...HEAD: Nurse-to-Patient Ratios A Literature Review: Nurse-to-Patient Ratios and Their Relationships with Other Variables Since the times when Florence Nightingale took care of patients, there has been a question about what factors affect patient care. One of these factors, nurse-to-patient ratios, has gotten significant publicity over the last several years due to a change in legislation in California. This increase in publicity has sparked many researchers' interest to further evaluate these ratios in connection with patient outcomes and other variables. Through lots of research and analysis there is evidence that a lower nurse-to-patient ratio does reduce the negative patient outcomes in patient care. Some of these outcomes include urinary tract infections, upper gastrointestinal bleeding, shock, pneumonia, failure-to-rescue, and death (Curtin, 2008). Although lowering the ratio does show a decrease in these outcomes, it does not solve all the problems in the nursing profession (“Safety in Numbers,” 2008). The other variables that have a significant relationship with these nurse-to-patient ratios include retention and recruitment of nurses, malpractice, medical errors, and cost. In this review of literature, a direct relationship between nurse-to-patient ratios and other variables should be visible to readers to better understand the issues that are currently identified in nursing in the health care industry. One of the most referenced studies done on nurse-to-patient...
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...nature of the nurse-patient relationship and discuss its relevance to the patient care experience. Through a wide range of research the essay will consider how the nurse-patient relationship can contribute positively towards the patient care experience and will conclude with a reflection on how the findings will inform personal and professional development. The nurse-patient relationship is founded on the need of care, assistance and guidance for the patient and therefore can be regarded as a therapeutic relationship. The patient is put in a vulnerable position when they need to rely on the nurse to guide and assist them in their own care. Hinchliff et al. (2003) suggested that the nurse has access to a wide range of personal information on the patient along with specialist knowledge and skills which puts them in a position of authority. Patients can feel reassured that all nurses are regulated by The Nursing and Midwifery Council (NMC). The NMC is a regulatory body which has a code of conduct that sets out standards that all nurses and midwives have to comply with in order to keep their registration. (NMC, 2008). The code sets out standards that incorporate trust, treating people as individuals, respecting confidentiality, collaborating with others, gaining consent and maintaining healthy boundaries. Before any health care professional, including nurses can begin to care or treat a patient they must gain consent. The consent must be informed and the patient must fully...
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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...
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...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 and...
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...Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction Grand Canyon University: NRS-433V 06-04-2016 PROBLEM STATEMENT: The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse staffing levels has an impact on patient outcomes and nurse retention in hospital practice. Purpose d Research Questions: With one of the most critical steps being the determination of the problem that will be studied in the research process. (Nieswiadomy, 2008, p.45). Linda H. Aiken et al states the research question as 1. Determine the association between patient-to-nurse ratio and patient mortality 2. Determine the association between patient-to-nurse ratio and failure-to-rescue (deaths following complications) among surgical patients 3. Determine the association between patient-to-nurse ratio and nurse retention/attrition. 4. Determine the association between patient-to-nurse and the facts that contributed to the stress that lead to nurse burnout ...
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...A Critique of the Literature Effects of Nursing Rounds: on patients’ Call Light Use, Satisfaction and Safety. Introduction: The findings of this article will critically review the methods of research, population, systems and data used to obtain results regarding this study. This evaluation of the outcome would determine whether or not there was a need to change the nursing management of patient care. The study would determine if patients were happy with their care and if the rate of falls were minimised. In the health care setting, the call light is an important communication tool for the nursing staff and patients especially in an emergency situation. Title: The title clearly summarises the content of this Journal article which suggests there was either a qualitative or quantitative designed research data used to conclude the findings. There was limited context which was not clearly defined (Meade et al.2006, p 58). Abstract: This is succinct, meaning the writer has been brief and precise with the back ground information about the research article. This...
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...Nurse-patient relationship According Cutliffe and McKenna (2005), research, theoretical and educational literature on interpersonal relations between nurses and patients has proliferated since the 1960s. This has generated a range of divergent accounts of what the nurse-patient relationship (NPR) ought to be, how this should be achieved, and how the NPR is constituted in practice. I have chosen the concept of nurse-patient relationship because this relationship is viewed as the essence of nursing practice (Moyle 2003). This essay’s aim is to demonstrate my understanding of the concept of the nurse-patient relationship through utilising relevant literature and relating this to a specific incident in my practice-experience. I will briefly explain an incident which I was involved in prior to identifying and discussing the significant aspect of the incident. Peplau‘s (1953) interpersonal relationship model and Rogers’ (1951) model of Self-Concept in mental health nursing will be used. I will then reflect on my learning and how this will impact on me as a registered mental health nurse. According to Julia and George (2002) a concept is an idea, thought, or notion conceived in the mind. These ideas or thoughts may be experimental or actual, depending on their ability to be observed in the real world. Meleis (2007), on the other hand, defined a concept as a term used to describe a phenomenon or a group of phenomenon. Nursing theories have been defined as reservoirs in which findings...
