...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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...Strategic Action Budget Having adequate staffing is a continual problem in nursing. Having the right quantity of nurses to care for the patients without going over the budget is difficult. According to Roussel, strategic staffing is an approach to analyze the problem. Strategic staffing analyzes the staffing needs based on long-term objectives for the unit and tries to find a combination of permanent and temporary employees with the best skills to meet these needs. Strategic staffing also requires an understanding of the different types of staffing. The purpose of this request is to obtain qualified nurses utilizing in-house or temporary staffing services to fill short-term nursing needs. Finding qualified individuals for interim placement is necessary because of the increased census of this facility as a result of the current hiring freeze. Leaving the facility understaffed is having a negative effect on the staff morale and quality of patient care, and must be addressed. According to Roussel, each patient care unit should have a master staffing plan that includes the basic staff needed to cover the unit for each shift. Basic staff is the minimum number of personnel needed to staff the unit and they need to be fully oriented full and part time employees (Roussel, 2013). Options are a) the staff already in place, b) using a short-term contingency staff or a temporary agency, or c) long term temporary nurses or travel nurses. With limited resources...
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...TITLE: NURSE STAFFING AND QUALITY SERVICE NAME: COURSE: INSTITUTION: DATE: INTRODUCTION Nurse staffing is the placement of qualified nurses in health facilities so that they can work together with doctors to deliver quality health services to the community. Hospitals with high nurse staffing levels are much likely to have good patient outcomes and satisfaction no matter the patient turn out. Nurse staffing focuses on recruiting and keeping qualified nurses in a hospital so that handling of patients becomes easy and focused on quality service to the public. It enhances the identification of individuals that are most likely to work in certain areas of the health sector and also helps to enhance the diversity of nurses by matching candidates and the communities they will provide health services to. Salary and benefits are the factors that motivate qualified nurses to work consistently in a health facility because with good remuneration, nurses are able to further their education which further improves their profession and level of knowledge in their field of operation (Sales, A. 2015). Low nurse staffing results in higher risks of disease infections particularly the transmittable diseases due to lack of the urgency of treatment because the health facility has less nurses with a high number of patients. Nurse shortage is caused by the lack of enough registered nurses that are allowed to practice, low salary offers, poor training that leads to low confidence of practice, lack of...
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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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...Important of Adequate Nursing Staff 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...
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...Can 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...
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...How Does Mandatory or Voluntary Overtime Affect the Quality of Patient Care? Pam Glasper Beaumont Hospital Wayne How Does Mandatory or Voluntary Overtime Affect the Quality of Patient Care? Registered Nurses (RNs) constitute an integral part of the patient care and recovery process. To many patients, nurses are the health care professionals they see most often. Additionally, patients seeking care in outpatient clinics may not be aware of the number of hours nurses work. However, short stay and long stay patients see the same nurses over many shifts. What they may not realize is how many hours RNs work in a given 24-hour period to provide continuous patient care. According to Bae (2012a), a 2004 research study found that “43% of U.S. RNs worked more than 40 hours per week and about 9% worked more than 60 hours per week” (p. 205). In most instances RNs work overtime to alleviate staff shortages in their units. According to Bae (2012b), staff shortage in hospitals is not a new phenomenon and many researchers in health care system contend that such chronic shortage of nurses has a direct and negative impact on patient care (Bae, 2010; Bae, 2012b, Bae, Brewer, & Faan, 2012). For example, in several of her research articles, Bae (2010, 2012a, & 2012b) cited several research articles where researchers have found that the long hours worked by RNs are at the root of many adverse patient outcomes. Anecdotal evidence should suggest that anyone working long hours over an extended...
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...Business Case Analysis - Nursing Second Shift Staffing Business Case Analysis - Second Shift Staffing Monarch General Hospital has recently experienced short staffing of the nursing workforce for the second shift (15:30 to 23:30). This report was commissioned to examine options for the Healthcare Chief Officers involved, which will provide valuable guidance toward a reliable business solution based on currently available evidence. Background Monarch is currently experiencing a deficit in the supply of nurses. In particular, the deficit is on the second shift. But, overall, the actual problem to address is a less than optimal supply of nurses. The plan to remedy the problem for the actual shift involved will be addressed in the strategy and implementation. This deficit of nurses will cause delayed delivery of care to patients and/or adverse events. This will likely lead to patient dissatisfaction, lawsuits and the hospital absorbing unnecessary and unplanned for costs. These factors will ultimately lead to a reduced number of hospital admissions. Monarch must achieve the ability to control the shortage instead of surrendering to it. This report will examine two of the four currently considered options. The first option is hiring additional permanent personnel and the second is hiring short-term, temporary personnel to be used on an as needed basis. Business and Operational Impacts The factors leading to a reduced numbers of hospital admissions will affect...
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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 Nursing Shortage The history of nurses in our textbook, “Policy and Politics for Nurses and Other Health Professionals”, seems to suggest a deficit in nursing staff since the early 1900’s (Nickitas, Middaugh & Aries, 2016). As healthcare has transformed from the late 1800’s to the 2010’s, nursing has had to alter its practice to remain relevant and current with each era. This paper will share insight into the potential causes of the current nursing shortage, offer awareness of how nurses are preparing themselves to work in this setting and suggest methods through legislation to alleviate safety concern produced by limited staffing. Events Leading to the Nursing Shortage Current predictions by the American Healthcare Association (2009)...
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...Staffing on the Inpatient Psychiatric Unit at the University of Virginia Hospital University of Virginia School of Nursing Margaret Halladay, Lillian McDonough, Chelsea Bateman, Olivia Robison, Elizabeth Whitsett, Hannah Knabe, Janie Rhodes, and Fangzhong Luo On our honor, as UVA students, we have neither given nor received aid on this assignment. Margaret Halladay, Lillian McDonough, Chelsea Bateman, Olivia Robison, Elizabeth Whitsett, Hannah Knabe, Janie Rhodes, and Fangzhong Luo Introduction The nursing students working on 5E, the psychiatric unit at the University of Virginia, identified patient safety as a clinical problem related to inadequate staffing. Previous research revealed that 63% of the staff on this unit identified that inadequate staffing greatly affected patient safety. In order to research this issue further, the nursing students developed a follow-up survey that would help to identify the aspects of patient safety that are most affected. By understanding which aspects of patient safety create an issue on this unit, the group will develop an intervention with increasing safety as the expected outcome. Safety on this unit is difficult to measure because the unit does not face the same problems that staff encounter on Medical Surgical Units. One way to measure safety on 5E is to review the number of patient falls. Data was obtained that revealed in November of 2012, 5E reported the most falls of any unit in the hospital. Other safety markers...
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...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, that directly affect patient care delivery and outcomes. Researchers have suggested that the work environment and staffing levels for nurses affect both...
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...Nursing Home Crisis Many may not understand what goes on at a nursing home. They think that it is easy work just taking 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...
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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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...the charge nurse becomes burdened down with three patients, she cannot assist in these emergency situations and poorly manages direction and flow of the unit. This has led to the charge nurse holding resentment to some of the other nurses because they refuse an extra workload. When it came time for the other nurses to take vacation the charge nurse who does the scheduling tried to be fair and took three days less of her own vacation days to facilitate the fellow nurses vacation. The charge nurse did bring it to the attention of the manager; both nurses cannot take vacation at the same time. The manager did not listen to the charge nurse and granted both the vacations. This led to multiple nights putting the intensive care unit short with their staffing matrix. Thus, causing the charge nurse to take three to four patients. The charge nurse became so...
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