Analysis Of The Article ' Missed Nursing Care '

This discussion question is based on a case study. As in all case studies, review the facts of the case and consider the various steps of the nursing process in order to address the critical thinking questions.

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

The development of knowledge requires a number of processes in order to establish credible data to ensure the validity and appropriateness of how it can be used in the future. For the healthcare industry, this has provided the ability to create and form new types of interventions in order to give adequate care across a of number of fields within the system. Research then, has been an essential part in providing definitive data, either by disproving previous beliefs or confirming newly found data and methods. Moreover, research in itself contains its own process with a methodological approach. Of the notable methods, quantitative research is often used for its systemic approach (Polit & Beck, 2006). Thus, the use of the scientific method is

Often there are delays in surgeries. Some operations can take longer than expected, unexpected emergencies come up. Staff can feel rushed to move forward to prevent further delays. Also, there can be times when staff are overworked due to being short-staffed. Being overworked has the potential for fatigue causing staff to be less aware and skip or forget about steps in an otherwise established process.

With a shortage of nurses, the care and safety of patients may become compromised. The nurses themselves may be having feelings of dissatisfaction, overwhelm and distress. Nurses who may become overwhelmed with the high number of patients may become frustrated and burnt out. And inadequate staff of nurses may lead to a negative impact on the patient’s outcome. The quality of care the patients may receive in facilities with low staffing may be poor.

Neither staff member identified the downward trending of the patients available vital signs and did not evaluate consciousness of the patient. Failure to assess appropriately and recognize deterioration of the patient resulted in a prolonged period of time in which the patient was not adequately oxygenated. Research has shown that short staffing, with decreased nurse to patient ratio, has been found to be associated with increased mortality (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Joint Commission on Accreditation of Healthcare Organizations, 2005; Needleman, Buerhaus, PKankratz, Leibson, Stevens, & Harris, 2011). This reinforces the need to match staffing with patient census, acuity, and need for nursing care.

One of the external threats that were present during the survey is the patients’ condition, which could have influenced the work of the nurses. Since there are different conditions of patients, one of these could have influenced patient cases, teamwork and hence the study was not considerate enough. In addition, the study failed to integrate the participation of the nurses and instead focused on other staffs (Kalisch & Lee, 2011, p. 86). This could have triggered any negative relationships between the selected staffs and the nurses.

Over the past number of years there has been a nursing shortage which has led to the need of more registered nurses in the hospital setting. This is due to the uprising acuity of patient care and a decrease in there overall hospital stay. In order for the patients to get safe and quality care, the staffing, education and experience of the nursing staff needs to be made a priority. Not only has the safety and quality of patient care suffered, the working conditions in hospitals

Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.

This paper will address and evaluate the research problem itself, the design of the study, the sample, how the data is collected, its limitations, and its findings. Furthermore, how does this study impact the overall nursing process?

I will methodically analyze all parts of the study to assess the validity of the article, by contrasting and comparing the information provided, with previous literature. I will try to make sure that recommendations provided by the authors are congruous with nursing practice and beneficial to the advancement of it. I will as much as possible provide in depth detail of previous studies on the same topic that either support or contradict the analysis provided by this study and its authors.

One important result that is occurring because of the lack of staff is the neglecting of tasks and more responsibility. Nurses are reporting that a lot of nursing tasks that are applicable to patient safety and good nursing are being left out. Nurses discussed how patient and family preparation for

Dr. Avedis Donabedian developed a model for categorizing and measuring the quality of healthcare providing a framework that conceptualized quality in broad terms and classification to measure and assess different aspects of quality in nursing care (Sollecito & Johnson, 2013). In the footsteps of Donabedian’s framework, Dr. Beatrice Kalisch developed a model conceptualizing missed nursing care otherwise known as “unfinished nursing care” or “care left undone”. Missed nursing care as defined in the Missed Nursing Care Model is any aspect of required patient care that is omitted, either in part or whole, or delayed (Kalisch, Landstrom, & Hinshaw, 2009). The structural aspects Kalisch’s model include labor resources, nursing staff, competency level of staff, education and experience, material resources, teamwork and communication. Kalisch model indicates that nurses with recent restricted resources in the nursing process determining clinical priorities is costly making decisions either to delay or omit certain care and is heavily influenced by team perception, nurse judgment, ("Missed Nursing Care AHRQ," 2015).

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

The first quantitative study analyzed was conducted by Dabney and Kalisch in 2015 and surveyed 729 patients. The purpose of the study was to continue researching for any correlation between patient outcomes and nurse staffing. They analyzed patient reports of missed nursing care and determined if there was a relationship between patient reports and the nurse staffing levels. The design and sample include data that was obtained in the study of patient reports of missed nursing care and compared it to the level of nurse staffing. The sample was made up of 729 patients on 20 units in 2 hospitals. The 20 units consisted of 12 medical units with 420 participants, 6 surgical units with 255 participants, and 2 rehabilitation