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Nurse to patient ratios and patient outcomes
Nurse to patient ratio quality improvement project
Nurse to patient ratios and patient outcomes
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In the health care industry, nurse to patient ratios is often a controversial issue. Registered nurses know and continue to reiterate the importance of safe staffing levels in health care facilities. Reductions in nursing budgets, coupled with the expanding nursing shortage, has resulted in a reduction of available nursing staff. As a result, the employed nursing staff are forced to work longer hours with more acutely ill patients. Consequently, patient care is compromised and ultimately perpetuates the nursing shortage because of this negative work environment. Providing safe quality health care is expensive. Health care facilities are always in search of ways to trim spending while maintaining the same quality of care. One of the methods in which hospitals trim the spending budget is through labor reduction. Tempting as this may seem, this method presents a massive dilemma to providing safe quality care. Less staff coupled with large patient workloads will lead to adverse patient outcomes. Evidence shows that it is more cost effective to maintain safe staffing levels and prevent adverse patient outcomes versus the estimated savings of labor reduction. Maintaining safe nurse to patient ratios reduces patient infection rates and patient mortality rates. Ratios also reduces nursing fatigue, which increases job satisfaction and nurse retention rates saving on the cost of hiring and training new staff. Mandating staffing ratios is not the answer because the health care industry is already burdened with an overwhelming number of regulations. The aforementioned issues necessitates further research on how to implement a cost effective, safe, and quality method of maintaining nurse to patient ratios. This research paper will prove... ... middle of paper ... ...5-2702.2011.03956.x Hospital costs in context:A transparent view of the cost of care [Excutive summary]. (2010). Retrieved from Massachusetts Hospital Association: https://www.mhalink.org/AM/Template.cfm?Section=Home&ContentID=11241&Template=/CM/ContentDisplay.cfm RN turnover costs hospitals an estimated $9.75 billion annually. (2010). Retrieved from http://www.altergroup.com/alter-care-blog/index.php/healthcare/rn-turnover-costs/ Scott, II, R. D. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf The future of nursing: Leading change advancing health [Report]. (2010). Retrieved from The Institute of Medicine: http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf
Institute of Medicine (2010). The future of nursing: Leading change advancing health Retrieved from http://books.nap.edu/openbook.php?record_id=12956&page+R1
Odom-Forren, J., & Hahn, E. J. (2006, February). Mandatory reporting of health care-associated infections: Kingdon’s multiple streams approach. Policy, Politics, & Nursing Practice, 7(1), 64-72. http://dx.doi.org/10.1177/1527154406286203
Scott II, R. (2009) The direct medical costs of healthcare-associated infections in U. S. hospitals and the benefits of prevention. Center of Disease Control and Prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
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
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
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.
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
What Seems To Be The Problem? A discussion of the current problems in the U.S. healthcare system.
The health care system in the United States encompasses so many individuals, businesses, and interest groups. Also, it can be difficult to pinpoint the most optimal approach to serve everyone’s unique needs and wants. This has led to a major health-care crisis in the society. As a matter of fact, the effect of the health-care crisis in the American society has been a longtime situation, and an effective policy response must focus on what is most enriching in the society: aiming to improve the overall quality of the system and positively impact the health status of all citizens, while subsequently minimizing costs.
With medical errors increasing the length of stay and cost of care, hospitals are facing even smaller margins. Struggling to turn a profit they only way hospitals can grow is to improve the quality of care and reduce errors. It was not until recent legislation that hospitals were being reimbursed for poor quality of care leading to longer patient stays or further hospital-acquired infections. The recent health care reform legislation, the Patient Protection and Accountable Care Act, has stopped hospitals from receiving reimbursement for readmissions due to error or nosocomial infections. Not only does this act prevent reimbursement for poor quality care, but also hospitals that deliver lower standards of care will not be able to participate in the Medicare and Medicaid programs (Andel et al.,
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
Scott, II, R. D. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf
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.
The Future of Nursing Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting, the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings, as well as the plans that put them at the forefront of the future.