The Impact of a Unit Clerk on Nurse Effectiveness in A Texas Long Term Care Facility




Ransom, Sandy

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Funding was provided by the Institute for Quality Improvement in Long Term Health Care for placement of a ward clerk at a busy nursing unit in a Texas nursing home. The purpose of funding the study was to establish a demonstration study to determine if the placement of the ward clerk would effectively reduce the amount of time the charge nurse was required to allocate to various forms of paperwork. Staff/resident ratios are frequently below optimum in Texas nursing homes. Nursing task time dedicated to compliance with corporate, state, and federal regulations is time that detracts, appreciably, from resident care. Detailed logs kept of nursing activities prior to placement of the ward clerk and after six months of the clerk's employment were compared for differences in utilization of time for the charge nurse. Types and frequencies of resident incidents were compared for the six-month time periods before and after the ward clerk was hired. Comparison of figures revealed that the charge nurse was actually able to spend 62% more time with the residents and 60% more time involved with staff supervision than previously. A decrease in 28.6% of charting time was realized, as well as a 42% reduction in the amount of time the charge nurse was involved with phone calls. An overall reduction of 48.5% of total incidents was achieved during the period of time under study.



eldercare, staff to resident ratio, quality of life, Texas nursing homes, Long Term Care Administration


Institute for Quality Improvement in Long Term Health Care. (1996). The impact of a unit clerk on nurse effectiveness in a Texas long term care facility. (IQILTHC Series Report 96-2).


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