...Lowering Nurse Staffing Ratios The growing need of more nurses in hospitals is becoming an issue in hospitals all over America. The patient’s safety is being put at risk due to the number of nurse to patient ratios (Welton 1). A low nurse to patient ratio will cause a lack of care for the patients. Nurses will have to take on more patients then they are capable of which will affect the health of the patient and the nurse. John M. Welton, an RN (Registered Nurse), said that “the safety of patients is directly related to the size and experience of the nursing staff” (Welton 1). A high nurse to patient ratio can be on the costly side for the hospitals. “Hospitals will not receive any additional revenue for providing more patient care”...
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...Qualitative Methodology: Hospital Nurse Staffing and Quality of Care Keli Feathler, RN Grand Canyon University NRS 433v Nora Bazydlo RN MSN October 29, 2011 Introduction Does the issue of nurse staffing have an effect on quality of patient care? This study addresses the topic of nurse staffing, which includes nurses (RN and LPN) and nurse’s aides. Research in Action: Agency for Healthcare Research and Quality (AHRQ) presents the study “Hospital Nurse Staffing and Quality of Care”. Nurse staffing is measured in one of two ways: nursing hours per patient day and nurse to patent ratio (Stanton, 2004). The article looks at periods of high vacancy rates, assesses the patients needs, the development of care plans and administration of medications and treatments in factoring the quality of care. It shows the effect lower staffing levels and its direct link to higher adverse outcome rates. The study of staffing and quality of care is essential, to link the two together, and prove that the issue needs to be addressed in all forums of nursing. The way to making improvements in nurse staffing is to present documentation/research that supports the issue at hand. With factual information, ways to improve the problem can be formed. Higher levels of nurse staffing at all levels showed a 2-25% reduction in adverse patient outcomes. In order to improve the quality and delivery of health care staffing needs to be addressed, and by performing research...
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...Research and Educational Trust DOI: 10.1111/j.1475-6773.2011.01274.x RESEARCH ARTICLE Staffing Ratios and Quality: An Analysis of Minimum Direct Care Staffing Requirements for Nursing Homes John R. Bowblis Objective. To study the impact of minimum direct care staffing (MDCS) requirements on nurse staffing levels, nurse skill mix, and quality. Data Sources. U.S. nursing home facility data from the Online Survey Certification and Reporting (OSCAR) System merged with MDCS requirements. Study Design. Facility-level outcomes of nurse staffing levels, nurse skill mix, and quality measures are regressed on the level of nurse staffing required by MDCS requirements in the prior year and other controls using fixed effect panel regression. Quality measures are care practices, resident outcomes, and regulatory deficiencies. Data Extraction Method. Analysis used all OSCAR surveys from 1999 to 2004, resulting in 17,552 unique facilities with a total of 94,371 survey observations. Principle Findings. The effect of MDCS requirements varied with reliance of the nursing home on Medicaid. Higher MDCS requirements increase nurse staffing levels, while their effect on nurse skill mix depends on the reliance of the nursing home on Medicaid. MDCS have mixed effects on care practices but are generally associated with improved resident outcomes and meeting regulatory standards. Conclusions. MDCS requirements change staffing levels and skill mix, improve certain aspects of quality, but can also lead to use of care...
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...Safe Staffing McConnell- 2 Safe Staffing Affects Everyone Abstract: Safe staffing is a vital component of quality nursing care. However, oftentimes units in healthcare facilities across the nation lack the personnel that give the units the number of human resources needed to provide safe and sufficient care. A variety of people are affected by unsafe staffing: the actual nurses and ancillary staff, as well as stakeholders such as administrators, government and legislative bodies, and last but not least, the tax payer. The adverse effects of short staffing and the future impending nursing shortage are discussed, along with specific actions that have been taken, and are in the process of implementing, to ensure safe staffing and positive patient outcomes for all states across the United States. Keywords: Safe staffing, nurses, patients, healthcare, problem, nursing shortage Safe Staffing: It Affects Everyone: An Introduction Safe staffing is an essential and vital component of quality care. However, safe nurse to patient ratios are often not met in today's healthcare environment. This paper will describe what safe staffing ratios are, the problems associated with the lack of safe staffing ratios, what some states have enacted to ensure safe staffing, and what the the state of New York is currently projecting to ensure safe staffing is a reality for the future. Safe Staffing McConnell 3 Safe Staffing: A Breakdown: Basically, a healthcare unit, be it a floor...
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...------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. ------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. Explanation of the facts, history, legislative regulations, controversial aspects and opinions Explanation of the facts, history, legislative regulations, controversial aspects and opinions MANDATED NURSE PATIENT RATIO How does it affect you and your loved ones? Nurse patient ratio for safe care means when the staffing between the nurses and the patients are safe to provide the care patients need to get well in the hospital or nursing homes. Why is this important? Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown that more infections like UTI,...
