Title : Reducing missed breaks in the ICU: The role of a structured break log
Abstract:
Purpose: The primary goal of this analysis is to evaluate the impact of the Break Log implemented in the MICU. This initiative was designed to improve compliance with break and meal regulations, enhance staff well-being, and ensure proper alignment with labor requirements. By examining pre- and post-implementation data, the report identifies trends, evaluates the effectiveness of the intervention, and provides actionable recommendations to address remaining gaps.
Description: Before the Break Log implementation, the MICU lacked a formal system to track missed meals and breaks, leading to consistently high missed hours. During the pre-implementation period (January 13 to June 14, 2024), the unit recorded an average of 449 missed hours per pay period, peaking at 556 hours in a two-week span. To address this, the Break Log was introduced to create transparency, accountability, and real-time tracking of compliance. Additionally, Break Relief (BR) coverage in AM and PM shifts was monitored to evaluate its role in reducing missed hours. Data collected post-implementation (June 15 to September 6, 2024) highlighted significant improvements, including reduced missed hours and enhanced operational insights.
Evaluation and Implications for Nursing Practice or Patient Outcomes Post-implementation data revealed a 36% reduction in total missed hours, with the lowest period recording 177 hours. Improved AM shift BR coverage directly correlated with this decline, demonstrating the effectiveness of the Break Log in addressing staffing gaps. However, PM shift BR coverage, averaging 88%, indicated persistent challenges that require further adjustments. The Break Log provided a clearer picture of operational inefficiencies, enabling leadership to make targeted interventions. An executive summary of the findings was presented to hospital leadership to collaboratively address gaps, explore strategies to enhance staffing, and improve retention efforts. Through this initiative, the MICU successfully reduced missed hours, fostered a culture of accountability, and laid the groundwork for long-term improvements in staff satisfaction and patient care delivery.