Download or read book Effects of Decreasing Nurse Staffing Ratios written by Adrianna Gallego and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Research has shown the effects of lower nurse to patient ratios in the healthcare community. It is safer, better patient care is given, and the mental and emotional well being of the nurse is improved. Nurses have the ability to provide whole centered patient care with lower ratios. They are able to answer call lights within a timely manner, provided efficient and effective teaching to patients and their families. High patient to nurse ratios increase the incidence of patient sentinel events, like medication errors and falls. Nurses are required to be task oriented, not being able to truly focus on any one patient at time. High nurse to patient ratios, 6 patients to 1 nurse, leave nurses with feelings of failure, being incompetent, and high nurse turnover rates. Decreasing nurse to patient ratios would enhance a better workplace environment, encourage people to come to this hospital for the safe and personal care. Evidence based research has shown the effects of lowering patient to nurse ratios. In some states like California, staffing ratios have been mandated, and the results of patient sentinel events, nurse turnover, and unsatisfied patients have decreased dramatically. The proposed plan is to decrease the staffing ratios by running a trial 3 month period with the new staffing ratios of 4 patients to one nurse. Prior to this a survey will be given out to both the nurses and patients about how they feel the care they are giving, or receiving has been, how safe they feel, and how satisfied they are. Patients and nurses that are receiving, and giving care during the 3 month trial period, will be asked to complete the same survey. Data will be collected and presented to stakeholders, and administrators. Education about the goals and purpose of lower patient to nurse ratios will also be addressed.
Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
Download or read book Safety in Numbers written by Suzanne Gordon and published by Cornell University Press. This book was released on 2012-03-15 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: Legally mandated nurse-to-patient ratios are one of the most controversial topics in health care today. Ratio advocates believe that minimum staffing levels are essential for quality care, better working conditions, and higher rates of RN recruitment and retention that would alleviate the current global nursing shortage. Opponents claim that ratios will unfairly burden hospital budgets, while reducing management flexibility in addressing patient needs. Safety in Numbers is the first book to examine the arguments for and against ratios. Utilizing survey data, interviews, and other original research, Suzanne Gordon, John Buchanan, and Tanya Bretherton weigh the cost, benefits, and effectiveness of ratios in California and the state of Victoria in Australia, the two places where RN staffing levels have been mandated the longest. They show how hospital cost cutting and layoffs in the 1990s created larger workloads and deteriorating conditions for both nurses and their patients-leading nursing organizations to embrace staffing level regulation. The authors provide an in-depth account of the difficult but ultimately successful campaigns waged by nurses and their allies to win mandated ratios. Safety in Numbers then reports on how nurses, hospital administrators, and health care policymakers handled ratio implementation. With at least fourteen states in the United States and several other countries now considering staffing level regulation, this balanced assessment of the impact of ratios on patient outcomes and RN job performance and satisfaction could not be timelier. The authors' history and analysis of the nurse-to-patient ratios debate will be welcomed as an invaluable guide for patient advocates, nurses, health care managers, public officials, and anyone else concerned about the quality of patient care in the United States and the world.
Download or read book The Effect of Hospital Nurse Staffing on Patient Health Outcomes written by and published by . This book was released on 2010 with total page 29 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals are currently under pressure to control the cost of medical care, while at the same time improving patient health outcomes. These twin concerns are at play in an important and contentious decision facing hospitals--choosing appropriate nurse staffing levels. Intuitively, one would expect nurse staffing ratios to be positively associated with patient outcomes. If so, this should be a key consideration in determining nurse staffing levels. A number of recent studies have examined this issue, however, there is concern about whether a causal relationship has been established. In this paper we exploit an arguably exogenous shock to nurse staffing levels. We look at the impact of California Assembly Bill 394, which mandated minimum levels of patients per nurse in the hospital setting. When the law was passed, some hospitals already had acceptable staffing levels, while others had nurse staffing ratios that did not meet mandated standards. Thus changes in hospital-level staffing ratios from the pre- to post-mandate periods are driven in part by the legislation. We find persuasive evidence that AB394 did have the intended effect of decreasing patient/nurse ratios in hospitals that previously did not meet mandated standards. However, our analysis suggests that patient outcomes did not disproportionately improve in these same hospitals. That is, we find no evidence of a causal impact of the law on patient safety.
