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A>c'}|nz6r}'wk9S,_W4rbzzJ:`纡Y*b(PD޾h{Yȁ[!|)> >vC8׶5t>!7X㣭kyg UD.`1pA}Nc=W6;ӥiw%':/6C!1ESR/ҍ-rA zqޕgqMi'qQĬ G\3d9f%ߢE݄A!L9hu9&9 QfaS;ҙ=)dU9F[umt49q/2F>+=Mh>nUΠ|t`:'i.G?L\6e>)LgHI*4ǭss}m18Lo;4U'ȱPbt3HA4 UHN~4 /U]C*(D#KUQmՋ9ľaqߛK\Oԃg; r,}n @V )eSx0WbiI){9)1:"DƑ#=ۇq[ Sڊzj2>#A"? W,eHl GsWzN¹ȒYXcchd5jܙ΃ @36 [+)ؠ3Ic"H,>vU*pk/iu rIS1t' T\gCn-:>'E{Bu܌[K>l5mxE﫛hN年2q{1A<2 ՈaPicyeF.. }BQ"r?sK<J(W0fGN1)(:nvd]]̽peKN)#6qϰק(M. :1Ie?ܬLZM #X@-\jA507bΰɸDJZ8sy,oDνqӍ=r:6 endstream endobj 471 0 obj <> endobj 546 0 obj <> stream application/pdfCalculating Optimal Patient to Nursing Capacity: Comparative Analysis of Traditional and New Methods59619Anna WareTerri BlumkePeter HooverDavid ArreolaJMIR Publications© Anna Ware, Terri Blumke, Peter Hoover, David Arreola. Originally published in JMIR Nursing (https://nursing.jmir.org)This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Nursing, is properly cited. The complete bibliographic information, a link to the original publication on https://nursing.jmir.org/, as well as this copyright and license information must be included.20242023Optimal nurse staffing levels have been shown to impact patients’ prognoses and safety, as well as staff burnout. The predominant method for calculating staffing levels has been patient-to-nurse (P/N) ratios and nursing hours per patient day. However, both methods fall short of addressing the dynamic nature of staffing needs that often fluctuate throughout the day as patients’ clinical status changes and new patients are admitted or discharged from the unit.In this evaluation, the Veterans Affairs Palo Alto Health Care System (VAPAHCS) piloted a new dynamic bed count calculation in an effort to _target optimal staffing levels every hour to provide greater temporal resolution on nurse staffing levels within the Veterans Health Administration.The dynamic bed count uses elements from both the nursing hours per patient day and P/N ratio to calculate current and _target staffing levels, every hour, while balancing across nurse types (registered nurses to nurse assistants) to provide improved temporal insight into staff allocation. The dynamic bed count was compared with traditional P/N ratio methods of calculating patient capacity at the VAPAHCS, to assess optimal patient capacity within their acute care ward from January 1, 2023, through May 25, 2023. Descriptive statistics summarized patient capacity variables across the intensive care unit (ICU), medical-surgical ICU, and 3 acute care units. Student t tests (2-tailed) were used to analyze differences between patient capacity measures.Hourly analysis of patient capacity information displayed how the dynamic bed count provided improved temporal resolution on patient capacity. Comparing the dynamic bed count to the P/N ratio, we found the patient capacity, as determined by the P/N ratio, was, on average, higher than that of the dynamic bed count across VAPAHCS acute care units and the medical-surgical ICU (P<.001). For example, in acute care unit 3C, the average dynamic bed count was 21.6 (SD 4.2) compared with a P/N ratio of 28.6 (SD 3.2). This suggests that calculating patient capacity using P/N ratios alone could lead to units taking on more patients than what the dynamic bed count suggests the unit can optimally handle.As a new patient capacity calculation, the dynamic bed count provided additional details and timely information about clinical staffing levels, patient acuity, and patient turnover. 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