This document summarizes a study that developed a goal programming algorithm to schedule 11 nurses across a two-week period at a hospital. The goals were to satisfy each nurse's contracted time, ensure minimum nurse requirements by role each day, give full-time nurses a weekend off while avoiding more than two consecutive days off, and honor nurses' weekend preference when possible. The algorithm solved the 154-variable, 120-constraint scheduling problem in under 30 seconds. The results showed schedules that met goals for minimum nurse levels each day and individual nurses' two-week schedules.
[HOW TO] Create High Performance Emergency DepartmentsEmCare
EmCare’s latest White Paper on implementing a system-wide approach to providing emergency care. At Baylor Health Care System, the initiative has fostered the development of numerous approaches to managing the challenges faced by its emergency departments, including an innovative protocol to manage overcrowding at the system’s flagship facility.
A Study to Assess the Level of Knowledge Regarding Airway Management Modaliti...ijtsrd
INTRODUCTION Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. Due to obstruction in the airway the life of the individual is in danger so use of airway management modalities will help to save the individual’s life. These modalities ensures an open pathway which provide breath to the lungs through the atmospheric air and mechanical support to secure life. The study was conducted to assess the level of knowledge on airway management among Nursing student. The main objectives of study were to assess the knowledge on airway management modalities and to associate the level of knowledge with selected demographic variables. A Quantitative research approach with Descriptive research design was used to evaluate the knowledge regarding airway management modalities. A sample of 60nursing students were selected by convenient sampling technique. structured questionnaire was used to obtain data from the sample . Data analysis was done by using descriptive and inferential statistics on the basis of objective of the study RESULT The result of the study shows that out of 60 samples 13 21.66 having good knowledge 45 75.3 having average knowledge and 2 3.33 having poor knowledge regarding airway management modalities. with regard to mean and standard deviation of knowledge shows 17.3 and 3.92 respectively. CONCLUSION The study concludes that, the knowledge level of students regarding airway management modalities associated airway management is average, the study suggest that proper teaching and adequate training on airway management will be helpful for the students to gain knowledge. Mr. Pradip Kumar Mishra | Mr. Raghavendran M "A Study to Assess the Level of Knowledge Regarding Airway Management Modalities among Nursing Student at Selected Nursing, College Kanpur" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45205.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45205/a-study-to-assess-the-level-of-knowledge-regarding-airway-management-modalities-among-nursing-student-at-selected-nursing-college-kanpur/mr-pradip-kumar-mishra
[HOW TO] Create High Performance Emergency DepartmentsEmCare
EmCare’s latest White Paper on implementing a system-wide approach to providing emergency care. At Baylor Health Care System, the initiative has fostered the development of numerous approaches to managing the challenges faced by its emergency departments, including an innovative protocol to manage overcrowding at the system’s flagship facility.
A Study to Assess the Level of Knowledge Regarding Airway Management Modaliti...ijtsrd
INTRODUCTION Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. Due to obstruction in the airway the life of the individual is in danger so use of airway management modalities will help to save the individual’s life. These modalities ensures an open pathway which provide breath to the lungs through the atmospheric air and mechanical support to secure life. The study was conducted to assess the level of knowledge on airway management among Nursing student. The main objectives of study were to assess the knowledge on airway management modalities and to associate the level of knowledge with selected demographic variables. A Quantitative research approach with Descriptive research design was used to evaluate the knowledge regarding airway management modalities. A sample of 60nursing students were selected by convenient sampling technique. structured questionnaire was used to obtain data from the sample . Data analysis was done by using descriptive and inferential statistics on the basis of objective of the study RESULT The result of the study shows that out of 60 samples 13 21.66 having good knowledge 45 75.3 having average knowledge and 2 3.33 having poor knowledge regarding airway management modalities. with regard to mean and standard deviation of knowledge shows 17.3 and 3.92 respectively. CONCLUSION The study concludes that, the knowledge level of students regarding airway management modalities associated airway management is average, the study suggest that proper teaching and adequate training on airway management will be helpful for the students to gain knowledge. Mr. Pradip Kumar Mishra | Mr. Raghavendran M "A Study to Assess the Level of Knowledge Regarding Airway Management Modalities among Nursing Student at Selected Nursing, College Kanpur" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45205.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/45205/a-study-to-assess-the-level-of-knowledge-regarding-airway-management-modalities-among-nursing-student-at-selected-nursing-college-kanpur/mr-pradip-kumar-mishra
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
Health workers competency is very critical in realization of quality health care which is a major pillar of Universal Health Coverage. This study assessed the influence of healthcare provider competency on Universal Health Coverage utilization in Seme Sub County, Kisumu County. The study targeted community households and health facility managers. The health facilities were stratified according to their tiers and randomly sampled. The catchment population was stratified by locations and a proportionate sampling technique applied in each stratum giving a computed sample of 377 participants. The descriptive statistics were summarized using tables and charts, while logistic regression was used to determine relationship between variables. The results revealed that quite a number of health service providers are not competent enough in their departments of operation and there is no periodic training on new guidelines. This study further revealed a statistical effect on competency of health service provider on UHC (OR=2.29, 95%CI=1.02-5.15, p<0.05). Healthcare service provider competency levels have direct significant influence on utilization of UHC services by community members.
Effective of a Structured Teaching Module Regarding Care of Children in the C...YogeshIJTSRD
A quasi experimental study, with pre test and post test without control group research design, the study was conducted on 100 nurses working in the cardio thoracic intensive care unit. purposive of sampling was used in selecting the sample for the study. The purpose of the study was to assess the effectiveness of a structured teaching module STM on the knowledge and practice of the nurses regarding management of patients in the cardio thoracic intensive care unit. The nurse taken for the study belonged mainly to the age group of 21 25 years 56 and were single 66 majority of the nurses were with diploma nursing qualification 72 .majority 65 had 1 3 years of experience and had worked in the cardiac surgery area. The finding of the study revealed that during pretest, the nurses had above average knowledge and practice before the structured teaching .with the implementation of the STM, these was an improvement in both the knowledge and practice of the STM, these was important in both the knowledge and practice of nurses . Mrs. Lata Kabdal | Mr. Yogendra Garg "Effective of a Structured Teaching Module Regarding Care of Children in the Cardio-Thoracic Intensive Care Unit on the Knowledge and Practice of the Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-3 , April 2021, URL: https://www.ijtsrd.com/papers/ijtsrd40062.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/40062/effective-of-a-structured-teaching-module-regarding-care-of-children-in-the-cardiothoracic-intensive-care-unit-on-the-knowledge-and-practice-of-the-nurses/mrs-lata-kabdal
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
Evidence based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients/clients.
