2.50
Hdl Handle:
http://hdl.handle.net/10755/162687
Type:
Presentation
Title:
New Graduate Nurses, New Hires, Acuity and Length of Stay
Abstract:
New Graduate Nurses, New Hires, Acuity and Length of Stay
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Chase-Ziolek, Andrew, RN, BSN, BA
P.I. Institution Name:Saint Francis Hospital
Title:Staff Nurse I
Contact Address:, Chicago, IL, 60602-, USA
Contact Telephone:(847) 316-2440
Co-Authors:Jeremy Carlsen, RN, BSN, BA, EMT-P; Dawn LeRoy, RN, BSN
Purpose: The use of new graduate (NewGrad) nurses in the emergency department is controversial and may be met with concern, in particular with respect to throughput and the ability of NewGrad nurses to handle patients with higher levels of acuity. A review of the literature, however, reveals no studies regarding the performance of NewGrad or new hire (NewHire) nurses in the emergency department with respect to throughput or acuity.

Design: Retrospective descriptive.

Setting: An urban Level I Trauma Center with 35,000 annual visits.

Participants/Subjects: 12 NewGrad nurses, 5 NewHire nurses with more than 1 year prior nursing experience, and 24 nurses who had been employed in the studied institution's emergency department for more than 1 year (EDVeteran) were studied.

Methods: Patient length of stay was determined for each nurse over a period of 19 months covering 53,097 patient visits. Nurses were grouped into three cohorts: NewGrad nurses, NewHire nurses, and EDVeteran nurses. Patients were divided into six groups based on charge levels, from Level 1 (minor visits) to Level 6 (critical care). Average length of stay per patient was determined for each nurse by charge level. To reduce chronological biases length of stay was normalized by month and nurses were grouped into cohorts by shift. Finally, acuity was calculated in direct nursing care minutes per patient using charge level to nursing hour equivalencies from the ENA Guidelines for Emergency Department Staffing (2003).

Results: During orientation length of stay for NewGrad nurses was 10% above that of EDVeteran nurses. Post-orientation, however, this declined to 1.1% for non-critical care patients. Both NewGrad and NewHire nurses had significantly longer length of stay for critical care patients (15-20%) even after orientation, as compared to EDVeteran nurses. Comparison of month-adjusted acuity showed an overall mean of 124 direct nursing care minutes per patient. NewGrad nurses had an average 4% lower month-adjusted acuity, while NewHire nurses were on average 5% higher as compared to EDVeteran nurses.

Recommendations: Post-orientation NewGrad and NewHire nurses do not significantly increase length of stay for non-critical care patients, and their use is appropriate for this patient population. Post-orientation NewGrad and NewHire nurses can handle similar overall acuity to EDVeteran nurses. However, with critical care patients NewGrad and NewHire nurses may increase length of stay, and the use of EDVeteran nurses may be useful to decrease length of stay.
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.titleNew Graduate Nurses, New Hires, Acuity and Length of Stayen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162687-
dc.description.abstract<table><tr><td colspan="2" class="item-title">New Graduate Nurses, New Hires, Acuity and Length of Stay</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">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Chase-Ziolek, Andrew, RN, BSN, BA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Saint Francis Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Nurse I</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Chicago, IL, 60602-, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(847) 316-2440</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">andrew.chaseziolek@gmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jeremy Carlsen, RN, BSN, BA, EMT-P; Dawn LeRoy, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The use of new graduate (NewGrad) nurses in the emergency department is controversial and may be met with concern, in particular with respect to throughput and the ability of NewGrad nurses to handle patients with higher levels of acuity. A review of the literature, however, reveals no studies regarding the performance of NewGrad or new hire (NewHire) nurses in the emergency department with respect to throughput or acuity. <br/><br/>Design: Retrospective descriptive.<br/><br/>Setting: An urban Level I Trauma Center with 35,000 annual visits. <br/><br/>Participants/Subjects: 12 NewGrad nurses, 5 NewHire nurses with more than 1 year prior nursing experience, and 24 nurses who had been employed in the studied institution's emergency department for more than 1 year (EDVeteran) were studied. <br/><br/>Methods: Patient length of stay was determined for each nurse over a period of 19 months covering 53,097 patient visits. Nurses were grouped into three cohorts: NewGrad nurses, NewHire nurses, and EDVeteran nurses. Patients were divided into six groups based on charge levels, from Level 1 (minor visits) to Level 6 (critical care). Average length of stay per patient was determined for each nurse by charge level. To reduce chronological biases length of stay was normalized by month and nurses were grouped into cohorts by shift. Finally, acuity was calculated in direct nursing care minutes per patient using charge level to nursing hour equivalencies from the ENA Guidelines for Emergency Department Staffing (2003).<br/> <br/>Results: During orientation length of stay for NewGrad nurses was 10% above that of EDVeteran nurses. Post-orientation, however, this declined to 1.1% for non-critical care patients. Both NewGrad and NewHire nurses had significantly longer length of stay for critical care patients (15-20%) even after orientation, as compared to EDVeteran nurses. Comparison of month-adjusted acuity showed an overall mean of 124 direct nursing care minutes per patient. NewGrad nurses had an average 4% lower month-adjusted acuity, while NewHire nurses were on average 5% higher as compared to EDVeteran nurses.<br/><br/>Recommendations: Post-orientation NewGrad and NewHire nurses do not significantly increase length of stay for non-critical care patients, and their use is appropriate for this patient population. Post-orientation NewGrad and NewHire nurses can handle similar overall acuity to EDVeteran nurses. However, with critical care patients NewGrad and NewHire nurses may increase length of stay, and the use of EDVeteran nurses may be useful to decrease length of stay.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:27Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:27Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.