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Table 3 Type and examples of planned QI actions as formulated during outreach visits and the number of QI plans (n = 13) in which they appeared

From: A multifaceted feedback strategy alone does not improve the adherence to organizational guideline-based standards: a cluster randomized trial in intensive care

Type of action Bed occupancy Nurse-to-patient ratio
Understanding low or high variation in performance 12 11
Verifying unusually high or low occupancy rates in specific shifts Develop standard registration procedure for combined intensive care—recovery nursing shiftsa
Investigate low performance 9 8
Investigate effect of daily operating-room schedule on bed occupancy rate Investigate the number of student-nurses in shifts with a ratio below the lower thresholdb
Adjust (process of) resource planning 2 4
Introduce labeling of the “best patient” in each shift who could be discharged in case of an emergency admission Take on additional part-time nurses or share nursing capacity with medium care to increase nursing team’s versatility
  1. aSome hospitals had combined ICU-recovery nursing shifts, which may interfere with the registration of nurse-to-patient ratio
  2. bStudent-nurses are not taken into account for the nurse-to-patient ratio