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...Can Adequate Nurse Staffing Improve Patient Outcomes? Nursing is more than caring for the sick and injured. It is a twenty-four hour inpatient monitoring system. It is well known that nurses spend significantly more time caring for and looking after patients than any other profession. They routinely monitor and report changing patient conditions around the clock that aid physicians in modifying and updating treatment plans to improve health and prevent complications. The level of safety of hospitalized patients and the degree of quality care that they receive has more to do than fixed nurse-to-patient ratios. It has been well established in the literature that when nursing workload increase to unmanageable levels; weather it be from the addition of patients, increases in acuity and/or care complexity, or from high levels of fluctuation in patient turnover, that nurses ability to perform patient surveillance is disordered, putting patients in undue risk (Needleman, et. al, 2011). Furthermore, excessive workloads contribute to burnout and dissatisfaction leading to nurse attrition that further compounds to the staffing problem. Hospitals need to be held accountable for providing safer nurse staffing levels. Payers and purchasers of care should demand compliance, but should also stimulate better quality and patient safety by providing financial incentives. In addition, a more comprehensive, proactive team approach to nurse staffing can help keep patients safer...
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...Theoretical Framework Definitions Nurse-to-patient ratio- Nurse-to-patient ratios are typically expressed in two ways: the number of nurses working per shift or over a 24-hour period divided by the number of beds occupied by a patient over the same time period or the number of nursing hours per patient bed days (The European Society of Cardiology, 2017). There are other more complex approaches to measure the nurse staffing ratio, but there is no single recommended approach. Nosocomial Infections: “Nosocomial” or “healthcare acquired infections” (HAIs) appear in a patient under medical care in the hospital or other healthcare facility which was absent at the time of admission. Nosocomial infections can affect patients in any type of setting where they receive care. Infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections and ventilator-associated pneumonia. Nosocomial pathogens include bacteria, viruses, and fungal parasites. To ensure consistency, we will use HAIs when referring to nosocomial...
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...Examining experiences of WA nurses workload under the NHPPD staffing model. One of onus for practising nurses as highlighted by the ANMC code of ethics (2008) is that “Nurses value quality nursing care for all people”. This becomes significantly harder as several complexity or factors within the health system impedes on nurses ability to efficiently fulfil this role. One of such issues is safe and effective workload or the optimal nurse to patient ratio for providing quality nursing care. As Twigg et al. (2011) noted the implementation of nursing hours per patient day (NHPPD) staffing model in 2002, a landmark event for western Australian public hospitals was a result of nurses taking a stand to combat the unreasonable workload that was being undertaken. With evidence showing, mandated nursing staff levels having a significant impact on health outcomes, implementation of various staffing models to foster quality nursing care and improved patient outcomes in the health care setting has been widely utilised globally (Twigg et al. 2011). With prominent research done by Aiken and colleagues in the US, and with several other studies carried out internationally the gains achieved for patient outcomes through appropriate nursing staffing levels has been thoroughly highlighted. Aiken et al (2002) demonstrates the significant impact low staffing levels has on patient’s mortality rate. The study noted that wards that had the worst staffing ratios saw a 31% increase in death rates. Increases...
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...Nurse Staffing Plans & Ratios Background Identifying and maintaining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care. Numerous studies reveal an association between higher levels of experienced RN staffing land lower rates of adverse patient outcomes. 42 Code of Federal Regulations (42CFR 482.23(b) requires hospitals certified to participate in Medicare to "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed". With such nebulous language and the continued failure of Congress to enact a quality nursing care staffing act to date, it is left to the states to ensure that staffing is appropriate to meet patients' needs safely. Massive reductions in nursing budgets have resulted in fewer nurses working longer hours, while caring for sicker patients. In a survey of almost 220,000 RNs from 13,000 nursing units in over 550 hospitals and a response rate of 70%, nurses reported to ANA that: 54% of nurses in adult medical units and emergency rooms do not have sufficient time with patients; overtime has increased during the past year with 43% of all RNs working extra hours because the unit is short staffed or busy; and that inadequate staffing affected unit admissions, transfers and discharges more than 20% of the time. • The benefits of increased RN staffing have been demonstrated. Each additional patient care RN employed...
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...Jean Watson's Caring Theory to the Nurse Staffing Ratio in Practice Chamberlain College of Nursing NUR501: Theoretical Basis Advance Nursing December 05, 2015 Introduction Nursing theory impacts the practice of nursing in many different ways that can have a great influence. Theory provides a structure to support and shape nursing practice, encourage quality of patient care, and can be utilized in practice situations to give solutions to problems in nursing practice. Utilizing theories to solve nursing obstacles can be used in educational settings, research environment, direct patient care, informatics, as well as in administration and management of nursing care services. The advantages of applying theory to resolve a challenge in nursing practice can be demonstrated by applying Jean Watson’s theory of human caring. Jean Watson’s theory of human caring is a grand theory that provides to the empirical stand point of nursing. It emphasizes on genuine caring about the human being as whole; meaning caring about the human’s mind, body and spirit in order for the healing process to sustain at highest level. Her theory is portrayed as a model of caring which art and science are both included; presenting a framework that involves and divides art, science, humanities, spirituality, mind-body-spirit in medicine, and nursing (Watson, 2000). Nursing practice today is impacted by Watson’s caring theory. It does not only enable nurses to improve care for patients as...
