...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 are utilized...
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...Mandatory Influenza Vaccinations Review Shumetria Cleveland English 321 Mandatory Influenza Vaccinations Review Introduction Influenza is a highly, contagious virus that affects the respiratory system. It is transmitted from person to person through respiratory droplets by an infected person coughing or sneezing. Influenza is much more serious than the common cold and is preventable. Good hand washing, covering your cough, and good health habits will prevent the spread of influenza and other respiratory diseases. It is onset by chills, fatigue, high fever, cough, sore throat, and body aches are some sign or symptoms of influenza often referred to as the flu. The incubation period is one to four days. Each year, influenza causes a significant increase in illness and death. In the elderly, children, patients with chronic illness and immune compromised disease. Once in a while the influenza changes to a severe disease. In the early 1900 there was a pandemic that killed approximately 20,000,000 people. Scientist later discovered the bacterial that causes the virus by testing the blood. Today physicians are able to keep the bacterial infections under control with antibiotics. In 2009 the swine flu epidemic caused illness, stole lives and flashed a light on health care workers to get mandatory influenza vaccinations. Some institutions, for the first time, implemented policies for mandatory influenza vaccines for health care workers due to the escalation of the swine flu...
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...Mandatory Pre-op for Total Knee Replacement The decision to undergo elective knee surgery can be very stressful for many patients. It is important for patients to be well prepared. Total knee arthroplasty has increased by eighty-four percent from 1997 to 2009 (Fawzi, 2012, para. 1). By making the Pre-op Total knee Arthroplasty class mandatory patients and their family members will be more educated and prepared for surgery and recovery. During the class patients will be able to ask any questions they may have, learn how to better prepare for surgery and ways to prevent infection during their hospitalization. Physical therapist will also discuss exercises and pain management techniques. By using the John Hopkins evidence based practice model a change can be made in the pre-op process for all total knee replacement patients. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is defined as a problem-solving approach to clinical decision-making within a health care organization (Dearholt, & Dang, 2012, p. 4). Nurses often use this model to facilitate change within their organization....
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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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...tract infections.(Clagg) This is an immense problem in hospital and nursing home settings. There are many ways we can examine this study to see how the nurses involved with these particular patients can decrease the risk of these infections. Patients admitted in the hospital are much easier to do this type of evidence based research on due to availability of data. In the hospital, the nurse can monitor the patient’s intake and output, the color of the patient’s urine, and whether or not it has any odor or sediment.(Clagg) This research may also be done in a nursing home setting with twenty-four hour nursing care. This type of research would be difficult in the patient who was at home with a Foley catheter without having a home health nurse multiple times per day. The steps of the nursing process closely relate to evidence-based practice. This is because the nursing process is designed to deliver complete care. The nurse taking care of the patient must evaluate the patient’s needs based on subjective and objective data, develop a nursing diagnosis regarding the patient’s most critical needs, come up with a plan of care, implement that plan, then evaluate how the plan worked.(The Nursing Process) These steps are very close to the steps you would take when doing evidence-based research. Once the research was completed, the nurse would use the new data to create alternate care plans that may enhance the patient’s...
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...Registered Nurse to Patient Ratio LLM Various participants in different states across the nation has lobbied the state legislatures and the United States Congress to proclaim laws that will recuperate the overall working conditions of hospital and clinical staffing. Proposed nurse to patient staffing ratios has become a huge discussion in the healthcare field. It has developed a huge concern that patients and nursing staffs are being harmed related to the inadequate nurse to patient ratio staff. This issue alone has caused an increase in severity of illness, fatigue, hospital stay, and harm to patients. With the increase in complexity of care per patients, nurses grow weary thus increase the negative impact of the inability to improve the quality of hospitalization outcomes for the patients. It is prominent that we identify and maintain the appropriate number of the nurse to patient staffing ratio, as it is critical key of delivering the optimal quality patient care. In the pass few years and even up until now, there has been a massive growth in need for more registered nurses in hospitals and clinics due to the rising acuity of patients and shorter lengths of stay. More and more patients appear looking for healthcare assistance. The safety and quality of the care patients are looking for are becoming difficult to find as registered nurses grow exhausted and drained out of energy. Inpatient working conditions has weakened in various facilities, as hospitals cannot fulfill...
