UT-Harris County Psychiatric Center

Nursing Procedures

 

Nursing Assignments

Nursing

Harris County Psychiatric Center: Office Administration

The Shift Leader is responsible for assigning nursing staff members to provide nursing care for patients

shift leader, acuity, cross-training, competency

The University of Texas Health Science Center at Houston

 

Date of Last Review: 5/19/08
SME: Associate Director of Nursing

 

Nursing is a highly specialized field.  To ensure quality patient care, nursing assignments should be made based on the knowledge, skills, and experience of each available staff member.

 

Procedure:

 

The Shift Leader is responsible for assigning nursing staff members to provide nursing care for patients.  Nursing responsibilities are assigned to nursing staff in accordance with the following:

 

·  The patient care policies/procedures

·  The complexity of the patient's condition and required nursing care

·  The dynamics of the patient's status

·  The degree of supervision required by each staff member and the availability of that supervision to each person

·  The complexity of the assessment required by the patient

·  The environment and type of technology employed in providing the nursing care

·  Relevant infection control and safety issues

·  Relevant competency assessment

·  Patient acuity

 

Cross-training for older adult patients, child and adolescent patients, early and middle adult patients, and patients with psychiatric emergencies takes into account the particular psychological and physiological needs and problems of these age groups. This prepares hospital staff to effectively care for patients in these developmental periods.

 

All nursing staff must be competent to provide care for any of the patients; thus the staff is cross-trained annually to maintain competency.

 

A Nursing Assignment Sheet will be completed daily on each shift by the shift leader.  The Nurse Manager reviews the 24-hour report and acuity report to ascertain available nursing staff members and to determine the condition/status of each patient.  The Assignment Sheets will be kept for a period of 3 years and will be submitted to the Support Specialist for filing at the end of each month.

 

Shift Leader

 

1.            Assesses patient care nursing needs related to the following:

 

·   Safety

·   Patient status and acuity

·   Patient progress or lack of progress

·   Number of staff

·   Number of special procedures

·   Meetings/staffings scheduled

·   Presence of infection

·   Treatment plans

·   Daily routine

·   Staff skill level

 

2.            Using appropriate assignment sheets and referencing the unit Nursing Department Competency Manual, the shift leader assigns staff responsibility for ongoing assessment of patients and to complete specific nursing tasks as outlined on the Nursing Assignment Sheet.

 

3.            All staff is expected to complete tasks as assigned.  It is not permissible for peers to switch assignment(s).  Failure to complete tasks may result in disciplinary action, up to and including termination.  Changes to assignments must be designated on the assignment sheet by the shift leader.

 

4.            The Shift Leader assigns lunch and break times for each staff member.

 

5.            The Shift Leader assigns a staff member to respond to a Code Blue, Special Team, or Fire Team which may occur during the shift.

 

Related Standards:

 

JCAHO CC 6-6.1, HR 2