Integration of the best research evidence with clinical expertise and patient values and using the best available research findings “to make clinical decisions that are most effective and beneficial for patients.
- It is a movement away from always doing things in the way in which we were taught and from decisions based on personal opinion. It requires that we look for and appraise research evidence to inform decisions about tests, treatments, patterns of practice, and policy.
Ask Converting information needs into clear questions
Acquire Seeking evidence to answer those questions
Appraise Evaluate the evidence for its validity and usefulness.
Apply Integrating findings with clinical expertise, patient needs, applying the finding.
Assess Evaluating performance.
Patient safety is the cornerstone of high-quality healthcare services. In the presentation, A summary of the frameworks & practical approaches to improve safety of patient care.
Real effectiveness medicine pursuing best effectiveness in the ordinary care ...Malmivaara Antti
These slides present a new concept of Real-Effectiveness Medicine (REM), which pursues the best effectiveness of patient care in the real-world setting. In order to reach the goal, four layers of information are needed: 1) expertise or the health care personnel, 2) use of up-to-date scientific evidence, 3) continuous documentation of performance and quality improvement, and 4) benchmarking between providers. The new framework is suggested for clinicians, organizations, policy-makers, and researchers.
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
Health workers competency is very critical in realization of quality health care which is a major pillar of Universal Health Coverage. This study assessed the influence of healthcare provider competency on Universal Health Coverage utilization in Seme Sub County, Kisumu County. The study targeted community households and health facility managers. The health facilities were stratified according to their tiers and randomly sampled. The catchment population was stratified by locations and a proportionate sampling technique applied in each stratum giving a computed sample of 377 participants. The descriptive statistics were summarized using tables and charts, while logistic regression was used to determine relationship between variables. The results revealed that quite a number of health service providers are not competent enough in their departments of operation and there is no periodic training on new guidelines. This study further revealed a statistical effect on competency of health service provider on UHC (OR=2.29, 95%CI=1.02-5.15, p<0.05). Healthcare service provider competency levels have direct significant influence on utilization of UHC services by community members.
Effective of a Structured Teaching Module Regarding Care of Children in the C...YogeshIJTSRD
A quasi experimental study, with pre test and post test without control group research design, the study was conducted on 100 nurses working in the cardio thoracic intensive care unit. purposive of sampling was used in selecting the sample for the study. The purpose of the study was to assess the effectiveness of a structured teaching module STM on the knowledge and practice of the nurses regarding management of patients in the cardio thoracic intensive care unit. The nurse taken for the study belonged mainly to the age group of 21 25 years 56 and were single 66 majority of the nurses were with diploma nursing qualification 72 .majority 65 had 1 3 years of experience and had worked in the cardiac surgery area. The finding of the study revealed that during pretest, the nurses had above average knowledge and practice before the structured teaching .with the implementation of the STM, these was an improvement in both the knowledge and practice of the STM, these was important in both the knowledge and practice of nurses . Mrs. Lata Kabdal | Mr. Yogendra Garg "Effective of a Structured Teaching Module Regarding Care of Children in the Cardio-Thoracic Intensive Care Unit on the Knowledge and Practice of the Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-3 , April 2021, URL: https://www.ijtsrd.com/papers/ijtsrd40062.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/40062/effective-of-a-structured-teaching-module-regarding-care-of-children-in-the-cardiothoracic-intensive-care-unit-on-the-knowledge-and-practice-of-the-nurses/mrs-lata-kabdal
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
Evidence based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients/clients.
Integration of the best research evidence with clinical expertise and patient values and using the best available research findings “to make clinical decisions that are most effective and beneficial for patients.
- It is a movement away from always doing things in the way in which we were taught and from decisions based on personal opinion. It requires that we look for and appraise research evidence to inform decisions about tests, treatments, patterns of practice, and policy.
Ask Converting information needs into clear questions
Acquire Seeking evidence to answer those questions
Appraise Evaluate the evidence for its validity and usefulness.
Apply Integrating findings with clinical expertise, patient needs, applying the finding.
Assess Evaluating performance.
Patient safety is the cornerstone of high-quality healthcare services. In the presentation, A summary of the frameworks & practical approaches to improve safety of patient care.
Real effectiveness medicine pursuing best effectiveness in the ordinary care ...Malmivaara Antti
These slides present a new concept of Real-Effectiveness Medicine (REM), which pursues the best effectiveness of patient care in the real-world setting. In order to reach the goal, four layers of information are needed: 1) expertise or the health care personnel, 2) use of up-to-date scientific evidence, 3) continuous documentation of performance and quality improvement, and 4) benchmarking between providers. The new framework is suggested for clinicians, organizations, policy-makers, and researchers.
College Writing II Synthesis Essay Assignment Summer Semester 2017.docxclarebernice
College Writing II Synthesis Essay Assignment Summer Semester 2017
Directions:
For this assignment you will be writing a synthesis essay. A synthesis is a combination of two or more summaries and sources. In a synthesis essay you will have three paragraphs, an introduction, a synthesis and a conclusion.
In the introduction you will give background information about your topic. You will also include a thesis statement at the end of the introduction paragraph. The thesis statement should describe the goal of your synthesis. (informative or argumentative)
The second paragraph is the synthesis. You will combine two summaries of two different articles on the same topic. You will follow all summary guidelines for these two paragraphs. The synthesis will most likely either argue or inform the reader about the topic.
The conclusion paragraph should summarize the points of your essay and restate the general ideas.
For this essay you will read two research articles on a similar topic to the previous critical review essay as you can use this research in your inquiry paper. You will summarize both articles in two paragraphs and combine the paragraphs for your synthesis. In the synthesis you must include the main ideas of the articles and the author, title, and general idea in the first sentences.
This essay will be three pages long and the first draft and peer review are due June 15. You must turn them in hardcopy in class so you can do a peer review.
Running head: THESIS DRAFT 1
THESIS DRAFT 3Thesis Draft
Katelyn B. Rhodes
D40375299
DeVry University
Point-of-Care Testing (PoCT) has dramatically taken over the field of clinical laboratory testing since it’s introduction approximately 45 years ago. The technologies utilized in PoCT have been refined to deliver accurate and expedient test results and will become even more sensitive and accurate in order to dominate the field of clinical laboratory testing. Furthermore, there will be a dramatic increase in the volume of clinical testing performed outside of the laboratory. New and emerging PoCT technologies utilize sophisticated molecular techniques such as polymerase chain reaction to aid in the treatment of major health problems worldwide, such as sexually transmitted infections (John & Price, 2014).
