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Nurse to patient ratio and clinical safety essay
Importance of adequate staffing for nurses
Nurse to patient ratio and patient outcomes
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Staffing issues amongst the nursing profession has been a major concern. Safety of both nurse and patient is important. There is a strong correlation between having an adequate nursing staff and patient safety outcomes. The rise in the acuity of patients and shorter hospital stays has been linked to errors, nurse burnout, and patients sometimes feeling neglected. Patient satisfaction has become the major focus point since the change of our health care system today. Being able to find an optimal nurse- to- patient ratio has been an ongoing struggle in mostly all health care facilities. This paper will answer the PICO question, how is quality of care and patient safety affected in regards to nursing staffing and nurse patient ratios?
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Sometimes there is success in doing this but not always. When staffing is low it can have a negative impact on the staff because of the acuity of the patients that are on these units. In this case the turnover rate in this facility is low. The problem arises when a nurse is out on vacation or is unable to work on a certain day of the week. The question was asked, can more full time nurses be hired? The answer was no because each nurse manager in the hospital have to stay within a certain budget. There can be a limited amount of FTE reported for each unit. According to Tzeng 2013, simply reporting the nursing personnel FTE numbers is not sufficient to capture the nurse staffing profile of a hospital or a specialty area. The numbers in data is not what is actual represented in …show more content…
It is a daily struggle that nurses have to go through. It take away from the individualized can that patients deserved. Nurse have to learn how to do the tasks in a fast paced manner in order to care for their patients. If the patient have a high acuity and high in ratio it can be difficult and dangerous for nurses to handle safely. There should be a way for nurses to effectively deal with this issue that just keep on growing. Nurses should step outside of the box and start to do more lobbying in the government instead of others who know nothing about the profession of nursing. Our voices need to be heard because we are advocating of the safety of all human beings that are in our care when they are ill. Patient safety should always be the key factor in aiding to make them better. Reimbursement from health insurance companies is indeed important, but how important will it be if the patient is harmed during time of care. According to Needleman as mentioned above staffing does matter and is very important in achieving patient satisfaction. This should not be neglected in order for a facility to try and cut back on hiring more people to get the job done right. Neglect in this area could affect reimbursements
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).
Over the past years, there has been a nursing shortage which has led to the need of more registered nurses in the hospital setting. This is the result of higher acuity of patient care and a decrease in their length of hospital stay. In order for the patients to get safe and quality care, the staffing, education and experience of the nursing staff needs to be made a priority. Because of the lack of nurses, patient quality of care has suffered.
What causes the problem? The problem is caused by finances. Hospitals claim they face declining reimbursements, and have chosen to cut nursing staff to lower their expenses. Has anyone tried to do anything about it? If so, why haven’t they succeeded?
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.
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”.
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.
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.
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
Patients Safety is the most crucial about healthcare sector around the world. It is defined as ‘the prevention of patients harm’ (Kohn et al. 2000). Even thou patient safety is shared among organization members, Nurses play a key role, as they are liable for direct and continuous patients care. Nurses should be capable of recognizing the risk of patients and address it to the other multi disciplinary on time.
Ethical climate moral distress, and trust worthiness are some of the few challenges that nurses face. According to Filipova, her researched proved that there is a direct correlation between ethical standards and their climate, by stating that “ethical climate has been associated with ethical behavior, developing knowledge about ethical climate in nursing facilities takes on a critical role (Filipova, 2009, para. 574)”. Climate plays a huge role in ethics because as a society we tend to form relationship with coworkers. Filipova supported this theory by utilizing Van Maaren and Bradley in her research that provided two explanations about common perception and similar attitudes (Filipova, 2009, p. 576). “Task interdependence, reporting relationship, proximity, design of offices, and shared equipment or facilities all bring certain members of an organization into contact with one another and could be regarded as possible contributors to the formation of subcultures (Filipova, 2009, para. 576)”.
Many people believe that nurses are overworked and it is true. Nurses that are overwork is no just in the United States but in serval other countries as well. They problem has been going on for several years and many wonder if there is any solution to fix it. OIverworked is defined as exhausted with too much work. Throughout the paper is a few reason that nurses are overworked.