Abstract：
BACKGROUND: Poor patient progression from the progressive care unit (PCU) beds has been recognized as a bottleneck, limiting the hospital\'s ability to optimize capacity for the sickest patients. Improving nurse management on PCU admission and discharge criteria could avoid PCU bottlenecks.
OBJECTIVE: Our institution lacked a standard process to identify clinically appropriate patients ready for transfer out of the PCU, causing delays in vacating PCU beds.
OBJECTIVE: The aim of this study was to determine if creating a standard process to empower bedside nurses and unit nursing leaders to push readiness information to the provider team improves the appropriateness of PCU stay and transfers patients out of the PCU earlier.
METHODS: The most common causes of delayed transfer out of the PCU were discussed among stakeholders. A process was designed to empower the bedside nurses to partner with a physician leader to send information to the provider team requesting evaluation of the patient\'s readiness to leave the unit. The improvement of meeting the criteria for PCU was evaluated by comparing 60 patients prior to the intervention phase with 139 patients during the intervention.
RESULTS: The primary outcome, percentage of patients meeting PCU criteria, was 53% during the audit phase and 68% during the intervention phase (P = .05). The PCU transfer time was pushed 1 hour earlier in the day.
CONCLUSIONS: The standard process of empowering bedside nurses to partner with physician leaders to push readiness for transferring patients out of the PCU resulted in a significant improvement in the percentage of patients meeting PCU criteria and earlier discharge of appropriate patients.
OBJECTIVE: Our institution lacked a standard process to identify clinically appropriate patients ready for transfer out of the PCU, causing delays in vacating PCU beds.
OBJECTIVE: The aim of this study was to determine if creating a standard process to empower bedside nurses and unit nursing leaders to push readiness information to the provider team improves the appropriateness of PCU stay and transfers patients out of the PCU earlier.
METHODS: The most common causes of delayed transfer out of the PCU were discussed among stakeholders. A process was designed to empower the bedside nurses to partner with a physician leader to send information to the provider team requesting evaluation of the patient\'s readiness to leave the unit. The improvement of meeting the criteria for PCU was evaluated by comparing 60 patients prior to the intervention phase with 139 patients during the intervention.
RESULTS: The primary outcome, percentage of patients meeting PCU criteria, was 53% during the audit phase and 68% during the intervention phase (P = .05). The PCU transfer time was pushed 1 hour earlier in the day.
CONCLUSIONS: The standard process of empowering bedside nurses to partner with physician leaders to push readiness for transferring patients out of the PCU resulted in a significant improvement in the percentage of patients meeting PCU criteria and earlier discharge of appropriate patients.
摘要：
背景：渐进式护理单元（PCU）病床的不良患者进展已被认为是瓶颈，限制医院优化病重患者能力的能力。改善PCU入院和出院标准的护士管理可以避免PCU瓶颈。
目的：我们的机构缺乏一个标准的流程来识别临床上适合的患者，准备转移出PCU，造成PCU病床空出延误。
目的：本研究的目的是确定是否创建一个标准流程来授权床边护士和单位护理领导向提供者团队推送准备信息，从而提高PCU停留的适当性，并更早地将患者转移出PCU。
方法：利益相关者讨论了PCU延迟转移的最常见原因。设计了一个流程，授权床边护士与医师领导合作，向提供者团队发送信息，要求评估患者离开病房的准备情况。通过比较干预阶段前的60名患者与干预期间的139名患者来评估满足PCU标准的改善。
结果：主要结果，符合PCU标准的患者百分比，在审计阶段为53%，在干预阶段为68%(P=0.05)。PCU传输时间在当天提前1小时推送。
结论：授权床旁护士与医师领导合作以推动患者从PCU转移的准备工作的标准过程导致满足PCU标准的患者百分比显着提高，并提前出院适当的患者。
目的：我们的机构缺乏一个标准的流程来识别临床上适合的患者，准备转移出PCU，造成PCU病床空出延误。
目的：本研究的目的是确定是否创建一个标准流程来授权床边护士和单位护理领导向提供者团队推送准备信息，从而提高PCU停留的适当性，并更早地将患者转移出PCU。
方法：利益相关者讨论了PCU延迟转移的最常见原因。设计了一个流程，授权床边护士与医师领导合作，向提供者团队发送信息，要求评估患者离开病房的准备情况。通过比较干预阶段前的60名患者与干预期间的139名患者来评估满足PCU标准的改善。
结果：主要结果，符合PCU标准的患者百分比，在审计阶段为53%，在干预阶段为68%(P=0.05)。PCU传输时间在当天提前1小时推送。
结论：授权床旁护士与医师领导合作以推动患者从PCU转移的准备工作的标准过程导致满足PCU标准的患者百分比显着提高，并提前出院适当的患者。
