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Impact of the manager leadership in nursing profession
Annotated bibliography nursing staff ratios
Effective leadership in nursing management
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The nurse manager in today’s health care has a solid role in providing a healthy working environment. Healthy working environment is the basis for safe and better patient outcomes. Healthy working environment in a unit depends on the inspiration, motivation and support from the nurse manager and the management in all the ways. So as a nurse manager in a unit, the change I wish to initiate is the safe staffing patterns. Safe staffing patterns are always important for safe working environments to deliver excellent patient care. Staffing and scheduling means providing an adequate staff mix to meet the needs of the patients (Grohar-Murray & Langan, 2011). Nurse manager should know how to schedule and skill mix to provide adequate staffing and better patient care. Skill mix offers information about the appropriate utilization of nurses in terms of workload shared among RNs, LPNs and NAs (CHIN, 2013).
The rationale for the change
Registered nurses are on the front line in all the hospitals for early detection and prompt intervention when patients' conditions deteriorate. So better patient outcomes depend on the number of skilled staff available to take care of the patients. To decrease staff burnout and improve staff satisfaction, adequate staff ratio is needed. Providing consistency of nursing caregivers may significantly improve both health and economic outcomes (Mefford, 2011). When there is an adequate staffing in the unit, it greatly decreases anxiety on the nurses, patients and the families. Adequate staffing can also greatly improve the patient satisfaction levels as well as the confidence level in their nursing caregivers. By safe staffing ratio, nurses get adequate time to take care of the patients which results in...
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...2013). Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria. Curationis, 36(1), 1-10. doi:10.4102/curaionis.v36i1.115
K., Wong, C. A., Grau, A. L., Read, E. A., & M. (2012). The influence of leadership practices and empowerment on Canadian nurse manager outcomes. Journal Of Nursing Management, 20(7), 877-888. doi:10.1111/j.1365-2834.2011.01307.x
Mefford, L. C., & Alligood, M. R. (2011). Evaluating nurse staffing patterns and neonatal intensive care unit outcomes using Levine's conservation model of nursing. Journal Of Nursing Management, 19(8), 998-1011. doi:10.1111/j.1365-2834.2011.01319.x
Robert wood johnson foundation initiative on the future of nt the institute of mursing, medicine. (2010, February 23). Retrieved from http://www.jointcommission.org/assets/1/18/RWJ_Future_of_Nursing.pdf
This article is a comprehensive look at staffing on hospital units. It used a survey to look at characteristics of how the units were staffed – not just ratio, but the experience and education level of the nurses. It evaluated several different categories of hospital facilities – public versus private, academic medical centers versus HMO-affiliated medical centers, and city versus rural. It is a good source because it shows what some of the staffing levels were before the status quo of the ratio legislation passed in California. It’s main limitation as a source is that it doesn’t supply any information about patient outcomes.
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).
Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, and nursing
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
The authors in this article aimed to discover nurse manager leadership styles and their outcomes. Nurses from hospitals in the Northeastern part of the United States were asked questions. The data was collected in a locked room, alone, so no one would influence the answers of someone else. The results were put into a software program and displayed for analysis. Results showed when choosing a nurse for a managerial leadership role, one should choose someone if they have the basic components of transformational leadership, not transactional leadership. The authors show that transformational leadership had revealed positive patient outcomes, retention, and satisfaction in the nursing staff. Those nurse leaders who have qualities of transformational leadership are encouraged to build on those skills constantly.
Identifying and maintaining the appropriate number of mixed nursing staff, RN/LPN/CNA, is critical to the delivery of quality patient care. Many studies reveal an association between a higher level of experienced RN staffing and lower rates of adverse patient outcomes (“Nurse staffing plans,” 2013). The nurse-patient ratios will in turn improve the nurses working conditions, decreasing the risk of errors to patients.
Zerwekh, J., Claborn, J. (2006). Nursing today: Transitions and trends (pp. 343-346). St. Louis, Missouri:
I am glad that you mentioned safe staffing in your post this week as one way that nurses can help facilitate positive change throughout the community. Not only does safe staffing help to save patient lives it also helps to prevent burnout at the nursing level. According to Peate (2015), nurses face major challenges in order to deliver the best possible care with fewer resources that is not only financial but human as well. This creates an environment of overworked nurses who are more than likely letting their health take a backseat. “Individual nurses are going the extra mile to get the job done, yet the damage to their health is real and is happening nationwide” (Peate, 2015, p. 133). There is one particular vivid memory of an example of short staffing that I personally experienced on my floor and although one of my
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
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.
In spite of the shortage among nurses, there are number of options and recommendations that can better help to maintain an adequate staff level and provide greater strategies needed to increase nursing. The choices open to cover for insufficient staff range from reallocating and postponing work, relocating staff within unit or from other units, to employing temporary additional nurses according to Buchan and Seccombe (1995). In health care, some of these options may not be available because ...
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.
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