Browsing by Author "Allen, Deborah H"

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    Evaluation of lay health workers on quality of care in the inpatient setting.
    (PloS one, 2023-01) Basnight, Ramona; Berry, Peter; Capes, Kellie; Pearce, Sherri; Thompson, Julie; Allen, Deborah H; Granger, Bradi B; Reynolds, Staci S

    Aims

    To evaluate the impact of a lay health worker support role in the inpatient setting.

    Background

    Healthcare systems are facing critical nursing and nurse assistant staffing shortages. These disciplines can be challenging to recruit and retain, leading healthcare leaders to identify innovative staffing models. Whereas lay health workers have been used in the community and low-income setting, there is scant evidence of their use in the inpatient setting. We implemented a lay health worker role, called Patient Attendant Service Aides (PASAs), on two medical/surgical units at a community hospital.

    Methods

    A pre/post-implementation design was used for this study. An online survey was provided to nurses, nursing assistants, and PASAs on the two medical/surgical units to assess their satisfaction and perceptions of the role. Nursing quality metrics, patient satisfaction, and nursing and nursing assistant turnover were evaluated before and after implementing the role.

    Results

    The online survey showed that nurses and nursing assistants felt that PASAs helped offload their workload, allowing them to focus on nursing-related tasks. PASAs felt supported by the team and believed they were making a meaningful contribution to the unit. There were slight improvements in patient satisfaction, although not significant. There was a significant improvement in nursing turnover on Unit A, from 71.1% to 21.6% (p = 0.009).

    Conclusions

    This is one of the first studies to evaluate the use of lay health workers in the inpatient setting; we found this role to be a feasible way to offload tasks from clinical staff. This role may serve as a pathway for workforce development, as several PASAs are now enrolled in nursing assistant training. Nurse managers may consider using lay health workers in the inpatient setting as they face severe clinical staff shortages.
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    Program Evaluation of an Early Nurse Intervention Team.
    (AACN advanced critical care, 2022-03) Heitman, Sarah; Allen, Deborah H; Massengill, Jennifer; Orto, Victoria; Thompson, Julie A; Reynolds, Staci S

    Background

    Many hospitals have implemented early rapid response teams to improve detection of patients at risk for decline. However, formal evaluation of these programs is rare.

    Objective

    To evaluate the Early Nurse Intervention Team program at a large community hospital in the southeastern United States.

    Methods

    A retrospective evaluation was performed of unplanned intensive care unit transfers, hospital length of stay, length of stay index, ventilator days, and mortality in 2 patient groups: those with and those without an Early Nurse Intervention Team nurse present.

    Results

    There was a marked decline in unplanned intensive care unit transfers as the Early Nurse Intervention Team nurse staffing increased. There were no significant interaction or main effects for length of stay, length of stay index, ventilator days, or mortality between the 2 groups.

    Conclusions

    This study showed a positive impact of implementation of an Early Nurse Intervention Team program, with significant savings given the cost of unplanned intensive care unit transfers.
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    Strategies to Sustain Quality Interventions: Case Examples of Chlorhexidine Gluconate Bathing.
    (AACN advanced critical care, 2022-09) Allen, Deborah H; Anello, Katia; Destine, Yvette; Fleurant, Monique; Yang, Bing; Granger, Bradi B; Reynolds, Staci S
    Sustaining improvements achieved through clinical inquiry projects is challenging. Often improvements are observed early after a change; however, over time, clinical staff will frequently revert to their previous practices, even if efforts to “hardwire” the practice change were initially put into place. One key reason why improvements are not sustained is that long-term monitoring of processes is not sustained. Identifying a few, simple metrics that can be easily measured over time to gauge how (or if) the processes are still in place is warranted.1 In clinical practice, these process metrics are often measured through tasks such as auditing nurse's documentation compliance with specific interventions. Only when process and outcome metrics are tracked can clinical staff see signals that the evidence-based change is not being sustained. By identifying these signals early, clinicians can quickly work to identify barriers and improve processes, outcomes, and ultimately, patient care. When learning skills for conducting and completing evidence-based practice (EBP) and quality improvement (QI) initiatives, it is imperative for nurses to also understand the importance of sustainability and how to maintain gains made over time.
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    Student nurse perceptions of an innovative role to support clinical practices during a pandemic: A qualitative study.
    (Nurse education today, 2021-08) Howard, Valerie; Hartman, Ann Michelle; Allen, Deborah H; Reynolds, Staci S

    Introduction

    During the COVID-19 pandemic, healthcare systems needed to quickly identify personnel to provide symptom screening and PPE observations. Through an established academic-practice partnership, pre-licensure nursing students were able to fill this new Patient Services Aid role. The purpose of this paper is to evaluate the students' experiences in this mutually beneficial innovative role.

    Methods

    Electronic surveys and qualitative focus groups were used to evaluate the students' experiences.

    Results

    A total of 34 students were employed at the health system as PSAs. Focus groups (n = 16) analysis showed that, while the role was not a substitute for academic clinical experiences, they did improve the students' confidence in the clinical setting and helped teach necessary non-technical skills. Students appreciated the ability to network with multiple disciplines while working as PSAs.

    Conclusions

    This role was developed to assist with immediate COVID-19 needs; however, this model of using pre-licensure students in non-clinical roles can improve students' non-technical skills and confidence in the clinical setting. The success of the activity was due to the strong relationships between the School of Nursing and health system. Other schools of nursing could benefit from developing collaborative partnerships with local healthcare systems.
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    The impact of nurse staffing on falls performance within a health care system: A descriptive study.
    (Journal of nursing management, 2022-04) Cooke, Melissa; de la Fuente, Margarita; Stringfield, Candice; Sullivan, Kelly; Brassil, Robert; Thompson, Julie; Allen, Deborah H; Granger, Bradi B; Reynolds, Staci S

    Aim

    The purpose of this study was to examine the impact of nurse staffing on inpatient falls performance across a multi-hospital system.

    Background

    Evidence to support which staffing variables influence fall performance so that health care organizations can better allocate resources is lacking.

    Method

    A descriptive study design was used to analyse the impact of nurse staffing and falls performance, with units dichotomized as either high or low performing based on national benchmarking data. The impact was evaluated using 10 nurse staffing variables.

    Results

    A total of nine units were included (five high and four low performing). Higher performing units showed less use of sitters and travellers, had fewer overtime hours worked by nurses, and employed more expert-level clinical nurses and combined nursing assistant/health unit coordinator positions, than lower performing units.

    Conclusion

    Findings provide evidence of how staffing variables affect a unit's falls performance. While significant relationships were found, further evaluation is needed to explore the relationship of staffing variables and quality outcomes.

    Implications for nursing management

    Nursing managers may consider trying to reduce use of sitters and travellers, and utilize innovative staffing models, such as using combined nursing assistant/health unit coordinator positions, to help improve their falls performance.