...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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...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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...------------------------------------------------- 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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...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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...As a nurse many of us enter the profession because of our love of caring for others. In our day and time, healthcare has become less about caring and more about business. The healthcare that was once 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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...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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...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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... 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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...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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... American Nursing Association Registered nurses join professional nursing organizations for many reasons. For example, some join to learn what's going on and stay current in their field or specialty. Others want to network or enjoy the peer recognition that comes from being an active member of a major organization. These are just a few of the benefits of being a part of a professional organization. Nurses may join a general organization, such as the American Nurses Association to stay current on the latest technology and advancement of nurses. “The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public” (ANA, America Nursing Association, 2011). In addition the ANA helps establish regulations for appropriate staffing and mandatory overtime are some of the aims and activities of the ANA. Mandatory Overtime An article within Health Affair magazine states, “Research indicates that risks of making an error are significantly increased when work shifts are longer than 12 hours, when nurses worked overtime, or when they worked more than 40 hours per week” (Rogers, 2004). Mandatory overtime is one of the many workplace issues that may be contributing to nurses leaving the workforce. The American Nurses Association has taken the position “that regardless...
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...Inadequate nursing staffing levels are known to influence on patient’s rate of complications, falls, medication errors and overall patient’s conditions. American Nurse Association found that 54 percent of nurses on medical unit report that nurses are not spending enough time with patients. Because nursing labor cost consumes the largest fraction of budget, many hospitals trying to save money by requiring nurse to work longer hours and care for more number of patients. This short-sight solution not only creates heavier work load to staffs but also threatens patient’s safety. There are no absolute answers to determine nurse to patient ration because it affected by variety situations and acuity of patient as well as units. However, since appropriate nursing staffing affects the patient and nurse mentally, physically and medically but also the financially, this issues must be addressed by Registered Nurses when one encounter with unsafe nurse-to-patient ratio. Nursing Staffs for Patient’s Safety When RN encounters with inadequate staffing, one must notify to direct supervisor because unsafe staffing is an important factor that threatens patient’s well-being. Management becomes accountable to provide adequate staffing for the nurses and the patients. Hospital faces the challenge to reconcile between their own needs and patient’s safety by providing enough nursing staffs. It would be easier if management incorporate collective factors into the staffing plan such as patient...
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...“Every nurse has the opportunity to make a positive impact on the profession through day-to-day advocacy for nurses and the nursing profession” (Tomajan, 2012, abstract). Nurses have the power to make a difference in their work organization by making positive changes. Changing the staffing matrix to staffing based on acuity and reducing the unit department’s acquired pressure ulcers will greatly contribute to patient safety and patient/nurse satisfaction. Goal 1: Leadership Development A major problem of the health care system today is the heavy workload of the hospital nurses. Nurses are experiencing job dissatisfaction and burnout due to three main reasons: increased patient acuity, inadequate nursing staff, and higher workload. Staffing by patient acuity is safer for patients. It decreases the heavy patient workload and eliminate overtime. It will also increase the nurse’s job satisfaction and create better patient outcome. The article “Safe Staffing Saves Lives” mentions, “insufficient nurse staffing has been linked with poor patient outcomes, longer hospital stays and increased risk of patient mortality” (2011, p. 16, para. 2). The article summarized how the American Nurses Association (ANA) introduced the formal legislation that required “hospitals that participate in Medicare to form committees that compromised of at least 55% direct care nurses” (“Safe Staffing Saves Lives,” 2011, p. 16, para. 2). Now the ANA has proposed a guideline to solve the nurse-staffing crisis...
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...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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...My Thoughts Advocating for mandated nurse-to-patient ratios is an easy choice because it saves lives. The nursing profession is founded on caring for others, providing and promoting the health, safety, and well-being of those in need and the best way to do that is with safe nurse-to-patient staffing. This mandate is a win-win for patients, staff, and facility. Patients get best care, staff has job satisfaction, and facility gets decrease costs from benefits that better health care and staff satisfaction will produce. References Agency for Healthcare Research and Quality. (2012). Retrieved from http://www.nationalnursesunited.org/news/entry/state-mandated. Clark, C. (2010, January). Does Mandating Nurse-Patient Ratios Improve Care? Health Leaders Media. Fraughton, H. (2014). Factsheet: Nurse to Patient Ratios are Cost-Effective. Retrieved from http://nsgeu.ca/factsheet-nurse-to-patient-ratios-are-cost. Gordon, S. (2009). Safety in Numbers Nurse-to-Patient Ratios and the Future of Health Care. Retrieved from http://www.cornellpress.cornell.edu/book/?GCOI=80140100337250 Rosseter, R. (2014). Nursing Shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage Shekelle, P. G. (2002). Effect of Nurse-to-Patient Staffing Ratios on Patient Morbidity and Mortality. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0055923/ State Staffing Plans and Ratios. (2014). Retrieved from http://www.nursingworld.org/MainMenuCategories/Poli...
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...Abstract This paper will explore the topic of nursing overtime and its effect on adverse 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...
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