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...The Nurse-Patient Relationship In this essay, I plan to explore the concepts of the “nurse-patient relationship” using the necessary literature to back up my findings. I have chosen to study this concept because I am interested in discovering what makes a successful, or indeed, an unsuccessful nurse-patient relationship, as I believe the relationship between nurse and patient to be an integral part of nursing. The main focus of my essay will be around the works of Hildegard Peplau, but I plan to incorporate other theorists, such as Carl Rogers and Abraham Maslow, comparing and contrasting their approaches as well as drawing on my own practical experiences out on placement. Before beginning, it is important to understand what a “concept” is. This is so as to fully understand what the essay question is asking. According to Arnold and Underman Boggs (1999), a concept is a series of:- “Broad comprehensive ideas that serve as building blocks to present key ideas that make up models in a logical and focused manner” (p552). Concepts are very important in nursing and it is important that we understand why in order to integrate them into our practice. Nursing is now considered to be an “evidence-based” profession and one that changes constantly as new and fresh ideas are embraced. These ideas are formed through theories which, in turn, are formed through concepts. A fundamental part of the nurse’s role is to maintain confidentiality, and student nurses are no different...
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...Critique: Nurses’ Perception of Patient Rounding by K. Neville, K. Lake, D. LeMunyon, D. Paul, K. Whitmore Introduction to Nursing Research February 19, 2012 Research Critique: Nurses’ Perception of Patient Rounding by K. Neville, K. Lake, D. LeMunyon, D. Paul, K. Whitmore Hourly rounding may be described as the purposeful checking of assigned patients at regular intervals. When rounding on patients, nursing staff do so with the intent of checking the “4P’s”- pain, position, potty (the need to toilet), and proximity of personal items and safety measures (call light, phone, side rails etc.) (Halm, 2009 pg 581). Evidence reveals that when doing purposeful patient rounding, falls decreased, use of call lights decreased, and patient satisfaction scores increased. However, the majority of studies did not include evaluate nurses’ the perception of whether hourly rounding would benefit their own practice. So while hourly rounding may increase patient safety and satisfaction outcomes; this study evaluates whether hourly rounding will increase or decrease nursing job satisfaction and what factors may influence their views. Somerset Medical Center (SMC), a 350-bed medical center located in New Jersey implemented hourly rounding over a six-month trial period, which proved to increase patient satisfaction and perception of pain management while decreasing the fall rate and use of call light. However, the postproject did not include an evaluation of the nurses’ perception...
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...1. Describe where/how you have experienced the impact of socioeconomic status and/or culture on health behaviors? As a home health nurse, I visited patients in their home, and the way people choose or are able to live reflects socioeconomic status and health behavior. I observed first hand a spectrum of poor individuals living in subsidized housing and surviving on meals on wheels, and affluent individuals living in high-rise condos with the ability to shop at natural food markets. The dichotomy overwhelmed me to have an unbiased approach to every individual patient. Garcia (2005) reflects how it is difficult for low socioeconomic status impacts the ability to eat a healthy diet. This was observed in the person’s dependent on meals on wheels...
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...years, the numbers of children who are affected by obesity have more than doubled (CDC, 2014). Clinically defined, children who are determined to be overweight are those who have excess body weight for their height and it is attributed to fat, muscle, bone, water, or a combination of (Stats, 2014). Children who are determined to be obese are those who have an excess amount of body fat and it is not attributed to physical characteristics (Krebs et al, 2007). For nurses who work with this population of patients, special care will need to be taken to address the host of physical and emotional issues that will be a part of this population’s treatment and care. Nursing staff must be prepared to appropriately diagnose obesity related health problems and provide effective intervention and treatment recommendations. Nurses who develop insightful treatment planning will be cognizant of the variety of health complications that may affect the patient in their care and can plan accordingly (Felix et al, 2013). As such, nurses also need to be more knowledgeable about how genetic susceptibility may also be a contributing factor to a child’s obesity (Seal, 2011). This will enable the treatment planning to incorporate genetic testing and environmental strategies in the overall intervention and treatment planning. All of this is critical in better understanding the negative impact that childhood obesity can have an on individual’s growth and functioning. The rise in obesity rates have been...
