...Review The purpose of this paper is to discuss the reviews of the literature that pertains to the problem/issue chosen by this writer. 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...
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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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...expectations. Challenges with oversight and regulations will be discussed as well as solutions to the problem. Challenges and solutions for staffing and training issues will also be discussed. The paper will also highlight “In Loving Hands Assisted Living” which is a local assisted living facility that I called and visited to aid in my research. I will give an overview of the Fort Washington area in terms of older adults and the long term care market. The challenges with this provider are marketing and staffing for which I suggest low cost advertisement and comprehensive staffing patterns. Lastly, a conclusion and summary are provided for the current state and future of assisted living facilities. Overview of Assisted Living While the definition of assisted living facilities vary from state to state, this type of facility is generally defined as “a housing option that involves the delivery of professionally managed, supportive services and depending on state regulations, nursing services in a group setting that is residential in character and appearance” (Evashwick, 2005, p 152). Assisted living facilities serve as a way to provide care to people who are having difficulty living independently, but do not require daily nursing services, or the amount of intensive medical and nursing care provided in nursing homes (University of Maryland, 2004). In Maryland, an assisted living provider is defined as: A residential or facility-based provider that provides...
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...studies over the years in the relationships between the staffinglevels in nursing homes and quality of care measures. Finding the best evidence for staffinglevels on the quality of care has become more and more difficult. In the research article“Systematic Review of Studies of Staffing and Quality in Nursing homes,” the results of thereview are based to three major categories, Staffing measures, Quality measures, and RiskAdjustment or Control Measures. Staffing measures are different nurse staffing calculations usedin the literature and range from numbers of staff per resident to staff turnover rates. Qualitymeasures indicate a measurement for quality care and are classified as either resident outcomesor facility outcomes....
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...Agency Nurse Orientation: A Case for Change EBT1-Task 3 Western Governors University A1) Procedure Nationwide there are currently 16,000 certified nursing homes caring for 1.4 million residents (Zhao & Haley, 2011). Due to high nurse turnover rates and persistent staffing shortages, many nursing homes utilize nurse staffing agencies to meet staffing needs. Holliswood Care Center (HCC), a 300 bed nursing home, with five residential floors, located in Hollis, New York is not exempt from such staffing challenges. In fact, according to Yves Pascal, Director of Nursing (DNS) at HCC, “Usually, 2-3 LPN’s per shift are required daily” (Y. Pascal, personal communication, December 15, 2013). Agency nurses are approved to work at HCC once they submit a current physical and complete an in-house facility orientation. During this orientation, agency nurses receive New York State mandated in-services, such as patient abuse and HIPPA. The nurses also receive specific instruction regarding emergency procedures, medication policy, employee conduct and procedures. However, specific unit policies and procedures, location of specific supplies are not included in the general orientation. Upon completion of the orientation, the agency nurse receives no further orientation or precepting. Thus when an agency nurse enters HCC for their first shift they are functioning independently and with limited knowledge. This is clearly a problem, which varies in degree of potential...
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...------------------------------------------------- Medical Malpractice in Nursing Homes By: Molly Hix Medical malpractice occurs on a daily basis to innocent patients. Today, malpractice continues to increase in nursing homes due to the shortage of qualified staff. Malpractice is when a hospital or any type of healthcare happens through neglect to a patient. Neglect might occur when the diagnosis is wrong, treatment or even aftercare. The number of malpractice cases is on the rise in nursing homes due to the lack of employee to patient ratio leaving patients to suffer and employees on the verge of lawsuits. Back in 1986 a report by the Institute of Medicine was released stating that residents were receiving negligent care. They were likely being physically or mentally abused as well as having all their rights ignored by the caregivers. In 1987 Congress decided to pass a legislation to establish rules and standards for nursing homes. Even though the legislation was passed the nursing homes along with the caregivers were still violating these rules. This regulation was established to make sure patients were receiving the correct care in a professional manner. This meant that the caregivers were required to actively use the available resources to get the proper training to further the patients’ lives and well-being. Fast forward to year 1999, the U.S General Accounting office found a lack of treatment in nearly one- third of all nursing homes. Stated in this report they found bed sores, a number...
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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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...W5 Application: Patient Safety Risks Nursing Home Setting This paper will focus on geriatric patients group with increased fall risk at nursing homes. A nursing home is chosen by as the selected healthcare setting. Nursing homes are not only for geriatric population, but for anyone who requires 24-hours care. Nursing homes focus their services for people who cannot be cared at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. Many of them are set up like a hospital setting. This type of facility provides interdisciplinary medical care, such as physical, speech, and occupational therapy, or even specialized care units. Patient Safety Among the key challenges of patient care, quality, and safety is to ensure that there are no injuries to patients from the care intended to help them. Another challenge is to provide care that is respectful of and responsive to patient preferences, needs, and values. Since the nation's health care system is prone to errors which can be detrimental to quality and safety. In fact, a variety of stakeholders are responsible of ensuring that patient care is delivered with the highest quality standards and that no harm occurs to patients. However, the possibility of errors is...
