...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 ratios...
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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, pneumonia...
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...concerned with quality of patient care, is now concerned with the quantity of dollars received. John Kariben (2017), the executive director of the Michigan Nurses Association, explains that administrators of hospitals are balancing budgets without much thought of what’s going on at the bedside. As a result of this nurses and patients are suffering. Kariben (2017) goes on to describe some of the profit driven cuts, one of the major cuts being nurse staffing. Poor nurse staffing has been directly linked to poor patient outcomes. The Minnesota Department of Health (2015) found, “strong evidence that...
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...global nursing shortage. A recent evidence-based practice report sponsored by the Agency for Healthcare Quality and Research concluded that a relationship exists between lower levels of nurse staffing and higher incidence of adverse patient outcomes . Nurses’ working conditions have been associated with medication errors and falls, increased deaths, and spread of infection . RN staffing levels have been associated with the spread of disease during outbreaks. However, increasing nurse-to-patient ratios alone is not adequate; more complex staffing issues appear to be at work. Many studies have found that the times of higher ratios of “pool staff” (i.e., nursing staff who were members of the hospital pool service or agency nurses) to “regular staff” (i.e., nurses permanently assigned to the unit) were independently associated with healthcare-associated infections . The skill mix of the staff, that is, the ratio of RNs to total nursing personnel (RNs plus nurses’ aides), is also related to healthcare-associated infections; increased RN skill mix decreases the incidence of healthcare-associated infections . In a recent comprehensive review of the literature, the authors concluded that evidence of the relationship between nurses’ working environment and patient safety outcomes, including healthcare-associated infections is growing. They also concluded that stability, skill mix, and experience of the nurse workforce in specific settings are emerging as important factors in that relationship...
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...achieve its goals and downsizing their workforce to avoid bankruptcy. “The single most important policy for solving the problem of overworked and understaffed hospitals is the establishment of staffing ratios, mandating both a minimum ratio of RNs to patients and controlling the ratio of RNs to lesser-trained hospital staff. While management generally opposes staffing ratios, evidence suggests that they have proven effective in the recruitment and retention of nurses. Linda Aiken, founder of the magnet hospital program and perhaps the most widely respected author in the field, argues that unless "a floor for staffing is established, we are not going to be able to stop the flight of nurses from hospitals."169 Similarly, JCAHO President Dennis O'Leary notes, "While mandated ratios are controversial among health professionals, there are established relationships between nurse staffing levels and patient outcomes." He also stresses "achievement of mandated ratios will be meaningless until controls are placed on the numbers of non-nursing tasks that nurses are required to perform."170 Management in hospitals that have adopted such ratios has come to appreciate them. Cape Cod Hospital in Massachusetts, which signed a collective bargaining agreement in 1997 mandating a 1:5 staffing ratio for...
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...analysis Shouldice hospital is a well-known hospital for its specialization in hernia operations. Last year, Shouldice performed operations on 7500 patients. The greatly developed technique that the hospital uses and the excellent customer service that all staff members and doctors work hard to provide give the hospital a great reputation. Thisincreases demand on the hospital as its exceptional reputation increases patients’ desire to have their hernia operations performed at Shouldice hospital. As per the customer service, the patient should arrive one day before the operation and stay one day after for a total of 3 days. The first day gives the patient the opportunity to understand his or her situation by meeting with other patients and sharing their personal experiences. Inaddition, the patient pairs with another who has similar interests and hopes. As a result, the patient forgets their fear and enjoys their time. The journey does not end by leaving the hospital; Shouldice has a yearly event where all patients are invited to mingle, socialize, and see the doctors and staff. Currently the hospital has 90 beds, 12 full time surgeons, 7 part-time assistances, 5 operating rooms, a patient recovery room, a laboratory, and six examining rooms. The hospital does 150 operations per week, 5 days a week. With each operation, the patient stays a total of 3 days in the hospital.Using the information that we have, the hospital utilization of its beds is: Beds available: 90 beds X 7...
