... The problem/issue chosen is the current issue with staffing of hospitals, nursing homes, medical clinics and specialty clinics, and why some of those problems are occurring. In addition to current issues in staffing, the future needs of nursing staff and what is being done now, and can be done in the future to enhance the quality and quantity of practicing registered nurses. In an article published in 2004 by the Agency for Healthcare Research and Quality, it was stated that “hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections. Major factors contributing to lower staffing levels include the needs of today’s higher acuity patients for more care and a nationwide gap between the number of available positions and the number of registered nurses (RN’s) qualified and willing to fill them” ( www.ahrq.gov, 2004). It is interesting that the same issues that are being faced today were an issue in 2004. “A persistent shortage of nursing staff across the United States challenges the belief and values of the profession. Many nurses find it difficult to carry out their ethical obligations to patients due to the insufficiency in staffing. Because of this shortage, many nurses complain that they experience emotional distress and job dissatisfaction and end up not providing quality care to their patients. As such nurses end up in an ethical dilemma, whereby they must choose...
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...Better Registered Nurse staffing levels have been shown to improve patient outcomes. Currently, there is no federal guideline to help determine the appropriate staffing levels needed for optimal patient outcomes. Significant patient outcomes include readmissions to the hospital after discharge and falls occurring during hospitalization. Staffing requirements vary from hospital to hospital based on whatever design the hospital uses to determine staffing levels. The only current federal regulation to guide nurse staffing states that “The nursing service must have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed”(Legal Information Institute,...
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...------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. ------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. Explanation of the facts, history, legislative regulations, controversial aspects and opinions Explanation of the facts, history, legislative regulations, controversial aspects and opinions MANDATED NURSE PATIENT RATIO How does it affect you and your loved ones? Nurse patient ratio for safe care means when the staffing between the nurses and the patients are safe to provide the care patients need to get well in the hospital or nursing homes. Why is this important? Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown...
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...Qualitative Methodology: Hospital Nurse Staffing and Quality of Care Keli Feathler, RN Grand Canyon University NRS 433v Nora Bazydlo RN MSN October 29, 2011 Introduction Does the issue of nurse staffing have an effect on quality of patient care? This study addresses the topic of nurse staffing, which includes nurses (RN and LPN) and nurse’s aides. Research in Action: Agency for Healthcare Research and Quality (AHRQ) presents the study “Hospital Nurse Staffing and Quality of Care”. Nurse staffing is measured in one of two ways: nursing hours per patient day and nurse to patent ratio (Stanton, 2004). The article looks at periods of high vacancy rates, assesses the patients needs, the development of care plans and administration of medications and treatments in factoring the quality of care. It shows the effect lower staffing levels and its direct link to higher adverse outcome rates. The study of staffing and quality of care is essential, to link the two together, and prove that the issue needs to be addressed in all forums of nursing. The way to making improvements in nurse staffing is to present documentation/research that supports the issue at hand. With factual information, ways to improve the problem can be formed. Higher levels of nurse staffing at all levels showed a 2-25% reduction in adverse patient outcomes. In order to improve the quality and delivery of health care staffing needs to be addressed, and by performing research...
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...Registered Nurse to Patient Ratio LLM Various participants in different states across the nation has lobbied the state legislatures and the United States Congress to proclaim laws that will recuperate the overall working conditions of hospital and clinical staffing. Proposed nurse to patient staffing ratios has become a huge discussion in the healthcare field. It has developed a huge concern that patients and nursing staffs are being harmed related to the inadequate nurse to patient ratio staff. This issue alone has caused an increase in severity of illness, fatigue, hospital stay, and harm to patients. With the increase in complexity of care per patients, nurses grow weary thus increase the negative impact of the inability to improve the quality of hospitalization outcomes for the patients. It is prominent that we identify and maintain the appropriate number of the nurse to patient staffing ratio, as it is critical key of delivering the optimal quality patient care. In the pass few years and even up until now, there has been a massive growth in need for more registered nurses in hospitals and clinics due to the rising acuity of patients and shorter lengths of stay. More and more patients appear looking for healthcare assistance. The safety and quality of the care patients are looking for are becoming difficult to find as registered nurses grow exhausted and drained out of energy. Inpatient working conditions has weakened in various facilities, as hospitals cannot fulfill...
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...Staffing on the Inpatient Psychiatric Unit at the University of Virginia Hospital University of Virginia School of Nursing Margaret Halladay, Lillian McDonough, Chelsea Bateman, Olivia Robison, Elizabeth Whitsett, Hannah Knabe, Janie Rhodes, and Fangzhong Luo On our honor, as UVA students, we have neither given nor received aid on this assignment. Margaret Halladay, Lillian McDonough, Chelsea Bateman, Olivia Robison, Elizabeth Whitsett, Hannah Knabe, Janie Rhodes, and Fangzhong Luo Introduction The nursing students working on 5E, the psychiatric unit at the University of Virginia, identified patient safety as a clinical problem related to inadequate staffing. Previous research revealed that 63% of the staff on this unit identified that inadequate staffing greatly affected patient safety. In order to research this issue further, the nursing students developed a follow-up survey that would help to identify the aspects of patient safety that are most affected. By understanding which aspects of patient safety create an issue on this unit, the group will develop an intervention with increasing safety as the expected outcome. Safety on this unit is difficult to measure because the unit does not face the same problems that staff encounter on Medical Surgical Units. One way to measure safety on 5E is to review the number of patient falls. Data was obtained that revealed in November of 2012, 5E reported the most falls of any unit in the hospital. Other safety markers...
