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In healthcare systems today, nurses play a valuable part in quality improvement. Healthcare system and the approach for taking care of patients continue to change every day. As healthcare continues to transform, so does the need for quality improvement. This is partially due to the increasing number of acutely ill patients that nurses and healthcare staff are responsible for taking care of (Hood, 2014, p. 490). According to Hood (2014), quality is defined as “a degree of excellence in which something possessed. For the patient this includes safe, timely, efficient, equitable, effective patient centered care” (p. 490). For nurses and other healthcare staff “nurse-patient ratios, adequate time to spend with patients, availability of supplies, …show more content…
This alone impact quality care in healthcare for not only patients, but nursing and staff as well. Decreasing turnover rates and increasing retention of nurses is important and should not be taken lightly.
Turnover rate involving nurses is at an all-time high. Hood (2014) states, “According to a poll conducted by the American Nurses Association (ANA, 2013) with 16,295 nurse participants, 118,130 nurses believed that inadequate staffing compromised the quality of nursing care services. When the question was asked if they were currently considering leaving their position, 8,734 responded affirmatively, and 3,773 reported that inadequate staffing was the reason for leaving” (p. 490). These statistics are caused by nurses feeling the wrath of working shorthanded, and stressed out from pulling extra shifts.
Although turnover rates for nurses are a negative impact on quality care, adjusting and implementing positive strategies for nurses in the workforce can improve quality improvement, therefore keeping nurses on the job and satisfied at the same
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Several elements factor in on when it comes to preventing pressure ulcers, such as wound risk management, turning/repositioning, and nutrition/hydration, but the most important is skilled and knowledgeable staff. “It is demonstrated by meticulous execution of psychomotor skills and coincident attention to safety, dignity, comfort and well-being of patients and families” (Sprayberry, 2014, p. 127).
Risk management tools are a necessity in pressure ulcer prevention. One familiar risk management tool is the Braden Scale. The Braden Scale is a short questionnaire that inquiries about a patient’s mobility, nutrition intake, ability to respond to painful stimuli, and moisture. Based on the answers given, the tool calculates a score and determines whether the patient is at risk for development of pressure ulcer or not. This tool give staff a chance to closely observe at risk patients and implement preventive
The Braden risk assessment tool was deemed to be appropriate due to the patient’s comorbidity’s of peripheral vascular disease and lymphoedema with the addition of an arterio-venous leg ulcer of the right leg. This scale is universally accepted as a tool to help identify those most at risk with a goal of allowing health care providers to use their experience and judgement to consistently reduce the risk or to ensure preventive care is appropriately prescribed (Guy, 2012). Pressure ulcers are a risk factor for those who suffer from
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
As the forthcoming nursing shortage threatens the United States, organizations must be knowledgeable in the recruitment and retention of nurses. The challenge facing health care organizations will be to retain sufficient numbers of nurses to provide safe, efficient, quality care to patients. Organizations will look to recruit and attract quality nurses to fill vacancies. As turnover in nursing is a recurring problem, health care organizations will look for strategies to reduce turnover. The rate of turnover for bedside nurses in 2013 ranged from 4.4 to 44.6% (American Nurses Association, 2013). Nurse retention focuses on keeping nurses in the organization and preventing turnover. The purpose of this paper is to discuss the significance of recruitment and retention of nurses, review the literature, and explore how recruitment and retention apply to nursing.
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
A pressure ulcer is an area of skin with unrelieved pressure resulting in ischemia, cell death, and necrotic tissue. The constant external pressure or rubbing that exceeds the arterial capillary pressure (32mmHg) and impairs local normal blood flow to tissue for an extended period of time, results in pressure ulcer (Smeltzer et. Al., 2013). According to National Pressure Ulcer Advisory Panel, 2014, pressure ulcers are a major burden to the society, as it approaches $11billion annually, with a cost range from $500 to $70,000 per individual pressure ulcer. It is a significant healthcare problem despite considerable investment in education, training, and prevention equipment. This paper includes two different studies to link cause-effect
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
The Braden Scale demonstrated both sensitivity and specificity in risk assessment of pressure ulcer development (VandenBosch et al., 1996). In order to maximize the intervention, it is important that nursing personnel are thorough in skin assessment evaluation and can accurately identify and stage lesions. For future research, it is recommended that a consistent cut-off value be continually updated to determine at risk-hospitalized patients. As previously discussed, a current cut-off value of 18 is used which places patients in a mild risk category of the Braden Scale (Braden & Makleburst, 2005). In this health care practice area, the RN cannot overlook physical assessment. It is recommended that all future research include a proper skin assessment in accordance with hospital policy and procedure. While evidence shows that the Braden Scale is an effective risk assessment tool, it should not stand in for traditional nursing assessment, but rather be used as a tool to help determine at risk patients that are may be in need for further intervention. It is a recommendation that future research study also discuss surgical procedures in relation to the Braden Scale and possible pressure ulcer development. According to Schoonhoven et al. (2002), surgery is considered a risk factor
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
I have had the opportunity to explore the physiological processes that are involved within the formation of pressure ulcers. This underpinning knowledge will be invaluable within my future role as an Assistant Practitioner as it provides an excellent evidence base to inform my clinical decisions. Pressure ulcers impact severely on patient’s health and wellbeing and furthermore promote significant economic burden within the NHS. It is essential as healthcare practitioners that we develop understanding regarding the risk factors that can promote the development of pressure ulcers and cause further deterioration to such wounds. This knowledge must incorporate how risk factors can impact on the process of homeostasis so that preventative care measures can be put in place to inhibit development or further wound
Finally, a more obvious and direct cause of nurse turnover is overall dissatisfaction with the current job. This can be for numerous reasons related to pay, benefits, job growth availability, lack of autonomy, or simply feeling unappreciated. According to one source, “a 2014 survey of more than 3,300 nurses found that they were stressed, overworked, underappreciated, and underutilized” (Fischer, 2016). No matter the reason a nurse chooses to leave their job, the negative outcomes remain the same. The most common of these outcomes are that hospitals lose money, it decreases patient quality of care, and it continues the cycle of more turnover in the nursing profession. “It is predicted that there will be a shortage of nearly 1 million nurses in the United States by 2020” (Hunt, 2009). Hospitals are impacted financially by the high nurse turnover rates. “The financial costs of losing a single nurse has been calculated to equal about twice the nurse’s annual salary” (Hunt, 2009). With these numbers in mind, the hospital spending more money to retain nurses could be a smart and beneficial action for them to
Quality improvement (QI) involves the regular and constant actions that enable measurable improvement in health care. QI results in enhanced health services, organizational efficiency, quality and safe care to patients, and desired health outcomes for individuals and patient populations (U. S. Department of Health and Human Service, 2011). A successful quality improvement program is patient-centered, a collaboration of teams, and uses data in systems. QI helps to develop a culture of excellence in nursing, identify and prioritize areas of improvement, promote communication and collaboration, collect and analyze data, and encourage continuous evaluation of systems and processes (American Academy
3. Cowan, L. J., Stechmiller, J. K, Rowe, M., & Kairalla, J. A. (2012). Enhancing Braden pressure ulcer risk assessment in acutely ill adult veterans. Wound Repair and Regeneration, 20(2), 137-148. doi:10.1111/j.1524-475X.2011.00761.x