...Safe Staffing McConnell- 2 Safe Staffing Affects Everyone Abstract: Safe staffing is a vital component of quality nursing care. However, oftentimes units in healthcare facilities across the nation lack the personnel that give the units the number of human resources needed to provide safe and sufficient care. A variety of people are affected by unsafe staffing: the actual nurses and ancillary staff, as well as stakeholders such as administrators, government and legislative bodies, and last but not least, the tax payer. The adverse effects of short staffing and the future impending nursing shortage are discussed, along with specific actions that have been taken, and are in the process of implementing, to ensure safe staffing and positive patient outcomes for all states across the United States. Keywords: Safe staffing, nurses, patients, healthcare, problem, nursing shortage Safe Staffing: It Affects Everyone: An Introduction Safe staffing is an essential and vital component of quality care. However, safe nurse to patient ratios are often not met in today's healthcare environment. This paper will describe what safe staffing ratios are, the problems associated with the lack of safe staffing ratios, what some states have enacted to ensure safe staffing, and what the the state of New York is currently projecting to ensure safe staffing is a reality for the future. Safe Staffing McConnell 3 Safe Staffing: A Breakdown: Basically, a healthcare unit, be it a floor...
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...“systematic approach to understanding the causes of an adverse event and identifying system flaws that can be corrected to prevent the error from happening again” (Huber & Ogrinc, 2010). The root cause analysis is used to determine why the problem occurred in the first place and to identify the cause of a problem using a specific set of steps (Mind Tools, n.d.). The RCA team which consists of interprofessionals who are knowledgeable of the issues and processes related to the incident and the people who are involved in the incident should be formed first before the RCA meeting takes place (Huber & Ogrinc, 2010). In the given scenario, the team includes the emergency department (ED) physician (Dr.T), the RN (Nurse J), the LPN (Mr.B’s LPN), the risk manager, the ER nurse manager, the ER nurse educator, and the quality improvement professional. These members would meet and would discuss the causative factors, errors and hazards that caused Mr.B’s sentinel event. The root cause analysis process has five steps. The first step in conducting a RCA is defining the problem (Mind Tools, n.d.). In the given scenario, the problem is the unexpected death of Mr.B. The second step is collecting the data (Mind Tools, n.d.). It is very important to record and report the data as accurately and as completely as possible. Mr. B’s vital signs, pain scores, laboratory values, and history of medication administered during the situation must be collected. Mr. B is a 67 year old patient who was admitted at 3:30...
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...administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (O'Shea 1999). The patient is expected to receive the correct medication at each drug round but several studies have shown that this is not always the case (Raju et al 1988, Ferner 1995). Medication errors do occur and are a persistent problem associated with nursing practice (O'Shea 1999). The aim of this paper is to answer the question: Why are nurses still continuing to make drug errors? In order to answer this question this paper shall examine the guidelines that nurses must adhere to when administering drugs, shall provide a definition of a drug errors, look at reasons why drug errors occur and approaches that are aimed at reducing drug errors on the ward. There are a number of pieces of legislation that relate to prescribing, supply, storage and administration. It is essential that nurses comply with them (NMC 2003). The 1968 Medicines Act was the first comprehensive legislation on medicines in the United Kingdom. The act provides the legal framework for the manufacture...
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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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...Abstract Patient safety and Medical errors are one of the major concerns of healthcare industry. Our group decided to throw more light on the present situation of this issue. In this paper we have given a clear picture about the types of errors, how these errors occur and towards the end we have discussed on how to prevent these errors. The implementation of the actions to prevent errors discussed in our paper will help in improving and reducing them. In doing so, we can be leaders in an effort to provide the best care possible to all Americans. We have also discussed about the importance of patient safety. Reducing errors and improving how we respond to error is but a subset of the all-important issue of quality of care. TABLE OF CONTENTS Introduction ……………………………………………………………………………... 5 Regulatory Authority……………………………………………………………………. 5 Patient safety ……………………………………………………………………………. 6 Medical Errors ………………………………………………………………………….. 7 Why medical errors occur? .............................................................................................. 8 When errors are not reported ………………………………………………………….. 8 Types of Medical Errors ………………………………………………………………… 9 Sentinel Events ……………………………………………………………………….. 9 Diagnosis or evaluation ………………………………………………………………. 9 Medical decision-making …………………………………………………………… 10 Treatment and medication …………………………………….…………………..… 10 Dispensing ……………………………………………………………………………11 Procedural complications...
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...Medicare, Medicaid, and the acute hospitals themselves. No longer do we see in the United States two week long acute hospital stays after major surgeries, strokes or other injuries that affect the activities of daily living (ADL). The hospitals discharge patients back home much sooner than before or transfer them to facilities for further recovery. Unfortunately some of these facilities are long term acute care hospitals or nursing homes where continuing daily therapy is very limited. The fortunate ones get admitted to a specialty hospital called a rehabilitation (rehab) hospital that this paper will focus on. Here, nurses, occupational therapists, physical therapists, speech therapists, case managers, dieticians, and physicians work all closely together to see the best results of recovery and to achieve this goal before the patient is ready to return home at the optimum level of wellness. As a nurse working in a rehabilitation hospital I see this multidisciplinary approach to regain a patient’s strength on a daily...