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...TITLE: NURSE STAFFING AND QUALITY SERVICE NAME: COURSE: INSTITUTION: DATE: INTRODUCTION Nurse staffing is the placement of qualified nurses in health facilities so that they can work together with doctors to deliver quality health services to the community. Hospitals with high nurse staffing levels are much likely to have good patient outcomes and satisfaction no matter the patient turn out. Nurse staffing focuses on recruiting and keeping qualified nurses in a hospital so that handling of patients becomes easy and focused on quality service to the public. It enhances the identification of individuals that are most likely to work in certain areas of the health sector and also helps to enhance the diversity of nurses by matching candidates and the communities they will provide health services to. Salary and benefits are the factors that motivate qualified nurses to work consistently in a health facility because with good remuneration, nurses are able to further their education which further improves their profession and level of knowledge in their field of operation (Sales, A. 2015). Low nurse staffing results in higher risks of disease infections particularly the transmittable diseases due to lack of the urgency of treatment because the health facility has less nurses with a high number of patients. Nurse shortage is caused by the lack of enough registered nurses that are allowed to practice, low salary offers, poor training that leads to low confidence of practice, lack of...
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...implement root cause analysis as part of their obligation. The root cause analysis team strives to assess and improve patient outcomes as specific situations occur by forming a team of experts that were involved in the situation. Cases are reviewed and processes are implemented to correct the errors that took place. Four key questions are asked, what happened, why did it happen, what can be changed to prevent it from happening again and how are we going to evaluate the change. This process takes place soon after the event so details are not forgotten. The professionals involved in the root cause analysis would take on roles. The team leader would be a representative from risk management. The nursing supervisor that was working on the day of the event would be the recorder. The team members would include the manager of the emergency department, the RN, LPN, and physician involved with the patient from the emergency department. The advisor would be the chief nursing officer or another member of the executive staff. The first thing is to review the many causative factors that were in place on this particular day. There was inadequate staffing for the emergency department for the number and high acuity of patients that were being treated. There was a hospital protocol for conscious sedation that was not followed. The nurse was ACLS and CPR certified. The patient was not fully monitored for the procedure. This would require Mr. B’s level of consciousness, blood pressure...
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...medications are too high. The American Nurses Association (ANA) has finally teamed up with the Obama Administration to address the epidemic of prescription drug abuse and heroin abuse (ANA supports, 2015). It’s important for us, as nurses, to advocate for our patients and be involved in policies that help patients with drug abuse issues and problems. Interventions need to be taken to make sure there is the right support for these patients. ANA supports efforts to address prescription drug abuse. (2015). Retrieved from http://www.theamericannurse.org/index.php/2015/10/22/ana-supports-efforts-to-address-prescription-drug-abuse/ Great job on your post Larry! Nurse fatigue is a very real and dangerous issue in the healthcare setting. Not only is nurse fatigue negative for the nurse suffering from it, but also for the patients being taken care of by the nurse. Nurse fatigue has a negative impact on the nurse’s physical health as well as his or her's mental health. It's very important for nurses to have the right support and interventions to reduce the risks of getting nurse fatigue. If a nurse has nurse fatigue, this puts the patient in an unsafe condition. Wrong medications, or wrong procedures could be done on the patient due to the nurse being tired. There needs to be some type of policy or protocol set in place to reduce the risk of nurse fatigue. This will improve patient safety and outcomes. Great job on your post Breanna! Inadequate nurse staffing is an issue that seems to...
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...All nurses begin with the strong intention to improve conditions within health care facilities and thus improve the outcomes associated. We often think of this notion as a way of dirty living and unsanitary conditions. This does not only apply to the hygiene concerns but emotional concerns as well. When one walks into a hospital and hands over the responsibility of their livelihood bad safety, their last concern may be that the professional personnel treating them may not be qualified for the job. Structural indicators have one consider not only the demand and need for appropriate staff is adequate but also that the education is up to par for those individuals (Savitz, 2005). Do these professionals hold the degree but not the special certification to preform a specific task or duty? In this scenario, it begs to differ as to why the CNA came to remove the restraints. Was this a direct command from the RN? Is the RN burned out and understaffed causing the CNA to be the only one available to respond to this patients needs? In addition, this CNA is preforming an assessment of a potential skin breakdown/ulcer and furthermore educated the patient's family on the matter. It does not seem clear that the RN assigned to patient is in full communication and authority with the health care team causing delays or misses in identifying and treating a problem. This sheds light on process indicators which include recognition, assessment, and nursing intervention methods (Savitz, 2005)...
