RESUMEN
BACKGROUND: Education opportunities for night shift nurses are limited compared with those for their day-shift counterparts. However, patients remain critically ill regardless of shift and require intensive nursing care at all hours. Overnight, this care is often provided with fewer resources. These challenges can lead to disengagement and high turnover on the night shift. OBJECTIVES: To see whether initiation of an informal education series called "Coffee Talk" could improve accessibility to learning for night shift nurses and elevate perception of support from administrators and overall job satisfaction. METHODS: The lecture series was created to facilitate education for night shift nurses. The program features various speakers within the interdisciplinary team discussing topics chosen by the nursing staff. The talks are presented in an informal setting during overnight hours. An electronic survey tool was used to determine nurses' opinions regarding Coffee Talk, using a retrospective pretest and posttest format. Questions centered on the type of educational offerings, relevance to practice, perceived leadership support, convenience of attendance, and overall job satisfaction. RESULTS: More than half of the nurses (59%) responded. All scores improved from before to after the intervention. The largest increases occurred in convenience of educational offerings and nurses' perception of leaders removing barriers to learning. Overall job satisfaction increased from 83% to 93%. CONCLUSIONS: The introduction of an informal educational series improved nurses' access to education and nurses' feelings of support from administrators and overall job satisfaction.
Asunto(s)
Enfermería de Cuidados Críticos/educación , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/educación , Horario de Trabajo por Turnos , HumanosRESUMEN
INTRODUCTION: We hypothesized that a nocturnist advanced practice provider (APP) model compared with overnight neurocritical care coverage with general critical care physicians and neurology residents would provide similar patient outcomes, as measured by patient mortality. METHODS: This study is a retrospective review of healthcare outcomes of aneurysmal subarachnoid hemorrhage (aSAH) patients from 2013 and 2016, after implementation of specialty-trained neurocritical care nocturnist APPs. In 2013, overnight hours were covered by the general intensive care unit team and a junior neurology resident. In 2016, these patients were cared for by APPs overnight. The primary outcome measured was comparison of mortality before and after this change of overnight coverage because the daytime coverage remained similar between years. RESULTS: In 2013, 58 patients were admitted to the neurocritical care unit with aSAH. In 2016, 19 aSAH patients were admitted to the neurocritical care unit. The mean modified Fisher grade was 3.36 in 2013, with 14 of 58 deaths (mortality rate, 24%). In 2016, the mean modified Fisher grade was 3.4. Three patients died (mortality rate, 15.7%). CONCLUSION: The active nocturnist APP model was associated with an approximately 10% reduction in SAH mortality (P = .54). This supports the hypothesis that APPs can provide noninferior care as the previous model. Further studies are needed to demonstrate the effects of both nocturnist and APP-driven models.