Implementation of Geographical Nursing Assignments on a Medical-Surgical Unit: An Evidence-Based Project to Improve Nurse Efficiency, Nurse Satisfaction, and Patient Outcomes

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The Ohio State University

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Nurse-patient assignments have an influence on both nursing staff and patient care. It is identified that inpatient hospital units prioritize nurse-patient assignments based on patient acuity and do not account for their geographical location; therefore, nurse-patient assignments are geographically dispersed throughout the inpatient unit. The focus of the project was to create nurse-patient assignments using geographical clustering (GC) on an inpatient Medical-Surgical unit, making their assignments closer together to improve nurse satisfaction, patient satisfaction, and quality measures. The literature stated that nurses who have closer proximity to their patients results in nursing step reduction, patient satisfaction, and increased direct patient-care time. Geographical clustering of nurse-patient assignments on the inpatient project host unit had a total implementation period of ten weeks. Data measures collected include nursing satisfaction, patient satisfaction, and unit quality data pertaining to falls, HAPIs, and call-lights. Pre-implementation data from July 1, 2022, to September 18, 2022, was compared to post-implementation data from September 19, 2022, to November 30, 2022. The findings support that GC improves nurse satisfaction, patient satisfaction, reduced patient falls and falls with injury, along with improving call-light responsiveness and reduction in number of times patients pressed their call-light. Ongoing data methods need to be collected to determine if GC reduces the number of steps nurses take during their shift.



geographical clustering, pod nursing, nurse-patient assignments