Historic Timeline
In the early-to-mid 1990’s, bench top analyzers entered the clinical laboratory scene. These analyzers were much smaller than the conventional analyzers being used, and utilized touch-screen PCs for ease of use. For this reason, they were able to be used closer to the patient’s bedside or outside of the laboratory environment. However, at this point in time, laboratory testing results were stored within the device and would have to then be sent to the main central laboratory for analysis.
Technology in the mid-to-late 1990’s permitted analyzers to be much smaller so that they may be easily carried to the patient’s location. Computers also became more ...
Reply1
Re: Topic 1 DQ 2
Topic 1 DQ 2
The inclusion of evidence-based practice provides nurses with the scientific research and experience to make a comprehensive decision. The practice enables the nurses to re-evaluate the risks and only adopt the best mechanism to ensure an improved patient outcome. Patients are also able to receive the best available outcomes. It is very advisable to move the nursing practice to be evidence-based to ensure that there is patient-centered care that is safe, inclusive, and effective. However, there have been barriers towards this progress since only 15% of U.S practice is evidence-based. One of the barriers which have led to lagging behind in adopting evidence-based practice is nurse shortage. Evidence-based practice requires massive documentation and research together with increased testing and experience. This requires a large human resource which is not available due to nurse shortage across the united states (Stavor et al., 2017). This has acted as a barrier towards the goal of moving practice to evidence-based. The government should employ more nurses and also dedicate some of the workforces specifically to matters to do with shifting traditional caregiving to EBP.
The second barrier is unsupportive administration. Research indicates that over 70% of nurses know about evidence-based practice, but the barriers to the practice in a clinical setting make it hard for them to adopt it. To move practice to EBP requires active collaboration from all stakeholders and more so from the administration of the healthcare setting. However, most administrations have been termed as unsupportive for the move due to the challenges of resources involved in the move. EPB presents a huge cost in the beginning due to its data requirements. However, it is able to reduce the cost of healthcare by 35% after its implementation. Lack of support from the management makes it hard to move nursing practice to EBP in a clinical setting since it’s a collaborative activity that requires dedicated and goal-oriented leadership (Duncombe, 2018). Policies and regulations should be created which force the push to enable the administration of various healthcare to have no otherwise but to comply in the shift.
References
Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the use of evidence-based practice and research utilization through the identification of barriers to implementation in a critical access hospital.
JONA: The Journal of Nursing Administration
,
47
(1), 56-61.
Duncombe, D. C. (2018). A multi‐institutional study of the perceived barriers and facilitators to implementing evidence‐based practice.
Journal of Clinical Nursing
,
27
(5-6), 1216-1226.
Reply 2
aur
1 posts
Re: Topic 1 DQ 2
As unprecedented development in the diagnosis, treatment, and long-term management of disease bring Americans closer than ever to the promise of personalized health care, we are faced with similarly unprecedented c.
Delivering Value Through Evidence-Based PracticeMacias, Charles .docxcuddietheresa
Delivering Value Through Evidence-Based Practice
Macias, Charles G; Loveless, Jennifer N; Jackson, Andrea N; Srinivasan, Suresh. Clinical Pediatric Emergency Medicine; Maryland Heights Vol. 18, Iss. 2, (2017): 89-97. DOI:10.1016/j.cpem.2017.05.002
1. Full text
2. Full text - PDF
3. Abstract/Details
Abstract
TranslateUndo Translation
Top of Form
FromTo
Translate
Bottom of Form
Translation in progress...
[[missing key: loadingAnimation]]
The full text may take 40-120 seconds to translate; larger documents may take longer.
Cancel
OverlayEnd
Unwanted variation in care is a challenge to high-quality care delivery in any healthcare system. Across the Emergency Medical Services for Children (EMSC) continuum, there is wide variation in care delivery for which best practices have demonstrated opportunities to minimize that variation through clinical standards (evidence-based pathways, protocols, and guidelines for care). A model of development of clinical standards is delineated and tools used in that process are described. Implementation strategies for improving utilization are also described with clinical decision support tools being a promising strategy for accelerating uptake of guidelines. Critical to implementing guidelines through improvement science strategies is the ability to make iterative improvements directed by data and analytics. The progression of sophistication in a system's informatics and analytics capabilities is driven by a maturity of data reporting to analytics that drives decision support for implementing clinical standards. Integration of financial data into the clinical standards processes and analytics platforms is necessary to determine value of the work. Within the EMSC continuum, a number of initiatives will drive national clinical standards activities and are fueled by current pockets of successful development and implementation activities within organizations and systems.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Longer documents ...
By administering assessments and analyzing the results, targeted aTawnaDelatorrejs
By administering assessments and analyzing the results, targeted and individualized interventions can be determined to best serve the needs of students with disabilities. The actual implementation of the interventions provides teachers opportunities to collect data and gauge the effectiveness of the interventions in addressing documented student needs. Teachers can also gain important skills and knowledge on how to best advocate for practical classroom interventions. Teachers will also be able to collaborate with colleagues and families in mentoring students to take ownership of learning strategies.
Allocate at least 2 hours in the field to support this field experience,
Part 1: Assessment and Interventions
Select at least one student to whom you will administer the informal RTI assessment created in Clinical Field Experience A. Score the assessment and share the results with the student to increase understanding of his or her strengths and areas for improvement.
Collaborate with the certified special education teacher and the student to develop 2-3 interventions based on the student assessment data to support the student’s progress in the classroom. In addition, detail one intervention that can be incorporated at home with family support.
Use any remaining field experience hours to assist the teacher in providing instruction and support to the class.
Part 2: Reflection
In 250-500 words, summarize and reflect upon the following:
· Describe each intervention, including teacher, student, and family roles, where applicable.
· Your experiences administering the assessment, analyzing the results, and providing the student feedback on his or her performance.
· Explain how you expect the interventions you developed to meet the needs of the student, incorporating his or her assessment results in your response.
· Explain how you will use your findings in your future professional practice.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
6
Annotated Bibliography
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
October 7, 2021.
Annotated Bibliography
Ali, H., Ibrahem, S. Z., Al Mudaf, B., Al Fadalah, T., Jamal, D., & El-Jardali, F. (2018). Baseline assessment of patient safety culture in public hospitals in Kuwait. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-2960-x
The researchers conducted a cross-sectional study in 16 public hospitals in Kuwait using the Hospital Survey on Patient Safety Culture (HSOPSC). The study aimed to assess patient safety culture in public hospitals as perceived by hospital staff and relate the findings similar to regional and international ...
