Evaluation
Staffing plans have been influenced by several complex factors of safety which must be maintained when developing a psychiatric-mental healthcare plan for the staff. This inquiry has identified many clinical concerns that are impacted by various staffing issues which are more negative related to the inpatient Behavioral Health Unit as a result of safety and quality issues. However, to determine whether working a twelve- hour shift as opposed to an eight-hour shift impacts patient safety in the Behavioral Health Unit. Further research is needed in this area. It is highly recommended that this transition plan considers change theory and recognize the difficulty associated with change (primarily related to scheduling) and began with
When the nursing team rounds on their patients hourly it is shown to have a relationship with a decrease call light use, falls, pressure ulcers, decrease in patient anxiety and increase in patient satisfaction rates (Ford, 2010). When hourly rounding does not occur on a hospital and patients cannot predict when the nurse will be available for physical and emotional assistance this can lead to patient consequences. When a patient cannot predict when the nurse will be available to assist or discuss can concerns that patient’s has can lead to an increase the patient’s anxiety level (Mitchell, Lavenberg, Trotta, & Umscheid, 2014). When a patient’s anxiety levels rises, the patient will try to compensate with inappropriate coping mechanisms such as, the patient trying to go to the
The focus of this model is for leadership to empower staff members with opportunities, information, support, and resources to facilitate engaged relationships that, in the long run, will facilitate staff in empowering patients by providing opportunities, support, information, and resources to reflect on their well-being. Opportunities being referred to in this model are training opportunities; training trauma-informed care. The model also requires that information be provided to increase understanding that behaviours such as self-harm in patients, can be as a result of a neurobiological response to trauma. In this way, the model follows patient centred care since it looks at the patients’ needs for effective treatment. Information about patient preferences is utilized to come up with a comprehensive list of physical, emotional, and cognitive responses to stress. The list focuses on triggers that can cause stress, calming activities and past experiences with restraint and seclusion. This follows quality improvement competency since patient data analysis enables the staff to come up with a better way to treat them. The model also emphasizes on teamwork by enhancing support. The theme of support refers to a collaboration between the staff and the leadership. Collaboration is achieved in schedule meeting and during shifts. There’s also the need for availability of patient’s
A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours are providing hasty performance with increased possibility of errors.
Human factors are derived from construction and adapted to a system of development in health care by carefully examining the relationship between people, environment, and technology. The consideration of human factors acknowledges the capability or inability to perform a precise task while executing multiple functions at once. Human factors provide an organized method to prevent errors and create exceptional efficiency. Careful attention must be exercised in all levels of care such as the physical, social, and external environment. It is also vital to carefully consider the type of work completed and the quality of performance. Applying human factors to the structure of healthcare can help reduce risks and improve outcomes for patients. This includes physical, behavioral, and cognitive performance which is important to a successful health care system that can prevent errors. A well-designed health care system can anticipate errors before they occur and not after the mistake has been committed. A culture of safety in nursing demands strong leadership that pays attention to variations in workloads, preventing interruptions at work, promotes communication and courtesy for everyone involved. Implementing a structure of human factors will guide research and provide a better understanding of a nurse’s complicated work environment. Nurses today are face challenges that affect patient safety such as heavy workloads, distractions, multiple tasks, and inadequate staffing. Poor communication and failure to comply with proper protocols can also adversely affect patient safety. Understanding human factors can help nurses prevent errors and improve quality of care. In order to standardize care the crew resource management program was
Luis is an athletic and determined young man, who is making the most of his high school career. Transitioning is a challenge for most and for Luis this was compounded by an event that seriously affected his family’s lives. He is a student who has not been dealt the most promising hand, but has adjusted extremely well. Luis has shown consistent and steady growth throughout his high school career. Most importantly he has learned how keep all areas of his life in a balance. The determination that he has shown is to be admired and a model for others. He is a delight to talk with and has a wonderful personality.
