I don't believe there are any ratios out there for outpatient settings. There are so many different kinds of outpatient procedures. I would simply start tracking the amount of time from start to finish, and if there is any way to figure out "actual" nursing minutes" on all procedures. Then categorize the different types of infusions, injections, dressing changes, etc and the amount of "average" time it takes. You could include a category to specifiy "increased difficulty" to capture difficult IV starts, etc.
Depending on what you see (antibiotics, wound dressings, PICC dressings, injections, chemo, Remicade, IVIG, transfusions, etc), the patient themselves (in wheelchairs, in diapers, bedbound, etc, etc), and whether the nurse also needs to play "clerk"---answering the phone, scheduling patients, calling MDs for new orders, stamping up the paperwork, ordering supplies, ordering lunches, or drinks, faxing orders to pharmacy, paging the pharmacist, getting infusions delivered, etc, etc, will determine at what point you will need a second nurse.
Even if you start out with only one nurse, there should be some mechanism in place for that nurse to get breaks, lunch, and to call someone in case of an emergency to observe the other patients while he/she takes care of the patient who is doing very poorly.
Also, take into consideration that outpatient is one of the fastest growing areas of healthcare. I'd be prepared to look at a larger space with a combination of infusion chairs, gurneys, and possibly a bed or two. Once you've demonstrated success you'll be surprised at all the kinds of outpatient "procedures" you'll get!! Infusions, transfusions, chemo, long infusions like Remicade, Rituxan, injections, wound care, dressing changes for PICCs, "evals" for fever work ups, catheter-related complications, etc. We do a lot of paracenteses for liver failure. Difficult IV starts for CT and MRI (because we have US). My guess is that you may start with one nurse, but within 2 months you'll need two nurses, and in 6 months 3 nurses or more! You may get a nursing home patient who needs transfusions but is bedbound and needs diaper changes, and meals.
We've had our non-oncology outpatient infusion center for 18 years and we are doing new infusions all the time. We continue to expand. This has got to be happening all over the country. You will need a computerized scheduling system (eventually) so that anyone can schedule a patient in our department (not just the clerk), so that you can schedule patients over multiple days (eg, daily or twice a day antiviral or antibiotic infusions) for weeks. You need a dedicated pharmacist who can help answer questions or get help getting insurance coverage in advance for certain expensive infusions. You will need a billing system and someone to take care of all that as well. Good luck!
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED], [EMAIL PROTECTED]
Subject: nurse/pt ratio infusion
Date: Sun, 22 Oct 2006 19:36:07 -0400
>
>Hello Nancy and Everybody
>
>We have initiated an infusion room for out patient infusions about six months ago.
>This room is open 8-4 M-F with one nurse. Weekend infusions go thru the ER.
> My question: Is there any data, policy/protocol, etc stating how many patients per nurse during infusions?
>We are looking for some type of documentation stating this so that maybe we can get another infusion nurse in the room, any help would be appreciated.
>
>Thanks
>Donna
>
>
