Implementing an Alternative Patient Care Technician Staffing Model on a Medical Unit: A Cross-Sectional Study

Area of Science:

• Nursing Staffing Models
• Healthcare Management
• Patient Care Delivery

Background:

• Healthcare systems face challenges with nurse and patient care technician (PCT) shortages.
• These shortages can lead to missed essential nursing care, decreased job satisfaction, poorer patient outcomes, and increased costs.
• Nonlicensed personnel can perform many patient care tasks, freeing up licensed nurses for specialized duties.

Purpose of the Study:

• To evaluate a new staffing model pairing one nurse with one PCT for every five patients.
• To assess the impact of increased PCT staffing on patient outcomes, staff experience, and healthcare costs.
• To determine the financial viability and effectiveness of a balanced nurse-to-patient and PCT-to-patient ratio.

Main Methods:

• A pre- and post-implementation study on an acute care medical unit.
• Transitioned from 1:4 RN/patient and 1:10-1:12 PCT/patient ratios to 1:5 RN/patient and 1:5 PCT/patient ratios.
• Utilized the MISSCARE Survey, HCAHPS nursing communication scores, bathing compliance, and financial data (labor hours, overtime, vacancy rates) for analysis.

Main Results:

• Statistically significant improvements were observed in six missed care items, including documentation, meal setup, toileting, bathing, feeding, and patient education.
• Enhanced Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) nursing communication scores and bathing compliance.
• Achieved significant cost reductions through decreased contingency labor, overtime, and vacancy rates, totaling $453,228 in annual savings.

Conclusions:

• Implementing a balanced nurse and PCT staffing model significantly improved care delivery, patient outcomes, and staff experience.
• The new model led to substantial cost savings, demonstrating financial benefits.
• Findings support the expansion of this staffing model to other units and for longitudinal data collection.