My stakeholders include family, the company I work for, coworkers, friends, and the local community. My family and friends expect success from me, just as I will expect success from them. My co-workers expect positive teamwork skills and dependability. I expect my teammates to be just and
As a nurse in a psychiatry emergency room, the staff must collaborate for the safety of patients and staff. There is a triage process that must be followed when a patient comes to the Psych ED, security takes any electronic devices, keys, purses, lighters, knives, wallets, etc. A nurse takes a mini-triage, which determines whether a patient needs to go to the medical ED side, if the patient is cleared to go to the Psych ED, the nurse must then decide whether to place the patient in a locked involuntary area or unlocked voluntary area. Any patient that goes into the involuntary waiting area must be searched, and go into a patient gown. Once there the patient must be seen by a nurse, then by a doctor. If a patient is agitated to the point of
Witkoski Stimpfel, Amy , Douglas M. Sloane, and Linda H. Aiken. "The Loger the shifts for hosital nurses, the higher the levels of burnout and patient disstisfaction." Health Affairs 31.11 (2012): 2501-2509. Proquest. Web. 11 Mar. 2014.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
Health care workers experience adverse effects from occupational stress. This type of stress is detrimental to the workers, patients, and the hospital itself. To respond to this ongoing problem, stress felt by workers should be reported, and treatment should be provided by the hospital. This will help reduce or ultimately eliminate occupational stress by deducing the sources that are causing or contributing to the stress, and by offering treatment options, it will alleviate the burden felt by workers. Hospital policy should enstate a mandatory session where they can discuss signs of occupational stress and the available treatment options. This will go a long way towards creating positive work environments, and interactions. This hospital policy,
Nurse staffing is a complex issue. There are many factors which need to be considered when staffing a nursing unit. Evidence shows an association between Registered Nurses (RNs) having decreased workloads and better patient outcomes, including a decrease in patient mortality (Aiken et al., 2011; Needleman et al, 2011; How Lin, 2013; Patrician et al., 2011; Wiltse-Nicely, Sloane, Aiken, 2013). A small percentage of patients expire during their hospitalization as evidence suggests that a portion of these deaths can be attributed to RN staffing levels (Shekelle, 2013). As the reimbursement system for hospitals today emphasizes quality outcomes, this has an increase in the importance of the nurse’s role in patient care (Frith, Anderson, Tseng, & Fong, 2012). The quality of care is effected when there are higher RN-to-patient ratios. Mortality rates can be decreased by 50% or more when there is a lower RN-to-patient ratio. The morale of nursing staff and the hospital’s reputation are effected when there is a large nurse turnover and poor patient outcomes (Martin, 2015; Knudson, 2013). Having adequate nurse staffing levels saves lives (Martin, 2015). The purpose
Nurse staffing ratio is an ongoing issue in healthcare. For some units, it is a temporary problem until more team members are hired. Unfortunately, for others it is an everyday challenge that must be addressed. Nurse staffing ratio is usually based on number of patients a nurse should be responsible for during a shift. Unfortunately, not having enough staff is a safety concern for both the patients and the nurses. Therefore, addressing this topic should be a priority for nurse managers and leaders. According to Vantage Point (2009) a patient has a greater chance of dying while in the hospital when nurses have to care for more patients than recommended. A heavier workload will not result in
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
The three-month intervention targeted the following areas: improvement of worker health through the involvement of unit managers, implementation of unit-wide safety changes, and worker education. The intervention agenda included three themes: 1) improvement of unit ergonomics and safety, 2) practicing safe patient handling, and 3) enhancing staff physical fitness. Floor safety champions were appointed to guide staff during the implementation of the safe patient handling activities. The program included mentoring sessions with an ergonomic specialist, which focused on increasing awareness of strategies to reduce the risk of injury to the worker and patient. Expanded knowledge, readily available supervisor support, and the improved work environment were associated with reduced worker stress and increased consistency in the implementation of safety techniques among workers (Caspi et al.,
Nurse management in healthcare organizations can be a difficult task due to the many scenarios that must be addressed for the entire system to run smoothly. There are many parts to the system but none more important than the people that work each shift to give quality patient care: nurses and nursing assistants. A major problem for nurse management occurs when the operation runs on short staffing. Inadequate staffing, whether it occurs due to nurse shortages, hiring freezes, or call-outs, can be a difficult hurdle for nurse managers to overcome due to the increased stress occurring in nurses that must perform with a heavy workload. Possible causes for this problem include difficult working conditions and negative attitudes toward the organization--problems that could be caused by short staffing, in turn creating a snowball effect. The problem occurs on a healthcare unit managed by a nurse supervisor who guides nurses (LPN and RN) and certified nursing assistants (CNA) while completing patient care on a shift by shift bases. The problem is happening due to the ability to call out of work using sick time, the inability for managers to fix the cause of a short staffing problem, or the inability of the organization to recruit new employees and retain current employees.