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...43% chance of spending some time in a nursing home (Kemper and Murtaugh, 1991) and about 24 % of these individuals will spend less than a year in residence at a nursing home (CDC, 2012). The key employees of the nursing home that have the most interaction and greatest impact with the residents of nursing homes are the registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). For several years the shortage and turnover rate of nursing home staff has long been a serious problem for multiple nursing homes nationwide (Pillemer, et al., 2008). Providing effective and safe quality care in nursing homes requires clinically and interpersonally competent staff. Research findings suggest that inadequate supervisory, managerial, and human resource practices within nursing homes contribute to poor outcomes, including high nursing staff turnover, lower employee satisfaction, and poor clinical outcomes (Anderson, et al 2003). When a staff member leaves an organization, the knowledge, skill and experience that the person has brought to, and gained at, the organization is lost. Although high rates of nursing home staffing shortages and...
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...prospective students can choose between different kinds of educational programs for nursing. Nursing education has developed into three main types of fundamental programs: Diploma, Associate of Science Degree in Nursing (ADN) and Baccalaureate of Science Degree in Nursing (BSN). According to the National Council of State Boards of Nursing (2010) all nursing programs must be approved for graduates to take the National Council Licensure Examination (NCLEX). As stated by The American Association of Colleges of Nursing [AACN] (2012) “The NCLEX tests for minimum technical competency for safe entry into basic nursing practice” (AACN, 2012). In compliance with imposed state regulation, all nursing programs provide the essential training for performing the duties required as a registered nurse. This paper will discuss the differences in competencies and decision-making skills of the registered nurse (RN) dependent upon their educational preparation. The main distinction amongst Diploma, ADN and BSN programs has been duration of study. The nursing diploma curriculums are the eldest type of nursing education that exists in the country. “Diploma programs are typically 2 to 3 years in length” (Creasia & Reid, 2011, p. 24). It is based in a hospital and exists outside typical universities. “Diploma nursing programs currently provide a solid foundation in...
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...Christine Mueller, PhD, RN, FAAN, and Amy Vogelsmeier, PhD, RN The obligation to provide safe, quality care creates challenges and concerns when registered nurses (RNs) delegate duties to unlicensed assistive personnel. These challenges and concerns are magnified in today’s health care environment of shrinking resources; patients with complex, chronic conditions; health care settings with high patient acuity rates; and the use of sophisticated technology. To make safe, effective delegation decisions, RNs must understand the responsibility, authority, and accountability related to delegation. Delegation decisions must be based on the fundamental principle of public protection. This article describes effective delegation by presenting the factors affecting delegation, explaining when and what an RN can delegate, and describing the delegation process. Learning Objectives ⦁ ⦁ ⦁ Identify three factors that affect delegation. Discuss what registered nurses can and cannot delegate. Explain the steps of the delegation process. N ursing’s Social Policy Statement (American Nurses Association [ANA], 2010), the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001), and individual state nurse practice acts (NPAs) underscore the responsibility, authority, and accountability of registered nurses (RNs) for their nursing practice. The RN’s obligation to provide safe, quality care creates distinct challenges when delegating care to unlicensed assistive...
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...Vulnerable Population in the Workplace Theresa Didion University of Phoenix The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability. The first goal of this paper is the examination of the vulnerable population of the mentally ill. Second, this paper will review the goals and agenda of Healthy People 2020 as it applies to mental illness. Third, this paper will review my work place assessment for barriers for the care and treatment of mentally ill patients. Finally, this paper will review a short presentation I gave to co-workers in an effort to aid in better treatment for the mentally ill. Recent figures suggest that in 2004, approximately 1 in 4 adults in the United States had had a mental health disorder in the past year, most commonly anxiety or depression ("Healthy People 2020 ", n.d.).. It is estimated that only about 17% of U.S. adults are considered to be in a state of optimal mental health ("Healthy People 2020 ", n.d.). An estimated 26% of Americans age 18 and older are living with a mental health disorder in any given year, and 46% will have a mental health disorder over the course of their lifetime ("Healthy People 2020 ", n.d.). Mental health disorders often have a serious impact on physical health and are associated with the prevalence, progression, and outcome of some of today’s most pressing chronic diseases including diabetes, heart disease, and cancer. Mental...