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...Medical Center. In the past, the primary nursing staff was giving verbal report to oncoming nurses at the nursing stations. There are many disadvantages to this practice. Verbal report at the nursing station is distracting with so many nurses talking at the same time and is frequently interrupted by other staff, call bells, and family members. There are also potential HIPPA violations when reporting on patients within earshot of other people who are not involved in that patient’s care. The patients and their family members or care givers are not directly involved in the report and hand off process (Gregory, Tan, Tilrico, Edwardson, & Gamm, 2014). Pertinent information was being reported incorrectly or not reported at all. Physician orders were being missed and not completed. All of these events, collectively, have adversely affected patient safety and overall patient satisfaction. Patients and their families do not like to feel that the primary nurse does not know the “whole picture” or has an incorrect understanding of the plan of care. In an effort to reduce potential errors, increase communication between staff and with patients and their care givers, and increase patient and nursing satisfaction, the nursing administration of Pelham Medical Center decided to implement bedside shift report on the medical-surgical unit. This change has been implemented and is mandatory practice, barring exceptional circumstances. Kurt Lewin developed a classic change theory that...
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...and Prevention, approximately fifty thousand Americans will be newly diagnosed with HIV this year alone (Basic Statistics, 2014). Although HIV can be transmitted in several ways the most common ways are via sexual transmission or intravenous drug use. Therefore there has always been a stigma attached to HIV – even for those who are in the health profession. A nurse who has been in this vocation for twenty years will probably be able to tell you of a nurse who refused to take care of an HIV patient. Nursing has come a long way since the 1980s, when HIV became known. However, there are still issues that a nurse may face today. One of these issues is when a newly diagnosed HIV patient has a significant other. Should a nurse, knowing the potential devastating consequences of HIV, tell a patient’s sexual partner about their HIV status? This paper will discuss, the legal, moral and ethical ramifications of HIV disclosure. It will weigh the pros and cons of a nurse revealing this information, and it will provide recommendations for nurses who encounter this issue during their practice. It is understandable that a nurse may feel perplexed about this ethical dilemma. Once someone is diagnosed with HIV, they will have the disease for the rest of their lives. Currently there is not a cure. Although treatment options are available, the medications needed to minimize the viral load can be numerous and expensive. In addition, the side effects that can occur from these medications...
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...hospitalized five times in the past 2 years. Three of those hospitalizations have occurred in the past year. She also has a history of not complying with health professionals and she has failed to take her prescription medications as directed. She was brought into the gero-psychiatric unit by the police because of complaints of violent, psychotic behavior towards others (Sotiropoulos, Poetter, and Napholz, RN, Ph.D.). Medical compliance is very important to the health and well-being of a patient. The patient’s quality of life is heavily affected by the medications and education of the medications and their illness. In order to attain the quality of life they deserve the health professionals must try to convince the patient that the best way for them to do so is to follow the directions of the doctor. Gathering Relevant Information For the purpose of this paper, I will assign the name Sally to the patient. Sally was diagnosed as being a paranoid schizophrenic more than 2 years ago. Paranoid schizophrenia is defined as “a chronic mental illness in which a person loses touch with reality (psychosis)” (Mayo Clinic Staff). As time goes by her condition is declining. She denies that she is schizophrenic or that she is in need of treatment or medication. She believes that any form of authority is a conspiracy against her. Her condition is permanent and only with medication and treatment will she show signs of improvement. Over the past 2 years, she has been hospitalized 5 times for unfavorable...
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...Hospital, so it is important that a new pain management process becomes implemented. If nurses become better educated on pain management and how to asses it, if pain goals are discussed and written on the whiteboards, and if pain assessments are included in hourly rounding, pain would be better controlled and patient satisfaction scores would increase. Change, however, is never easy to implement. Once change begins, monitoring the implementation process is important to evaluate the effectiveness, the quality of the change, and how it will affect staffing. Communication also plays a vital role in the implementing process, as keeping everyone informed and empowered is important in order for change to be successful. The proposed solution to help implement the change would be to hold educational programs about pain management and assessments that each and every medical-surgical unit nurse would need to attend. The educational program will be held three times per week for each shift to complete. The program will be mandatory and each week a certain nursing unit will be assigned until all units/nurses have attended the educational program. The educational program for pain management and assessment will teach nurses about the pain process, how to assess it visually and through communication, and what interventions can be done to help manage it. The educational program will also teach nurses on how to use assessment tools for pain and how to explain the importance on educating the...
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...efficacy whilst reflecting both service priorities and governance requirements. 2. Purpose and scope The Directorate is committed to ensuring a highly motivated and highly skilled workforce that can serve the women, babies and families in our care both safely and effectively. The unit has adopted a systematic approach to training for all relevant staff groups who provide care. This training needs analysis (TNA) and training plan outlines the minimum training needs of all relevant staff groups within the Directorate and provides details of the comprehensive programme of educational sessions. The TNA focuses on the service specific training requirements considered to be mandatory by the Directorate to meet policy and CNST requirements. Trust wide mandatory training requirements are identified in the Trust Mandatory Training Policy and TNA, and therefore are not included in this document. 3. Service Description The maternity department based at the Royal Victoria Infirmary (RVI) delivers approximately 7,100 women per annum. We offer antenatal, intrapartum and post natal services to women with both low and high risk pregnancies. As a regional unit we also provide care to women with...