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...BSN Nurses Create a Safer Patient Environment In recent years a movement has been emerging in more and more hospitals and health care facilities to hire nurses with BSN degrees. In addition, many health care employers are requiring, or at least urging, their current staff to earn higher degrees. This movement gained momentum following a study released by the Institute of Medicine in October 2010 recommending “increasing the number of baccalaureate-prepared nurses in the workforce to 80% and doubling the population of nurses with doctorates” to meet the demands of the evolving health care system (American Association of Colleges of Nursing [AACN], 2014, para. 5). In addition, the AACN stated that positive patient outcomes are increased with the care of nurses educated at a BSN or graduate level. Employers say they want to ensure their staff is equipped to meet the increasing health care demands (Trossman, 2012, para. 1). This can cause some confusion amongst those who believe that an RN is and RN, but there are many routes to earning the title of registered nurse. Nursing students who have graduated from diploma, ADN, and BSN programs all sit for the same NCLEX-RN licensing exam, but are they all equally equipped to practice? (American Association of Colleges of Nursing [AACN], 2014). Does staffing with high percentage of BSN educated nurses really lead to a safer patient environment? While all RNs do sit for the same NCLEX-RN exam to obtain licensure, it is important...
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...Higher Education for Nurses Means Safer Care for the Patients Ethan Hu May 29, 2014 Higher Education for Nurses Means Safer Care for the Patients I. Introduction: In today ever changing world of healthcare, where technologies become more advance and patients become sicker, there is an urgent call from many nursing associations, especially the American Nurse Association, which encourages nurses to pursuit higher education. While two-year prepared nurses have the same set of clinical skills as four-year prepared nurses, there are data that show association between better patient outcomes and higher educational level of nurses. This paper will focus on the differences in competences, approaches as well as clinical decisions made by associate nurses and baccalaureate nurses and how they affect patient outcomes. II. Definitions: According to American Nurses Association, nurses who have completed any qualified two-year degree nursing program offered by any community or private colleges and successfully pass the National Council Licensure Examination (NCLEX) are considered Associate Degree Nurse (ADN). ADNs are only prepared to meet the standard defined by the nurse’s scope of practice in order to practice nursing at an entry-level. ("How to Become a Nurse," n.d.) Baccalaureate nurses are those who have gone though a four-year program and received a degree of Bachelor of Science in Nursing (BS/BSN). Besides possessing the basic skills required to enter practice, BSNs...
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...Level RN and the Bachelor Level RN The formal education for nursing in the United States began shortly after the Civil War ended in 1872 with the first permanent nurse training school at the Women ‘s Hospital of Philadelphia. Early education followed the Nightingale model and has been evolving ever since. As the needs of patients have changed so has the need for educating nurses. Over the last decade multiple organizations including the Institute of Medicine and the American Organization of Nurse Executives have come to the conclusion that nurses with higher degree levels provide more thorough care. Research has shown that magnet hospitals with highly educated nurses not only have a lower mortality within the acute care setting but also thirty days post. A survey conducted in 2001 and published by the Journal of Nursing Administration reported that Bachelor trained nurses have better critical thinking, communication, and leadership skills. (Hahn, 2001) To better understand these facts we must appreciate the history and differences between the associate and diploma trained Registered Nurse and the bachelor trained Registered Nurse. The Committee for the Study of Nursing Education published the Goldmark Report in 1923 recommending that nursing education be moved from the hospital to the university and that nurse educators receive advanced education. It was found that the diploma based hospital programs gave higher priority to the needs of the hospital instead of their students’...
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...profession that sets on exceptional nurse apart from others. Safer patient outcomes and reduction in patient mortality and secondary insults of illness has decreased with an increase of staffing Baccalaureate Degree in Nursing (BSN) nurses over a staff consisting mainly of Associate’s Degree in Nursing (ADN) nurses. This paper focuses on the educational differences and competencies between nurses with an ADN and BSN respectively and the experience and skill sets that form the clinical decisions made by these nurses and how their decisions affect patient care and outcome. Mildred Montage was a nurse educator in the 1950’s and was the leading advocate and creator of the ADN in reaction to the stark shortage of nurses in the years preceding World War II (Creasia & Friberg, 2011, p.14-15). This degree was designed to decrease the shortage of nurses and the adequate level of clinical nursing skills and successful pass rate of graduates on the National Council Licensure Examination (NCLEX) were all taken into accountability for measuring the success of the ADN programs. An associate degree nurse is defined as a nurse attending a community college, up to three years but no less than two years, with training in clinical skills. A nurse graduating from a community college nursing program gains an ADN and is then qualified to sit for the NCLEX to obtain licensure as a Registered Nurse (RN) (ANA, 2014) A baccalaureate degree nurse is defined as a nurse attending a university or state...
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