...Introduction 12-Hour shifts have constantly been an argument in the field of nursing. This topic interests me because there is constant jitter around this topic in the nursing field, about whether these shifts are safe, or not. This can be taken into view from the patients view and also the nurses. Many people would support a side that nurses working these long 12-hour shifts could lead to accidents in the working environment. There are also people who would argue that these shifts benefit the patient/nurse relationship, and is more beneficial because there is only three shifts per week. Nurses should not be allowed to work 12-hour shifts because, the physical and emotional impact on their bodies is too debilitating, and the length of the...
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...the American Nurses Association House of Delegates resolved to disseminate recent research findings on the relationship between work hours, fatigue and errors. Dr. Ann Rogers presented the results of her study “The Working Hours of Hospital Staff Nurses and Patient Safety” published in Health Affairs, July/August 2004. Her study followed 393 registered nurses working over 5,317 shifts. Each nurse tracked hours worked, time of day worked, overtime, days off, sleep/wake patterns, errors and near misses. According to Dr. Rogers, fatigue results in: * Forgetfulness * Slowed reaction time * Diminished decision making * Reduced vigilance * Apathy, lethargy * Impaired communication. Delivery of health care requires higher cognitive functions – judgment, logic, complex decision-making, memory, vigilance, information management and communication skills. Fatigued workers try ineffective solutions to problems and neglect activities deemed non-essential. Sleep research indicates that most people need at 7.5-8 hour of sleep each night. Nurses in the study averaged 6.8 hours of sleep. Long hours, and the impact of competing priorities in personal lives impact getting adequate rest prior to working. In more than half the shifts, nurses were unable to take breaks due to shift demands. Findings included correlation among work duration, overtime, number of hours worked and reported errors and near errors. Regardless of the scheduled shift length, overtime...
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...Many nurses prefer 12-hour shifts, but what is it doing to their bodies? Dall’Ora, Ball, Recio-Saucedo and Griffiths (2016) studied the association of nurses’ shift characteristics with sickness absence. It has been believed that the hours of nurses’ shifts can affect nurses’ wellbeing (Dall’Ora et al, 2016). Dall’Ora et al (2016) mentioned that previous studies have relied on self-reported data and that shift characteristics and how they impact nurses’ health and wellbeing have never been studied before now. This purpose of this study was to investigate the association of shift work characteristics in acute hospitals and nurses’ sickness absence (Dall’Ora et al, 2016). Dall’Ora et al (2016) used the sickness absence as an indicator of wellbeing....
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...events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s discretion over and above that specified for a full-time employee. Both of these...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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...for a culture of always. Journal of Nursing Care Quality, 29(4), 371-378. A2. Graphic Background Information | The purpose of this article was to identify patient perceptions of bedside handover through directly asking patients about their care. The study was done on a two in-patient medical-surgical departments at Borgess Medical Center in Michigan. They had implemented bedside handoff at shift change 18 months prior to this study. Then a sample of patient participants was chosen from the two nursing departments for the study. They had to meet certain criteria to be a participant and they had to experience three handoffs. Then they were given a survey to fill out after the beside handovers. Participants were positive about the RN bedside handoff process. The overall mean from the survey was 3.32 on a scale of 1 (strongly disagree) to a 4 (highly agree). | Review of Literature | There were multiple references that provided statistics and facts during this study. Most of these studies have focused on implementing bedside handoffs and nurse perceptions of the handoff. Published studies that focused on patients’ perceptions of beside handoff have been mainly qualitative. Recently, researchers have published studies that seek to measure bedside handover quantitatively. Whether qualitative or quantitative, all studies report an increase in patient satisfaction with bedside handover. | Methodology | This quantitative study was to identify patients’...
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...How Does Mandatory or Voluntary Overtime Affect the Quality of Patient Care? Pam Glasper Beaumont Hospital Wayne How Does Mandatory or Voluntary Overtime Affect the Quality of Patient Care? Registered Nurses (RNs) constitute an integral part of the patient care and recovery process. To many patients, nurses are the health care professionals they see most often. Additionally, patients seeking care in outpatient clinics may not be aware of the number of hours nurses work. However, short stay and long stay patients see the same nurses over many shifts. What they may not realize is how many hours RNs work in a given 24-hour period to provide continuous patient care. According to Bae (2012a), a 2004 research study found that “43% of U.S. RNs worked more than 40 hours per week and about 9% worked more than 60 hours per week” (p. 205). In most instances RNs work overtime to alleviate staff shortages in their units. According to Bae (2012b), staff shortage in hospitals is not a new phenomenon and many researchers in health care system contend that such chronic shortage of nurses has a direct and negative impact on patient care (Bae, 2010; Bae, 2012b, Bae, Brewer, & Faan, 2012). For example, in several of her research articles, Bae (2010, 2012a, & 2012b) cited several research articles where researchers have found that the long hours worked by RNs are at the root of many adverse patient outcomes. Anecdotal evidence should suggest that anyone working long hours over an extended...
