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Intro Check-in Scheduled meds Rounds, on-demand Check-out

Assignment Board

Ann Charng
Dickson Fong
Wendy Lo
Steffan McMurrin
Evan Prowten
Laura Wishingrad
Intro Check-in Scheduled meds Rounds, on-demand Check-out

Assignment Board Overview CCP = Assistant


RN names
assigned for nurse names
each patient

AM = the daytime
Doctor
shift.
attending
PM= the nighttime
to the
shift
patients

Information
about extra
care needed
for the
patients Comments
made to keep
track of
nurse to
patient ratio
Sticker
labeled
“Name
Alert”

Census indicates the


number of patients
admitted
Intro Check-in Scheduled meds Rounds, on-demand Check-out

Continuous Flow of Information

Charge Nurse
Assignment board
Decides assignments
updated

Nurses copy their


Possible updates
Assignments at
During a 12 hour
Beginning of their
Time period
shift
Intro Check-in Scheduled meds Rounds, on-demand Check-out

The Process: Our Observations


•By the time we arrived the assignment board had already been updated with the
names of the nurses for the next shift

•The charge nurse spent a significant amount of time assigning nurses to patients,
and repeatedly counting what looked like the number of times she’d written down a
name.
–California law requires a max ratio of 1 nurse to 5 patients.

• After assigning names, the CCP column was filled out. The CCP designates
assistant nurses to patients. The symbol ‘one prime’ lets a nurse know that she does
not have an assistant for a particular patient.
–The night of our observation the majority of the patients did not have a CCP
which caused a noticeable amount of distress to the incoming nurses.

•Throughout this process the Charge Nurse repeatedly yelled questions to the
secretary. Also, the Charge Nurse was constantly being asked questions by random
nurses walking through the secret hallway.

•Eventually, the Charge Nurse made the comment “ this is as good as it’s going to
get”, and walked off. Later a different nurse came and made a tally in the comments
section of the assignment board that tallied the nurses and the number of patients
that they had.
Intro Check-in Scheduled meds Rounds, on-demand Check-out

Main Interactions
•Charge Nurse
– Is responsible for assigning nurses to their patients.

•Secretary
– Takes down the nurses assigned to the patients in order to know which nurse
to contact after a patient calls the secretary from their room.
•Maybe this has changed with Adrian’s cell phones, because patients can
call nurses directly?

–If a nurse for whatever reason changes who they are taking care of ( nurses
can swap patients ..i.e. if they cared for the m the previous day) and are
responsible for telling the secretary about the change.

•Tallying the Nurse : Patient ratio


– We don’t know if it was that particular nurses job. The night of our
observation there were not enough nurses for patients, so it is possible that the
Charge Nurse did not want to make it this discrepancy obvious.

•Incoming Nurses
– The first thing each incoming nurse did was copy information off the
assignment board. It is not clear exactly what they copied, but it can be
assumed that they at least needed the name of their patient, their patients
room number, and the previous nurse in charge of the patient.