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...The Future of Nurse Leadership A paper submitted in partial fulfillment of the course MHST/NURS 604 Leadership Roles in Health XXXXX February 28, 2013 Abstract Canada’s healthcare environment faces dynamics of change and elements of uncertainly. However, change and uncertainty need not be met with prospects of a dismal future. The framework of healthcare faces distinct challenges, potentially providing the opportunity for nurse leadership to provide a pathway for the future. One concern is the capacity to prepare the next generation of nurse leaders, both formal and informal, to become effective leaders, contributing to the future health of the workplace. This study is an analysis pertaining to the development of future nurse leaders. The analysis seeks to uncover the challenges of developing nurse leaders, and the necessary requirements for the next generation of leaders within healthcare. The findings suggest that the development of nursing leadership is vital in relation to healthy workplace environments, and quality patient care. Furthermore, a new paradigm and set of competencies necessary to lead nursing into the future. Keywords: leadership, nursing, development...
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...Management in a Magnet Hospital The purpose of this paper is to compare and contrast traditional hospital management and the current magnet model hospital. According to Margaret McClure, a professor at New York University and president of American Nurses Association, Magnet Credential program has developed as a result of a collection of nursing leaders discussing nursing shortages, thirty years ago in the 1980’s. The term Magnet Hospital is used in reference to the particular certification and standard of nursing practice that has been established by the American Nurses Credentialing Center (ANCC). The ANCC, is a division of the American Nurses Association (ANA) and is delegated with the task of advocating for excellence in nursing care around the world. ANCC’s credentialing acknowledges and endorses specialized nursing certification in the individual nurse while promoting a safe and positive working hospital culture, (Summers, S. & Summers, H.J., 2015). Magnet status, at its core, encourages and supports leadership that has a goal of creating change while building strength, and honoring exceptional professional practice as well gaining knowledge through empirical study. Established on the premise of 14 forces of Magnetism nursing was assessed in 163 hospitals according to this criteria. The task was to determine the factors that produce a climate that appealed to and retained experienced and knowledgeable registered Nurses who provided quality nursing care, (Yoder-Wise...
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...Health Care Management Issues | March 29 2013 | Medical errors and the quality problems to which they lead harm millions of Americans each year. If the errors reduce and improve quality substantially professionals must create systems and care processes that anticipate inevitable human errors and either prevent them or compensate for them before they cause harm. National surveys of registered nurses, physicians, and hospital executives document considerable concern about the U.S. nurse shortage. There were also many areas of divergent opinion within and among these groups, including the impact of the shortage on safety and early detection of patient complications. Healthcare providers need quick access to patient medical information whenever and wherever patients present for care. A system to standardize electronic medical records, such as the National health Information Infrastructure, would provide quick access to patient information. | HEALTH CARE | Health Care Management Issues There is now a robust evidence base in the quality improvement literature on process and outcomes, but structure has received considerably less attention. The health care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinates of process change and quality improvement. Solutions to the health care management issues dealing with the quality of care should be discuss with the following key...
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...Learning Healthcare Organizations MHA601: Principles of Health Care Administration (NBA1407A) Instructor: March 17, 2014 Week 5 Assignment: Learning Healthcare Organizations Transformational change is a radical shift in culture for the healthcare industry. It is an organizational wide, new way to strategize and update old theories and skills that are less reliable than the old processes and systems that were used in the past. The new changes are meant to be rolled out over a period of time because it is associated with the restructuring of an organization and it relies on collaboration of all its employees. It is about interdependence and working relationships within the organization for a collective purpose. Organizational learning in the healthcare industry is of particular interest to many organizations that are concerned with making transformational changes because it is viewed as a source of competitive advantage, it recognizes the link between improved patient outcomes, and it is a way to stay relevant in unpredictable markets. One of the key features of this new type of approach in building a learning organization is the focus on teamwork. Management may be redefining these changes within their own organizations in a way that stays consistent with the learning organizational theory. There are many challenges in the design of such change because it is hard to find working examples in place and leaders must understand this in order to guide, and influence such transformations...
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...Elder Abuse in Residential Care Facilities Elder abuse is a catch all term referring to any deliberate or negligent act by a care giver or any other individual that results in harm or a major risk of harm to a vulnerable adult over the age of 60 years (Stefanacci & Haimowitz, 2013, p. 68). Under the umbrella definition for elder abuse, more specific types of abuse can be identified such physical abuse, sexual abuse, emotional abuse, exploitation, neglect and abandonment (Stefanacci & Haimowitz, 2013, p. 68). The physical abuse refers to the infliction, or threat to inflict, physical harm onto an elderly individual or the deprivation of their basic needs. Sexual abuse is defined as any form of nonconsensual sexual contact. Exploitation refers to the illegal misuse, theft, or concealment of an elderly individual’s funds, assets, or property. Neglect is the failure or refusal of a formal or informal caregiver to supply the vulnerable elder in their care with shelter, food, health care, or protection. Abandonment refers to the desertion of the vulnerable elder by either a legal custodian or anyone who has assumed responsibility for their care (Stefanacci & Haimowitz, 2013, p. 68). Residential care facilities (RCFs) have a multitude of different names across the Unites States but are most commonly referred to as assisted living facilities (ALFs), adult congregate living facilities, domiciliary care homes, and shelter care homes. Since the mid 1990’s, RCFs have made up one...
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