Many healthcare financial decisions have a direct effect on nursin.docxalfredacavx97
Many healthcare financial decisions have a direct effect on nursing practice and patient care delivery. What are the ethical implications of these financial decisions? Discuss and explain two specific ways to involve nursing staff in financial planning.
Peer 1 Response:
Lauren Van Hemelrijck posted
The ethical implications of financial decisions that have a direct effect on nursing practice consist of the reduction in available money that is spent on staffing in order to ensure there are appropriate ratios at all times as well as cutting costs related to specific equipment and or tools needed to perform our jobs. Specific nurse to patient ratios have been implemented in some places however, it is not currently the norm regardless of numerous studies that have been conducted and shown that the higher the ratio the worse a patient's outcome. Although facilities will save a substantial amount of money when they cut down on staff, which is why they often choose to do so, an immoral and unethical act in and of itself, the end result effects the patients in often times very negative ways. If patients are having poor experiences they are either not likely to return because they are afraid the care that they receive will continue to be less than adequate or they will have to return due to complications that could have been prevented had there been an appropriate nurse to patient ratio when they were being cared for. As a study on this very subject has found "there is already a significant amount of empirical evidence showing the relationship between certain individual and organizational characteristics of hospital nursing and patient outcomes. These characteristics include nurses' level of education, patient-to-ratios, percentage of RNs among all nursing staff (skill mix), and the nurse practice environment" (Simonetti, 2019, p. 79).
Often times, more expensive equipment makes our jobs easier because it is more efficient and or effective. If we begin to "cut corners" in these ways it will undoubtedly have a direct impact on how well we are able to perform our jobs in certain situations. This is unethical because equipment could mean the difference between accuracy and efficiency among other things. This then means that it could then make or break a patient's outcome. If safety is compromised it is completely inappropriate to substitute equipment that might be unsafe thus putting the patient at an increased risk for illness or injury. This is not only incredibly unethical, it will have an all around negative impact on the facility's reputation and financial standing in the long run. Nurses should have a say in how money is spent because they are often times the most knowledgeable about all of the above. One article that looks at lifting equipment or lack there of states that "the results indicate that fewer than 12 percent of the responding nurses told us they have a "No Lift Policy". More than 85 perfect of hospitals have some type of.
Patient Safety in Indian Ambulatory Care settings By.Dr.Mahboob ali khan PhdHealthcare consultant
Despite the fact that the vast majority of health care takes place in the outpatient, or ambulatory care, setting, efforts to improve safety have mostly focused on the inpatient setting. However, a body of research dedicated to patient safety in ambulatory care has emerged over the past few years. These efforts have identified and characterized factors that influence safety in office practice, the types of errors commonly encountered in ambulatory care, and potential strategies for improving ambulatory safety.
113DNP Prospectus Comment by Cynthia Fletcher Th.docxherminaprocter
1
13
DNP Prospectus Comment by Cynthia Fletcher: This is a good beginning Ann Marie. There are many areas that we will discuss at our meeting to improve clarity and congruence with a DNP Project.
Educating Inpatient Nurses to use Standardized Care Plans
Anne Marie Wouapet
Doctor of Nursing Practice – Nursing Informatics
A00505587
Prospectus: Educating Inpatient Nurses to use Standardized Care Plans
Problem Statement
Standardized care plans can be described as the pre-determined menu of interventions which are used for different patient situations (Monsen, Swenson & Kerr, 2016). Evidence-based care is the conscientious use of the most recent evidence to make decisions on the care of individual patients or in the delivery of health care services (Murdaugh, Parsons & Pender, 2018). The current best evidence is the most recent information which has been obtained from valid and relevant research about the effects of different types of healthcare, the accuracy of diagnostic tests, the potential for harm from exposure to different agents, or predictive power of prognostic factor (Schmidt & Brown, 2017). Standardized care plans form the main basis for the implementation of evidence-based care directly in practice and for the improvement of patient outcomes (Nussbaum et al., 2015; Yehuda & Hoge, 2016). A health care facility recently transitioned to the use of a new and better electronic health record system. The facility also purchased standardized care plans to increase efficiency in their operations. However, the compliance with using the standardized care plans was only 40 percent among the inpatient nurses. Comment by Cynthia Fletcher: ?Comment by Cynthia Fletcher: Questionable purpose.Comment by Cynthia Fletcher: Was it different for those who were not inpatient nurses?
Accordingly, the facility recently had a visit from the Joint Commission on Accreditation of Healthcare Organizations and received a negative rating because the nurses were not adding care plans based on the patients' primary problem or diagnosis in the patients' charts upon admission. This presents several specific problems in the healthcare facility. There is poor compliance from the nurses concerning the addition of standardized care plans to the charts of patients based on their diagnosis or primary problem(s). The system which the facility invested in was not being used for the improvement of patient outcomes and quality of care delivered. The focus of this project is the failure of inpatient nurses to make use of standardized care plans. The gap in nursing is the failure of delivery of evidence-based practice using the standardized care plans which result in poor patient outcomes and quality of life. One of the areas of knowledge that has not yet been explored is the cause of low rates of adoption of standardized care plans by nurses. Another gap is the lack of studies on nurses’ perception of the standardized care plans and how they affect their use in .
E V I D E N C E S Y N T H E S I SModels of care in nursing.docxmadlynplamondon
E V I D E N C E S Y N T H E S I S
Models of care in nursing: a systematic reviewjbr_287 324..337
Ritin Fernandez RN MN (Critical Care) PhD,1,2 Maree Johnson RN BAppSci MAppSci PhD,3,4
Duong Thuy Tran BMed (Vietnam) MIPH (USyd)5 and Charmaine Miranda BPsycholgy6
1School of Nursing, Midwifery and Indigenous Health, University of Wollongong, Wollongong, 2Centre for Research in Nursing and
Health, St George Hospital, Kogarah, 3Centre for Applied Nursing Research, Sydney South West Area Health Service, 4School of Nursing
and Midwifery, University of Western Sydney, Sydney, 5School of Medicine, University of Western Sydney, Sydney, and 6Centre for Positive
Psychology and Education, School of Education, University of Western Sydney, Sydney, New South Wales, Australia
Abstract
Objective This review investigated the effect of the various models of nursing care delivery using the diverse levels
of nurses on patient and nursing outcomes.
Methods All published studies that investigated patient and nursing outcomes were considered. Studies were
included if the nursing delivery models only included nurses with varying skill levels. A literature search was
performed using the following databases: Medline (1985–2011), CINAHL (1985–2011), EMBASE (1985 to current)
and the Cochrane Controlled Studies Register (Issue 3, 2011 of Cochrane Library). In addition, the reference lists of
relevant studies and conference proceedings were also scrutinised. Two reviewers independently assessed the
eligibility of the studies for inclusion in the review, the methodological quality and extracted details of eligible studies.
