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nurse to patient ratios and patient outcomes
nurse to patient ratio quality improvement project
nurse to patient ratios and patient outcomes
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In the health care industry, nurse to patient ratios is often a controversial issue. Registered nurses know and continue to reiterate the importance of safe staffing levels in health care facilities. Reductions in nursing budgets, coupled with the expanding nursing shortage, has resulted in a reduction of available nursing staff. As a result, the employed nursing staff are forced to work longer hours with more acutely ill patients. Consequently, patient care is compromised and ultimately perpetuates the nursing shortage because of this negative work environment. Providing safe quality health care is expensive. Health care facilities are always in search of ways to trim spending while maintaining the same quality of care. One of the methods in which hospitals trim the spending budget is through labor reduction. Tempting as this may seem, this method presents a massive dilemma to providing safe quality care. Less staff coupled with large patient workloads will lead to adverse patient outcomes. Evidence shows that it is more cost effective to maintain safe staffing levels and prevent adverse patient outcomes versus the estimated savings of labor reduction. Maintaining safe nurse to patient ratios reduces patient infection rates and patient mortality rates. Ratios also reduces nursing fatigue, which increases job satisfaction and nurse retention rates saving on the cost of hiring and training new staff. Mandating staffing ratios is not the answer because the health care industry is already burdened with an overwhelming number of regulations. The aforementioned issues necessitates further research on how to implement a cost effective, safe, and quality method of maintaining nurse to patient ratios. This research paper will prove... ... middle of paper ... ...5-2702.2011.03956.x Hospital costs in context:A transparent view of the cost of care [Excutive summary]. (2010). Retrieved from Massachusetts Hospital Association: https://www.mhalink.org/AM/Template.cfm?Section=Home&ContentID=11241&Template=/CM/ContentDisplay.cfm RN turnover costs hospitals an estimated $9.75 billion annually. (2010). Retrieved from http://www.altergroup.com/alter-care-blog/index.php/healthcare/rn-turnover-costs/ Scott, II, R. D. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf The future of nursing: Leading change advancing health [Report]. (2010). Retrieved from The Institute of Medicine: http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf
The United States offers some of the most established and advanced health care in the world. Practitioners and administers are constantly trying to improve the quality of care received by patients in the US. Data has consistently shown that the presence of a registered nurse contributes directly to positive patient outcomes (Cho et al., 2016). The debate across the country, however, concerns the precise number of staff required to provide safe, high-quality care. The issue of safe staffing is one that is of great importance to all involved in the delivery of health care across the country.
Institute of Medicine (2010). The future of nursing: Leading change advancing health Retrieved from http://books.nap.edu/openbook.php?record_id=12956&page+R1
Scott II, R. (2009) The direct medical costs of healthcare-associated infections in U. S. hospitals and the benefits of prevention. Center of Disease Control and Prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
Needleman, J., Buerhaus, P., Pankratz, S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. England Journal of Medicine, Retrieved from http://www.nejm.org/doi/full/10.1056/nejmsa1001025
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
What Seems To Be The Problem? A discussion of the current problems in the U.S. healthcare system.
...staff would not be required to put in the overtime to compensate for the lack of workers. Patients would no longer have to suffer the neglect of the staff because he or she was too busy. Making sure the patient gets the best quality care reduces the time spent for recovery. Reducing the time spent for recovery increases the organization’s finances. Providing a safe facility also reduces the expenses on the private hospital’s budget. Ensuring a patient is safe can reduce potential use of ongoing treatment and services. Hiring the appropriate nursing staff needed can save the organization money. Instead of cutting back on staff, more staff needs to be hired to fulfil the needs of the patient. In the economy today, private hospitals need to focus on the overall long term effects of each action opposed to quick reactions resulting in financial strain for the facility.
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.
There are new challenges every year in the health care field. Research on the future of U.S Healthcare System is of paramount importance to the entire Health care industry as well as the citizens of the U.S. To begin with, the research will discuss how challenges for future healthcare services can be enhanced by reducing the costs of medication. By creating a better quality of health care, Information technology advancements, including future funding, lower rising costs, the Medicare and Medicaid programs. The research will also discuss the challenges of market shares for different ages of populating and maintaining a skilled work place. It will further discuss the tentative solutions to these challenges. The role that the government plays to ensure that these challenges are mitigated and that health care is available to all American citizens is also discussed. Among these problems poor quality of care is perhaps the most visible and troubling, resulting in nearly 100,000 preventable deaths each year (Institute of Medicine, 1999) and reduced quality of life for millions of Americans due to non-fatal yet serious adverse events such as wrong-limb amputation, hospital-acquired infection, and medication errors (Institute of Medicine, 2006; Leape, 1997).
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.
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
This system provides annual statics on Medicare payment amounts for institutional providers. A nurse leader can use HCRIS to find other similar institutions with whom to compare reimbursement rates and use this information to make necessary adjustments (“Healthcare Cost Report”, 2016). Lastly, nurse leaders can also use cost-to-charge ratios, volume-based measures, per diem rates, and balanced scorecards to gain better insight of unit reimbursement (Liberty University,
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main
Nurses know that there is a correlation between maintaining adequate staffing levels and safe patient outcomes. Nurse to patient ratios is a very complicated issue in the health care industry. Nursing shortages, higher patient acuities, shorter hospital stays, and the cost of health care has presented a challenge to this staffing issue. An inadequate staff ratio puts patients at an increased risk of adverse outcomes such as medical or medication errors, increased hospital acquired infections, and increased mortality rates ("Nurse," n.d.). The complications and adverse outcomes associated with the inadequate staffing levels come at a cost, which is an even larger financial burden on the health care industry related to the cost of treating infections or law suits from wrongful death situations.
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.