Download or read book Taking Action Against Clinician Burnout written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-02 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Download or read book The effect of hospital nurse staffing on patient health outcomes evidence from California s minimum staffing regulation written by Andrew C. Cook and published by . This book was released on 2010 with total page 29 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals are currently under pressure to control the cost of medical care, while at the same time improving patient health outcomes. These twin concerns are at play in an important and contentious decision facing hospitals--choosing appropriate nurse staffing levels. Intuitively, one would expect nurse staffing ratios to be positively associated with patient outcomes. If so, this should be a key consideration in determining nurse staffing levels. A number of recent studies have examined this issue, however, there is concern about whether a causal relationship has been established. In this paper we exploit an arguably exogenous shock to nurse staffing levels. We look at the impact of California Assembly Bill 394, which mandated minimum levels of patients per nurse in the hospital setting. When the law was passed, some hospitals already had acceptable staffing levels, while others had nurse staffing ratios that did not meet mandated standards. Thus changes in hospital-level staffing ratios from the pre- to post-mandate periods are driven in part by the legislation. We find persuasive evidence that AB394 did have the intended effect of decreasing patient/nurse ratios in hospitals that previously did not meet mandated standards. However, our analysis suggests that patient outcomes did not disproportionately improve in these same hospitals. That is, we find no evidence of a causal impact of the law on patient safety.
Download or read book Nursing Staff in Hospitals and Nursing Homes written by Institute of Medicine and published by National Academies Press. This book was released on 1996-03-27 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Download or read book Nurse to patient Ratios and the Impact on Patient Care written by Amanda Martinez and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Positive patient outcomes are directly related to quality of care received and there is a vast amount of research that determines the relationship between nurse staffing ratios and patient outcomes. The problem observed in this study is a facility in which there is a high acuity and high nurse-to-patient ratio assignments. The quality of care decreases due to the nurse having so many patients, typically six, and so much to do and assess for each one. Due to the negative patient outcomes and stress of nurses not being able to complete every task, especially not on time. With at least four extensive medication passes per patient and ordered tasks for each patient throughout the day, one can observe how the nurses ability to turn six patients every two hours on the hour, providing them with prompt PRN medications for pain, and performing tasks as proper as they should be performed is hindered. The nurse-to-patient ratio in the acute care setting should be 1:4 (one nurse per four patients), no exceptions. The problem associated with this plan is that the facility does not want to spend the money on hiring and having more nurses per shift. The facility provides staffing according to Hours Per Patient Day or HPPD. The problem with this system is that the HPPD has a set number and only the number of patients determines the staffing, not the acuity level of the patients. The problem needs to be presented to administration and management along the company chain with an exceptional and effective strategy, goal, implementation process, and evaluation process. After one year of implementation, data collected and obtained will be compared with data from one-year prior to determine the difference in results. The results will compare occurrence of wounds, medication errors, hospital-associated infections, falls and injuries, all associated costs with each as well as patient satisfaction surveys and nurse job satisfaction surveys. The results will be disseminated in an effective and appropriate manner.
Download or read book Mandatory Nurse patient Ratios and the Effect on Patient Outcomes written by Alex J. Weigle and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: There is a long, ongoing debate, discussing the effects of nurse staffing on patient outcomes, the incidence of adverse patient events, and patient satisfaction with care. Nurse staffing issues also effect the nurse's perceived quality of care, the rate of burnout, and job satisfaction. Studies done throughout the world, show a significant association between nurses working with large patient loads, and various adverse events and outcomes for the patient and nurse. To combat this, California Legislators introduced mandatory nurse-patient ratios for each type of unit in the hospital setting. Additional research has been done in the United States and around the world linking positive patient outcomes, decreased incidence of adverse patient events, and increased patient satisfaction when mandatory nurse-patient ratios identical or similar to those in California hospitals are initiated. Mandatory nurse-patient ratios also have been proven to increase nurse job satisfaction and their perceived quality of care. This research study will propose a solution to this nursing issue, and provide an implementation, evaluation, and dissemination plan. Included will also be a review of supporting literature and various tools to be used to educate and collect data from key stakeholders and study participants.
Download or read book The Future of the Nursing Workforce in the United States written by Peter Buerhaus and published by Jones & Bartlett Publishers. This book was released on 2009-10-06 with total page 329 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.