Data were analysed using the RevMan software (Nordic Cochrane Centre, Copenhagen, Denmark).
Results Fourteen studies were included in this review. The results reveal that implementation of the team nursing
model of care resulted in significantly decreased incidence of medication errors and adverse intravenous outcomes,
as well as lower pain scores among patients; however, there was no effect of this model of care on the incidence of
falls. Wards that used a hybrid model demonstrated significant improvement in quality of patient care, but no
difference in incidence of pressure areas or infection rates. There were no significant differences in nursing outcomes
relating to role clarity, job satisfaction and nurse absenteeism rates between any of the models of care.
Conclusions Based on the available evidence, a predominance of team nursing within the comparisons is
suggestive of its popularity. Patient outcomes, nurse satisfaction, absenteeism and role clarity/confusion did not differ
across model comparisons. Little benefit was found within primary nursing comparisons and the cost effectiveness
of team nursing over other models remains debatable. Nonetheless, team nursing does present a better model for
inexperienced staff to develop, a key aspect in units where skill mix or experience is diverse.
Key words: evidence-based practice, nursing, systemat ...
E V I D E N C E S Y N T H E S I SModels of care in nursing.docxkanepbyrne80830
E V I D E N C E S Y N T H E S I S
Models of care in nursing: a systematic reviewjbr_287 324..337
Ritin Fernandez RN MN (Critical Care) PhD,1,2 Maree Johnson RN BAppSci MAppSci PhD,3,4
Duong Thuy Tran BMed (Vietnam) MIPH (USyd)5 and Charmaine Miranda BPsycholgy6
1School of Nursing, Midwifery and Indigenous Health, University of Wollongong, Wollongong, 2Centre for Research in Nursing and
Health, St George Hospital, Kogarah, 3Centre for Applied Nursing Research, Sydney South West Area Health Service, 4School of Nursing
and Midwifery, University of Western Sydney, Sydney, 5School of Medicine, University of Western Sydney, Sydney, and 6Centre for Positive
Psychology and Education, School of Education, University of Western Sydney, Sydney, New South Wales, Australia
Abstract
Objective This review investigated the effect of the various models of nursing care delivery using the diverse levels
of nurses on patient and nursing outcomes.
Methods All published studies that investigated patient and nursing outcomes were considered. Studies were
included if the nursing delivery models only included nurses with varying skill levels. A literature search was
performed using the following databases: Medline (1985–2011), CINAHL (1985–2011), EMBASE (1985 to current)
and the Cochrane Controlled Studies Register (Issue 3, 2011 of Cochrane Library). In addition, the reference lists of
relevant studies and conference proceedings were also scrutinised. Two reviewers independently assessed the
eligibility of the studies for inclusion in the review, the methodological quality and extracted details of eligible studies.
Data were analysed using the RevMan software (Nordic Cochrane Centre, Copenhagen, Denmark).
Results Fourteen studies were included in this review. The results reveal that implementation of the team nursing
model of care resulted in significantly decreased incidence of medication errors and adverse intravenous outcomes,
as well as lower pain scores among patients; however, there was no effect of this model of care on the incidence of
falls. Wards that used a hybrid model demonstrated significant improvement in quality of patient care, but no
difference in incidence of pressure areas or infection rates. There were no significant differences in nursing outcomes
relating to role clarity, job satisfaction and nurse absenteeism rates between any of the models of care.
Conclusions Based on the available evidence, a predominance of team nursing within the comparisons is
suggestive of its popularity. Patient outcomes, nurse satisfaction, absenteeism and role clarity/confusion did not differ
across model comparisons. Little benefit was found within primary nursing comparisons and the cost effectiveness
of team nursing over other models remains debatable. Nonetheless, team nursing does present a better model for
inexperienced staff to develop, a key aspect in units where skill mix or experience is diverse.
Key words: evidence-based practice, nursing, systemat.
Similar to Scheduling Of Nursing Staff in Hospitals - A Case Study (20)
Epistemic Interaction - tuning interfaces to provide information for AI supportAlan Dix
Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
As machine learning integrates deeper into human-computer interactions, the concept of epistemic interaction emerges, aiming to refine these interactions to enhance system adaptability. This approach encourages minor, intentional adjustments in user behaviour to enrich the data available for system learning. This paper introduces epistemic interaction within the context of human-system communication, illustrating how deliberate interaction design can improve system understanding and adaptation. Through concrete examples, we demonstrate the potential of epistemic interaction to significantly advance human-computer interaction by leveraging intuitive human communication strategies to inform system design and functionality, offering a novel pathway for enriching user-system engagements.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
"Impact of front-end architecture on development cost", Viktor TurskyiFwdays
I have heard many times that architecture is not important for the front-end. Also, many times I have seen how developers implement features on the front-end just following the standard rules for a framework and think that this is enough to successfully launch the project, and then the project fails. How to prevent this and what approach to choose? I have launched dozens of complex projects and during the talk we will analyze which approaches have worked for me and which have not.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
Key Trends Shaping the Future of Infrastructure.pdfCheryl Hung
Keynote at DIGIT West Expo, Glasgow on 29 May 2024.
Cheryl Hung, ochery.com
Sr Director, Infrastructure Ecosystem, Arm.
The key trends across hardware, cloud and open-source; exploring how these areas are likely to mature and develop over the short and long-term, and then considering how organisations can position themselves to adapt and thrive.
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
91mobiles recently conducted a Smart TV Buyer Insights Survey in which we asked over 3,000 respondents about the TV they own, aspects they look at on a new TV, and their TV buying preferences.
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
JMeter webinar - integration with InfluxDB and Grafana
Scheduling Of Nursing Staff in Hospitals - A Case Study
1. International Journal Of Mathematics And Statistics Invention (IJMSI)
E-ISSN: 2321 – 4767 P-ISSN: 2321 - 4759
www.Ijmsi.Org || Volume 2 Issue 11 || December. 2014 || PP-28-33
www.ijmsi.org 28 | P a g e
Scheduling Of Nursing Staff in Hospitals – A Case Study
1,
O.Vinod Kumar , 2,
B.V.Lakshmi , 3,
G.Ravindra Babu , 4,
T.Yugandher
1,
Professor,Dept of Sci & Humanities, Dhruva Institute of Engineering & Technology.,Toopranpet,
Greater Hyderabad,Telangana.
2,
Assoc.Professor,Dept of Sci & Humanities, Dhruva Institute of Engineering & Technology.,Toopranpet,
Greater Hyderabad,Telangana.
