In the past two decades, there has been a push for appropriate staff to client ratios. However, measuring client needs and nursing efforts have been around since 1922 (Lewinski-Corwin, 1922, pp. 603-606). The earliest recorded effort was by the New York Academy of Medicine. Superintendents and nurses from ten training schools documented the time spent providing bedside care. From complied information, the researchers revealed each client required an average of five hours and four minutes of care in a 24-hour period. From these observations, they evaluated staffing issues in New York City. At that time, none of the hospitals were sufficiently staffed (Lewinski-Corwin, 1922, pp. 603-606).
Still today, nurse staffing is a crucial health policy issue. Since the 1980s, the nursing profession has taken on more prominence in America with a large focus on research studies. In fact, U.S. Public Law 99-158, Health Research Extension Act of 1985, authorized the National Center for Nursing Research (NCNR) at National Institutes of Health (NIH) (Health Research Extension Act of 1985, 1985). With U.S. Public Law 103-43, NIH Revitalization Act of 1993, the NCNR was formally changed to the National Institute of Nursing Research (NINR) (NIH Revitalization Act of 1993, 1993). The NINR started constructing purposeful research projects, which produced a positive correlation between the number of staff and quality of care. However, the 1996 Institute of Medicine (IOM) report expressed, at that time, no significance between nurse staffing and clients’ outcomes in acute-care hospitals (Institute of Medicine Staff, Davis, Sloan, & Wunderlich, 1996, p. 9).
For a while, hospitals were cutting staff, using the IOM report in 1996 as evidence-based rese...
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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
NIH Revitalization Act of 1993, 42 U.S.C. § 1511 (1993), http://history.nih.gov.
Nursetraveler. (1999). The original bill that put staffing ratios in place! Retrieved September 10, 2011, from http://nursetraveler.org
Registered Nurse Safe Staffing Act of 2003, S. 991, 108th Cong. (2003), http://thomas.loc.gov.
Sovie, M. D., & Jawad, A. F. (2001, December). Hospital restructuring and its impact on outcomes. nursing staff regulations are premature. Journal of Nursing Administration, 31(12), 588-600. Retrieved from http://journals.lww.com
Tone, B. (n.d.). California nurse-to-patient ratio still undecided, comment period ahead. Retrieved September 10, 2011, from http://www.nursezone.com
Healthcare organizations are committed to providing clients with quality service and experience while promoting safety, health, and healing. Nurses have the biggest impact in providing safe client care and are known for their commitment in improving or increasing client health. However, this ethical commitment may not always be met due to breakdowns in healthcare delivery. Deviations such as adoption of unsafe practices or behaviors can lead to sentinel events. Any disconnects or disruptions can be a detriment to client care. This paper will present recent cases of witnessed breakdowns of facility protocols and adoptions of unsafe nursing practices, discuss its relevance to education, and how it has affected my personal perspective on the
stationed staff in one area of a hospital ED to treat patients presenting to the ED" (Minott, 2008). This results of this experiment stated that "28 percent of patients diverted back home and avoided hospital readmission" (Minott, 2008). Another study showed that "greater registered nurse hours spent on direct patient care were associated with decreased risk of hospital related death" (Kane, Shamiliyan, Mueller, Duval and Wilt, 2007). This shows that there is a correlation between direct care between healthcare providers and a better outcome amongst patients.
The problem, as defined for my argument research paper, is that to cut costs, hospitals have been steadily increasing the number of patients nurses must care for. In many areas it's not uncommon for one nurse to have to assess, give medications to, and manage the care of as many as 12 patients. This puts tremendous strain on nurses. Many of the studies I have seen in my research indicate that a high ration of patients to nurses increases the rate of death or other poor outcomes for patients. It also leads to increased nurse burnout and higher turnover, though at this point I believe my paper will focus on patient outcomes.
V ́ericourt, F., & Jennings, O. B. (n.d.). Nurse-to-patient ratios in hospital staffing: a queuing perspective. Retrieved from https://faculty.fuqua.duke.edu/~fdv1/bio/ratios3.pdf
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).
Needleman, J., Buerhaus, P., PKankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse Staffing and Inpateint Hospital Mortality. The New England Journal of Medicine , 364, 1037-1045.
Report on the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification. O’Brian, J. M., (2003). The 'Path of the Earth'. Journal of Science, How Nurse Practitioners obtained provider status: History of nurse practitioners.
A growing subspecialty of nursing practice is clinical research nursing. According to Harvard’s Catalyst Clinical Research Center (HCCRC) and the National Institutes of Health (NIH) nurses play an active role in providing care within a delivery system that is focused on conducting clinical research (HCCRC, 2014). Nurses serve as clinical research nurses and as study nurse coordinators. Within these roles they have the added responsibility of ensuring care is delivered in compliance with the protocol, as well as human subjects protections’ ethical and regulatory guidelines, policies, and regulations that span from an institutional level, to the state level and up to the f...
Nevidjon, B., & Erickson, J. (31 January, 2001). The Nursing Shortage: Solutions for the Short
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.
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 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.
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.
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.