PICOT Statement and Research References
Does Continuity of care (I) influence Length of Stay (O) in Diabetes patients who have been hospitalized in a med-surgical unit (P) during inpatient stay (T)?
Population: Hospitalized/ In-patient Medical Surgical Patients
Intervention: The nursing staff role regarding staffing assignments and concept of continuity of care
Comparison: The nursing staff role as a non-consistent or no continuity staffing assignment (staffing varies day to day)
Outcome: When the nurse staffing is maintained at continuous members per patient when available, there will be decreased readmission rates for same diagnosis over a 6-month period of time and an overall decreased need for lengthened inpatient time.
Time: Length of stay, including the 6 months post discharge.
PICOT Question:
Does the inpatient length of stay decrease for those who have access to better continuity of care in staffing assignments versus when the nurse assignment is non-continuous and varied?
Does continuity of care effect the overall readmission rate for same diagnosis readmits within a 6 month time frame?
Batch, M., Barnard, A., & Windsor, C. (2009). Who’s talking? communication and the casual/part-time nurse: A literature review. Contemporary Nurse : A Journal for the Australian Nursing Profession, 33(1), 20-9. Retrieved from https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/203168670?accountid=7374
The rapidly evolving nursing working environment has seen the increased use of flexible non standard employment, including part-time, casual and itinerate workers. Evidence suggests that the nursing workforce has been at the forefront of the flexibility push which has seen the appearance of a dual workforce and marginalization of part-time and casual workers by their full-time peers and managers. The resulting fragmentation has meant that effective communication management has become difficult. Additionally, it is likely that poor organizational communication exacerbated by the increased use of non-standard staff, is a factor underlying current discontent in the nursing industry, and may impact on both recruitment and retention problems as well as patient outcomes. This literature review explores the relationship between the increasing casualisation of the nursing workforce and, among other things, the communication practices of nurses within healthcare organizations.
Fletcher, K. E., Wiest, F. C., Halasyamani, L., Lin, J., Nelson, V., Kaufman, S. R., . . . Schapira, M. (2008). How do hospitalized patients feel about resident work hours, fatigue, and discontinuity of care? Journal of General Internal Medicine, 23(5), 623-8. doi:http://dx.doi.org.lopes.idm.oclc.org/10.1007/s11606-007-0384-0
Patient-centered care requires that physicians understand patients’ perspectives. Since the resident work hour rules were instituted, little information is available about how patients perceive these issues. Our objectives were to explore patients’ knowledge, concerns, and attitudes about resident work hours, fatigue, and continuityof inpatient care and to evaluate the association between patients’ trust and satisfaction with these concerns and attitudes.
We conducted a cross-sectional survey of 134 internal medicine inpatients at 3 institutions including a tertiary care academic health center, a Veterans Affairs medical center, and a private community teaching hospital.
Mean age was 59 (range, 24-90), with 60% men and 70% white. Most patients agreed (50%) or felt neutral (38%) toward resident work hours being limited. Patients estimated that residents worked 60 h per week but thought that they should work no more than 51 h per week (p<.01 for the difference twenty-seven percent ofpatients had some concern about fatigue in residents and reported how often hand-offs of care occurred. factor analysis yielded factors: discontinuity toward resident work hours fatigue. multivariable analyses significantly predicted trust satisfaction also satisfaction. inpatients are concerned both physicians care. this may play a role patients. taking steps to design systems minimize would be ideal. van walraven c. taljaard m. bell etchells e. stiell i. g. zarnke k. forster a. j. prospective cohort study found that provider information continuity was low after patient discharge from hospital. journal clinical epidemiology doi:http: continuityofcare is composed can change value over time. most studies have quantitatively associated outcomes ignored these characteristics. detailed examination ofcontinuityofcare patients discharged hospital simultaneously measured separate components ofcontinuity time or determined factors with which they associated. multicenter community elective emergent hospitalization. all physician visits during months we identified availability ofparticular summary any previous four scores admitting consultant postdischarge two visit were calculated where perfect thousand five hundred fifty-three people followed median days. values: varied extensively few exceptions measures independent each other. influence on between influential being admission urgency service number who regularly treated patient. usually other picot statement research references. future should measure multiple completely capture>