3,
Professor,Dept of CSE., Avanthi Institute of Engg.& Tech., Greater Hyderabad,Telangana.
4,
Assoc.Professor,Dept of Sci & Humanities, Guru Nanak Group of Institutions, Hyderabad,Telangana.
ABSTRACT: In the face of national attention paid to rapidly escalating medical errors and patient safety,
healthcare organizations have recently expanded different employee initiatives that promise to enhance
healthcare quality management programs. The Institute of Medicine (IOM) reports suggest that 58 percent of
the medical error-related Indian hospital deaths may have been prevented. The IOM reports recommend
improvements in healthcare quality systems to resolve patient safety errors. Similarly, the insurance company
consultant Health- Grades examined comprehensive data from 2000 to 2012 and concluded that about
195,000 deaths in Indian hospitals can be attributed to medical errors. Furthermore, errors inflate medical
costs due to longer and more costly hospital stays. The Juran Institute has estimated the cost of poor quality
as nearly a third of our direct medical expenses. By comparison, 14.9 percent of real Indian Gross Domestic
Product was spent on healthcare in 2006, far beyond the expenditure for Germany, France, Italy, Britain, and
Japan. Concern about the increasing worldwide number of high profile major errors raises the demand for
cultural and structural change in healthcare systems. Some research demonstrates the psychological and
systemic barriers that prevent learning from healthcare errors . In response to the troubling number of
hospital errors, many healthcare organizations have undertaken initiatives targeted toward patient safety. In
a longitudinal study of surgeons, the development of a patient safety data system identified several process
improvement factors. Redesigning hospital processes for best practices based on competitive benchmarking
has emerged as one of the most common approaches. Indeed, worldwide fervor for patient safety has
promoted the successful application of a variety of quality management practices on a global scale.
I. INTRODUCTION
There is increasing interest in the implementation of several different types of quality programs in
healthcare. In a recent survey, healthcare CEOs expressed a 62% likelihood of launching a new quality initiative
in the next year, as compared to 52% for manufacturing CEOs, 31% for education top administrators, and 35%
for other service CEOs. For the various quality initiatives, those healthcare CEOs report actual use of each of
the quality programs is 79% for Continuous Quality Improvement (CQI) and Total Quality Management
(TQM), 8% for the Six Sigma System, and 7% for the Malcolm Baldrige National Quality Award (MBNQA)
system. For the first winner of the Baldrige Award in the healthcare category, Sister Mary Jean Ryan, CEO of
SSM Health Care, attributes CQI to the success of SSM. For healthcare quality management programs,
employee commitment and control initiatives have become a major focus. Comparing U.S. health care
workforce commitment from 2003 to 2004, there has been an increase from 91 to 97.6 percent, while
commitment for the overall U.S. workforce has dropped from 99.7 to 97.6 percent. Employee commitment is
critical to maintain quality program success when 40 percent of healthcare workers reported intentions to leave
the field in the last few months. A study of healthcare employee commitment revealed key predictors are
organizational support, job skill enrichment, quality control, and a culture of continuous learning. This study
adopts the perspective of theory-driven empirical research as an approach to the theory building process
The idea that the metabolic syndrome results merely from interplay between an individual‟s emetic
inheritance and dietary habits now appears to be an oversimplification. Epidemiologic findings showing that
infants born small are prone to develop this syndrome have led to the „thrifty phenotype‟ or „fetal origins
hypotheses, the „predictive adaptation with subsequent mismatch between early and later environments
hypothesis‟ and the „developmental origins of disease hypothesis‟ (DOHAD). These closely related hypotheses
have a common factor, the concept of critical windows [such as fetal, early neonatal and puberty periods] during
which the individual is highly susceptible to „programming‟ of adaptations for future stressful events.
2. Scheduling Of Nursing Staff In Hospitals – A Case Study
www.ijmsi.org 29 | P a g e
A neo-Lamarckian concept has emerged, partially from observations in animals and more recently
with the use of sophisticated molecular biological tools that supports nutritional and several other environmental
stimuli being able to „program‟ characteristics not only for the individual‟s lifetime but also for subsequent
generations. Expanding capacity, the number of beds in the unit, is not an option, as ICU care is an unusually
expensive therapy. Reducing capacity is not an option either, as this would risk deserving patients being denied
admission to the unit or released prematurely. Thus, the ICU administrator‟s problem is how to better utilize the
existing capacity so as to relieve what upon occasion is a bed shortage and better serve the patients without
incurring additional cost. Patients, however, are only one of several constituencies to which the administrator is
accountable, and the preferences of those constituencies in the prioritization process often conflict. One
especially prominent conflict in our sample hospital is between the operating surgeons and the ICU physicians.
This is a potential conflict in any hospital that has an ICU.
The basis for the conflict is that the surgeons must schedule elective surgeries and the operating theater
well in advance, and assume there will be an empty bed in the ICU, whereas the ICU physicians set their
admissions priorities based upon all the applicants‟ needs. In this setting, the administrator often must deny
admission to an elective-surgery _ES. patient, ex ante, thereby forcing the surgeon to cancel and reschedule the
surgery, which can have several negative consequences. First, this can wreak havoc with both the surgeons‟
schedules and those of the supporting staff, and waste the time of some highly skilled people. Second, the
cancellations require changes in the operating theater‟s schedule. Last, they can cause great psychological stress
on patients, few of whom view their own surgeries as being „„minor‟‟. To resolve the conflict, the surgeons have
proposed reserving some ICU beds exclusively for ES patients. Though blatantly self-serving, this is not
necessarily a bad idea. Indeed, some form of reservation strategy might be a very good idea that offers the
administrator a way out of a very ticklish managerial situation. But lives rather than personal sensibilities are
involved in the bed-reallocation process.
Therefore, in lieu of tinkering with the actual bed arrangements, we use a simulation model to explore
the implications of a bed-reservation strategy. The model generates the data that are relevant to evaluating the
effects of two specific forms of reservation strategy: a classic dependency unit _DICU. Attached to the surgery
department, and a novel flexible bed allocation FBA scheme that reserves beds for ES patients. The strategies
are evaluated on various performance criteria both for ICU patients as a group and for patients delineated by
each of four distinct sources from which the unit receives its referrals. The model‟s parameters are determined
empirically from historical data. The unavoidable interaction between the different environmental
compartments, lets humans to be the direct or indirect target of the pollution. In fact polluting agents follow a
cycle starting and ending to humans. While it is very easy to break the biogeochemical cycles, any attempt to
escape from the pollution circle results unsuccessful. In most of the cases, drug consumption is due [or at least is
increased] to pathologies related to the environment pollution such as allergies and pulmonary diseases caused
by polluted air, stomach diseases caused by polluted foods and so on. This paper presents a single-phase goal
programming algorithm for scheduling nurses in one unit of the hospital. The goals represent the scheduling
policies of the hospital and nurses preferences for weekends on and off. An application to one unit of hospital
with 11 nurses resulted in satisfactory schedules. The computer time to solve the problem using a goal
programming algorithm was very reasonable.
