North Shore Hospital report - New Zealand Doctor

Opinion 07HDC2174214. Make it the brief of the Clinical Nurse Directors to institute clinical governance, tomonitor efficiency and effectiveness of nursing services, including nurse-sensitiveoutcome measures, and to evaluate their contribution to the broader multi-professionalorganisation and patient outcomes.15. Link up the nursing structure so the responsibility, accountability and authority is alignedto the positions and vested in current practising nurses.16. Align the nursing structure to the management and medical structure so the desired multiprofessionalteamwork is modelled, enabled and expected across and at every level of theorganisation.17. Provide adequate access to modern, linked, electronic tools so that nurses have theinformation they require to plan, implement, monitor and evaluate their work. Informationareas include patient demand, acuity, staffing and competence, care planning, quality andrisk including nurse-sensitive outcome measures as well as audit, along with usualconsumable imprests, human resources and finances.18. Invest in a modern patient call bell system to differentiate the ringing for the nurses.ReferencesAiken, L., Clarke, S. P., Douglas M., Sloane, D., Sochalski, J., and Silber, J.H. (2002)Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction.JAMA, 288: 1987:1993.American Emergency Nurses Association position statement 2003(http://www.ena.org/about/position).Australasian College of Emergency Medicine (2004) Access Block and Overcrowding inEmergency Departments.Brennan, F., Carr, D. B., and Cousins, M. (2007). Pain Management: A Fundamental HumanRight. Pain Medicine Vol. 105, No. 1, July.Benner, P. (1984). From Novice to Expert: Excellence and Power in Clinical NursingPractice. Addison Wesley Publishing California.Baugust, A., Place, M., and Ponett, J. (1999). Dynamics of bed use in accommodatingemergency admissions: stochastic simulation model. British Medical Journal. July 17;319(7203): 155–158.Canadian Health Services Research Foundation (2004). Evidence-based Standards forMeasuring Nurse Staffing and Performance.Cleaning, Infection & Sterilization Guideline, MidCentral Health June 2007.College of Emergency Nurses New Zealand (2006). Position Statement on Nursing StaffingRequirements in Emergency Departments.Colville, A., Weaving, P., and Cooper, T. (2007). How infection prevention professionals canmake it easier for designers and planners, British Journal of Infection Control, Sept. Vol. 8No. 4 pp. 22–25.Emergency Nurses Association Position Statement Staffing and Productivity in theEmergency Care Setting, USA.Emergency Nurses Association Position Statement. Crowding in Emergency Departments.Revised 2005.Evidence Report/Technology Assessment Number 74. The Effect of Health Care WorkingConditions on Patient Safety. Agency for Healthcare Research and Quality May 2003.April 2009 107