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Nurse to patient ratio and safety
STAFFING effects on nursing care
STAFFING effects on nursing care
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Inadequate Nurse Staffing and The Effects on Nurses and Patients Cody T. Barger Baker University School of Nursing Inadequate Nurse Staffing and The Effects on Nurses and Patients Job dissatisfaction is four times higher for nurses than the average rate for all workers in the United States, and one in five nurses report that they intend to quit their jobs within a year. (Martin, 2015) The main reason for this job dissatisfaction is that nurse staffing is simply insufficient in almost all healthcare facilities. Inadequate nurse staffing is when the number of patients in a healthcare facility is far higher than the number of nurses, and nurses are not able to provide quality care. This has a negative effect on not only the nurses, but the patients as well. Inadequate nurse staffing leads to an increase in adverse patient events and patient mortality rates that could be avoided with an adequate amount of nurse …show more content…
L., Kim, S., & Hong, O. (2016). The relationships of nurse staffing level and work environment with patient adverse events: Work environment and adverse events. Journal of Nursing Scholarship, 48(1), 74–82. Gordon, S., Bretherton, T., & Buchanan, J. (2008). Safety in numbers nurse-to-patient ratios and the future of health care. Ithaca: ILR Press/Cornell University Press. Retrieved from http://public.eblib.com/choice/publicfullrecord.aspx?p=3138281 Keogh, Kat (2014). Safety guidance is no substitute for mandatory minimum staffing. Nursing Standard, 28(38), 14-16. Martin, C. J. (2015). The effects of nurse staffing on quality of care. Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses, 24(2), Suppl 4–6. Ratios: It’s all about patient safety. (2015). Queensland Nurse, 34(2), 28-29. Shekelle, P. G. (2013). Nurse-patient ratios as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(5 Pt 2), 404–409.
Without participating in a longitudinal study, it is difficult to truly assess the efficacy in mandating nurse staffing ratios. It is difficult to measure the benefits of mandated staffing due to numerous confounding variables. These confounding variables include the resources available at specific hospitals in addition to the populations that they serve. Hospital volume, RN job satisfaction and the relationship between physicians and nurses have also been shown to affect patient outcomes (Duval et al., 2007).
Nursing standards are the building blocks that lead to excellent patient care. The ANA (American Nursing Association) has standardized sixteen common practices for the best quality care of patients by nurses. Nurses are only able to facilitate minimal standards to patients due to time restraints derived from patient ratios and lack of support from administration. The hope to achieve the best possible outcomes in patient care are limited to the minimal standards expected of nurses from the National Council of State Boards of Nursing (ANA, 2010). Patient ratios have been seen as a huge issue across the realm of nurses and health care facilities in deliverance on patient care. Addressing the issue of nursing shortages and the effects on ...
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
As defined by the American of Nurses Association (ANA, 2002), “Nursing-Sensitive Indicators are those indicators that capture care or its outcomes most affected by nursing care.” The ANA uses the National Database of Nursing Quality Indicators (NDNQI) to statistically test the relationships between nursing interventions, staffing levels, and positive patient outcomes (Nursing Quality - NDNQI, 2016). These indicators utilize unit specific data enabling action planning and intervention according to the unit if improvement is needed (Nursing Quality – NDNQI, 2016). The purpose of this paper is to show how Good Samaritan Medical Center’s 5th floor, pavilion 2, Medical Surgical/Oncology unit uses nurse sensitive indicators such as pain management,
Surveys of Canadian frontline nurses, today, show that issues with intense workload, while ensuring safe patient care are the most significant challenges they face at work on a daily basis (Berry & Curry, 2012). Research shows that a heavy nursing workload adversely affects both the patient and nurse. For example, many Registered Nurses (RN) are experiencing ethical distress because they are not able to
...ck, T., Anen, T., & Soto, E. M. (2013). Nurse staffing: The illinois experience. Retrieved from http://www.medscape.com/viewarticle/815065_3
Needleman, J., Buerhaus, P., PKankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse Staffing and Inpateint Hospital Mortality. The New England Journal of Medicine , 364, 1037-1045.
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
In the past two decades, there has been a push for appropriate staff to client ratios. However, measuring client needs and nursing efforts have been around since 1922 (Lewinski-Corwin, 1922, pp. 603-606). The earliest recorded effort was by the New York Academy of Medicine. Superintendents and nurses from ten training schools documented the time spent providing bedside care. From complied information, the researchers revealed each client required an average of five hours and four minutes of care in a 24-hour period. From these observations, they evaluated staffing issues in New York City. At that time, none of the hospitals were sufficiently staffed (Lewinski-Corwin, 1922, pp. 603-606).
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main
Bedside nurses want to change staffing levels to assure that they have enough time to both keep up with the constantly evolving health care and to provide safe patient care. Yet, healthcare employers consider that reducing nurse patient ratio is an unnecessary expense that has not been proven to improve quality of patient care (Unruh, 2008). Employers emphasize that raising nursing staffing level is not cost-effective. In fact, in accordance with ANA’s report (2013), a study, in the Journal of Health Care Finance, confirmed that reducing patient-nurse ratios increased hospital costs, but did not lower their profitability. Higher hospital costs were attributed to wages and benefits allocated to newly hired nurses. Yet, according to Cimiotti et.al (20112), it is more costly for hospitals to not invest money on nursing.
Finally, a more obvious and direct cause of nurse turnover is overall dissatisfaction with the current job. This can be for numerous reasons related to pay, benefits, job growth availability, lack of autonomy, or simply feeling unappreciated. According to one source, “a 2014 survey of more than 3,300 nurses found that they were stressed, overworked, underappreciated, and underutilized” (Fischer, 2016). No matter the reason a nurse chooses to leave their job, the negative outcomes remain the same. The most common of these outcomes are that hospitals lose money, it decreases patient quality of care, and it continues the cycle of more turnover in the nursing profession. “It is predicted that there will be a shortage of nearly 1 million nurses in the United States by 2020” (Hunt, 2009). Hospitals are impacted financially by the high nurse turnover rates. “The financial costs of losing a single nurse has been calculated to equal about twice the nurse’s annual salary” (Hunt, 2009). With these numbers in mind, the hospital spending more money to retain nurses could be a smart and beneficial action for them to