II. DATA OF THE PROBLEM
The zero-one goal programming heuristic procedure described above was used to schedule 11 nurses [7
full-time and 4 part-time] in one unit of the hospital for the day shift. The schedule, for a two-week period,
should satisfy the following goals set by the management of hospital:
All nursing staff members are scheduled for their contracted time.
A minimum number of nurses each of classification [Table 1] are needed.
A predetermined number of nurses [Table 2] are desired for patient care.
All full-time nurses get at least one weekend off. If the weekend off with the constraint that no full-time
nurse has three or more consecutive days off.
Table 1: Minimum And Desired Number of Nurses
Nurse type Minimum nurses Needed Desired no. of nurses
RN 1 3
LPN 1 2
NA 2 2
The data regarding the contracted days for all 11 nurses is shown in table2
3. Scheduling Of Nursing Staff In Hospitals – A Case Study
www.ijmsi.org 30 | P a g e
Table 2: Contracted Time And Weekend Preference For Nurses
Nurse Number Types of nurse Contracted no. of
days
Preferred
Weekend
1 RN 10 2
2 RN 10 1
3 RN 8 1
4 LPN 6 2
5 LPN 10 1
6 NA 10 2
7 NA 10 2
8 NA 4 2
9 NA 10 1
10 NA 10 1
11 NA 2 2
III. ZERO-ONE GOAL PROGRAMMING PROGRAM
A zero-one programming can be written as follows:
m
Min z = Pi (di
-
+ di
+
) --------- (1)
i=1
n
Subject to aij xj +di
-
+ di
+
= bi ---------- (2)
j=1
xj = 0 or 1 ------------ (.3)
dj
-
,di
+
0 i ------------ (4)
dj
-
,di
+
=0 i ------------ (5)
Where z is the achieving (objective) function.
Pi is the priority assigned to ith
goal.
di
-
is the negative deviation.
di
+
is the positive deviation.
aij is the coeff. of jth
decision variable in the iih
goal.
Xj is the jth
decision variable.
m is the number of goals., n is the number of decision variables.
Formulation of Goals.
G1: Contracted time
The objective of these goals is to assure that each nurse works for her/his contracted time. The goal for
the first nurse is formulated as follows
X1,1 + x1,2 +…….+x1,14 + d1
-
- d1
+
= 10,
Where xi,j is the ith
nurse working on jth
day
Similarly, ten other such goals, one for each nurse, were established.
G2: Minimum Number of Nurses
Satisfaction of this goal will mean that at least a certain known number of in each classification is
assigned on each day. The goal for the assignment of an RN for the first day can be written as follows:
X1,1 + x2,1+x3,1 + d12
-
- d12
+
= 1,
Similar goals are developed for RN‟s for the remaining 13 days in the schedule and for LPN‟s and NA‟s for the
14 days this results in a total of 42 goals.
G3: Number of nurses for Patient care
These goals are similar to goals needed for a minimum number of nurses. For example, for assignment
of RN‟s on the first day, we have
X1,1 + x2,1+x3,1 + d54
-
- d54
+
= 3.
G4: Weekend off for Full-Time Nurses
The purpose of this goal is to assure that nurses get one weekend off. If the weekend cannot be given
off, then two should be off in that week. This goal for the first Full-
4. Scheduling Of Nursing Staff In Hospitals – A Case Study
www.ijmsi.org 31 | P a g e
Time Nurse can be written as follows:
X1,1 + x1,2+……+x1,7 + d96
-
- d96
+
= 5.
A total of seven goals were needed for seven full-time nurses.
G5: Weekend off preference for Full-Time Nurses
This goal attempts to assign the preferred weekend for full-time nurses. For the first nurse, this goal can
be written as follows:
X1,13 + x1,14+d103
-
- d103
+
= 0.
Similarly goals can be written for six other full-time nurses.
G6: Weekend off preference for Part-Time Nurses
These goals are similar to goals presented for full-time nurses. For example, for the third nurse the goal
is:
X3,6 + x3,7+d110
-
- d110
+
= 0.
Four such goals are needed for four part-time nurses.
G7: Three Consecutive Days Off
This goal assures that no full-time nurse gets three consecutive days off. For nurse 1, this goal can be
written as:
X1,1 + x1,12+d114
-
- d114
+
= 5.
A total of seven such goals were needed.
3.2: Formulation of Achieving Function
The formulation of achieving function requires priorities of different goals. The following priorities
were used in developing the schedule:
Priority 1: Achieve the contracted time goals.
Priority 2: Achieve the minimum number of nurses goals.
Priority3: Satisfy weekend preferences of full-time nurses, assign at least one weekend or two days off and
do not violate the “three consecutive days off” constraints. Achieve desired number of nurses for patient care.
Priority 4: Satisfy the weekend preference for the part-time nurses.
The weights for the four priorities were taken as 9,7,5 and 3. A summary of goals, weights, and
deviations to be minimized as shown in table.3.
Table3: Summary of Goals, Priority Levels, Weights And Deviations to be Minimized
Goal description Total
no. of
Goals
Goal
priority
level
Goal
weight
1.Satisfy contracted days 11 1 9 Absolute
2Satisfy minimum requirement 42 2 7 Negative
3. Satisfy weekend preference for full-time nurses 7 3 5 Absolute
4. Satisfy goal that three or more consecutive days are not off 7 3 5 Absolute
5. Weekend off for full-time nurses. 7 3 5 Absolute
6. Satisfy desired no. of nurses‟ goals 42 3 5 Negative
7. Satisfy weekend preference for part-time nurses 4 4 3 Absolute
The achieving function can be written as follows:
11 53 109 113
Minimize Z = P1∑( di
-
+di
+
) + P2∑ ( di
-
+ di
+
) + P3∑ (di
-
+ di
+
) + P4∑ (di
-
+ di
+
)
i=1 i=12 i=54 i=110
120
+P3∑ (di
-
+ di
+
)
i=114
Subject to seven constraints shown in Formulation of Goals.
