Title of Submission
Improving the Nurse Patient Assignment Process on a Medical Surgical Unit
Doctorate of Nursing Practice
Major Advisor Name
Type of Submission
Background: Nurse patient assignments (NPA) on an adult medical surgical unit at a community hospital are often accomplished with inconsistent processes. Each charge nurse utilizes individualized methods to determine which patients to assign to the available nurses. There are frequently no criteria by which the number and/or complexity of patients that are assigned. Staff skill and competency are also not being considered.
Project Design: A pilot project was conducted on the unit with the purpose of implementing an evidence-based solution to nursing patient assignments which includes patient complexity and nursing competency. The project utilized the American Association of Critical Care Nurses (AACN) Synergy Model to guide the assessment of staff competency levels and patient complexity scores. The Synergy Model adapted to the medical surgical environment incorporates the analysis of patient needs and nurses’ ability. The project outcomes were to improve on-time medication administration, while also improving patient and nursing satisfaction.
Results: Clinical areas of improvement for this project were found in the number of medications given on time. Feedback from staff participants revealed team assignments felt more balanced. Expected improvements to staff and patient satisfaction were not realized during the sixteen-week measurement period of the project.
Recommendations and Conclusions: The AACN Synergy Model provides evidence-based structure and processes for charge nurses to incorporate each patient’s situation and build a patient team that is aligned with each nurse’s level of capabilities. The project demonstrated the use of evidence-based tools, processes, and principles to improve patient care and outcomes.