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Why nursing advocacy is important
Does patient nurse ratio affect patient outcome
Nurse ratios and patient outcomes
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Recommended: Why nursing advocacy is important
Overview
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.
A nurse's code of ethics calls for the principle of beneficence, which is defined as preventing harm and promoting good (Burkhardt & Nathaniel, 2007). Above all, nurses are patient advocates. Finding a solution to the issue of safe nurse to patient ratios is the ultimate example of patient advocacy. The health care industry must maintain patient safety as the number one goal in health care. This goal must be attained in a quality and cost effective manner. Health care facilities, administrators, and staff must learn to collaborate with one another to acquire a solution to this problem.
Angle
This research paper will explore alternative methods of implementing nurse to patient ratios without decreasing crucial staffing levels and without additional government regulations while maintaining safe quality health care.
Providing safe quality health care is expensive. Health care facilities are always in search of ways to trim spending wh...
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...ical Care Nurse, 31(6), 55-65. Retrieved from http://ccn.aacnjournals.org/content/31/6/55.full.pdf
Nurse staffing. (n.d.). Retrieved from http://www.nursingworld.org/nursestaffing
Scott, II, R. D. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf
Warye, K., & Granato, J. (2009, January). Target: zero hospital-acquired infections [Feature story]. Healthcare Financial Management, 86-91. Retrieved from http://www.apic.org/Resource_/TinyMceFileManager/Advocacy-PDFs/HFMJan2009WaryeandGranatoTargetZeroHospitalAcquiredInfections.pdf
Welton, J. M. (2007, September). Mandatory hospital nurse to patient staffing ratios: Time to take a different approach. Online Journal of Issues in Nursing, 12(3). http://dx.doi.org/10.3912/OJIN.Vol12No03Man01
This article is skeptical of mandated nursing ratios, and discusses some outside factors that may be biasing the other studies I plan to cite. This article's strengths are that is from a peer-reviewed journal and written by a recognized expert, which makes it a credible source. Rather than simply supporting or opposing mandated maximum ratios, it introduces the idea that the other ratio studies may have missed some important considerations. The main drawback to this source is that it's a short article and doesn't go into a lot of detail. I may have to end up using other sources to supplement the ideas it proposes.
The problem, as defined for my argument research paper, is that to cut costs, hospitals have been steadily increasing the number of patients nurses must care for. In many areas it's not uncommon for one nurse to have to assess, give medications to, and manage the care of as many as 12 patients. This puts tremendous strain on nurses. Many of the studies I have seen in my research indicate that a high ration of patients to nurses increases the rate of death or other poor outcomes for patients. It also leads to increased nurse burnout and higher turnover, though at this point I believe my paper will focus on patient outcomes.
Needleman, J., Buerhaus, P., Pankratz, S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. England Journal of Medicine, Retrieved from http://www.nejm.org/doi/full/10.1056/nejmsa1001025
Nursetraveler. (1999). The original bill that put staffing ratios in place! Retrieved September 10, 2011, from http://nursetraveler.org
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 ...
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
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.
Safe nurse-patient ratio is a complex issue debated on for many years. Due to inadequate staffing registered Nurses are faced with high patient ratios, and nurse burn out everyday. According to the American Nurses Association, “Massive Reductions in nursing budgets combined with, the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside”. (2012) Through the nursing process, the essential role of the Registered Nurse is to assess, diagnose, and plan based on outcomes, implement and evaluate the effectiveness of nursing care. However, it is not realistic to thoroughly implement these core guidelines in a safe and effective way, when you are
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.
...f infections acquired during the hospital. Many of these studies have indicated that these infection control interventions will decrease the number of sick or dying patients related to hospital acquired infections and lower the medical cost by decreasing the stay of each patient in the hospital.
The purpose of his article was to find a better way to prevent healthcare-associated infections (HCAI) and explain what could be done to make healthcare facilities safer. The main problem that Cole presented was a combination of crowded hospitals that are understaffed with bed management problems and inadequate isolation facilities, which should not be happening in this day and age (Cole, 2011). He explained the “safety culture properties” (Cole, 2011) that are associated with preventing infection in healthcare; these include justness, leadership, teamwork, evidence based practice, communication, patient centeredness, and learning. If a healthcare facility is not honest about their work and does not work together, the patient is much more likely to get injured or sick while in the