurse Manager: __________________________________________Nursing Supervisor: _________________________ Beeper: ________ Charge Nurse: __________________________________________ Resource Nurse: __________________________________________AA: __________________________________________ Assigned PCA: __________________________________________Case Manager: ___________________ Ext. __________Beeper: ______________Physical Therapist: _________________ Ext. ___________Beeper: ____________Respiratory Therapist: ______________ Ext. __________ Beeper: ____________ Dietitian: ___________________ Ext. ___________Beeper: _____________Patient Meal Times: Breakfast:__________ Lunch: _________Dinner: _________Combination numbers: Medication room: __________________ Clean Utility Room: __________________ Staff Lounge: __________________Emergency Supplies Location: Code Cart Intubation Tray Staff Members Names:RNs: _______________ __________________ ________________ ________________PCAs: ______________ _________________ _________________ ________________Break Times: ___________ _______________ ____________
ResurveyResurvey
Distributed the same “Floating Experience” Distributed the same “Floating Experience” Tool with two additional questionsTool with two additional questions Have you used the “Floating Tool?Have you used the “Floating Tool? Was it helpful?Was it helpful?
Results of Survey (Post)Results of Survey (Post)
0
5
10
15
20
25
30
35
40
Nurse InCharge
AA Dietician LoungeCombination
Clean UtilityRoom
Break Time AssignedAccuity
Was itHelpful?
Resurvey Results Days
Yes Day Shift
No Day Shift
N/A
Results of Survey (Post)Results of Survey (Post)
0
5
10
15
20
25
30
35
Nurse InCharge
AA Dietician LoungeCombination
Clean UtilityRoom
Break Time AssignedAccuity
Was itHelpful?
Resurvey Results Nights
Yes Night Shift
No Night Shift
N/A
Results of Survey (Post)Results of Survey (Post)
0
2
4
6
8
10
12
14
1
Units Floated From (Post)
5D
4D
4M
ICCU
3M
MICU
2D
Mother Baby
ICN
L&D
SICU
0
2
4
6
8
10
12
14
1
Units Floated To (Post)
5D
4D
4M
ICCU
3M
MICU
2D
Mother Baby
ICN
L&D
SICU
ResultsResults
Hospital has hired nurses for a “Float” Hospital has hired nurses for a “Float” PoolPool
Decreased number of nurses who floatDecreased number of nurses who float Decreased overtimeDecreased overtime
ConclusionConclusion
Continue with Task ForceContinue with Task Force Develop unit-specific “Float Tools”Develop unit-specific “Float Tools” Utilize float poolUtilize float pool
Thank You!!!Thank You!!!
Thank you!!!