Problem-
"Do longer working shift impact on patient care reflected on falls, medication errors, patient and staff complaints due to staff fatigue?"
Working at neurosurgical ward in one of the teaching hospital for last four years has assisted my knowledge and understanding in managing neurosurgical patients. Neurosurgical department has 21 ward beds and 4 beds neurosurgical step-down unit (NSDU) for a patient who is needed close monitoring. In order to deliver continuous care to the neurosurgical patients, decrease high turn over staff and improve quality care to all patients, in February 2010, neurosurgical unit established long hours working shift for nursing staff that is agreed to work 12 hours shift a day instead of 8 hours shift. Most of the nursing staff decided to work 12-hour shift, only 2 of the nursing staff work 8 hours shift. However, a longer working hour is believed to be associated with in patient falls, medication errors, staff and patient complaints due to staff fatigue or burn out. Most of department in acute setting are resistance to commence 12 hours working shift due to the errors mentioned above.
Point including in introduction
- Why need to develop 12 hours shift
- problems
Literature review
Point including in literature review are:
1. What the literature review says about 12 hours shift related to falls, medication errors, patient complaint, and staff complaint related to fatigue.
2. The advantages of 8 hours and 12 hours working shift
3. What the literature review says about 8 hours shift related to errors.
The Aim of the Project
- To analyze errors that occurs in Neurosurgical department by comparing Incident Information Management System (IIMS) report from year 2009 and 2011. The finding of this project might be useful to the unit in preventing further errors and complaints, improving patient and staff safety by providing nursing staff with adequate resources and education in order to deliver excellent nursing care to all patients.
Method
Secondary analysis of data collected from Incident Information Management System (IIMS) data used is specific to Neurosurgical department.
Data Analysis
Data sample that used in this project is data
Table 1 Errors occur during 2009
|
Type of Errors
|
Total Errors
|
|
Medication
|
53
|
|
Falls
|
62
|
|
Patient Complaints
|
10
|
|
Staff Complaints
|
13
|
|
Pressure sore
|
9
|
|
|
Table 2 Errors occur during 2011
|
Type or errors
|
Total Errors
|
|
Medication
|
58
|
|
Falls
|
63
|
|
Patient Complaints
|
12
|
|
Staff Complaints
|
23
|
|
Pressure sore
|
22
|
Test the data above if any significant different in number using MS Excel.
Additional information-
The problem related to Basic Statistics and discuss about the application of ANOVA for data analysis. A statement about longer working hours increasing fatigue in medical staff and the increase in errors has been statistically tested using ANOVA in the solution.