...The Impact of Shift Work on Nurses The Impact of Shift Work on Nurses The purpose of this paper is to discuss nursing shift work and its impact on nursing staff health and family life. The position of the International Council of Nurses is quoted below. It is their position that shift work is detrimental. Position Statement: “The International Council of Nurses (ICN) recognizes that many nursing services must be accessible on a twenty-four basis, making shift work a necessity. At the same time ICN is very concerned that shift work may have a negative impact on an individual’s health, ability to function, immediate support group and the continuity of care, thus affecting the services provided” (ICN, 2007). The impact of shift work on nurses affects productivity at work. Nursing leaders should also encourage work place cultures that respect nurses’ days off and vacation time, promote nurses’ prompt departure and allow nurses to refuse to work overtime without retribution. Traditional eight hour shifts are becoming a thing of the past, twelve hours days and night shift are the norm providing flexibility and a balance family life. Because of unforeseen circumstances such as nurses calling out, change in patients’ condition, short staff on the schedule which was posted two weeks ago, hence the reason twelve hour shift becomes an unplanned longer shift. According to the article in the Journal of Nursing Law, “Compounding the situation nurses work long shifts and often have...
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...Study Links Long Hours to Increased Errors | Top Abstract Background Method Results Discussion References | Study Links Long Hours to Increased Errors In 2005, the American Nurses Association House of Delegates resolved to disseminate recent research findings on the relationship between work hours, fatigue and errors. Dr. Ann Rogers presented the results of her study “The Working Hours of Hospital Staff Nurses and Patient Safety” published in Health Affairs, July/August 2004. Her study followed 393 registered nurses working over 5,317 shifts. Each nurse tracked hours worked, time of day worked, overtime, days off, sleep/wake patterns, errors and near misses. According to Dr. Rogers, fatigue results in: * Forgetfulness * Slowed reaction time * Diminished decision making * Reduced vigilance * Apathy, lethargy * Impaired communication. Delivery of health care requires higher cognitive functions – judgment, logic, complex decision-making, memory, vigilance, information management and communication skills. Fatigued workers try ineffective solutions to problems and neglect activities deemed non-essential. Sleep research indicates that most people need at 7.5-8 hour of sleep each night. Nurses in the study averaged 6.8 hours of sleep. Long hours, and the impact of competing priorities in personal lives impact getting adequate rest prior to working. In more than half the shifts, nurses were unable to take breaks due to shift demands. ...
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...nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s discretion over and above that specified...
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...Beaumont Hospital Wayne How Does Mandatory or Voluntary Overtime Affect the Quality of Patient Care? Registered Nurses (RNs) constitute an integral part of the patient care and recovery process. To many patients, nurses are the health care professionals they see most often. Additionally, patients seeking care in outpatient clinics may not be aware of the number of hours nurses work. However, short stay and long stay patients see the same nurses over many shifts. What they may not realize is how many hours RNs work in a given 24-hour period to provide continuous patient care. According to Bae (2012a), a 2004 research study found that “43% of U.S. RNs worked more than 40 hours per week and about 9% worked more than 60 hours per week” (p. 205). In most instances RNs work overtime to alleviate staff shortages in their units. According to Bae (2012b), staff shortage in hospitals is not a new phenomenon and many researchers in health care system contend that such chronic shortage of nurses has a direct and negative impact on patient care (Bae, 2010; Bae, 2012b, Bae, Brewer, & Faan, 2012). For example, in several of her research articles, Bae (2010, 2012a, & 2012b) cited several research articles where researchers have found that the long hours worked by RNs are at the root of many adverse patient outcomes. Anecdotal evidence should suggest that anyone working long hours over an extended period of time will experience fatigue and decreased working performance. However, the health...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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...University 12/20/2015 Applying Middle-Range Theory to Solve Fatigue in Nursing For a long period, nursing has been viewed as a profession with great rewards. However, there have been also a lot of challenges and complexities surrounding current health care. Nurses often undergo fatigue in their environment of work. Registered nurses who operate in tertiary care locations often expose themselves to long hours of working, trauma, abuse, and even death, which collectively make them become fatigued both emotionally and physically (Lenz & Pugh, 2003). A review of the literature has proved the importance of education to nurses about risks, and how to fight fatigue. This report discusses, in detail, the Evidence-Based Practice Change Model, and Transpersonal Caring Theory to bring about solutions to the problem of fatigue among nurses. Nurses who find it difficult to adapt to health care environments are the ones who go through many troubles and are often fatigued. Providing care to others for an extended period of time will undoubtedly lead to fatigue if not handled properly. Those who are fatigued may experience symptoms such as nuisances, despair, annoyance, chronic weariness, and little ability to perform sufficiently at work (Lenz & Pugh, 2003). Fatigue is an idiosyncratic involvement that can lead to undesirable implications for the nurse. If the implications of fatigue are overlooked, nurses will not...
