Criteria for 1:1 Tech-to-Patient Ratio

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Criteria for 1:1 Tech-to-Patient Ratio

Postby endymion » Fri Jan 23, 2015 6:36 pm

Hi, everyone. Have been off the forums for a while, but peeking in to ask a question...

What criteria do you use, when deciding whether to make a patient a one-on-one instead of maintaining your usual 2:1 tech-to-patient ratio?

We have some criteria related to whether the patient can ambulate and get in and out of bed on their own, change their own clothing, etc. But have quite a few questions arise about how to handle patients with dementia, psycho-social issues, or communication problems.

What do you do at your facility?
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby stars » Fri Jan 23, 2015 9:45 pm

A.Provider order
B.Patient Special need as total care/ behavior problem/
Age/ or his medical problem requiment a lot attention
C.child 3yo or less
Generally on base your medical director and management position
I think no really standard rules
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby respbarb » Sat Jan 24, 2015 12:28 pm

Basically, I make the decision to determine if the patient should be one on one.
Children under 8
Patients arriving on stretchers and/or wheelchairs that can not stand and require Hoya lift.

We have not experienced patients without physical limitations, but with dementia requiring one on one.
However, we are 6 bed lab and have 3 techs working together. There is always help available for difficult patients.
We will not allow a 3 to 1 ratio.
So we take the hit financially every time we have a one on one
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby endymion » Tue Feb 03, 2015 5:01 pm

Thanks for the input. I have been assessing on a case-by-case basis, but just wanting to know if anyone had any specific criteria. Thanks again!
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby truckerdave1970 » Thu Feb 11, 2016 1:11 am

I understand that there may not be any required or mandated regulations for 1:1 staffing.

But can anyone provide me with a copy of their individual lab policy regarding same? I am looking for a template to forward to the higher management.
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby stars » Thu Feb 11, 2016 2:17 am

This is different from lab to lab
Very much by medical director order
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby MrBig » Thu Feb 11, 2016 2:26 am

Here, the person actually doing the procedures has no say in it. The decision is made by a person that has never done a sleep study.
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby somnonaut » Thu Feb 11, 2016 7:14 am

In our pediatric only lab it is:
< 4th birthday = 1:1
Any age mental or physical issues (MS, CP, Trisomy. etc) necessitating extra hand on = 1:1
Any age treatment = 1:1 (CPAP, vent documentation)
All others > 4th birthday = 2:1

Nomenclature for ease of discussion 1:1= "HIGH", 2:1 = "LOW"

Sometimes a Trisomy falls through the cracks, as well as complex med hx. has also. It is not perfect, but when those responsible use critical judgement it works.

I would like to add a question which has been rumbling around my brain, How do others incentivize their schedulers? Is there a way to do this? Helping to bring down No-Shows or other scheduling issues, such as above. Just keeping the lab full is part of the job, so no incentive should be there, but to try and weed out no-shows or mitigate other debacles such as incorrect understanding of how the whole family cannot sleep over, or siblings to stay, requiring patient go home because no one communicated properly. What is the downside for schedulers to just say they did tell them? Do you have incentives for these staffers?
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby truckerdave1970 » Thu Feb 11, 2016 12:58 pm

I understand that each lab can have their own policy regarding tech ratio. I am trying to locate actual examples of what other labs do so I can present a cohesive argument for the management at our lab to look at and hopefully implement!

Anyone willing to share ANY written policy's? I will of course maintain the strictest confidence! If you would rather not share on a public forum, please feel better to send me a private message!!!
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby stars » Thu Feb 11, 2016 2:28 pm

Just look post above best detail explanation
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby zack » Tue Mar 01, 2016 11:14 pm

somnonaut wrote:In our pediatric only lab it is:
< 4th birthday = 1:1
Any age mental or physical issues (MS, CP, Trisomy. etc) necessitating extra hand on = 1:1
Any age treatment = 1:1 (CPAP, vent documentation)
All others > 4th birthday = 2:1

Nomenclature for ease of discussion 1:1= "HIGH", 2:1 = "LOW"

Sometimes a Trisomy falls through the cracks, as well as complex med hx. has also. It is not perfect, but when those responsible use critical judgement it works.

I would like to add a question which has been rumbling around my brain, How do others incentivize their schedulers? Is there a way to do this? Helping to bring down No-Shows or other scheduling issues, such as above. Just keeping the lab full is part of the job, so no incentive should be there, but to try and weed out no-shows or mitigate other debacles such as incorrect understanding of how the whole family cannot sleep over, or siblings to stay, requiring patient go home because no one communicated properly. What is the downside for schedulers to just say they did tell them? Do you have incentives for these staffers?



All of your PAP studies are 1:1?

Do you also do a lot of APAP titrations in lue of in-lab? Meaning most your in lab titrations are low compliance or significant comorbidities?
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby somnonaut » Wed Mar 02, 2016 1:28 pm

This is a PEDS only lab. PAP is a secondary choice to surgery for treatment of OSA. We have a bi-weekly CPAP Clinic where we have CPAP candidates come for explanation and trial with the doc, a Child-life specialist and myself prior to Titration PSG.
http://www.cornellpediatrics.org/ser_di ... e1=2Active

This CPAP Clinic is also provided to the long term PAP use patients, and we have a very robust and highly compliant population of users of PAP. Just yesterday had a 4yo, 6yo, 9yo and even a Downs 10yo all using and compliant with their CPAP. We even go younger with babies using it. The Clinic is the key. You can't just open the pit that is CPAP and not expect much hand holding in this pediatric population.
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Re: Criteria for 1:1 Tech-to-Patient Ratio

Postby somnonaut » Wed Mar 02, 2016 1:30 pm

Sorry, APAP is NOT used in our center, and I would not assume APAP is capable in the ped population.
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