Traditional models of care also don’t fit non-traditional forms of acute care services.
Like the growth in acute observation units like Capital and Coast DHB’s Short Stay Unit. It is an observation unit for cardiology and ED patients opened midway through last decade.
Mikaela Shannon has been charge nurse manager of the unit for the past two years and says 95 per cent of its patients are discharged within 24 hours, the vast majority home, and the average length of stay is 11 hours.
The unit’s usual staffing is three RNs on duty in the morning with an HCA and the same for the afternoon shift. So the ratio of patients per nurse is about five or six with the unit’s average turnover of 18–20 patients a day. But one recent Friday they had 30 patients in 24 hours. So the nurses need to be very skilled in assessment, treatment and discharge planning along with strong links with community care.
The cardiac role is a new one for the short stay unit that followed the opening of the SAPU (surgical assessment and planning unit) easing some of Shannon’s unit’s workflow so it could step in to help the cardiology flow by assessing low acuity chest pain.
So the unit has 12 cardiac monitors and the team has spent a lot of time over the last 18 months upskilling in cardiac care as well as being trained to work with at risk mental health patients.
Shannon says a lot of making the unit’s new focus work is team work and found the Releasing Time to Care process gave the nursing team the tools and skills to make the changes needed. So the daily flow of nursing tasks are nurse-led to make it work for patients and staff.
“It’s worked. We don’t have many complaints and we have lots of compliments.” (SEE ALSO MAIN STORY: CARING ABOUT OR CARING FOR PATIENTS)
