...Due to the problem of inadequate nurse staffing levels it has lead hospitals to experience complications in their budgets. This problem all begins with hospitals not making any money because there aren’t enough patients to care for. In the article “How The Nursing Shortage Affects Patient Care and Healthcare Services” provided by Nurse Grid explains how new registered nurse graduates find it difficult to get a full time nursing job due to hospital's budget restrictions. These restrictions don’t allow hospitals to meet their full potential because it prevents them from expanding any type of research that is being done by physicians, considering medical research requires lots of money. Again in Jim Gogek’s article “Inadequate Staffing Harms Quality...
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... 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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...Can Adequate Nurse Staffing Improve Patient Outcomes? Nursing is more than caring for the sick and injured. It is a twenty-four hour inpatient monitoring system. It is well known that nurses spend significantly more time caring for and looking after patients than any other profession. They routinely monitor and report changing patient conditions around the clock that aid physicians in modifying and updating treatment plans to improve health and prevent complications. The level of safety of hospitalized patients and the degree of quality care that they receive has more to do than fixed nurse-to-patient ratios. It has been well established in the literature that when nursing workload increase to unmanageable levels; weather it be from the addition of patients, increases in acuity and/or care complexity, or from high levels of fluctuation in patient turnover, that nurses ability to perform patient surveillance is disordered, putting patients in undue risk (Needleman, et. al, 2011). Furthermore, excessive workloads contribute to burnout and dissatisfaction leading to nurse attrition that further compounds to the staffing problem. Hospitals need to be held accountable for providing safer nurse staffing levels. Payers and purchasers of care should demand compliance, but should also stimulate better quality and patient safety by providing financial incentives. In addition, a more comprehensive, proactive team approach to nurse staffing can help keep patients safer...
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...Examining experiences of WA nurses workload under the NHPPD staffing model. One of onus for practising nurses as highlighted by the ANMC code of ethics (2008) is that “Nurses value quality nursing care for all people”. This becomes significantly harder as several complexity or factors within the health system impedes on nurses ability to efficiently fulfil this role. One of such issues is safe and effective workload or the optimal nurse to patient ratio for providing quality nursing care. As Twigg et al. (2011) noted the implementation of nursing hours per patient day (NHPPD) staffing model in 2002, a landmark event for western Australian public hospitals was a result of nurses taking a stand to combat the unreasonable workload that was being undertaken. With evidence showing, mandated nursing staff levels having a significant impact on health outcomes, implementation of various staffing models to foster quality nursing care and improved patient outcomes in the health care setting has been widely utilised globally (Twigg et al. 2011). With prominent research done by Aiken and colleagues in the US, and with several other studies carried out internationally the gains achieved for patient outcomes through appropriate nursing staffing levels has been thoroughly highlighted. Aiken et al (2002) demonstrates the significant impact low staffing levels has on patient’s mortality rate. The study noted that wards that had the worst staffing ratios saw a 31% increase in death rates. Increases...
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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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...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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...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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...PROVIDING QUALITY CARE Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units Sung-Hyun Cho, Kyung Ja June, Yun Mi Kim, Yong Ae Cho, Cheong Suk Yoo, Sung-Cheol Yun and Young Hee Sung Aim. To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. Background. Nurse staffing has been reported to influence patient and nurse outcomes. Design. A cross-sectional study with a survey conducted August–October 2007. Methods. The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. Results. The average patient-to-nurse ratio was 2Æ8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3Æ26; 95% confidence interval, 1Æ14–9Æ31) or 2Æ0–2Æ5 patients (odds ratio, 2Æ44; 95% confidence interval, 1Æ32–4Æ52), compared...
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...Safe Nurse Staffing and Patient Outcomes Regina Valenzuela Northern Arizona University Abstract Proper nurse staffing has been a debate since the modernization of nursing for many years. This paper examines the results of five researched based articles on the effects of nurse staffing and the outcomes of patient care within a hospital setting. The articles do vary in their methods of gathering information. One study used organizational data from 799 facilitates in eleven states to examine the outcomes of care from the type of nursing care received (Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002). Another study examined the outcomes of care of intensive care patients in 65 hospitals in the United Kingdom (West, Barron, Harrison, Rafferty, Rowan, & Sanderson, 2014). A third study that was reviewed used cross-sectional patient outcome data from a a nationwide project that provided information from 77 Level I and Level II trauma centers (Glance, Dick, Osler, Mukamel, Li., & Stone, 2012). The fourth article was a synthesis of research publications that examined the outcomes and mortality of patients based on specific determinants (Tourangeau, Cranley, & Jeffs, 2006). The fifth article is an investigative report on nurse to patient ratios and nurse work hours associated to patient care (Agency for Healthcare Research and Quality, 2007). The fifth article was also prepared for the United States Department of Health and Human Services based on a survey...
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...Lowering Nurse Staffing Ratios The growing need of more nurses in hospitals is becoming an issue in hospitals all over America. The patient’s safety is being put at risk due to the number of nurse to patient ratios (Welton 1). A low nurse to patient ratio will cause a lack of care for the patients. Nurses will have to take on more patients then they are capable of which will affect the health of the patient and the nurse. John M. Welton, an RN (Registered Nurse), said that “the safety of patients is directly related to the size and experience of the nursing staff” (Welton 1). A high nurse to patient ratio can be on the costly side for the hospitals. “Hospitals will not receive any additional revenue for providing more patient care”...
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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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...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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...mandating minimum nurse to patient ratios. It wasn’t until 2004 that the minimum staffing ratios were implemented. The law was established in an effort to improve patient care and retain nursing staff. Since implementation of this law, California has been able to report improved quality measures along with improved nurse retention rates (Dorning). California has documented improvement in patient outcomes and quality measures since the staffing law went into effect. Assuring a safe environment for patients assures full reimbursement to the organization for their services. California’s report showed significant improvement in the reduction of pressure ulcers, falls, and medication errors to hospitalized...
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...“Every nurse has the opportunity to make a positive impact on the profession through day-to-day advocacy for nurses and the nursing profession” (Tomajan, 2012, abstract). Nurses have the power to make a difference in their work organization by making positive changes. Changing the staffing matrix to staffing based on acuity and reducing the unit department’s acquired pressure ulcers will greatly contribute to patient safety and patient/nurse satisfaction. Goal 1: Leadership Development A major problem of the health care system today is the heavy workload of the hospital nurses. Nurses are experiencing job dissatisfaction and burnout due to three main reasons: increased patient acuity, inadequate nursing staff, and higher workload. Staffing by patient acuity is safer for patients. It decreases the heavy patient workload and eliminate overtime. It will also increase the nurse’s job satisfaction and create better patient outcome. The article “Safe Staffing Saves Lives” mentions, “insufficient nurse staffing has been linked with poor patient outcomes, longer hospital stays and increased risk of patient mortality” (2011, p. 16, para. 2). The article summarized how the American Nurses Association (ANA) introduced the formal legislation that required “hospitals that participate in Medicare to form committees that compromised of at least 55% direct care nurses” (“Safe Staffing Saves Lives,” 2011, p. 16, para. 2). Now the ANA has proposed a guideline to solve the nurse-staffing crisis...
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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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