Stocking of essential supplies in an emergency department (ED) is crucial in order to efficiently and effectively take care of patients. When equipment and supplies are not available to patient care providers, an imbalance in the delivery of care is created. The amount of time nurses spend away from the bedside obtaining supplies has only been superficially studied; however, one study proposed that the majority of nurses spend 5 to 20 percent or more of their time during a shift. This results in 30 minutes to two-and-a-half hours of a twelve hour shift being lost to retrieving supplies that are not available.

Cabinets and drawers have recently been eliminated in the rooms and stock is kept in "supply towers" that contain all the necessary supplies to adequately take care of patients with the exception of medications, or stationary supplies. Towers are restocked every morning by a stocking technician by taking the towers to the stock room, resupplying them based on previously established PAR levels, and utilizing a standard chart that describes exactly what supply, and how many to stock within a specified area of the cart.

During their shift, the stocking technician must also respond to pages concerning low stock levels.

Hypothesis:

Nurses spend a significant amount of time away from the patient bedside during their shift looking for supplies.

Objectives:

• Determine the amount of time nurses spend outside of a patient room obtaining supplies to care for the patient.
• Determine what supplies are obtained when the room is left.
• Determine how many times per shift the nurse leaves to obtain the same item.
• Determine if utilizing a "supply tower" located in patient rooms decreases the amount of time nurses spend obtaining supplies outside of a patient room to care for patients.
• Determine if implementation of a full time stocking technician decreases the amount of time that nurses spend outside a patient's room obtaining stock.
• Conduct spot checks on carts to determine if PAR levels are over, under, or exactly as established.

Inclusion Criteria:

• Nurse is an employee of LVHHN, and is working at the CC site.
• Nurse is working a full shift (7a-7p, 7p-7a, 7a-3p, 3p-11p, 11p-7a).
• The nurse being observed is working in Pod 1, Pod 2, Pod 3, or Pod 4 at the CC site.
• The supply needed is related to a procedural task for patient care.

Exclusion Criteria:

• The nurse is working at LVH-M or LVH-17.
• The nurse being observed is working in the express care area or trauma bay.
• The supply being obtained is a supply that is not maintained in the cart (Appendix 2).
• The nurse is scheduled for a shift less than 8 hours.

Participants will include the nurses in the emergency department who will be observed during their shift.

However, the overall study results were published in JONA, vol 44, issue 11, November, 2014.