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...Wesley D. Pointjour Final Research Paper: Telehealth In Nursing Homes Health Quality Management April 02, 2015 Introduction In many nursing home facilities, patient safety is little to non-existent and if they are, there displayed on a need be and not obliged basis. They are displayed case by case rather than nursing home protocol. Even with changes in regulations, reporting systems, and documentation over the past couple of years, the nursing home industry still has its share of problems. Patient safety is meant to provide patients freedom from healthcare associated preventable harm, meaning when things go right, nothing bad happens. Nursing home organizations have been constantly trying to improve their reputation and the way people view them, but how? Don’t patients make up a nursing home? What about their safety? Shouldn’t we start there? How do we make improvements? Telehealth, a new approach to improving patient safety in nursing homes, will use telecommunication technologies to deliver health related services and information that support patient care, administrative activities, and health education (Dixon, Hook, McGowan, 2008). In this paper I will explore the major benefits of Telehealth and how its implications can improve patient safety in nursing home care. What is Telehealth and why is it important? Telehealth is the means and methods to improving access to care and reducing healthcare associated costs. It is also a system that can be used for education...
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...Formal Paper Heather Shuping Theoretical and Professional Foundations in Nursing Assessment/Background In the time that I have spent in the clinical setting during my nursing education, I have noticed several problems that concerned me. One of the main concerns I have seen in the hospital setting is staff turnover among the nursing profession. The turnover can ultimately lead to temporary problems like understaffing. Thankfully though, I believe this problem is amendable with proper intervention to facilitate a change toward staff retention. So why is staff turnover a problem in the nursing profession? First and foremost, this is not a unifactoral issue. In fact, staff turnover is the byproduct of multiple job related factors and stressors in the nursing profession. For instance, job-related stress plays a major factor in decreasing one’s job satisfaction. Stress in nursing usually occurs when one perceives that his or her resources are exceeded in a given situation (Esther, et al., 2005). Typical factors that can promote stress in a nurse are high job demands and excessive work hours. With these factors, the nurse may continually feel overworked, while also feeling like they are working “all the time.” Other factors that could cause stress are having little control over your work environment or having limited supportive relationships in the workplace. As we all realize, at least some sense of control and peer support are necessary to promote feelings of job satisfaction...
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...Clinical practice problem A survey of the nursing literature shows that supporting medical nurse staffing guarantees quality nursing watch over patients and has been a progressing test for attendant directors and executives. Inability to guarantee adequate numbers and empathetic medical attendant staff has been shown to adversely affect tolerant fulfillment and results. The medical nurse staffing issue is not restricted just to guarantee sufficient quantities of staff that are being lost in the intense consideration settings because of workaholic behavior, burnout, sympathy exhaustion and wounds; the attendant staffing issue additionally incorporates the effect to patient consideration and to the nursing work power when empathy and caring is truant and the negative impacts this has on both the patient and the medical attendant. Customary systems for tending to medical nurse staffing issues with monetarily based enrollment and maintenance arrangements have not determined these issues; be that as it may, applying the theory of human caring to the issue of attendant staffing gives critical knowledge and arrangements that can help supervisors, executives and associations to enhance the conveyance of consideration, bolster medical attendants as a profitable asset and enhance tolerant results. The deficiency of qualified nursing experts is frequently connected with the interest for nursing staff. To be sure, medical attendants speak to clinics' biggest work cost, containing the...
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...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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...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, shock or cardiac arrest increases when patients receive fewer hours of nursing care. Medication errors and unsafe hand washing techniques were found more in increased patient workloads. Unsafe staffing gave more job dissatisfaction, job burnout and more nurses quit or drove nurses away from nursing. This increased mandatory overtime and increased nurse...
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...MANU 556- Current Issues in Health and Nursing Unit 3: Health Care Systems Learning Objectives: 1. Discuss the quality impact of “corporation” of health care through mergers and acquisitions. 2. Look at the effect of staffing that is based on patient outcomes and not nursing interventions. 3. View the trends in long term care as a continuum along the life of an individual. 4. Described the impact of the Philhealth Insurance on nursing practice. Basic health and medical care is a pervasive social need. Taken as a whole, the collective subsystems of health care form a unique system. In a broad sense, the health care delivery system refers to the major components of the system and the process that enables individuals to receive health care. The health care system is defined as all of the structures, organizations, and services designed to deliver professional health and wellness services to consumers. Traditionally, Philippines health care has been organized around the physician and the hospital. A triad of client, nurse, and physician became the basis of health care delivery, although not all members had equal status. Today, health care is increasingly more complex. Nursing personnel constitute the largest group of health care providers in the Philippines. They are the health care personnel who both deliver and coordinate care for clients. Therefore nurses are poised to be the care providers most prepared for population health and care coordination roles. As...
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...interview by asking her how she came about her career in the healthcare field, she responded, “What got me started in this field is that I had prior experience at MassMutual Financial group overseeing a team of associates and reviewing their work loads and assignments. When I saw the opportunity to be a staffing coordinator, at Wingate of Wilbraham, it seemed to be a much less stressful job than the one at MassMutual. I never received a degree but the combination of college courses that I took which included pre-med, pre-nursing, counseling psychology and then business management and all the jobs I had within those related fields subsequently gave me a variety and a mix of experience and knowledge for my current position.” This really showed me how valuable work experience, coupled with academic experience, can be helpful when applying for jobs or deciding what type of jobs to apply for. The interview discussion then moved onto the work environment she dealt with and her daily duties. I asked her about her previous working conditions as well and what skills were utilized and necessary in her field. She responded by stating, “My daily duties are to insure that a 24 hour nursing and rehabilitation facility is safely and adequately staffed for the...
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