Download or read book Effect of Nurse Patient Ratios on Patient Satisfaction and Outcomes written by Cecile A. Emanuel and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care in the United States as well as other international health care facilities have undergone or are undergoing major reform in the delivery and practice of patient care. Health care facilities are being closely scrutinized and reimbursements are now tied to the quality of services provided Centers for Medicare and Medicaid Services. (2013, April 10). Value based purchasing or value placed on quality of care provided has now become modus operandi for hospitals being compensated. Hospitals and health care providers have delivered patient care reflective upon the ethics and principles that have guided practice over the years. Concerned with the financial impact the quality of care delivered may have on future performance, health care providers are seeking avenues that will impact the best quality of care and perception of health care delivered to patients. One of the largest impacts on patient satisfaction lies with the interaction and care delivered by nurses. The high nurse patient/ ratio invariably affects the time the nurse has to spend in this care delivery which can have a negative impact on patients' safety and their perception of care. This research focuses on the impact the nurse/ patient ratio has on patient satisfaction and outcomes, the nurse satisfaction in the work environment and the effect this all has on the patient survey scores. Patient survey scores, also known as hospital consumer assessment of hehealth careroviders (HCAHPS) are now being used as one of the tools tied to reimbursements of health care facilities by the Centers for Medicaid and Medicare Services and other organizations responsible for financial compensations in other countries. An analysis of available research on the current nurse/patient staffing ratio being used in most hospitals identifies three areas that should be of concern to hospital administrators and senior leaders: poor patient outcomes, lower patient and nurse satisfaction and lower scores on national patient surveys.
Download or read book Impact of Safe Staffing Ratios in Nursing written by Cristina Sarabando and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Insufficient nurse staffing ratios have led to a variety of problems and concerns within acute care hospital settings. Issues that can arise are things such as: increase in nurse turnover rates and burnout as well as an increase in patient safety concerns and dissatisfaction. Quality patient care is directly affected when units are inadequately staff and nurses are unable to provide the care patients expect and deserve. The nursing profession suffers due to unsafe staffing levels as it contributes to an increase in 'never events' occurring which are non-reimbursable and costly for hospitals. A multitude of studies have been conducted that support the magnitude of safe nursepatient ratios. Needleman and others (2011), collected data from hospital-level administration and found a positive correlation between lower levels of nurse staffing and an increase in patient mortality rate. This observational study reinforces the need to adequately staff units based on patients' individual needs. The nursing profession involves critical thinking where a variety of factors must be taken into close consideration. Safe and proper staffing of an acute hospital unit includes paying close attention to patient acuity, census, unit layout, ancillary staff available, and the experience of the nurses on staff (American Nurse Association, 2013). The projected change emphases safer staffing ratios based on patient acuity and daily census. There are multiple variables that need to be taken into consideration when properly staffing a unit. In the nursing world every day is different and each patient has their own specific requirements to their care. The American Nurses Association advocates for safe nurse staffing ratios and supports the Registered Nurse Safe Staffing Act. The Act validates the importance of safe nurse-to-patient staffing ratios and supports the substantial evidence that suggests that increasing the amount of RNs working on a unit can save a facility as much as 3 billion dollars. They have determined that there are staffing strategies that have reduced costs, decreased adverse events from occurring, and improved patient outcomes by implementing the evidenced-based practices in their facilities. There is software now available that aids in the management of scheduling based on census and acuity, productivity, and workload. This special software helps administration visualize adjustments needed in staffing, correlation between budget and staffing, and prepares upper management with applicable hours-per-patient-day objectives based on real census information.
Download or read book A Delphi Policy Analysis written by Sarah Ann Horne Delgado and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Surveys of nurses indicate that persistent and pervasive staffing deficits affect care delivery. A systematic review of longitudinal observational studies demonstrates that staffing levels impact patient outcomes, including mortality and length of stay. Studies of California's mandated patient-level ratios show mixed results in improving patient outcomes, though the policy is linked to higher nurse staffing levels and greater nurse satisfaction. A quasi-experimental study conducted in Australia showed that a unit level nurse-to-patient ratio policy in medical-surgical units led to improved staffing, reduced patient mortality, and shorter length of stay. Objectives: The aim of this project is to leverage diverse perspective in an analysis of a policy that requires minimum unit-level nurse-to-patient ratios in acute care medical-surgical settings in the United States. Specifically, the project examines policy impact on staffing levels, patient length of stay and nurse attrition, and gathers input on potential unintended consequences, such as increasing healthcare costs or decreasing innovation. Methods: The Delphi Policy analysis involves inviting a diverse panel of participants to share their perspectives through a series of iterative surveys. For this project, 28 panelists including direct care nurses and health care leaders, were enrolled. Prior to completing the first survey, participants viewed a short presentation on the evidence related to ratio-based nurse staffing policy. Panelists completed the second and third surveys after reviewing the results of the prior survey. This process creates a virtual, anonymous dialogue between panel members. Results: In survey 1, participants demonstrated moderate agreement that the proposed policy would have a positive impact on staffing levels and patient length of stay, and less agreement regarding the effect on nurse attrition. Survey 1 also elicited a wide range of unintended consequences of the policy. In Survey 2, participants ranked the likelihood that these consequences would occur. In Survey 3, participants further examined the unintended consequences and the policy impact on different stakeholder groups. Results indicated an expectation that the policy will create positive change for nurses and patients, and conflicting views about the policy's effect on healthcare costs and care delivery innovation. Conclusion: This project demonstrates that a unit-level ratio policy may benefit nurses and patients and will also have unintended consequences. Inclusion of direct-care nurses and healthcare leaders in policy development is crucial to identifying and mitigating the untended consequences that staffing policy will generate. This project also demonstrates that the Delphi policy analysis process is an effective tool for studying the divisive topic of staffing policy.