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... The problem/issue chosen is the current issue with staffing of hospitals, nursing homes, medical clinics and specialty clinics, and why some of those problems are occurring. In addition to current issues in staffing, the future needs of nursing staff and what is being done now, and can be done in the future to enhance the quality and quantity of practicing registered nurses. In an article published in 2004 by the Agency for Healthcare Research and Quality, it was stated that “hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections. Major factors contributing to lower staffing levels include the needs of today’s higher acuity patients for more care and a nationwide gap between the number of available positions and the number of registered nurses (RN’s) qualified and willing to fill them” ( www.ahrq.gov, 2004). It is interesting that the same issues that are being faced today were an issue in 2004. “A persistent shortage of nursing staff across the United States challenges the belief and values of the profession. Many nurses find it difficult to carry out their ethical obligations to patients due to the insufficiency in staffing. Because of this shortage, many nurses complain that they experience emotional distress and job dissatisfaction and end up not providing quality care to their patients. As such nurses end up in an ethical dilemma, whereby they must choose...
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...Safe Staffing Examine Nurse-to-Patient Ratios Primary health care organizations such as New York Presbyterian (NYP) are impacted by low nurse-to-patient ratios. The recent implementation of the Patient Protection and Affordable Care Act (ACA) has required organizations such as NYP to explore many approaches to improve quality and patient outcomes that contain costs. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes” (www.nursingworld.org, 2015, para. 1). For this reason, nurse-to-patient ratios is an issue that needs to be addressed at NYP in order to improve quality healthcare within their organization. The acuity of the unit in which patient care is being provided, should determine the acceptable nurse-to-patient ratio. According to the American Nurses Association (ANA), factors that influence the nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; availability of or proximity to technological support or other resources ("Optimal Nurse Staffing," 2015). Currently, New York is one of only fourteen states that addresses the nurse staffing issue in hospitals. New York State requires organizations such as NYP to disclose their nurse-to-patient staffing ratios to the public; however the state does not require a minimum...
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...Nurse to Patient Ratio 1 Safe Nurse to Patient Staffing Ratios A Qualitative Summary Introduction to Nursing Research Grand Canyon University Nurse to Patient Ratio 2 Abstract The healthcare industry stands in the face of many changes, one of which is the forecasted shortages of registered nurses in acute care settings. Unless action is taken and resolutions are not put in place evidence shows that this problem will only worsen in the coming years. Left unaddressed this shortage deprives the acute care patient of quality care, overburdens current staffing and detracts from the facilities overall performance. A further complication to the already strained workforce is the predicted retirement of the “ baby boomer” generation, which is forecast to increase the patient care needs at a rate that cannot be met by the current staffing levels. According to the “United States Registered Nurse report Card” issued by the American Association of Colleges of Nursing (2012) this shortage is predicted to spread across the United States through 2030. Nurse to Patient Ratio 3 Summary A quantitative approach to understanding this problem is the most appropriate choice to gather information such as low morale, increasing workload, high attrition levels and difficulty hiring replacement staff. The previously mentioned problems need to be understood...
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...continually on the mend. Healthcare is ever changing and can always be improved. One way that healthcare can be improved is by ensuring that all health care facilities are properly staffed. Meaning that the patient to nurse ratio is adequate to meet patient needs while ensuring safety as well. The understaffing of hospitals and other healthcare facilities can greatly reduce the quality of care provided to patients in many ways. Understaffing leads to medical errors that can negatively affect patient outcomes and in more serious cases it could even lead to death. Understaffing affects healthcare providers and their ability to do their jobs properly, therefore risking patients overall safety. Understaffing is a serious issues that needs to be addressed to ensure that healthcare is being provided at the highest quality possible. In healthcare facilities such as hospitals, how does understaffing of nurses compared to properly staffing of nurses affect patient care during their stay? There is a growing body of research that validates the link between nurse staffing levels and patient outcomes. The study entitled Nurse Staffing and Inpatient Hospital Mortality by Needleman, Buerhaus, Pankratz, Leibson, Stevens, and Harris (2011), examines...
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...PROVIDING QUALITY CARE Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units Sung-Hyun Cho, Kyung Ja June, Yun Mi Kim, Yong Ae Cho, Cheong Suk Yoo, Sung-Cheol Yun and Young Hee Sung Aim. To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. Background. Nurse staffing has been reported to influence patient and nurse outcomes. Design. A cross-sectional study with a survey conducted August–October 2007. Methods. The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. Results. The average patient-to-nurse ratio was 2Æ8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3Æ26; 95% confidence interval, 1Æ14–9Æ31) or 2Æ0–2Æ5 patients (odds ratio, 2Æ44; 95% confidence interval, 1Æ32–4Æ52), compared...
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