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Nurse to patient ratios and patient outcomes
Abstract on nursing shortage
Nurse to patient ratios and patient outcomes
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Are Nursing Shortages Linked to Patients Quality of Care? 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”. The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu... ... middle of paper ... ...os are associated with significantly lower mortality. When nurses’ workloads were in line with California-mandated ratios in all three states, nurses’ burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care (Aiken, Sloane & Cimiotti, 2012). In order for optimal patient care to be achieved nurses need to be inspired by their work and feel supported by the health care staff. Both patients and nurses deserve to be given the attention and support they need to thrive. The patient to nurse ratio in California is already being addressed and this is a movement that needs to extend worldwide. It is imperative that health care professionals as a whole are being heard and supported. Patients depend on their health care providers and nurses are the backbone of patient care thus acknowledging their needs should always be top priority.
Nurses have long been known for their attention to patient care. The reason many nurses have entered this profession is due to their desire to care for people. The overwhelming responsibilities of documentation, chart reviews, verifying orders and medications, monitoring lab results, among others, leaves the direct care of the patient to another, possibly unqualified, staff member. Bolton, Gassert, and Cipriano (2008) estimate that a mere 23-30% of a nurse’s day is spent providing care to a patient. This leaves the greater part of a 12-hour shift performing some kind of paperwork. In fact, the inability to provide more patient care has been cited as a reason many nurses leave their job, and the profession altogether (Bolton et al., 2008).
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 ...
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
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.
Since the 1990’s, the interest in nursing and the profession as a whole has decreased dramatically and is still expected to do so over the next 10-15 years according to some researchers. With this nursing shortage, many factors are affected. Organizations have to face challenges of low staffing, higher costs for resources, recruiting and reserving of registered nurses, among liability issues as well. Some of the main issues arising from this nurse shortage are the impact of quality and continuity of care, organizational costs, the effect it has on nursing staff, and etc. However, this not only affects an organization and community, but affects the nurses the same. Nurses are becoming overwhelmed and are questioning the quality of care that each patient deserves. This shortage is not an issue that is to be taken lightly. The repercussions that are faced by both nurses and the organization are critical. Therefore, state funding should be implemented to private hospitals in order to resolve the shortage of nurses. State funds will therefore, relieve the overwhelming burdens on the staff, provide a safe and stress free environment for the patient, and allow appropriate funds needed to keep the facility and organization operational.
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
The California Department of Health set a criterion that was unit specific, and provided mandated ratios for each unit. Some examples include that an ICU nurse should have a nurse-patient ratio of 2:1, Psychiatry 6:1, Telemetry 5:1 and Medical-surgical units 5:1. According to the research study “Implications of the California Nurse Staffing Mandate for Other States” by Aiken, L, “29 percent of nurses in California experienced high burnout, compared with 34 percent of nurses in New Jersey and 36 percent of nurses in Pennsylvania, states without minimum staffing ratios during the period of research. The study also found that 20 percent of nurses in California reported dissatisfaction with their jobs, compared with 26 percent and 29 percent in New Jersey and Pennsylvania” (2010) Aiken found that about 74% of California staff nurses thought the quality of care of their patients have improved significantly as a result of the mandated staffing
The health care system of today will be invaluable without the help of well-trained registered professional nurses. According to Wilkinson, Treas, Barnett, Smith (2016) registered nurses in today’s health care have the training required to develop a care plan with other health care workers that is specific for each patient in their care, instead of the same general approach for every patient. This is known as patient centered care because each patient is different from the other and the registered nurse role includes developing a good plan for every patient they care for. In performing such duties, registered nurses tend to create a strong bond with their patients by caring for their patients by all means possible. By caring for their patients, they tend to gain their patients and their families trust. According to Wilkinson et al. (2016) There are many support systems for patients in our communities that have good intentions of assisting sick people and those in need. Most of them are not known by the patient or their families. The registered nurse is the one who is in the position to inform the patient or family about such resources that may be very helpful for them if they are interested. By doing so, the patient knows that the nurse really cares about him/her and that feels very comforting and may help the patient get well
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
The field of nursing provides one the opportunity to make a difference in the lives of others. Nurses interact directly with patients at times of hardship, vulnerability, and loss. The nursing profession has been around for decades. Due to the contribution from historical leaders in nursing, the nurse’s role has progressed over time. Although the roles of nurses have evolved throughout the years, one thing has remained the same: the purpose in giving the best patient care.
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.
Nurses are responsible for the quality of the care that is provided. However, an inadequate nurse to patient ratio can damper the quality of care a nurse is able to provide if he or she has a bigger patient load than they should. The student nurse believes that adequate staffing is key to providing quality care and nurse retention. Inadequate staffing creates a safety issue for patients and drives more nurses to burnout. In her opinion, the student nurse feels that the best method of staffing is to look at the patient census and staff according to the ratio of nurse to patient. The student nurse’s feels that adequate staffing is accomplished when the nurse to patient ratio is low enough that nurses do not feel overwhelmed with their workload
Nurses know that there is a correlation between maintaining adequate staffing levels and safe patient outcomes. Nurse to patient ratios is a very complicated issue in the health care industry. Nursing shortages, higher patient acuities, shorter hospital stays, and the cost of health care has presented a challenge to this staffing issue. An inadequate staff ratio puts patients at an increased risk of adverse outcomes such as medical or medication errors, increased hospital acquired infections, and increased mortality rates ("Nurse," n.d.). The complications and adverse outcomes associated with the inadequate staffing levels come at a cost, which is an even larger financial burden on the health care industry related to the cost of treating infections or law suits from wrongful death situations.
Feedback from my fellow nurse colleagues helped me notice what I should expand on and clear up for future nursing development. This informal presentation serves as an important informative topic for nursing and how nurses can be a better and reliable care provider. The three nurses have had similar experiences as I have had as a registered nurse in multiple situations of patient care. They understand the health care system and constant research on how to improve health for the patients, so that nurses can learn and educate themselves to incorporate their studies. Three nurse colleagues included are Silvestre Rodriquez, Maria Ramirez, and Tiffany Muñoz, who have the same amount of experience as I have as a registered nurse.
...leman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse-Staffing Levels and the Quality of Care in Hospitals. New England Journal of Medicine, 346(22), 1715-1722. Retrieved from EBSCOhost