Implementing an admission-discharge nurse program to improve patient and nurse outcomes

Abstract Purpose: This study assessed the impact of implementing an admission discharge registered nurse (RN-AD) on five inpatient units at an acute care, 718-bed Magnet ® -designated, academic, and Level I trauma center on throughput pressures, nurse staffing ratios, and increased workload. Method: To assess the impact of implementing RN-ADs, the authors conducted a nonequivalent pre/post quasi-experimental study utilizing electronic health record data (discharge time, admission date, discharge date) and standardized patient experience survey scores. Predata were collected from August 2016 to July 2017, and postdata were collected from August 2017 to July 2018. Results: Of the 19 114 patient encounters examined, length of stay decreased, discharge before noon increased, and patient experience scores increased; nurses also noted a positive impact on patient discharge. Conclusion: Implementation of an RN-AD role was associated with improvements in length of stay, earlier discharge timing, patient experience, and nurse satisfaction. These findings suggest that dedicated admission and discharge nurse support may be an effective workforce strategy to improve patient flow while reducing the operational burden on bedside nurses.