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...Personal Reflection on American Nurses Association Code of Ethics Veronika Babuts NURS 3540, Ethics in Health Care North Park University February 2, 2012 Personal Reflection on ANA Code of Ethics American Nurses Association (ANA) has developed the Code of Ethic for nurses to establish ethical standards and to guide them in decision making. The Code of Ethics is derived from many ethical theories and reflects the ethical and moral aspects of the nursing profession. After reading the ANA Code of Ethics, I took some time to think about its meaning and how it affects me. Even though, this was the first time I have read the Code of Ethics in its wholeness, I found that I abided by it over the course of 7 years being a professional nurse in the U.S. I abided by the code without knowing it, because it represents the universal ethics and morals accepted in most parts of civilized world. As a nurse, I understand the imperativeness of following the morals and ethics in every aspect of my profession as well as personal life. For all nurses in every part of the world it is important to provide ethical, high-quality care for patients, while being fully aware of all aspects of care and surroundings. It is vitally important to respond appropriately to the patient’s cultural beliefs, and values. Having principles and forming expectations help improve the quality of patient-centered care and communication. I was grateful to read the ANA Code of Ethics in its wholeness as it helped...
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...Substance Abuse and Addiction in Nursing Drexel University Substance Abuse and Addiction in Nursing There was a time when substance abuse (SA) in nursing was unheard of; however, it was always there. The reality was that it was merely disregarded. How could any type of addiction or SA in nursing be disregarded? It is difficult to speculate why our culture overlooked this, but one explanation is associated with the Gallop Poll which reports nursing as the most trusted and ethical profession in the United States (US) (Cherry & Jacob, 2014). Therefore; how can the most trusted and ethical profession coexist with SA, addiction, or an impaired nurse? Townsend defines an individual with a substance abuse disorder as a person who fails at several attempts to control or stop a substance that interferes with that individual’s ability to perform daily functions such as obligations at home, school, or work (Townsend, 2014). It is this impaired ability that endangers patients, coworkers, the organization’s reputation, the nursing profession as a whole, and ultimately themselves. Drug and alcohol abuse is a serious issue that has reached epidemic proportions in the general population (Taylor, Lillis, LeMone, & Lynn, Walters Kluwer Health/Lippincott Williams & Wilkins). It is now believed that the incidence of drug and alcohol abuse in the nursing profession parallels the proportions of the general public (Valdes, 2014). Therefore; ignoring this issue is no longer...
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...October 25,2015 HealthCare and Public Health Issues-Nursing Shortage Introduction When we are sick, we will go to the hospital. We want good quality of care but this is a challenge due to the shortage of nurses. Nursing shortage happens all over the world. The problem will get more severe. The population is continually growing, the demand for healthcare workforce increases. For example, while I was working in the operation room over the years, I witnessed an increasing volume of patients entering the hospital. Even though there is this demand, the administration department cut the staff number due to budget reasons. Nursing shortage affects the quality of patient care, increases healthcare staffs' stress, and affects staffs' job satisfaction. The quality of patient Care With advance medical treatment and good living environment, people live longer. In 2020 the demand of nurses is increasing but the supply of nurses is beginning to decrease. As baby boomers’ generation are starting to retire which will reduce the supply of nurses and there are not enough new nurses to fill the gap. With limited nurses, they may do the vital signs improperly, rush of judgment, or giving medication without fully check. A patient can develop an infection or bed sore with not having a nurse every two hours around to turn them. For serious result, patient will die due to not frequently round. A report by Ford stated that 18 mental illness patients commit suicide in a year during observation. Half...
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...Professional Employees, AFL-CIO (DPE), Nursing has been among the fastest growing occupational fields, and the demand for nurses is expected to continue as baby boomers retire, creating a need to replace retiring nurses and care for the aging population. Nurses are integral to our health care system; however, their profession is made more difficult by unsafe working conditions, causes of burnout, and being an underpaid profession. Ultimately, these difficulties not only affect nurses, but jeopardize safe and efficient patient care. According to the DPE 2012 fact sheet, there are an estimated 500,000 RNs in the U.S. who are not practicing their profession, in part because of difficult working conditions of nurses that are exacerbated by limited staffing and long working hours. Additionally, with managed care restructuring the health care industry in the 1990s, hospitals reduced staffing levels to lower costs. Nurses now care for more patients during a shift, which has led to a number of problems for both nurses and patients. Overworking results in injury: 39% percent of RN injuries resulting in missing work were attributed to overexertion. Many hospitals routinely require nurses to work unplanned or mandatory overtime and to “float” to departments outside their expertise. Over 60% percent of RNs report being forced to work voluntary overtime, which leads to Nurses’ cardiovascular health suffering from working long shifts and overtime. In a 2010 study, researchers showed a clear link...
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