Access Management Quarterly

Adding admission nurses enhances bed placement

With nursing units swamped in the afternoon with unscheduled admissions, nurses at the Medical University of South Carolina in Charleston were complaining about the arduous database they had to complete on admission of each patient, notes Maureen McDaniel, RN, manager, bed management, in the patient access services department.

"[Nurses] do an initial database for all patients coming through the emergency department [ED] and from the clinics," she explains. "The database has grown in size because there’s an inordinate amount of tracking done now. Nurses were complaining that it takes too long to admit a patient."

That issue was contributing to the general reluctance nurses felt at the idea of quickly turning over beds and bringing more patients — and paperwork — onto the unit, McDaniel says.

"The director of nursing approached me about managing a couple of nurses who would complete the data base," she adds. "The director and I both agreed that patient access was the place for these nurses, since bed placement starts in our shop."

The two admitting nurses are located in the bed control office, and they do hourly checks of the unscheduled admissions.

What was started as a trial, however, with the goal of boosting morale and creating a nurse retention tool, has become much more than that, says McDaniel. "[The admitting nurses] have made a big impression with patients," she notes. "It’s something you can’t measure in dollars and cents, but the customer service piece is remarkable."

In addition to the database duties, McDaniel says, the admitting nurse makes sure the phone works and the patient’s dentures are put away, and explains how the security lockup works. "She is the first person the patient or family member sees."

One admitting nurse works 11 a.m. to 7 p.m.; and the other, noon to 8 p.m., she adds, because unscheduled admissions typically begin after 11.

The day after an admission, McDaniel says, the admitting nurses go back into the computer system to make sure the demographic information for those patients is accurate, comparing the data they gathered with what the registrar has put in.

"They make sure everybody has their advance directives, and if they see anything wrong in the demographics, they take it to the registration staff and change it," she adds. "They also give patients the cafeteria hours, parking information, and a map of the hospital, and leave e-mails for the physical therapist and the nutritionist. "It’s a nice hotel kind of thing."