• Michelle Hill and Jessica DeWitt.
• Questions or comments about this article may be directed to Michelle Hill, MS RN AGCNS-BC CNRN CCRN SCRN, at michelle.hill@ohiohealth.com. She is Stroke Program Coordinator, Riverside Methodist Hospital, Columbus, OH. Jessica DeWitt, BSN RN, is Neuroscience Outcomes Manager, Riverside Methodist Hospital, Columbus, OH.
• J Neurosci Nurs. 2018 Oct 1; 50 (5): 268-272.

ObjectiveTo enhance nursing staff retention and ensure a consistently high standard of care, a study was conducted to determine an appropriate nurse staffing model for a neurocritical care unit. In addition to being critically ill, these patients often require extensive diagnostic testing to determine treatment. Nurses traveling with patients leave higher nurse-patient ratios remaining on the unit.MethodsProspective observation was used to assess relationships between neurologic assessment, documentation, and the amount of time spent traveling with patients. Patient acuity and nursing experience were also measured.ResultsOver the 30-day study period, more than 226 hours were spent traveling, equivalent to approximately 38% of a single nurse's shift. There was no correlation between the experience of nurses and the time necessary to perform a neurologic assessment. When controlling for acuity, a relationship was found between nursing experience and the time needed to chart an assessment.ConclusionsSignificant time was spent every day off the floor, in addition to the documentation and performance of frequent assessments. These results advocate for a staffing position without a dedicated patient assignment but to assist with traveling and high-acuity patients so that safe and attentive care can be consistently given.

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