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Nurse-patient ratios and patient outcomes annotated bibliography
Nurse-patient ratios and patient outcomes annotated bibliography
Nurse patient ratio affects patient outcomes
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Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press. This book is a comprehensive look at mandatory legislated ratios and how effective they are in the localities where they have been enacted. It takes into account the pro-ratio arguments, the anti-ratio arguments, discusses the events leading up to the enactment of this legislation, and discusses the results and the research used in evaluating ratio legislation. The strengths of this source are that it’s comprehensive and credible source (it was published by an academic publisher). One of the weaknesses of this source is that the book is very long, and some of the subtopics are not as well indexed as I would have liked. Hodge, M. B., Romano, P. S., Harvey, D., Samuels, S. J., Olson, V. A., Sauve, M., & Kravitz, R. K. (2004). Licensed Caregiver Characteristics and Staffing in California Acute Care Hospital Units [Electronic version]. The Journal of Nursing Administration, 34(3), 125-133. 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. DeVandry, S., & Cooper, J. (2009). Mandat... ... middle of paper ... ...so much detail about the data that it can be difficult to get a clear picture of how the staffing models would “look” in practice. Griffiths, P. (2009). Staffing Levels and Patient Outcomes [Electronic version]. Nursing Management, 16(6), 22-23. This article is skeptical of mandated nursing ratios, and discusses some outside factors that may be biasing the other studies I plan to cite. This article's strengths are that is from a peer-reviewed journal and written by a recognized expert, which makes it a credible source. Rather than simply supporting or opposing mandated maximum ratios, it introduces the idea that the other ratio studies may have missed some important considerations. The main drawback to this source is that it's a short article and doesn't go into a lot of detail. I may have to end up using other sources to supplement the ideas it proposes.
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,
For my research paper, I will be taking the position that low nurse-patient ratios (the number of patients a nurse is assigned to care for during their shift) are beneficial to patient safety and should be adopted on a larger scale. What made you interested in this topic? I am interested in this topic because when I graduated from nursing school last year, I accepted a job where I am comfortable with my workload, while many of my classmates ended up in work environments where they are responsible for taking care of as many as 9 patients at a time while working as the Charge Nurse on the unit. Several have expressed to me that they feel their patients aren't safe because of the workload they face as nurses. How is it related to your field of study, major, or to what you plan on doing after you graduate?
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
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.
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
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.
2. Bauer M, Nay R. Improving family-staff relationships in assisted living facilities: the views of family. Journal Of Advanced Nursing [serial online]. June 2011;67(6):1232-1241.
The term “nursing shortage” is not new to America. In fact, the United States has
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
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.
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
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.