Changing A Failed System : Nurse Patient Ratios

Review of Literature Literature Support For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

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.

Major studies in the last three decades have confirmed an association between the registered nurse to patient ratio and adverse patient outcomes such as mortality, morbidity, length of stay, failure to rescue (Hunt 19). For example, bed sores or patient falls, are considered an adverse outcome because it is a complication that occurred after the patient was admitted to a healthcare facility, Nonetheless, the key to

The rising rates of seasoned nurses have resulted in replacing the more experienced and skilled professionals by infusing fresh graduates who lack the required skill and experience needed to effectively adapt to a clinical environment. This is coupled by the booming level of workload witnessed by these graduates who many are unable to cope with. Adding fuel to fire the initial work experience is discouraging for many graduates who hence are exhausted .This results in numerous fresh graduates completely burning out in just 18 months of their introduction to professional medical environment (World Health Organization, 2006).

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.

Kim Rodriguez Nurse Staffing and Patient Outcomes RNSG2432 February 28, 2016 Nurse Staffing and Patient Outcomes Introduction The healthcare industry has long emphasized that staffing issues are a constant concern. It is a worry that influences the safety of both the patient and the nurse. A study reveals that over seventeen percent of new graduate

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

Nurse Patient Ratio and Patient Outcomes Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job

Introduction When someone is hospitalized, they are often in their most vulnerable state. Whether you are the fearful individual being hospitalized, a concerned loved one, or the compassionate care provider, ensuring the patient receives the best possible care throughout their stay is a substantial concern. When receiving care and trusting a facility with the health of the individual involved, wouldn’t it be assumed that the amount of attention and level of care received would be unwavering throughout the nation? Would it be surprising to you to find out that the patient’s outcome may be different depending on in which state they are being cared for? Depending on the state in which the care is being received, there may not be a limit to how many other patients your nurse is assigned to, thus, limiting time and energy that nurse has to spend with each individual. While this fact is a scary one, there is evidence that thousands of lives could be saved if hospitals across the nation would implement change and mandate nurse to patient staffing ratios.

Implementing Fixed Patient-to-Nurse Ratios in High-Volume High-Acuity Settings Striving for excellent patient care is the cornerstone of nursing. However, delivery of innovative care requires nurses to take initiative in finding issues and concerns in current clinical practices to promote change that leads to optimal patient outcomes. One current issue in clinical practice is the varying patient-to-nurse ratios (PNRs) amongst different hospitals (Aiken et al., 2012). Having high PNRs may lead to nurse burnout, medical errors, and ineffective nursing care (Aiken et al., 2012; Karavasiliadou & Athanasakis, 2014). The solution would be to regulate PNRs, especially in areas such as the emergency room. To initiate this change, a task force would have to be established to use current data and research as evidence to propose the change, implement the change and evaluate its effectiveness.

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Why are Patient Outcomes so Low when Patient to nurse ratio are so high Teena A. Estudillo Idaho State University Abstract Why are the outcomes of patients so low when patient to nurse ratio is so high? Nurses are taking on more responsibility than ever before. Hospital administration worldwide believe that they can continue to add responsibility to the nurse’s shoulders and the outcome of patients will thrive. There are several reasons why the patient outcomes depend on nurses. Nurses have fewer resources which is leading to infections and potential falls. The risk of increased medication errors when staffing is inadequate must also be considered. Most importantly, exhausted overworked nurses will lead to poor patient

AtlantiCare Regional Medical Centre 1500 Healthy Lane Community, CA XXXX Phone (201)123-1234 FOR IMMEDIATE RELEASE: Your Name Your (hypothetical) position Your (hypothetical) telephone number Reducing nurse-to-patient ratios AtlantiCare Regional Medical Centre is proud to announce it has made a commitment to raise its current ratio of nurses to patients, exceeding the mandated requirements

Effect of new policy on Nursing practice, Health care delivery and Health care consumers (now and in the future). Mandated nurse-patient staffing ratios will affect nursing practice, healthcare delivery and healthcare consumers in beneficial ways. Through Bill 394, mandatory minimum staffing levels were implemented in California

Nurse to patient ratios is an important topic in health care today. The quality of care and safety of patients is a priority that demands constant improvement. The effect that nurse to patient ratios has on these matters has been the focus of many studies. One study found that the risk of patient mortality increases 7% per patient that a nurse is responsible for (Ratios, 2015). This percentage can become dangerously elevated when the nurse to patient ratio is high.