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...Critical Appraisal #1 of Scott, Hofmeister, Rogness, and Rogers Article The University of Texas at Arlington College of Nursing Shirley McKenzie-Pace In partial fulfillment of the requirements for N5301 Research in Nursing Susan K. Grove, PhD, RN, ANP-BC, GNP-BC July 12, 2014 Critical Appraisal #1 Theoretical Framework The study framework is not clearly identified; however, a tentative theory is proposed since a tentative theory “has had minimal exposure to critique by the discipline, and has had little testing, (Burns and Grove, 2009). The conceptual framework is limited to the model impaired sleep. The linking of the concept impaired sleep to independent variables of the fatigue countermeasures program for nurses (FCMPN). The FCMPN in this study was “modeled after the National Aeronautics and Space Administration Ames Research Center’s Fatigue Countermeasures Program and the Sleep, Alertness, and Fatigue Education in Residency Program” (Scott et al., 2010, p. 253). The major study concepts include: “sleep deprivation (inadequate sleep), sleep disruption (fragmented sleep), lifestyle situation, and health related issues” (p. 251). There is no map or model of the impaired sleep model purposed by Lee et al., 2004 (as cited in Scott et al., 2010) in the article; however, there is a diagram of the conceptual framework for the FCMPN. Variable Identification and Definitions The research variables that Scott et al. (2010) observed and measured were the FCMPN, sleep...
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...Nurse Staffing Plans & Ratios Background Identifying and maintaining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care. Numerous studies reveal an association between higher levels of experienced RN staffing land lower rates of adverse patient outcomes. 42 Code of Federal Regulations (42CFR 482.23(b) requires hospitals certified to participate in Medicare to "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed". With such nebulous language and the continued failure of Congress to enact a quality nursing care staffing act to date, it is left to the states to ensure that staffing is appropriate to meet patients' needs safely. Massive reductions in nursing budgets have resulted in fewer nurses working longer hours, while caring for sicker patients. In a survey of almost 220,000 RNs from 13,000 nursing units in over 550 hospitals and a response rate of 70%, nurses reported to ANA that: 54% of nurses in adult medical units and emergency rooms do not have sufficient time with patients; overtime has increased during the past year with 43% of all RNs working extra hours because the unit is short staffed or busy; and that inadequate staffing affected unit admissions, transfers and discharges more than 20% of the time. • The benefits of increased RN staffing have been demonstrated. Each additional patient care RN employed...
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...Continuous Accreditation Compliance - Task 4 AFT2 Accreditation Audit October 31st, 2014 Continuous Accreditation Compliance - Task 4 Nightingale Community Hospital (NCH), like many other health care facilities, uses a Periodic Performance Review (PPR) as an assessment tool that assists in examining performance on a consistent basis to ensure compliance with Joint Commission standards. A PPR concentrates attention on procedures, methods, and processes that contribute an environment that provides for proper care and emphasizes patient safety. NCH has shown to be 100% compliant with the majority of standards including: Infection Prevention and Control, Right and Responsibilities to Patients, Human Resources, Transplant Safety, Emergency Management, and Performance Improvement. During the last inspection NCH was found to be non-compliant in the following areas: National Patient Safety Goals, Record of Care, Environment of Care, Nursing, Treatment and Services, Leadership, Life Safety, Provision of Care, and Universal Protocol. Trending Areas of Concern The PPR revealed numerous issues in all areas of NCH. In order to address issues that affect patient safety and accreditation it is necessary to focus on issues that are found to be present in several areas of the facility. These patterns and trends of non-compliance often expose a weakness in policy, procedure, or training that needs to be addressed in order to ensure patient safety and accreditation compliance...
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...A Registered Nurse is a licensed health professional who is responsible for ensuring that the delivery of nursing care is executed using the art of caring and the science of healthcare to focus on quality of life (Office of Professions, n.d.). The role of the Registered Nurse, however, goes well beyond that. They are educated professionals responsible for assisting in management, supervision, and direction of nursing care in accordance with applicable federal, state, and local Department of Health codes and regulations. To be able to perform each of the essential functions of this position, an RN will qualify by graduating from an accredited school of registered nursing and successfully passing the board exam for registered nurse in their state. Generally speaking, an RN must complete an associate’s degree in nursing, a diploma program, or a bachelor’s degree in nursing to qualify for their licensure examination (Fried & Fottler, 2011, p. 32). In New York State, Registered Nurses must renew their license every 3 years and complete 3 contact hours of Infection Control & Barrier Precautions training every 4 years. Upon initial licensing, the RN must also complete 2 contact hours child abuse (New York Board of Nursing State CE Requirements, n.d.). The Registered Nurses employed by my organization are responsible to assess residents and identify their needs with regard to their illness or condition and develop a comprehensive care plan to meet their needs. They are responsible...