5. Scheduling Of Nursing Staff In Hospitals – A Case Study
www.ijmsi.org 32 | P a g e
IV. RESULTS AND DISCUSSION
The scheduling problem with 154 decision variable and 120 constraints was solved using the algorithm
described in [3]. The CPU time on a UNIVAC 1100 for solving this problem was 28.3 sec. The schedule for one
two-week period is shown in Table 4 and the schedule for all individual nurses is shown in Table.5.
Table4: Schedule for two-week period using the algorithm
Nurse
type
M T W R F S S M T W R F S S
RN 2 2 1 1 2 1 1 2 2 1 1 1 1 1
LPN 1 1 2 1 2 1 1 1 1 1 1 1 1 1
NA 4 5 4 3 3 3 3 4 3 3 3 3 3 2
Table 5: Schedule for individual nurses for two-week period
Nurse M T W R F S S M T W R F S S
1 1 1 1 1 1 0 0 1 1 1 0 1 1 0
2a
1 1 0 0 1 1 1 0 0 0 0 0 0 0
3b
0 0 0 0 0 0 0 1 1 0 1 0 0 1
4 0 0 1 1 1 1 1 0 0 0 0 0 0 1
5 1 1 1 0 1 0 0 1 1 1 1 1 1 0
6 1 1 1 1 0 1 1 1 1 0 1 1 0 0
7 1 1 1 1 1 1 1 1 0 1 0 1 0 0
8 0 1 0 0 0 1 0 0 0 0 0 1 0 1
9 1 1 1 0 1 0 0 1 1 1 1 0 1 1
10 1 1 1 1 1 0 0 1 1 1 1 0 1 0
11 0 0 0 0 0 0 1 0 0 0 0 0 1 0
a) In this scheduling period, nurse 2 has the second week off.
b )In this scheduling period, nurse 3 has the first week off.
It is worth mentioning that all nurses work for their contracted time. The preferred weekend off is
allocated to all nurses except nurses number 2 and 8. It should be noted that nurse number 2, for this
scheduling period, took one week off. Also nurse number 8 is a part time nurse and the relative importance of
satisfying this goal was the lowest. The desired number of nurses for RN and LPN cannot be met because of
the low total number of RN‟S and LPN‟S working in this unit, but the goal of minimum number of nurses is
satisfied for all days of the two-week period.
V. CONCLUSION
In this paper we study the nursing staff members with their scheduled times on contracted time by
taking care of patients with weekend off for full time and part time basis on giving the priorites on equal
oppurtunites. The analysis performed has provided the applicability based support system which desired for
patient care.
REFERRENCES
[1] Ankjar-J ensen et al. [2006]: Variable prospective financing in the danish Hospital sector and the development of a
Danish case-mix system. Health Care Management Science 9, 259-268.
[2] Ashby J et al. [2000]: “An analysis of hospital productivity and product change”, Health Affairs Vol. 19 No. 5,
pp 197-205
[3] Bozer YA et al. [2008]: Optimizing Inbound and Outbound Door Assignment in Less than Truckload Cross docks..
IIE Transactions 40(11): 1007- 1018.
[4] Brett-Fleegler et al.[2010]: Debriefing assessment for simulation In healthcare (DASH):assessment of the reliability of a
debriefing instrument. Oral Presentation Harvard Medical School: Medical Education Day. Boston MA. April 13-15,2010.
[5] Burke et al. [2010]: A scatter search methodology for the nurse rosterin problem Journal of the Operational Research Society
6. Scheduling Of Nursing Staff In Hospitals – A Case Study
www.ijmsi.org 33 | P a g e
[6] Carlo HJ et al. [2011]: Analysis of Optimum Shape and Doo Assignment Assignment Problems in Rectangular Unit-
Load Cross docks. International Journal of Logistics: Research and Applications, 14(3): 149–163.
doi:10.1080/13675567.2011.608654.
[7] Cooper JB et al. [2011]: Design and Evaluatio of Simulation Scenarios for a Program Introducing Patient
Safety, Teamwork, Safety Leadership,and Simulation to Healthcare Leaders and Managers. Simul
Healthc. 2011,6:231-238
[8] David Zepeda [2011]: "Designing Health Care Supply Chain for Heterogeneous Population: Towards an
Integrative Framework for Quality Improvement and Disparity Reduction", presented at the Production &
Operations Management Society (POMS) Annual Meeting Reno, NV.
[9] Harper PR et al. [2010]: Modelling the Size and Skill-mix of Hospital Nursing Teams”. Journal of the Operational
Research Society. 61: 768-779.
[10] Kanishka et al. [2011]: Critical interactions between Global Fund-supported programmes and health systems
: A case study in Lao People’s Democratic Republic (Lao PDR). Health Policy and Planning 25(1):37–42. Journal
of Health anagement : 13 (3), 366-368. doi:10.1177/097206341101300309 SAGE Publications.
[11] Kollberg et al. [2007]: “Measuring lean initiatives in health care services:issues and findings”, International
Journal of Productivity and Performance Management Vol. 56 No. 1, pp. 7-24.
[12] Kumar et al. [2011]: Health Insurance in India A Study of Provider’s Perceptions in Delhi and the NCR. Journal
of Health Management:13 (3), 259-277. doi:10.1177/097206341101300302 SAGE Publications.
[13] Li et al. [1996]: Performance measurement criteria in health care organizations. The European
Journal of Operational Research 93, 449–468.
[14] Mehta S [2011]: Service Quality as Predicator of Patient Satisfaction : A Study of the Health Care Sector. Journal of Health
Management : 13 (2), 211-229. doi:10.1177/097206341101300206 SAGE Publications
[15] Oliveira M et al. [2008]: Modelling hospitals costs to produce evidences that promote equity and
efficiency. European Journal of Operational Research, 185, .933e947
[16] Ramanujam P et al. [2011]: Service Quality in Health Care Organisations : A Study of Corporate Hospitals n Hyderabad.
Journal of Health Management : 13 (2), 177-202. doi:10.1177/097206341101300204 SAGE Publications.
[17] Rosko et al. [2010]: Inefficiency differences between critical access hospitals and prospectively paid
rural hospitals. Journal of Health Politics, Policy and Law, 35(1), 95e126.
[18] Shiver JM et al.[2010]: Optimizing Emergency Department Throughput: Operations Management Solutions for Health
Care Decision Makers. Boca Raton: CRC Press/Taylor & Francis Group, pp. 1-241.
[19] Thomson et al. [2006]: Choices in health care: the European experience. Journal of Health Services Research &
Policy, 11(3), 167-171.
[20] Woolhandler et al. [2007]: Competition in a publicly funded healthcare system. British Medical Journal, 335, 1126-
1129.