Nurse Staffing Levels: The Effects on Patient Outcomes Nurse staffing is a complex issue. There are many factors which need to be considered when staffing a nursing unit. Evidence shows an association between Registered Nurses (RNs) having decreased workloads and better patient outcomes, including a decrease in patient mortality (Aiken et al., 2011; Needleman et al, 2011; How Lin, 2013; Patrician et al., 2011; Wiltse-Nicely, Sloane, Aiken, 2013). A small percentage of patients expire during their hospitalization as evidence suggests that a portion of these deaths can be attributed to RN staffing levels (Shekelle, 2013). As the reimbursement system for hospitals today emphasizes quality outcomes, this has an increase in the importance of the nurse’s role in patient care (Frith, Anderson, Tseng, & Fong, 2012). The quality of care is effected when there are higher RN-to-patient ratios. Mortality rates can be decreased by 50% or more when there is a lower RN-to-patient ratio. The morale of nursing staff and the hospital’s reputation are effected when there is a large nurse turnover and poor patient outcomes (Martin, 2015; Knudson, 2013). Having adequate nurse staffing levels saves lives (Martin, 2015). The purpose …show more content…
A higher nurse-to-patient ratio was significant in the outcomes of patients, although none of the studies could give a specific RN ratio-to-patient which achieved the greatest patient outcomes (Patrician et al, 2011; Kalisch & Hee Lee, 2011; How Lin, 2013). A familiar theme throughout the studies was to consider the patient care needs and match these needs with the number of RNs it takes to meet the care needs of the patient. A recommendation of having a nurse staffing council and a position control team is necessary to manage staffing issues (Dent, 2015; McKenna,
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 ...
Nurses are the largest and the most trusted professional group in the health care system. They are highly educated and skilled in their areas of practice. However, today’s nurses are experiencing an ever increasing workload, which negatively impacts their ability to deliver safe patient care (Berry & Curry, 2012). This paper explores four published journals that report on survey results on nursing workload and their direct correlation with patient care outcomes. The purpose of this paper is to address the ongoing nursing workload issues and explore the reasons behind it.
Identifying and maintaining the appropriate number of mixed nursing staff, RN/LPN/CNA, is critical to the delivery of quality patient care. Many studies reveal an association between a higher level of experienced RN staffing and lower rates of adverse patient outcomes (“Nurse staffing plans,” 2013). The nurse-patient ratios will in turn improve the nurses working conditions, decreasing the risk of errors to patients.
Once upon a time, my best friend, Bryan Martinez, often heard his mother’s medical conversations with friends. One day at school, our teacher confronted Mrs. Martinez and told her that she was able tell that Bryan was a son from a nurse. Apparently there was an incident at school where a little boy was acting out and Bryan told our teacher that the little boy was agitated, and to give him some medication to calm him down. As demonstrated by Bryan, nursing is ongoing profession that promotes the health and well-being of individuals.
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.
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).
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
When it comes to switching shifts, nurses usually give a quick report on the patient, so the oncoming nurse knows what is going on with the patients. Sometimes nurses are rushing through the report, skipping through vital information, which can cause harm in our patients. We must have a standard hand off report each nurse must follow to provide patient safety and satisfaction.
The level of job satisfaction for a nurse is a vital factor in creating positive outcomes for their patients. California RNs report having much more time to spend with patients. The hospitals are far more likely to have enough RNs on staff to provide quality patient care. In California, where hospitals have better compliance with the staffing limits, RNs report fewer complaints from patients and families and the nurses have more confidence that patients can manage their care upon discharge. California RNs are substantially more likely to stay in their jobs because of the staffing limits, and less likely to report burnout than nurses in any other state. Two years after implementation of the California staffing law which mandates minimum staffing levels by hospital unit, nurse workloads in California were significantly lower than that of any other state. The legislation of the mandated nurse patient ratio has achieved its goals of reducing nurse workloads, improving recruitment and retention of nurses, and having a favorable outcomes on patient
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
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
Nurse staffing is perceived as a major issue due to its effect on the safety and quality of patient care (Hinno, Partanen and Vehvilainen-Julkunen, 2011). Inadequate patient care could result in readmission. Readmission and emergency department visits by patients within 30 days of their discharge exhibits avoidable and costly outcomes (Weiss, Yakusheva and Bobay, 2011). The Affordable Care Act (ACA) has developed a financial penalty refusing the Centers for Medicare and Medicaid services for hospital reimbursement due to readmission (Berenson, Paulus and Kalman, 2012). Hospitals are now seeking to reduce patient readmission. The pertinence of this literature review is to unfold the effect of nurse staffing on patient readmission.
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
The literature supports that high nursing workload adversely affects the quality of patient care, nurses’ satisfaction with job, and the healthcare institutions’ attempt to provide cost effective nursing care.