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...Nursing Shortage and the Nurse to Patient Ratio Nursing Shortage Issues and the Nurse to Patient Ratio Throughout this paper the focus is going to be on nursing and how it is affected by a growing issue of shortages. The facility where I work has been affected by a nursing shortage; this is why I chose to focus on this topic. I have seen first-hand how everyone throughout the facility is affected by the shortage. I will talk about how the facility has handled the shortage as well as the type of structural organization that the company uses that has helped to keep it afloat. I have formed a null-hypothesis and an alternate hypothesis and formed an opinion based on my research. I hope to adequately inform you of all the issues surrounding the shortages. Since I work in a skilled nursing facility I will make it my main focus. Null Hypothesis: Shortages have not played a role in in-adequate care of others. Alternate Hypothesis: Shortages have played a role in in-adequate care of others. In today’s day and age women now have more career choices; back in the day it was common for women to become nurses, but now they can be just about anything. This affects the nursing field greatly. Not only do more career choices affect the nursing ratio, but an older and aging workforce is also part of the growing shortage. Some internal factors that I have noticed affecting the facility where I work is the pay...
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...discussion of the conceptual framework is limited to the model of impaired sleep. The linking of the concept of impaired sleep to independent variables of the Fatigue countermeasures program for nurses (FCMPN). The major study concepts include: sleep deprivation (inadequate sleep), sleep disruption (fragmented sleep), lifestyle situation, and health related issues. Variables Identification and Definition Independent Variables: Feasibility of an FCMPN intervention for patient and nurse safety Conceptual Definition: “The model of impaired sleep (Lee et al., 2004) guided the intervention for evaluating the feasibility of an FCMPN for improving sleep duration and quality while reducing daytime sleepiness and patient care errors… Performance accomplishment was achieved by ‘educating’ the staff about fatigue, sleep, and circadian rhythms; neurobehavioral and health effects associated with sleep loss or deprivation; and misconceptions about sleepiness” (Scott, et al. 2010, p. 250, 253). Operational Definition: “A one-group pretest-posttest repeated measures approach was used. Participants provided data 2 week before the FCMPN, 4 weeks after receiving the intervention, and again at 3 months after intervention (Scott, et al. 2010, p. 250). Dependent Variables: Fatigue Countermeasures Program for Nurses (FCMPN) Conceptual Definition: The FCMPN is conceptually defined that sleep deprivation and sleep disruption can lead to sleep loss and poor sleep quality as shown in Figure 1 (Scott, et...
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...------------------------------------------------- Top of Form Edit your favorites Cancel Bottom of Form « ‹ › » /22 × 1 comment Comments 1 - 1 of 1 comment previous next * Al Balushiya at The Government, 1 year ago Yes No nice ------------------------------------------------- Top of Form Embed Video Subscribe to comments Post Comment Bottom of Form ------------------------------------------------- Top of Form Edit your comment Cancel Bottom of Form Speaker Notes on slide 1 stress in nursing - Presentation Transcript 1. REDUCING STRESS IN NURSING BY: Khai Ho & Josh Saleeby 2. POSTER PRESENTATION: * TOPIC: Reducing Stress in Nursing * SAMPLING POPULATION: hospital base nurses * SAMPLING METHOD: Convenience sampling (research other related works, survey, and questionnaire) * ASSESSMENT TOOLS: 3. SA MPLING METHOD...
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...Organizational Change Plan III Christian Malone HCS/587-Creating Change within Organizations February 12, 2011 Dr. Margaret Walker Organizational Change Plan III Employees may be one of the hardest stakeholders to agree to change. “Employees resist because they believe the management is mishandling the process” (Bert Spector, 2010, p.). The individuals suffering from the unfair scheduling are ready for this change. They have expressed their unhappiness, and have even limited their availability, making it difficult to have enough staff on hand. By repeatedly emphasizing the importance of employee cooperation and fair scheduling, individuals will believe in the system, and continue to become better so business can remain successful. A work schedule is made to benefit the needs of the business first, and the employee second. A flexible employee allows the company to make schedule changes at the last minute or even pull a double shift if a co-worker calls out. The employees that are not flexible make it difficult to make a schedule to benefit the needs of the business, and he or she is not able to work extra hours. A rotating schedule is the solution to an unfair work schedule. One option a manger has is a rotating schedule, and this will allow each individual to work his or her promised hours. By doing this, he or she does not have to work the same days each week, gives the individual more time to spend with the family or just attend to their personal needs. The advantage...
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...Issues Affecting Nurse Retention and Nursing Leadership in the United States Today Registered nurses (RNs) make up the largest group of healthcare professionals in the United States today (Bureau of Labor Statistics, U.S. Department of Labor, 2015). While the nursing profession is listed among the top occupations exhibiting job growth, nursing shortages have escalated, causing significant problems for the industry (Bureau of Labor Statistics, U.S. Department of Labor, 2015). Nurse turnover and nurse retention are concurrent causatives in this issue at hand. Turnover is defined as, “the number of persons hired within a period to replace those leaving or dropped from a workforce” (Merriam-Webster, 2017). Retention is defined as, “the act of...
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