Download or read book Hazards of Nurse to Patient Ratio written by Dana Cammiso and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the nursing profession there are many issues that can impede patient care. A concerning issue is increased nurse to patient ratio; not only does this effect patient outcomes as well as nurse outcomes. This paper will discuss the topic of nurse to patient ratio and the impact it has on delivery of care. Recent research has shown that an increased nurse to patient ratio impacts patient care and outcomes. Studies have concluded increased nurse to patient ratio can cause mortalities, never events, readmissions, and decreased patient and nurse satisfaction. According to the National Institute of Health Also increasing the nurse's workload by one patient increases the likelihood of patient death by 7 percent (2014). Decreasing nurse to patient ratio will improve patient care as well as prevent complications associated with nurse sensitive outcomes. The Department of Professional Employees reports that increased nurse to patient ratio Besides the occupational hazards caused by understaffing, numerous studies show a correlation between inadequate nurse staffing and poor patient outcomes. High nurse-to-patient ratios are associated with an increase in medical errors, as well as patient infections, bedsores, pneumonia, MRSA, cardiac arrest, and accidental death (2014). An implementation plan was created that will decrease nurse to patient ratio from 6:1 to 4:1 on telemetry units. An evaluation plan was created to educate stakeholders and gather baseline data to measure the effectiveness of implementing this change. This research paper will discuss solution, implementation plan, theory, evaluation plan, disseminating evidence, and a review of literature.
Download or read book Nurse staffing Ratios written by Alexis Bullard and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This project addresses the PICOT question: In hospitalized patients, how do low nurse-patient ratios compared to high nurse-patient ratios affect patient outcomes during their hospital stay? Research shows high nurse-patient ratios in hospital settings are associated with decreased patient satisfaction, poor outcomes and poor working conditions for nurses. Adverse events, medication errors, patient falls and hospital-acquired infections increase when high nurse-patient ratios are present. This project describes the current problem, offers a proposed nurse staffing solution and recommends an implementation plan for evidence-based solutions nurse staffing. Utilizing the Nursing Intellectual Capital Theory supports the proposed nurse staffing solution to inform investment in human capital increases quality care and good patient outcomes. A dissemination plan and evaluation of the implementation will be included to measure change processes and determine effectiveness of the solution.
Download or read book Adequate Staffing Ratio s by Acuity written by Jennifer Hohmann and published by . This book was released on 2010 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: There is currently a growing body of evidence to support the major issue of low staffing levels leading to higher percentages of patient mortality, adverse events, and dissatisfied nurses, but what is really being done to support safe staffing levels? With the predicted crisis of the nursing shortage by the year of 2025, many evidence-based practice studies have reflected the issue in nursing in acute and long-term hospitals as well as legislative backing for safe staffing levels for registered nurses in the state of California. A proposed solution that is designed to promote better patient outcomes, less adverse events such as hospital acquired infections and medication errors, lower hospital stays, reduce health care costs, better Medicare reimbursements to hospital, and nurse retention is to mandate nurse-to-patient ratio's based upon acuity level of patients. A plan for a six month study will be conducted with a before and after evaluation of overall patient and nurse satisfaction, safety of work environment, number of adverse events, and trial staffing grid for higher staffing levels based upon patient acuity. A random qualitative questionnaire survey will be administered for nurses to fill out voluntary to measure their perceptions of work environment and satisfaction. The study will include a trial staffing grid along with an acuity flow sheet to the participating unit. Patient satisfaction scores as well as the number of adverse events will be collected prior to the start of the study and compared to the results of the same unit scored during the study. During the implementation phase, a presentation will be held to address the current proposal and issue as well as staff and administrators. The study's results will be reviewed to present stakeholders involved directly toward patient care for further approval. All data including the study's results and the proposed changes will be disseminated to administration for further deliberation towards change for nurse staffing levels, based upon acuity level of patients, to promote quality of care and promotion of better patient outcomes and safer environments. Literature review articles and studies used in this project focus primarily on the effects of unsafe nurse staffing levels, unsafe working environments, adverse outcomes, nurse burnout, and overall quality of care.
