American Nurses Association: Safety 360 It Starts With You

The Ohio house bill 346 also protects nurses by providing laws on staffing. HB 346 “requires hospitals to establish staffing plans, with meaningful input from direct patient care nurses, which are consistent with the principles of safe staffing developed by the American Nurses Association and other nationally recognized organizations” (Ohio Nurses Association, 2011). The American Nurses Association as well as other nursing organizations should continue to advocate for nurses to work towards decreasing nursing workload and preventing burnout.

In a profession where others' health and well-being are priority, there leaves room for neglect of those who are delegated to care for these people. As a professional nurse, there are many obstacles that arise and affect the care provided to a patient, as well as the livelihood of the nurse. The current deteriorating and unsafe staffing conditions in hospitals and other institutions prompts workplace advocacy as the universally appropriate concept for maintaining professional nursing practice.  Common

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

I am writing to you in regard to safe patient ratio bill titled Safe Nurse Staffing for Patient Safety and Quality Care Act. My name is Angelina David and I am a registered nurse and practicing in the surgical intensive care unit. I am also enrolled in the Adult nurse practitioner program to further advance my knowledge in nursing. One thing I have learned is that as nurses no matter what the level of care or which facility you are practicing; patients’ safety is our number one priority. Patients’ safety and their quality of care have improved over the year. However, oftentimes nurses are still placed into a situation where it is unsafe to practice because they are required to care for more patients than it is safe.

Primarily, it is crucial for health care organizations to focus on ensuring safe and quality patient care, as well as improved job satisfaction by enforcing an optimal and adequate nurse-to-patient ratio and creating innovative and long-term strategies through a collaborative effort. In order to ensure the safety of patients and nurses, state-mandated safe-staffing ratios are necessary. Adequate nurse staffing is key to patient care and nurse retention, while inadequate staffing puts patients at risk and drives nurses from their profession. As baby boomers age and the demand for health care services grows, staffing problems will only intensify. Consequently, safe-staffing ratios have become such an ever-pressing concern. In 2004, California became the first state to implement minimum nurse-to-patient staffing ratios, designed to improve patient care and nurse retention. Subsequent studies show that California’s program measurably improved patient care and nurse retention.

When was the last time you were in the hospital or a loved one was in the hospital, and ever wondered where the nurse is, and they haven 't returned for hours. You finally push the assistance button several times, and they open the door and hurriedly say, “I will be right back”, then you don 't see them for a while again. When they come back to check up on you, you explain to them what you need, and then they send in a less qualified staff member to assist you. At this point, you become very annoyed and frustrated not to mention scared to be admitted in the hospital to begin with. Little do you know, your nurse has ten other patients and other non-nursing tasks that they are responsible taking care of. They have been working a double shift and are extremely exhausted, and a large stack of charts that they will have to do before their shift is over. As a patient, you now become frustrated and are not happy about this; as a nurse, they are just as frustrated as you are, not only because the amount of work they have but more importantly they can 't deliver the appropriate care they long to give. For most hospitals they do not hire enough registered nurses for reasons that are good and bad. This is an issue that needs to be addressed not only locally but nationally and on a constant basis. When there are too many patients for one registered nurse to attend to, nurses become exhausted, mistakes are made, and patients are unsatisfied. A minimum nurse to patient ratio needs to be

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

Mandating safe staffing levels for registered nurses in acute care settings has been an important topic of discussion for many years. As the demand for registered nurses continues to rise, so does the clinical demands on the nurses currently working. If there are no specific policies in place that mandate safe and appropriate nurse-to-patient ratios for all acute care facilities, registered nurses (RNs) may be required to take on even more patients than the already high numbers currently given to many of them. Inadequate RN staffing has the potential to cause increases in adverse patient events (American Nurses Association (ANA), The registered nurse safe staffing act, 2015) as well as an increase in nurse injury (Musick, Trotto, & Morrison,

As a result, overtime can compromise patients ' health or safety. Medical residents cited fatigue as a cause for their serious mistakes in four out of 10 cases (Boodman 2001), and two studies linked infection outbreaks at hospitals to overtime work (Arnow et al. 1982; and Russell et al. 1983). Indeed, the California Nurses Association reports that more nurses are refusing to work in hospitals with unsafe conditions, in which they include being forced to work unplanned overtime. The American Nurses Association (ANA), in a national survey of 7,300 of its members, found, disturbingly, that 56% of nurses believe that the time they have available for care for each patient has decreased, and 75% feel that the quality of patient care at their own facility has decreased in the last two years. The cited inadequate staffing as the chief reason.

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Nursing is the powerhouse in the delivery of safe, quality patient-centered care in the healthcare industry. To ensure continued safety of the patient and nursing staff, the issue of inadequate staffing must be addressed. Consequently, patient’s mortality rate has been linked to the level of nursing staff utilized in ensuring an utmost outcome (Aiken, 2011). This paper will outline the issue associated with inadequate nurse to patient staffing ratios in the hospital setting; essential factors such as economic, social, ethical and political and legal affecting the issue will be established; current legislature and stakeholders will be ascertained and policy option, evaluation of bill and the results of analysis will be reviewed.

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)

In the challenge of the increasing demand and pressures on health attention from the general public, the aging populations, and development of new technologies calls for policies that are ready to embrace the new patients’ needs. Registered Nurse safe staffing Act was introduced to US senate in April, 2015 and the goal is that every healthcare provider or hospital stablish an appropriate number of registered nurses provide direct patient care in each unit and on each shift of the hospital to ensure staffing levels that: address the unique characteristics of the patients and hospital

One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.