Background on Nurse Staffing Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014). There are various issues that arise with having a shortage among nurses in the hospital setting. Scientists have found that nursing shortages can lead to both complications during a patient’s hospital stay and in some cases patient mortality. This is due to the fact that nurses are unable to focus on proper care for each individual patient’s needs. Assessment of Findings Nurse Staffing and Inpatient Hospital Mortality According to J. Needleman et al., “lower levels of staffing among registered nurses [in the hospital setting]” has shown an association with increased patient mortality. Scientists found that nurses experience a very high workload during their shift and this leads to “impairment on patient surveillance.” Nurses are given numerous patients during their single shift and are not able to balance the high patient turnover with proper patient care. High patient turnover was also associated with an increased risk for mortality rates. Scientists argue that hospitals are trying to cut health car... ... middle of paper ... ...P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm., 38(5), 223-229. doi: 10.1097/01.NNA.0000312773.42352.d7 Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. The New England Journal of Medicine, 364(11), 1037-1045. doi: 10.1056/NEJMsa1001025 Rosseter, R. (2014, January 21). Nursing shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage Trinkoff, A. M., Johntgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nursing Research, 60(1), 1-8. Retrieved from http://vwvw.massnurses.org/files/Nurses_Work_Schedule_ Characteristics_Nurse 11.pdf
Suresh, G., Horbar, J., Plsek, P., Gray, J., Edwards, W., Shiono, P., & ... Goldmann, D. (2004).
Tadić, A., Wagner, S., Hoch, J., Başkaya, Ö., von Cube, R., Skaletz, C., ... & Dahmen, N. (2009).
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 ...
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
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.
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).
Without participating in a longitudinal study, it is difficult to truly assess the efficacy in mandating nurse staffing ratios. It is difficult to measure the benefits of mandated staffing due to numerous confounding variables. These confounding variables include the resources available at specific hospitals in addition to the populations that they serve. Hospital volume, RN job satisfaction and the relationship between physicians and nurses have also been shown to affect patient outcomes (Duval et al., 2007).
The nursing shortage most likely does not mean a great deal to people until they are in the care of a nurse. The United States is in a severe nursing shortage with no relief in sight due to many factors compounding the problem and resulting in compromised patient care and nurse burnout. Nursing shortages have been experienced in the past by the United States and have been overcome with team effort. However, the current shortage is proving to be the most complex and great strides are being made to defeat the crisis before it becomes too difficult to change. Researchers anticipate that by 2010, the United States will need almost one million more registered nurses than will be available (Cherry & Jacob, 2005, p. 30).
Staffing issues amongst the nursing profession has been a major concern. Safety of both nurse and patient is important. There is a strong correlation between having an adequate nursing staff and patient safety outcomes. The rise in the acuity of patients and shorter hospital stays has been linked to errors, nurse burnout, and patients sometimes feeling neglected. Patient satisfaction has become the major focus point since the change of our health care system today. Being able to find an optimal nurse- to- patient ratio has been an ongoing struggle in mostly all health care facilities. This paper will answer the PICO question, how is quality of care and patient safety affected in regards to nursing staffing and nurse patient ratios?
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
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.
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
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.
Barker, V., Giles, H., Hajek, C., Ota, H., Noels, K., Lim, T-S., & Somera, L. (2008).
How come my nurse doesn't spend more time with me? Why is she/he always rushing to get out of my room? As reported by the American Nurses Association (ANA), staffing in nursing is one of the biggest health care issues affecting the nation (2017). For one, there are just too many patients and not enough nurses, which makes it unsafe for the clients and the licensed professional. The administrators must reduce the ratio of nurse to patient because the current nurses' workload can lead to nurses' burnout, patient dissatisfaction, and negative patient outcomes.