TY - JOUR

T1 - Statistical power analysis to estimate how many months of data are required to identify PACU staffing to minimize delays in admission from ORs

AU - Epstein, Richard H.

AU - Dexter, Franklin

AU - Traub, Rodney D.

PY - 2002

Y1 - 2002

N2 - When each nurse in the Phase I setting is caring for the maximum number of patients allowed by hospital staffing standards (typically 2 per ASPAN standards), patients may have to be held in the OR until a PACU nurse becomes available. Previously, the authors described a statistical method to determine the process of scheduling existing nurses without increasing staffing hours (Dexter et al. Anesth Analg. 92:947-949, 2001). The end result was to minimize the percentage of future workdays during which at least one patient would wait in his or her OR for Phase I PACU admission. In this study, the authors performed a statistical power analysis to determine how many months of PACU workload data are needed to optimize PACU staffing by using this "set covering" algorithm. One year (232 workdays) of data was available from a PACU employing up to 10 nurses working a total of 72 clinical hours a day. The data were divided into 2 subsets. Using the first subset, which varied in size between 20 and 140 days of data, the authors identified the optimal staffing solutions. These solutions were tested on the second subset of data. This process then was repeated thousands of times. There was a marked improvement in the performance of the staffing solutions at preventing "PACU hold" by increasingfrom 20 to 80 historical workdays of data, a slight but statistically significant improvement between 80 and 100 workdays, but no significant improvement in further increasing the number of workdays of data. PACU nurse managers should use at least 4 months of data when choosing a staffing solution to minimize the chance of patients waiting in ORs for PACU admission. Tampering with PACU staffing more often than every 4 months is unlikely to result in improvements in OR efficiency and may harm recruitment and retention of nursing staff.

AB - When each nurse in the Phase I setting is caring for the maximum number of patients allowed by hospital staffing standards (typically 2 per ASPAN standards), patients may have to be held in the OR until a PACU nurse becomes available. Previously, the authors described a statistical method to determine the process of scheduling existing nurses without increasing staffing hours (Dexter et al. Anesth Analg. 92:947-949, 2001). The end result was to minimize the percentage of future workdays during which at least one patient would wait in his or her OR for Phase I PACU admission. In this study, the authors performed a statistical power analysis to determine how many months of PACU workload data are needed to optimize PACU staffing by using this "set covering" algorithm. One year (232 workdays) of data was available from a PACU employing up to 10 nurses working a total of 72 clinical hours a day. The data were divided into 2 subsets. Using the first subset, which varied in size between 20 and 140 days of data, the authors identified the optimal staffing solutions. These solutions were tested on the second subset of data. This process then was repeated thousands of times. There was a marked improvement in the performance of the staffing solutions at preventing "PACU hold" by increasingfrom 20 to 80 historical workdays of data, a slight but statistically significant improvement between 80 and 100 workdays, but no significant improvement in further increasing the number of workdays of data. PACU nurse managers should use at least 4 months of data when choosing a staffing solution to minimize the chance of patients waiting in ORs for PACU admission. Tampering with PACU staffing more often than every 4 months is unlikely to result in improvements in OR efficiency and may harm recruitment and retention of nursing staff.

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U2 - 10.1053/jpan.2002.31840

DO - 10.1053/jpan.2002.31840

M3 - Article

C2 - 11925580

AN - SCOPUS:0036550672

VL - 17

SP - 84

EP - 88

JO - Journal of Perianesthesia Nursing

JF - Journal of Perianesthesia Nursing

SN - 1089-9472

IS - 2

ER -