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 Mandated Nurse Staffing Ratios written by Emerald Bell and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this proposal is to examine the association between patient to nurse staffing ratios and patient outcomes, in hospitalized patients, in the acute care environment. After identifying the patient care issue related to the absence of mandatory nursing staffing ratios, fifteen evidence-based articles were reviewed to determine a solution. The use of mandatory nurse staffing ratios, based on unit specific acuity, was determined to be an evidence-based solution, and an implementation plan was created. The implementation plan integrated the use of mandatory patient to nurse staffing ratios throughout a 339 bed acute care facility over a six month trial period. An evaluation plan was formed to review results of the implementation plan, as well as to provide information to disseminate to key stakeholders, and the greater nursing community. The findings provide evidence that mandated patient to nurse staffing ratios, in comparison with no mandated patient to nurse staffing ratios, result in fewer incidences of inpatient mortality, pressure ulcers, failure to rescue, patient falls, pneumonia, urinary tract infections, and blood stream infections in hospitalized patients, in the acute care setting.
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 Mandatory Staffing Ratios written by Stephanie Mello and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The objective of this proposal is the mandatory implementation of nurse-to-patient staffing ratios nationally. Implementation of mandatory staffing at a national level requires state and federal legislation to be passed. This legislation would mandate a change in staffing from the current suggested safe guidelines to a government mandate requiring hospitals to adhere to safe staffing ratios. Currently the state of California is the only state with legislatively mandated staffing ratios. According to research, past and present inadequate nurse-to-patient ratios have resulted in adverse patient outcomes, nurse job dissatisfaction, burnout and turnover, all of which impact health care facilities financially as well as carry costly physiological and psychosocial implications for patients and families affected by adverse outcomes. This proposal supports the state and federal implementation of mandatory staffing ratio models similar to that of California's legislation AB394. Due to the magnitude and regulatory aspect of this change, partnering with national and state nursing organizations such as the American Nurses Association and the Nevada Nurses Association will be crucial in getting legislation passed, disseminating evidence and evaluation of the implemented change. Through the use of quantitative and qualitative research the need for change has already been established. Going forward as future legislation is passed, the continued use of these types of studies will be used to gather and assess data regarding the successes, barriers and failures of implementing mandatory staffing ratios to ensure the continued safety and satisfaction of patients and nursing staff.
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 Congressional Record written by United States. Congress and published by . This book was released on 1952 with total page 1414 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Congressional Record is the official record of the proceedings and debates of the United States Congress. It is published daily when Congress is in session. The Congressional Record began publication in 1873. Debates for sessions prior to 1873 are recorded in The Debates and Proceedings in the Congress of the United States (1789-1824), the Register of Debates in Congress (1824-1837), and the Congressional Globe (1833-1873)
Download or read book Mandatory Nurse to patient Ratios written by Traci Pate and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals are operating on tight budgets and one area where cuts are often made is in payroll expenses. Nurses have reported for years there are too few nurses in hospitals to provide quality patient care. Research evidence supports the assertion inadequate nurse staffing results in poor patient outcomes because of increased medication errors, falls, infections and failure to rescue. Nurses with heavy workloads are more likely to miss changes in their patients' conditions (Shever, 2011). It is also important to note this country is facing a worsening nursing shortage and retention of our current nursing professionals and attracting new students is imperative. California was the first state to implement minimum nurse staffing requirements. In a follow-up study performed two years post implementation of mandatory staffing minimums, researchers found the mandated nurse-to-patient ratios resulted in better patient outcomes as well as decreasing nurse burn out and dissatisfaction (Aiken and others, 2010). This proposal presents a plan to increase nurse staffing to adequate levels to provide quality patient care and improve patient outcomes. The proposal includes a complete implementation plan, the resources required for implementation, a method of evaluating the plan, and a plan for dissemination of the results to the stakeholders and greater community.
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 Mandated Nurse to patient Staffing Ratios in Massachusetts written by and published by . This book was released on 2018 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 Principles for Nurse Staffing written by and published by American Nurses Association. This book was released on 1999 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 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 Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes written by and published by . This book was released on 2015-11-20 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Comparison of the Nursing Costs Associated with the Implementation of the Mandated Nurse to patient Ratios in California written by Shelly Carol Wells and published by . This book was released on 2009 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nurse executives are challenged to provide adequate nurse staffing to prevent adverse patient outcomes, promote patient satisfaction and enhance nurses' job satisfaction. Historically, nurse staffing strategies have involved the use of patient classification systems, the use of time studies to predict staffing numbers and the best guesses of the nurse administrators. Collective bargaining units moved to include staffing ceilings or nurse-to-patient ratios to address staffing needs in hospitals. In 1999, the state of California signed AB394 into law requiring the implementation of mandated minimum nurse-to-patient ratios. The California Department of Health Services estimated that the mandated nurse-to-patient ratios would cost California hospitals $956 million annually after implementation given adequate recruiting sources (CHA, 2004). While this estimate was made prior to the known fiscal impact of the ratios, no study has been published addressing the actual costs differences to the hospitals of the mandated nurse-to-patient ratios that were implemented in 2004. As other states consider introducing legislation to implement the staffing ratios as California has done, the impact of these costs should be revealed. The aim of this study was to examine the impact on nursing costs expressed as a percentage of hospital operating costs from before the staffing ratios in California were implemented (2002) and after the staffing ratios were implemented (2006). Two hundred eighty-two hospitals were included in this study. Financial and productivity data were obtained from the Office of Statewide Health Planning and Development in California. Examination of the percentage of total hospital operating costs attributed to nursing costs shed light on the fiscal impact of the mandated nurse-to-patient ratios in California. Results demonstrated that there was significant difference in the percentage of total hospital operating costs attributed to Registered Nurse costs and to overall nursing costs. There was no significant difference in the percentage of total hospital operating costs attributed to the costs for the licensed vocational nurse. In addition, there were no significant differences noted in the level of unit support staff (aides/orderlies, technicians, clerical) after the implementation of the ratios.
Download or read book Staffing Patterns Before and After Mandated Nurse to patient Ratios in California s Hospitals written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Staffing patterns before and after mandated nurse-to-patient ratios in California's hospitals.
Download or read book Ordered to Care written by Susan M. Reverby and published by Cambridge University Press. This book was released on 1987-08-28 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt: An engaging study of the dilemmas faced by American nursing, which examines the ideology, practice, and efforts at reform of both trained and untrained nurses in the years between 1850 and 1945. Ordered to Care provides an overall history of nursing's development and places that growth within the context of topical questions raised by women's history and the social history of health care. Building upon extensive use of primary and quantitative data, the author creates a collective portrait of nursing, from the work of the individual nurse to the political efforts of its organizations. Dr Reverby contends that nursing's contemporary difficulties are caused by its historical obligation to care in a society that refuses to value caring. She examines the historical consequences of this critical dilemma and concludes with a discussion of why nursing will have to move beyond its obligation to care, and what the implications of this change would be for all of us.
