Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press. This book is a comprehensive look at mandatory legislated ratios and how effective they are in the localities where they have been enacted. It takes into account the pro-ratio arguments, the anti-ratio arguments, discusses the events leading up to the enactment of this legislation, and discusses the results and the research used in evaluating ratio legislation. The strengths of this source are that it’s comprehensive and credible source (it was published by an academic publisher). One of the weaknesses of this source is that the book is very long, and some of the subtopics are not as well indexed as I would have liked. Hodge, M. B., Romano, P. S., Harvey, D., Samuels, S. J., Olson, V. A., Sauve, M., & Kravitz, R. K. (2004). Licensed Caregiver Characteristics and Staffing in California Acute Care Hospital Units [Electronic version]. The Journal of Nursing Administration, 34(3), 125-133. This article is a comprehensive look at staffing on hospital units. It used a survey to look at characteristics of how the units were staffed – not just ratio, but the experience and education level of the nurses. It evaluated several different categories of hospital facilities – public versus private, academic medical centers versus HMO-affiliated medical centers, and city versus rural. It is a good source because it shows what some of the staffing levels were before the status quo of the ratio legislation passed in California. It’s main limitation as a source is that it doesn’t supply any information about patient outcomes. DeVandry, S., & Cooper, J. (2009). Mandat... ... middle of paper ... ...so much detail about the data that it can be difficult to get a clear picture of how the staffing models would “look” in practice. Griffiths, P. (2009). Staffing Levels and Patient Outcomes [Electronic version]. Nursing Management, 16(6), 22-23. This article is skeptical of mandated nursing ratios, and discusses some outside factors that may be biasing the other studies I plan to cite. This article's strengths are that is from a peer-reviewed journal and written by a recognized expert, which makes it a credible source. Rather than simply supporting or opposing mandated maximum ratios, it introduces the idea that the other ratio studies may have missed some important considerations. The main drawback to this source is that it's a short article and doesn't go into a lot of detail. I may have to end up using other sources to supplement the ideas it proposes.
It is clear that statewide mandated nurse-to patient ratios result in drastic financial changes for every hospital impacted. Hospitals often have to compensate for hiring more nurses by laying off support staff. Mandated ratios also result in an increase in holding time in emergency rooms . (Douglas,
J.G. and Mrs. D.J. with the following questions concerning the issues of staffing and nursing shortage. How long has the organization tried to address the issue of staffing and nursing shortage? “Nursing shortage has always been an issue for the Lexington Medical Center. I have been employed here for almost five years and there continues to be a struggle with staffing the unit. We have to utilize agency nurses to fill in the needs on the unit” (J. Gudvangen, personal communication, April 30, 2016). What measures have been taken to address the issue of staffing shortage? “There are incentives being offered to attract new employees to work at the facility. A sign on bonus is offered to the nursing staff for up to fifteen thousand dollars, depending on what area of nursing you specialize in. Also during the peak season when the census is really high in the hospital, a bonus incentive program is offered for medical staff in a twelve weeks span. If the employee works a certain amount of extra hours, in addition to their regular schedule, at the end of the twelve weeks a bonus is paid to the employee. The bonus can range from twenty-five hundred dollars to twelve thousand dollars. This is used a method to attract the staff to work extra hours during the busiest time of the season" (J. Gudvangen, personal communication, April 30, 2016). What future steps have been planned to address the issue of staffing shortage? “The hospital is
The level of job satisfaction for a nurse is a vital factor in creating positive outcomes for their patients. California RNs report having much more time to spend with patients. The hospitals are far more likely to have enough RNs on staff to provide quality patient care. In California, where hospitals have better compliance with the staffing limits, RNs report fewer complaints from patients and families and the nurses have more confidence that patients can manage their care upon discharge. California RNs are substantially more likely to stay in their jobs because of the staffing limits, and less likely to report burnout than nurses in any other state. Two years after implementation of the California staffing law which mandates minimum staffing levels by hospital unit, nurse workloads in California were significantly lower than that of any other state. The legislation of the mandated nurse patient ratio has achieved its goals of reducing nurse workloads, improving recruitment and retention of nurses, and having a favorable outcomes on patient
Nursing standards are the building blocks that lead to excellent patient care. The ANA (American Nursing Association) has standardized sixteen common practices for the best quality care of patients by nurses. Nurses are only able to facilitate minimal standards to patients due to time restraints derived from patient ratios and lack of support from administration. The hope to achieve the best possible outcomes in patient care are limited to the minimal standards expected of nurses from the National Council of State Boards of Nursing (ANA, 2010). Patient ratios have been seen as a huge issue across the realm of nurses and health care facilities in deliverance on patient care. Addressing the issue of nursing shortages and the effects on ...
Shekelle, P. (2013). Nurse-patient ratios as a patient safety strategy. 158, 404-409. Retrieved from http://eds.b.ebscohost.com
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
Nelson, R. (2008, March). AJN reports: California’s ratio law, four years later. American Journal of Nursing, 108(3), 25-26. Retrieved from http://www.nursingcenter.com
The term “nursing shortage” is not new to America. In fact, the United States has
Since the 1990’s, the interest in nursing and the profession as a whole has decreased dramatically and is still expected to do so over the next 10-15 years according to some researchers. With this nursing shortage, many factors are affected. Organizations have to face challenges of low staffing, higher costs for resources, recruiting and reserving of registered nurses, among liability issues as well. Some of the main issues arising from this nurse shortage are the impact of quality and continuity of care, organizational costs, the effect it has on nursing staff, and etc. However, this not only affects an organization and community, but affects the nurses the same. Nurses are becoming overwhelmed and are questioning the quality of care that each patient deserves. This shortage is not an issue that is to be taken lightly. The repercussions that are faced by both nurses and the organization are critical. Therefore, state funding should be implemented to private hospitals in order to resolve the shortage of nurses. State funds will therefore, relieve the overwhelming burdens on the staff, provide a safe and stress free environment for the patient, and allow appropriate funds needed to keep the facility and organization operational.
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
One of the issues involving health care and the aging population is majority of health profession employees being a percentage of the aging population. With the knowledge of health profession employees being a factor in the aging population puts a strain on doctors and nurses that come into the workforce after ones have retired. The fewer employees there are, the greater the work load will become on one person. It is imperative for each nurse in a unit to have four patients maximum. Giving more responsibility to one employee does not make the situation less of a challenge, it more so puts people’s lives at a greater risk of danger. The new demands placed on the health care system for health services will not only include a need for more workers, but also require changes in the way services are provided.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
Bedside nurses want to change staffing levels to assure that they have enough time to both keep up with the constantly evolving health care and to provide safe patient care. Yet, healthcare employers consider that reducing nurse patient ratio is an unnecessary expense that has not been proven to improve quality of patient care (Unruh, 2008). Employers emphasize that raising nursing staffing level is not cost-effective. In fact, in accordance with ANA’s report (2013), a study, in the Journal of Health Care Finance, confirmed that reducing patient-nurse ratios increased hospital costs, but did not lower their profitability. Higher hospital costs were attributed to wages and benefits allocated to newly hired nurses. Yet, according to Cimiotti et.al (20112), it is more costly for hospitals to not invest money on nursing.