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Nurse Staffing Ratios and Patient Outcomes
Factors affecting the nurse - patient relationship
Factors affecting the nurse - patient relationship
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Recommended: Nurse Staffing Ratios and Patient Outcomes
Independent variables: Nurse staffing ratios is an independent variable
Dependent variables: The dependent variable are patient outcomes pressure ulcers, patient falls, preventable gastrointestinal bleeds, sepsis, and deep vein thrombosis (DVT) due to decreased mobility.
Confounding variables: Multiple confounding factors exist including the number of “float” RN staff available to supply the unit and the division of patient care between licensed staff and unlicensed assistive personnel (UAP). In addition, the skill set and educational background of the RN’s providing care on the unit are confounding variable that have the possibility to effect the study’s outcome. Patient’s consent is needed to access their medical record, and track outcomes
According to the Registered Nurse (RN) Scope of Practice Position Statement, “the RN is responsible for providing safe, compassionate, and comprehensive nursing care to patients and their families with complex healthcare needs” (Texas Board of Nursing, 2011). Nurses often care for five to six patients at one time; therefore, in order to provide the best quality care, patients are often connected to monitoring devices such as, physiological monitors, venti...
Long Term Acute Care Hospital With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care for acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys. For patients requiring longer acute care than what is generally given at an inpatient acute care hospital, the Long Term Acute Care Hospital is an option. To be admitted to an LTACH, patients are required to have “medically complex situations with a mean length of stay > 25 days” (Munoz-Price, 2009, p. 438 ).
Painter, L. M., & Dudjak, L. A. (2010). Actions, Behaviors, and Characteristics of RNs Involved in Compensable Injury. Journal of Nursing Administration, 40(12), 534-539. http://dx.doi.org/10.1097/NNA.0b013e3181fc19eb
The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan...
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite Professor, College of Nursing, The University of Texas at Tyler, Tyler, TX, and CEO, Management Solutions for Healthcare, Houston, TX; Jean Dois, RN, PhD, NEA-BC, FACHE, is the System Director for Quality and Nursing, CHRISTUS Health System, Houston, TX; and Peggy Landrum, RN, PhD, is Clinical Professor, College of Nursing, Texas Woman 's University, Houston,
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
Licensed practical nurses (LPN 's) fill an important role in modern health care practices. Their primary job duty is to provide routine care, observe patients’ health, assist doctors and registered nurses, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes (Hill). A Licensed Practical Nurse has various of roles that they have to manage on a day to day basis, such as being an advocate for their patients, an educator, being a counselor, a consultant, researcher, collaborator, and even a manager depending on what kind of work exactly that you do and where. It is the nursing process and critical thinking that separate the LPN from the unlicensed assistive personnel. Judgments are based
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 nurse needs to recognize the limitations of each staff member and learn what assignments are within the scope of their practice and what are tasks that need delegation. Delegation is defined as a complex process that requires clinical judgment and final accountability for patients’ care (Weydt, 2010). An assignment is defined as “giving someone else a task within his/her own practice and is base on job descriptions and policies” (NCSBN, 2005, p. 1). The Board of Registered Nursing (BRN) and the Board of Vocational nursing & Psychiatric Technicians (BVNPT) website, lists what duties the RN and the LVN can legally do and is within their scope of practice, this is called the ‘nurse practice act’. A nurse assistant personnel (NAP) or Unlicensed Assistive personnel (UAP) may perform different tasks depending on the state that they reside in, but most include tasks that are considered activities of daily living (ambulating, hygiene, grooming)(NCSBN, 2005). The LVN can perform tasks that the nursing assistant can do, as well as other tasks which include: medication administration (oral, subcutaneous, intramuscular), simple dressing changes, wound care, suctioning, catheter insertion, drawing blood from a patient, and starting an IV and intravenous fluids. IV and blood draws are dependent on the LVNs certification, competence, and
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
For a nurse, trying to provide individualized care for a patient is extremely difficult to do, due to dealing with up to 20 patients a day. Assessing a patient’s needs and problems is first and foremost the most important thing for a nurse to do. Nurses are always caught between taking their time with a patient, and sorting out who needs care the most or whose condition is more severe. According to research done by the National Institute of Nursing found on nursingworld.org, patients who received 80% more of their care from RN’s had an 18.7% lower odds of readmission. Under the same circumstances, 1.9% had a shorter length of stay. Additionally, when there is a 10% increase in hiring of nurses, there is also a 10% decrease in the practice’s mortality rate. Some establishments are actually given higher pension compensations for quality of care based on statistics of their patient income and recovery time. This can be based on doctors and their performance, but there are some that are based solely on RN’s as well as the entire nursing staff and their performance with patients. In a private interview, registered nurse Whitney Sharp says “personally, as a charge nurse and a registered nurse, I make sure that the patient is comfortable, is receiving the right treatment and that the patient is monitored at all times. A patient can have a heart attack, loss of breath, or
...ut supplements nursing care in a health care facility (Jacob & Cherry, 2007). For example, if a hospital’s medical-surgical unit uses a team nursing approach to patient care, a system of case management also might be in place to assist with coordinating the patient’s total care through discharge (Jacob & Cherry, 2007). Moreover, case management is not always necessary with every patient in a health care facility. Typically case management is generally reserved for the seriously ill or injured, chronically ill, and high cost cases (Jacob & Cherry, 2007).
The population is the patient amount. The direct outcome is a decreased mortality rate. A higher nurse to patient ratio would be the dependent variable. The specific question regarding a qualitative res...
The second standard in the nursing process is diagnosis. During this step, the registered nurse analyzes the assessment data to determine the diagnosis or issues (“American Nurses Association,” 2010). Analysis involves recognizing cues, sorting through and organizing or clustering the information, and determining patient strengths and unmet needs. These findings are compared with documented norms...