A clinical area of concern in the nursing discipline on 8 West orthopedics at Mount Carmel West is hourly patient rounding. Currently the nursing staff on 8 West does not do patient hourly rounding when providing patient care even thou the nursing manger on the unit tried to implement hourly rounding several times. There are numerous research studies done on hourly rounding and research has proven that hourly rounding has improved patient outcomes and improved quality care nurses give to their patients. Hourly rounding can help address a potential patient problem before the problem occurs (Ford, 2010).
When the nursing team hourly rounds on their patients it is shown to have a unique relationship. There is a decrease call light usage, decrease in falls, decrease patients developing pressure ulcers, and decrease patient anxiety. With hourly rounding patient
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Patient falls were reduced by 24%-80% when hourly rounding occurred (Mitchell et al., 2014). Most falls occur in the hospital setting are caused when a patient is trying to get to the bathroom or bedside commode and ambulating on their own (Tucker, Bieber, Attlesey-Pries, Olson, & Dierkhising, 2012). With hourly rounding the nurse can help address elimination needs for the patient and help assist the patient to the bedside commode or the bathroom. Pressure ulcers were reduced by 56%. Hourly rounding can help address the issue of turning patients every two hours to reduce the risk of developing a presence of a pressure ulcer (Ford, 2014).
To resolve the problem of patient dissatisfaction, patient falls, increase use in nurse call light and interruptions; 8 West Orthopedics would need to implement hourly rounding into their patient care and preform patient rounding every hour. Implementation of hourly rounding can be a difficult process but with the adequate nursing staff and leadership it can be an uncomplicated
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,
The Implementation Committee must clearly identify the desired results for this project. The ultimate goal is to improve customer satisfaction as a result of the leader adoption of the rounding process and timely identification and resolution to patient issues. In order to do this, nurse leaders must adopt and be held accountable to the Orchid technology and standardized rounding script. This process will improve efficiency of rounding, recording and reporting process. Meanwhile this robust reporting will identify, track and trend data collected during the reporting.
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
Ford, B. M. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. MedSurg Nursing, 19(3), 188-191.
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
...anging as new research and methods are discovered to better serve the patients and healthcare professionals (Ignatavicius & Workman, 2013). As nurses use rounding in all their patient care, they will become more skilled with the nursing process, especially with assessments and interventions. Patients are the major users of hospitals and deserve the highest level of care with the best outcomes. With nurse rounding, patient outcomes are improving with a reduction in patient falls and pressure ulcers, use of call light, patient complaints, and most importantly an increase in patient satisfaction (Forde-Johnston, 2014). Nurses play a critical role in the patient care experience; they have the ability to transform healthcare by delivering optimal care thereby improving quality and safety through competent and compassionate use of nurse rounding (Blakley, et al.,2011).
HAI rates, nurse staffing, length of patient stay, and patient outcomes need to be evaluated in a collaborative manner. Nurses play a vital role within the health care system, and the effects of nurse staffing on patient stay, outcomes, and HAIs is a critical element in health care needing immediate attention. A positive increase in nurse-to-patient ratio, even by adding one additional nurse per shift, will decrease HAIs, patient length of stay, and patient mortality. Stronger educational programs within hospitals regarding infection control are also needed. A more informed and educated nursing staff will likely result in a better educated patient. Overall, staffing of nurses proves to be a critical link between patients and HAI rates.
Kruse, B., (October 28, 2010) Patient scheduling benefits medical professionals, Retrieved January 25, 2011 from http://www.buzzle.com/articles/patient-scheduling-benefits-medical-professionals.html
Safe nurse-patient ratio is a complex issue debated on for many years. Due to inadequate staffing registered Nurses are faced with high patient ratios, and nurse burn out everyday. According to the American Nurses Association, “Massive Reductions in nursing budgets combined with, the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside”. (2012) Through the nursing process, the essential role of the Registered Nurse is to assess, diagnose, and plan based on outcomes, implement and evaluate the effectiveness of nursing care. However, it is not realistic to thoroughly implement these core guidelines in a safe and effective way, when you are
It is important to have a strong nurse-to-patient relationship to ensure adequate care is provided. However, when nurses are short staffed this does not occur the way it should because the nurses are now having to take care of more patients. This means that the one-on-one time with each individual patient is cut short and nurses are now becoming overworked which affects their overall performance as well. Ensuring proper staffing levels have been shown to; reduce errors, decrease complications when providing patient care, lower death rates, improve patient satisfaction, reduce nurse fatigue, improve nurse retention and job satisfaction. (2015, American Nurses Association) Optimal staffing is essential in order to provide optimal patient care. Innovative and collaborative strategies that focus on developing long-term solutions will improve
Low nurse staffing levels are an issue hospital-wide at St. Vincent Healthcare, particularly observed during my management hours with a House Supervisor. A responsibility of a House Supervisor is to ensure efficient utilization and allocation of nurses among the floors, so I have had the opportunity to thoroughly discuss and personally observe a variety of causes and consequences of low staffing with my preceptor. A primary reason for inadequate staffing appears to be due to finances; along with making patient safety a continuous priority, St. Vincent Healthcare must strive for good financial outcomes as well. There are certainly challenges that arise in maintaining a balance between providing adequate staff to deliver safe patient care and delivering services at lower costs. Other causes of low staffing are employee conflicts, management and/or leadership discrepancies, heavier patient loads/higher acuity patients, floating to other units, or decreased job ...
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.
Nurse staffing ratio is an ongoing issue in healthcare. For some units, it is a temporary problem until more team members are hired. Unfortunately, for others it is an everyday challenge that must be addressed. Nurse staffing ratio is usually based on number of patients a nurse should be responsible for during a shift. Unfortunately, not having enough staff is a safety concern for both the patients and the nurses. Therefore, addressing this topic should be a priority for nurse managers and leaders. According to Vantage Point (2009) a patient has a greater chance of dying while in the hospital when nurses have to care for more patients than recommended. A heavier workload will not result in