...------------------------------------------------- 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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...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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...Applying the 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...
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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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...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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...With the extreme success of California’s movement, a nationwide Safe Patient Ratios Campaign has been implemented. The campaign speaks about how California nurses went directly to the legislature to push their cause, and after 13 years of campaigning they won. The Safe Patient Ratios Campaign encourages nurses across the US and nurses worldwide to come together to stand for safe patient ratios, (NNU, 2017). You can visit and join the movement by visiting the link I will provide below. In addition, there is another movement that is occurring called Nurses Take DC. I came across this movement on social media, where it has spread like wild fire with nurses across the United States sharing their testimonies and coming together for a common interest. On May 4th and May 5th, Nurses involved in the movement will be rallying in Washington DC for safe nurse-patient ratios. (nursestakedc, 2017). This is a way that we as nurses can become involved and make a change for the better. California was able to achieve safe staffing, and so can...
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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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...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 was done...
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...Politics, Legislation, and Implications to Patient Care Abstract There are constant changes to laws and legislation regarding patient care and safety. The purpose of this report is to inform the reader of recent and upcoming changes to legislation that may affect nursing care of patients. Research by L. Aiken, et al. and A. Tourangeau, support the need for higher education of registered nurses. Their research proves that patient outcomes are improved when registered nurses carry a bachelor’s degree in nursing. Research conducted by J. Needleman, et al., concluded that reducing the nurse-patient ratio resulted in the patient being at less risk for developing hospital-acquired illnesses as well as a reduced risk of inpatient mortality. The reader will also be informed about the Joint Commission’s protocol for reducing the occurrence of wrong-patient, wrong-site, and wrong-procedure during surgical procedures. Politics, Legislation, and Implications to Patient Care As the American population ages, healthcare and its resources are in greater demand. As the demand for healthcare increases, the topic of patient safety has become increasingly important. Laws and legislation regarding patient care are changing almost constantly to maintain patient safety while still providing comprehensive patient care. This report will focus on informing the reader of recent and upcoming legislation regarding patient care, what has brought those changes about, and the effects it can...
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...Abstract Adequate nursing staff is critical factor for patient’s safety and health. 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...
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...Literature Review Problem Validation Literature 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...
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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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...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 centered care that is safe and effective (IOM, 2003). The snowballing effect of inadequate staffing that imposes increased workloads, extended work periods mandatory overtime also generate work related stress and burnout...
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...they received an ADN or BSN degree, they just expect that nurse to be competent in their job. The NCLEX-RN exam is based on minimal competency and does distinguish between graduate levels. Therefore, all nurses graduating from a nursing program and getting ready to take the exam are equal at that time. Regardless of whether a nurse graduates with their associates or bachelor’s degree, when they are hired at a hospital or health care facility, the extensive training gets them prepared to deliver safe effective patient care. Although receiving a BSN degree a person will achieve better assessment skills, critical thinking, communication, and leadership skills, graduating with an associates does not make a nurse less competent. All nursing programs teach how to assess, plan, implement, diagnose, teach, and evaluate, the skills it takes to be a nurse. In a hospital setting, acute care units have critically ill patient, which makes them unpredictable and challenging, therefore the nurses need have sharp critical thinking skills, perform quality patient care, and maintain positive outcomes. Patient load makes it difficult for any nurse to do her job well and efficient. Understaffing is a big problem in hospitals and it leaves the nurse to patient ratio significantly uneven which puts patient safety at risk. So the question is, are patients at risk because not enough nurses have their bachelor’s degree, or are they at risk because the facility they are in is not adequately staffed...
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