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Managing workload and timeliness in critical care units depend on the ability of its personnel and processes to be efficient, effective, and accurate. Errors including failure to carry out accurate treatment in critical patients can result in preventable disability and/or death.1 Patient safety is directly affected by the impacts of overwhelming workload among critical care personnel. A safe care environment may be compromised when critical care nurses experience high workload stressors.2 As State and Federal Agencies issue regulations related to mandatory overtime and clinical process measures, evidence is mounting regarding the impact of workload on patient outcomes and errors.
Accurate and timely diagnoses may mean replacing more invasive devices with less invasive devices, thus decreasing the likelihood of complications, including infection.3 This has long been recommended by many clinical intensivist organizations from around the world as a means to improve patient safety and quality outcomes. This is especially true for cardiac conditions in critical and intensive care patients.3
Using point-of-care (POC) diagnostics may improve workload by moving testing from a centralized lab to the bedside, improving diagnosis-to-treatment time and decreasing preanalytical errors.4 This can have positive outcomes, including reducing patient blood draws, decreasing the use of blood volume needed for testing, and faster diagnostic results, allowing for the development of accurate treatment protocols. Another positive outcome using POC diagnostics may be the reduction of potential errors from patient identification that can occur when tests are sent to a centralized lab.5 Performing testing at the bedside reduces patient identification errors.5 These factors alone can have a potential impact on decreasing an overwhelming workload and improving patient safety.
At one health care facility, POC bedside testing has resulted in a 44% reduction in length of stay which decreases the risk of adverse events such as healthcare associated infections (HAIs) and other extended stay complications.6 Facility financial health may also improve as POC testing has been shown to decrease patient care costs in one hospital by 47%.6
Federal and state governments, as well as accreditation and quality organizations continue to create more measures focused on patient outcome, care coordination, and staffing in an effort to improve quality and safety, control costs, and increase accountability. These measures have an impact not only on reimbursement and fiscal health, but also on a facility’s ability to market itself as a viable and safe treatment facility to its communities.
* The results shown here are specific to this health care facility and may differ from those achieved by other institutions.
1. Rothschild et al. The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care*. Critical Care Medicine. August 2005 - Volume 33 - Issue 8 - p 1694-1700.
2. Carayon et al. Workload and Patient Safety Among Critical Care Nurses. Critical Care Nursing Clinics of North America. Volume 19, Issue 2, June 2007, Pages 121-129.
3. Ceconni et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Medicine.
December 2014, Volume 40, Issue 12, pp 1795–1815.
4. Parco et al. Hematology point of care testing and laboratory errors: an example of multidisciplinary management at a children’s hospital in northeast Italy. J Multidiscip Healthc. 2014; 7: 45–50.
5. Alreja. Reducing patient identification errors related to glucose point-of-care testing. J Pathol Inform. 2011; 2: 22.
6. Helping Advance Patient Care at a Busy New York CVICU.
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