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...Health Services Finance Recruiting and Retaining Nurses Health Services Finance HS543ON June 16, 2011 ISSUE/BACKGROUND With quickly changing demographics, new technologies, limits on resources and public expectations the health care arena is constantly changing at a quick pace (Nowicki, p. 338). The Bureau of Labor statistics reported in April 2011 that despite the recent economic downturn and high unemployment health care is continuing to grow. It was estimated that approximately thirty seven thousand jobs were added in March 2011 alone (AACN). The staffing of registered nurses has been a long time concern due to the fact the shortage greatly affects patient safety as well as quality of care (nysna.org). Studies have shown that adverse patient outcomes have been related to the ineffective nurse staffing as patients have had longer hospital stays, increased infections, and higher mortality rates (Needleman, et al, 2002). To relieve the pressures put on an organization with the shortage many have begun to substitute people who are not as prepared to care for patients. This has been done by hiring temporary nursing services or recruiting foreign nurses who are not familiar with the facility, policies and procedures or the patients ( nysna.org). The ineffective nurse staffing also leads to retaining issues as nurses experience decreased morale, increased stress and anxiety, increased physical ailments, and burnout. DEFINE THE PROBLEM The problem...
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...IMPACT OF NURSE SHORTAGE ON HOSPITAL‐BASED PATIENT CARE AND NURSES 1 Literature Review Nursing shortage is acknowledged nationwide as a problem in the health care sector that has generated a body of research by various scholars. A review of the existing literature was done using EBSCO Host and Cochrane data bases with the goal of exploring the nature of nursing shortages in hospitals and other health care facilities. The search keywords include nursing shortage, stress, work environment, job satisfaction, economic crisis and hospitals, and quality of patient care. The body of literature reviewed indicated that nursing shortage impacts on the quality of patients’ care, as well as the nurses who feel the direct impact of these shortages. A major research gap in the body of literature was found to be the failure to examine the role of the poor economic conditions that all sectors are being faced with, including the health care sector, in exacerbating the nursing shortages since 2008, which is worsening by the day. Framework This review of literature on nursing shortage was done within the frame work of the general theory of nursing, which explains the purpose of nursing as that of assisting patients to achieve their highest possible level of physical, mental/emotional and spiritual well being. Simply put, the nursing theory is about facilitating healing. But the reality is that some nurses, in no small percentage, are working in conditions that do not lend credence to this...
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...Shift work sleep disorder. Today's American society functions in the environment of a 24/7 economy. This situation is certainly welcomed by employers and consumers, but what about workers who are required to work outside of the regular 8-5 schedule? What is the impact of shift work on the individual’s health, and especially sleep? Research evidence suggests that shift workers are at a higher risk for developing a wide range of diseases, including cardiovascular disease, obesity, diabetes, gastrointestinal problems, and sleep disturbances. In addition, sleep disorders in shift workers pose a serious risk to public health and safety because they impair an individual’s ability to perform effectively, and may result in occupational and traffic accidents. Employees, who work night shift on a regular or rotating basis, are at risk of developing shift work sleep disorder (SWSD) (Keller, 2009). SWSD belongs to the group of circadian rhythm sleep disorders. Circadian rhythms are the natural internal body mechanisms that regulate body wake/sleep cycle. When circadian rhythms are disturbed the person may experience warning signs of SWSD. The two main symptoms of SWSD are excessive sleepiness at night, during working hours, and insomnia during daytime sleeping hours. SWSD is widely undiagnosed and undertreated in the medical community. The diagnosis usually based on the patient’s history alone, when sleep disturbances cannot be explained by any medical problem, medication, or substance...
