Transformation of observation unit to address higher acuity patients and increase bed capacity during a Covid-19 surge

Abstract

A Magnet^®-designated acute care community hospital in Southeast Texas experienced a COVID-19 surge during the summer of 2020 that increased the acuity of admitted patients. The critical care, intermediate care, and COVID-19 units were consistently at capacity. These beds were no longer considered an available resource, but their need continued to grow. As hospital acuity increased, patients were placed in medical or surgical (medsurg) units when historically they may have been placed in a critical care unit. Hospital leadership determined that more space was needed to cohort COVID-19 patients, specifically those on high-flow oxygen. Given the decrease in observation status patients, an existing observation unit was converted into a high-flow oxygen unit using team nursing and personal protective equipment (PPE) zones. The successful transformation of the observation unit provided a guide on the cohorting of patients and team nursing approach for any future disease surges.