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...Staffing Day to Day The American Nursing Association defines staffing as matching the registered nurse expertise with the needs of patients requiring nursing care services. There are many influences and factors that go into determining the staffing level. There are two different ways of staffing: centralized and decentralized. Centralized staffing is when there is one department responsible for all the units, float staff and on-call staff. Decentralized staffing is when unit leaders or charge nurses, managers, or directors determine the level of staff needed before and during the shift. Staffing nurses is typically set in a 24-48hr window, whereas scheduling can be a month out (Mensik, 2014). In addition to the two different ways of staffing, there are three different models that staffing...
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...that many nurses like and expect this schedule, as it is the norm in many institutions (Geiger-Brown & Trinkoff, 2010). No hospital want their nurses to work exhausted, sick and give low quality of care. However, even the hospital that no mandatory overtime they will allow nurses to “self- schedule” in a way that substantially increase fatigue risk or may ask nurses to accept “on call” or mandate overtime to cover open shifts so as not to use expensive supplemental staffing (Geiger-Brown & Trinkoff, 2010). Eventhough, some states regulate the use of mandatory overtime. Some nurses is not aware of it or use the voluntary overtime the same as mandatory overtime. The willingness of nurses to work longer hours is one main concern on how hospital nurse administrators and executives will maintain nurses satisfaction retention and recruitment and patient outcomes while preventing the use of mandatory overtime. Some nurses have misconception that if they refuse to work they are scared to loss the job In united states, not every states have restriction to mandatory overtime because it is a complex issue to be solved. Or we can say the failure of government to pass a law that will help healthcare providers to address the issues of mandatory overtime. According to experts at the National Institute on Occupational Safety and Health, there has been little research into the ways in which overtime by health care providers compromises patient and staff safety. Short Staffing is the reason...
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...HEAD: Nurse-to-Patient Ratios A Literature Review: Nurse-to-Patient Ratios and Their Relationships with Other Variables Since the times when Florence Nightingale took care of patients, there has been a question about what factors affect patient care. One of these factors, nurse-to-patient ratios, has gotten significant publicity over the last several years due to a change in legislation in California. This increase in publicity has sparked many researchers' interest to further evaluate these ratios in connection with patient outcomes and other variables. Through lots of research and analysis there is evidence that a lower nurse-to-patient ratio does reduce the negative patient outcomes in patient care. Some of these outcomes include urinary tract infections, upper gastrointestinal bleeding, shock, pneumonia, failure-to-rescue, and death (Curtin, 2008). Although lowering the ratio does show a decrease in these outcomes, it does not solve all the problems in the nursing profession (“Safety in Numbers,” 2008). The other variables that have a significant relationship with these nurse-to-patient ratios include retention and recruitment of nurses, malpractice, medical errors, and cost. In this review of literature, a direct relationship between nurse-to-patient ratios and other variables should be visible to readers to better understand the issues that are currently identified in nursing in the health care industry. One of the most referenced studies done on nurse-to-patient...
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...Patient Services: An Annotated Bibliography Team Blue: Rolanda Allen, Eric Blake, Ryan Bartholomeo, Patricia Carr, and Chasity Anderson HLT 205 November 26, 2011 A new diabetes monitor is being developed that with communicate with IPods and Android smart phones. The new technology will make it possible to communicate blood sugar readings directly to doctors or family members. The new monitor will help the doctor provide better diabetes management by keeping close track of readings. This monitor would be beneficial for elderly diabetes patients who must have help monitoring their condition. The devise also uses micro needles to eliminate the pain of drawing blood with lancets. The cost of the device is planned to be half of what current constant blood monitors cost. Being able to constantly check blood sugar levels with help type 1 diabetics regulate their insulin throughout the day. This new technology will help diabetics control their diabetes better and allow doctors to manage treatment efficiently so that patients can remain healthy. This article discussed the Department of Defense implementing and/or discussing remote technology and video conferencing in military mental health patients. The intend of applying this technology to military mental patients is too better serve those who live in areas where there are a shortage of mental health providers and all well as for those who would otherwise not receive treatment/care altogether. Psychologists agree that...
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...Agency Nurse Orientation: A Case for Change EBT1-Task 3 Western Governors University A1) Procedure Nationwide there are currently 16,000 certified nursing homes caring for 1.4 million residents (Zhao & Haley, 2011). Due to high nurse turnover rates and persistent staffing shortages, many nursing homes utilize nurse staffing agencies to meet staffing needs. Holliswood Care Center (HCC), a 300 bed nursing home, with five residential floors, located in Hollis, New York is not exempt from such staffing challenges. In fact, according to Yves Pascal, Director of Nursing (DNS) at HCC, “Usually, 2-3 LPN’s per shift are required daily” (Y. Pascal, personal communication, December 15, 2013). Agency nurses are approved to work at HCC once they submit a current physical and complete an in-house facility orientation. During this orientation, agency nurses receive New York State mandated in-services, such as patient abuse and HIPPA. The nurses also receive specific instruction regarding emergency procedures, medication policy, employee conduct and procedures. However, specific unit policies and procedures, location of specific supplies are not included in the general orientation. Upon completion of the orientation, the agency nurse receives no further orientation or precepting. Thus when an agency nurse enters HCC for their first shift they are functioning independently and with limited knowledge. This is clearly a problem, which varies in degree of potential...
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