Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit

Area of Science:

• Neuroscience nursing
• Healthcare quality improvement
• Nursing workforce management

Background:

• Neuroscience intermediate units faced challenges with high patient acuity and nurse-to-patient ratios (1:4-1:5).
• Existing staffing levels impacted nurse satisfaction and the unit's capacity to manage increasingly acute patients.
• Clinical nurses advocated for a lower nurse-patient ratio to improve care delivery.

Purpose of the Study:

• To justify a staffing increase in a neuroscience intermediate unit.
• To analyze the return on investment (ROI) of increased nurse staffing.
• To evaluate the impact of staffing adjustments on quality metrics and nurse satisfaction.

Main Methods:

• A mixed-methods approach was employed, combining quantitative and qualitative data.
• Quantitative analysis involved reviewing 9,832 patient days to assess patient acuity.
• Qualitative data was gathered through descriptive interviews with nurse managers from similar units at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina.

Main Results:

• A lower nurse-patient ratio resulted in an 80% decrease in controllable nurse turnover.
• There was a 75% reduction in falls with injury following the staffing adjustment.
• Nurse satisfaction regarding staffing, measured by the Press Ganey survey, increased from 2.44 in 2013 to 3.72 in 2015.

Conclusions:

• Increased nurse staffing positively impacted key quality metrics in the neuroscience intermediate unit.
• The reduction in nurse turnover and patient falls with injury provided a clear return on investment for the staffing increase.
• The findings support the benefits of lower nurse-patient ratios for both patient outcomes and staff morale.