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...systematic review of nurses’ inter-shift handoff reports in acute care hospitals” 2013 Outline: A) Introduction. B) Article Analysis. C) Conclusion. Thesis: The present paper provides the analysis of the systematic review “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010). The influence of this review on clinical practice is discussed. The article “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010) provides the systematic review of the handoff reports between and among the nurses which ensure the quality exchange of information for the improved health care service. The continuity of care is the major concern for nurses, and the procedure of patient care transfer should take that into account. The objective of the review was stated clearly and mentioned the appraisal and synthesis of the qualitative evidence related to the nursing handoff report. Moreover, the authors aimed at recommending the improvements which would facilitate and enhance the information transfer. by reviewing the qualitative studies which dealt with the real experience of nurses with their inter-shift handoff reports. As the authors admit, this is likely to contribute to the improvement of the patient care. The conclusion on the potential impact of the article on clinical...
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...By the year 2020, it is predicted that there will be a 20% shortage of nurses in hospitals in the United States (Punnakitikashem 1). Short staffing in nursing has been a recurring problem since 1998 (Buerhaus et al. 854). With a constantly growing population comes an increasing number of newborns and elders that demand care from nurses around the world (Punnakitikashem vi). This constant demand places a heightened stress upon nurses in hospitals. Because a shortage is present in the United States, nurses are faced with an excessive workload and the demand from patients cannot be met with complete satisfaction. Research shows this conflict leads to a decreased quality of care given to patients in hospitals. Also, it creates a higher chance of...
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...doctrine. Corporate negligence is the failure to provide the equipment, facilities, and staff to carry out the duties of the corporation in accordance with the established standard of conduct (Showalter, 2007). Corporate negligence is evident in this case in regard to the failure to ensure that sufficient healthcare personnel were available to provide the established standard of care to the patients in the facility. Moreover, the personnel that were required to remain at the hospital from the day shift were likely not performing at their peak after already working their own shift; which could result in errors in patient care. The nurse managers should have been proactive and had a plan in place in the event of severe weather such as forming a team of healthcare personnel who were willing to come to work at the beginning of the storm and stay until they could be relieved. This team should consist of a variety of personnel in sufficient numbers to allow for some personnel to rest while others work. Ultimately, it is the responsibility of the hospital to ensure proper personnel coverage regardless of the circumstances. Policies and procedures for handling this type of crisis must be in place and utilized as needed. The second legal consideration in this case is vicarious liability (respondeat superior). In this case a patient died as a result of be administered the wrong medication and several patients were injured from falling out of bed. The hospital could be held vicariously liable...
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...Business Case Analysis - Nursing Second Shift Staffing Business Case Analysis - Second Shift Staffing Monarch General Hospital has recently experienced short staffing of the nursing workforce for the second shift (15:30 to 23:30). This report was commissioned to examine options for the Healthcare Chief Officers involved, which will provide valuable guidance toward a reliable business solution based on currently available evidence. Background Monarch is currently experiencing a deficit in the supply of nurses. In particular, the deficit is on the second shift. But, overall, the actual problem to address is a less than optimal supply of nurses. The plan to remedy the problem for the actual shift involved will be addressed in the strategy and implementation. This deficit of nurses will cause delayed delivery of care to patients and/or adverse events. This will likely lead to patient dissatisfaction, lawsuits and the hospital absorbing unnecessary and unplanned for costs. These factors will ultimately lead to a reduced number of hospital admissions. Monarch must achieve the ability to control the shortage instead of surrendering to it. This report will examine two of the four currently considered options. The first option is hiring additional permanent personnel and the second is hiring short-term, temporary personnel to be used on an as needed basis. Business and Operational Impacts The factors leading to a reduced numbers of hospital admissions will affect...
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...Nursing communication 2 Nursing seems to be facing more various challenges as today. These include nurses’ shortages, communication, freeze of salary and many more. In this essay, communication in the nursing field-its importance and the impact on nursing practise will be explained. The impact communication has on the safety of the patients and quality of care they received will also be evaluated. Communication is the transfer of information between the nurse, the patient, the patient’s family and among other health workers in the team (Anderson L, L 2013). Communication in general include verbal and written, information are exchanged in form of written and spoken language. Non-verbal communication involves exchange of information without using words, sometimes known as body language, which simplifies understanding of complex meanings of the spoken word. This also includes touch and sight (Weimann & Giles, 1988). Communication in it various forms is a keystone of basic nursing practice and an essential skill across all settings of care to identify the patient's goals of care. The importance of effective communication is vital in all aspect of nursing that is why I have chosen it as a major challenge facing nurses today. The implications of communication deficiencies impact the whole nursing practice. From clinical assessment, attention to physical symptoms and psychosocial concerns of the patients are only achieved through effective communication. The responses to suffering...
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