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...ACTPACO INDIVIDUAL BUSINESS CASE 1T AY 2013-14 Reference: Accounting 2nd edition. Waren,C., Reeve, J.,and Duchac, J. ( with slight modifications) Case 1. Partnership agreement Jose Reyes, M.D. and Joseph Luke, M.D. are sole owners of two medical practices that operate in the same medical building. The two doctors agree to combine assets and liabilities of the two businesses to form a partnership. The partnership agreement calls for dividing income equally between the two doctors. After several months, the following conversation takes place between the two doctors: Reyes: I have noticed that your patient load has dropped over the last couple of months. When we formed our partnership, we were seeing about the same number of patients per week. However, now our patient records show that you have been seeing about half as many patients as I have. Are there any issued I should be aware of? Luke: I see. Well, I find that I am working as hard as I did when I was on my own, yet making less that I did previously. Essentially, you are sharing in half of my billings and I am sharing in half of yours. Since you are working much less than I am, I end up on the short end of the bargain. Reyes: Well, I don’t know what to say. An agreement is an agreement. The partnership is based on a 50/50 split. That’s what a partnership is all about. Luke: I that is so, then it applies equally well on the effort end of the equation as on the income end. Answer...
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...BBA 14th Batch Fundamentals of Business Finance Course Code B 201 Department of Banking University of Dhaka [pic] [pic] Prepared for Mrs. Hasina Sheykh Associate Professor Department of Banking (DU) Prepared by [pic] |ID NO |Name | |059 |Farhanaz Luna (Leader) | |091 |Nesat Santa Rahman | |099 |Shaharin sultana | |006 |Zarin Tasnim | |102 |Humaira Sadia | |008 |Sajia Akter Moury | [pic] To Mrs Hasina Sheykh Associate Professor Dept. of Banking University of Dhaka Sub: Submission of Term Paper Dear Sir, It is our pleasure to submit term paper on Assessing financial health of banks in Bangladesh: A case of “Dutch Bangla Bank Limited” as a part of our B.B.A. Program. We tried our best to gather relevant...
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...care of the basic needs of a resident. As for the time that I have been a nurse aide I have found how hard of work being a nurse aide is and how much many nursing home forget the importance of meeting the basic needs of their residents. You would think that this would be the most important aspect that all nursing homes must meet, but just like every other business a nursing home is also money base, it is not charity. Many times in this hard economy nursing homes have to make cuts, and unfortunately they are cutting all in the wrong places. Many times office jobs in the nursing home are the last to be cut and the nurse aides are the first to be cut, and the reason being is because many states do not have laws stating the aide to resident ratio. Today, a local nursing home has just got a new hope in recovering the problem of the loss of success that their nursing home has encountered. They have begun to cut nurse aides and have begun to run the halls short-handed, unfortunately their complaints have went up and their residents have become very unhappy. The nursing home has now decided to fire the current administrator and hire a new administrator in hope for new ideas and better success for their nursing home. Although the new administrator has many difficult problems to solve she has a lot of faith in recovering the problem the nursing home is now encountering. The new administrated began looking through past experiences working in a nursing home as a nurse aide. She remember...
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...I would be responsible for managing (not 4). The responsibilities continued to pile on at a rate that was rather intense and impeded on my first two weeks of “new-hire training”. Before my hiring, _____________ acted as somewhat of an interim director. She played a pivotal role in my training and understanding of the numerous tasks that seemed endless. During my second week on staff (month/dates), I met with______________, Director of Resident & Family Services, to review my training status. In that meeting, I voiced my concern of being extremely understaffed (4 activities staff to carry out the day’s activities with 100 residents); she sympathized with me and encouraged me with “…it will get better…” and advised that I bring the ratio issue up to my manager, _____________. Later that week, (date), I...
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...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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...nursing profession relies heavily on current research to guide patient care with the integration of evidenced-based practice. Statistics provide valuable information to caregivers to help them understand, plan, evaluate, and improve the quality of patient care. In the acute care hospital setting there are ongoing measurements of such things as patient satisfaction, hand washing compliance rates, catheter acquired urinary tract infections, and central access infection rates, just to name a few. The collection of this data involves descriptive statistics, inferential statistics, and levels of measurements. Acute care hospitals use descriptive statistics in many ways. Descriptive statistics describes raw data in the form of samples or graphs (Bennett, Briggs, & Triola, 2009). One area in which they are used in the hospital is to evaluate hand washing compliance of health care providers. According to Vincent (2003), nosocomial infections occur in approximately 30% of patients in the intensive care setting and are associated with increased morbidity and mortality. Research shows that effective hand washing can prevent many hospital acquired infections (Vitez, 2010). In the hospital setting, hand washing compliance is monitored on an ongoing basis. Health care workers who come in contact with patients are observed by an unidentified member of the staff who monitors the subject upon entering and leaving a patient room. Hand hygiene can be performed by either by washing with...
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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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...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 in this area, it offers evidence based information. Review of Literature Lower levels of staffing are associated with adverse outcomes. Patients are requiring a higher acuity of care, but the skill...
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...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 help hospitals...
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