2.50
Hdl Handle:
http://hdl.handle.net/10755/162412
Type:
Presentation
Title:
A Virtual Acute Admission Unit: Nurses' Perceived Effects
Abstract:
A Virtual Acute Admission Unit: Nurses' Perceived Effects
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:van der Linden, Naomi, BSc Organizational Anthropology, MSc Health Econom
P.I. Institution Name:Medical Center Haaglanden, location Westeinde
Title:Medical student, researcher
Contact Address:Postbus 432, Westeinde 100, The Hague, 2501 CK, The Netherlands
Contact Telephone:00-31-703302077
Co-Authors:Christien van der Linden, RN, MANP, MSCE; R. Lindeboom, PhD; C. Lucas, PhD
[ENA Annual Conference - Research Presentation]
Background: Emergency department overcrowding (EDO) is a widespread problem in the Netherlands and elsewhere. EDO can be aggravated by a lack of unoccupied inpatient beds to admit ED patients. This was the case in the study setting. While there was sub maximal hospital occupancy, hospital wards were reluctant to admit acute patients from other specialties to 'their beds'. Whenever the 'right ward' was fully occupied, the patient needed to be transferred to another hospital, even when there was still capacity in the hospital as a whole. As a result, ED patients requiring hospitalization had to wait in the ED until transfer to another hospital was arranged, thus occupying valuable space in the ED.
To address this problem, some hospitals have turned to opening acute admission units (temporary holding areas) for these patients. However, this is associated with advantages as well as disadvantages, in particular high costs. Therefore, another approach was chosen: implementing a 'virtual' acute admission unit (VAAU) consisting of 15 inpatient regular beds, of which the physical location, on several different departments, was determined on a daily basis. These 'VAAU beds' were used to admit acute patients when an inpatient admission bed on the appropriate floor was not yet available. This intervention was expected to decrease ED throughput problems and transfers to other hospitals.

Purpose: In order to determine the effects of the implementation of the VAAU, qualitative analyses were carried out. In this study, ED nurses' views and experiences with the VAAU project were identified.

Design: A qualitative analysis of e-mail-questionnaire- and focus group results.

Setting: An inner-city, level 1 trauma centre in the Netherlands with >50.000 ED patients per year.

Participants: Two techniques were used for data collection. First, ED nurses received an e-mail with an open-ended research question: 33 nurses (79%, 7 male, 26 female) responded. Furthermore, in the weekly ED newsletter nurses were asked to participate in a focus group. The focus group was attended by seven ED nurses (17%, two male, five female).

Methods: Content analysis was performed on the transcribed focus group data and the e-mail responses. By mutual agreement, two researchers extracted, coded, categorized and analyzed all statements related to alleged effects of the VAAU intervention.

Results: ED nurses experienced various -mainly positive- effects that they attributed to the implementation of the VAAU. These alleged effects are related to ED throughput, to ED nurses' own workload and time and to their feelings of pressure and irritation. Also, practical suggestions were done to further improve the VAAU. When improving patient flow, communication and "cultural differences" between ED nurses and personnel from other hospital wards turned out to be important factors to take into account.

Implications: Implementation of a VAAU seems a viable way to address several problems related to EDO. While awaiting quantitative results, it can already be concluded that ED nurses' experiences with the VAAU are mainly positive and offer possibilities for further improvement.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Virtual Acute Admission Unit: Nurses' Perceived Effectsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162412-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Virtual Acute Admission Unit: Nurses' Perceived Effects</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">van der Linden, Naomi, BSc Organizational Anthropology, MSc Health Econom</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Medical Center Haaglanden, location Westeinde</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Medical student, researcher</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Postbus 432, Westeinde 100, The Hague, 2501 CK, The Netherlands</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">00-31-703302077</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">researchacutecare@mchaaglanden.nl</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Christien van der Linden, RN, MANP, MSCE; R. Lindeboom, PhD; C. Lucas, PhD</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Research Presentation] <br/>Background: Emergency department overcrowding (EDO) is a widespread problem in the Netherlands and elsewhere. EDO can be aggravated by a lack of unoccupied inpatient beds to admit ED patients. This was the case in the study setting. While there was sub maximal hospital occupancy, hospital wards were reluctant to admit acute patients from other specialties to 'their beds'. Whenever the 'right ward' was fully occupied, the patient needed to be transferred to another hospital, even when there was still capacity in the hospital as a whole. As a result, ED patients requiring hospitalization had to wait in the ED until transfer to another hospital was arranged, thus occupying valuable space in the ED.<br/>To address this problem, some hospitals have turned to opening acute admission units (temporary holding areas) for these patients. However, this is associated with advantages as well as disadvantages, in particular high costs. Therefore, another approach was chosen: implementing a 'virtual' acute admission unit (VAAU) consisting of 15 inpatient regular beds, of which the physical location, on several different departments, was determined on a daily basis. These 'VAAU beds' were used to admit acute patients when an inpatient admission bed on the appropriate floor was not yet available. This intervention was expected to decrease ED throughput problems and transfers to other hospitals.<br/><br/>Purpose: In order to determine the effects of the implementation of the VAAU, qualitative analyses were carried out. In this study, ED nurses' views and experiences with the VAAU project were identified. <br/><br/>Design: A qualitative analysis of e-mail-questionnaire- and focus group results.<br/><br/>Setting: An inner-city, level 1 trauma centre in the Netherlands with &gt;50.000 ED patients per year.<br/><br/>Participants: Two techniques were used for data collection. First, ED nurses received an e-mail with an open-ended research question: 33 nurses (79%, 7 male, 26 female) responded. Furthermore, in the weekly ED newsletter nurses were asked to participate in a focus group. The focus group was attended by seven ED nurses (17%, two male, five female).<br/><br/>Methods: Content analysis was performed on the transcribed focus group data and the e-mail responses. By mutual agreement, two researchers extracted, coded, categorized and analyzed all statements related to alleged effects of the VAAU intervention. <br/><br/>Results: ED nurses experienced various -mainly positive- effects that they attributed to the implementation of the VAAU. These alleged effects are related to ED throughput, to ED nurses' own workload and time and to their feelings of pressure and irritation. Also, practical suggestions were done to further improve the VAAU. When improving patient flow, communication and &quot;cultural differences&quot; between ED nurses and personnel from other hospital wards turned out to be important factors to take into account.<br/><br/>Implications: Implementation of a VAAU seems a viable way to address several problems related to EDO. While awaiting quantitative results, it can already be concluded that ED nurses' experiences with the VAAU are mainly positive and offer possibilities for further improvement.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:47Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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