Dialysis Clinics Case Study

According to L.H. Aiken et al., there is strong evidence that supports a connection between better nurse staffing and better patient outcomes. Scientists argue that a higher amount of nurses on staff allows for a lower rate of overall patient mortality. The reasoning behind this point is the fact that higher nurse rates correlate with “better nurse care environments.” Patient to nurse ratio, highly educated nurses, and increased nurses on staff during a single period of time effects the environment that allows for proper patient care. If there are too many patients assigned to a single nurse it will lead to increased patient complications (medical care/ medication errors, mortality rates, etc.) increased nurse fatigue, and decreased nurse retention/job satisfaction. Scientists argue that these issues must be looked at immediately because there are “numbers of lives that would be saved through improved care environments.” Scientists also argue that the way to improve care environment is by having hospitals become “magnet

Current nurse-to-patient ratios is a topic that has constant focus on today’s patient outcomes and safety. There have be many studies and there continues to be studies done on how a higher nurse to patient ratio effects not only patient and nurse safety and patient outcomes once they leave the hospital, but also patient mortality rates as well. When a nurse has been assigned more of a patient load than they can safely handle, whether it be because of a large patient volume or patient acuity, patients suffer and the quality of care declines. With the higher ratio,

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.

In an article published by Applied Nursing Research the authors point out that nurse staffing is related to patient outcomes, “lower levels of RN staffing are associated with higher rates of OPSN (Outcomes Potentially Sensitive to Nursing) in both medical and surgical patients treated in hospitals, U.S. Medicare, and other publically available administrative data” (Duffield et al., 2011, p. 245). The writer of this paper researched 5 relevant articles regarding the relationship between nurse to patient ratio, morbidity, and mortality, every article related similar information. “A systematic review of 102 studies concluded that increased RN staffing levels are associated with lower rates of morbidity and mortality” (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013, p. 2).

Duffin (2012) stated, “The California Nursing Association argues that this [mandated nurse-to-patient ratios] reduces mortality levels and allows nurses to spend more time with patients” (p.7). Duffin also quoted the co-president of the California Nursing Association, who said “A study from the University of Pennsylvania which concluded that New Jersey hospitals would have 14 percent fewer deaths if they matched California’s surgical unit ratios” (p.7). Increased nurse-to-patient ratios have been shown to decrease the infection risks in facilities. The Centers for Disease Control and Prevention (2004) stated, “They have identified a link between improved nurse to patient ratios and lower hospital outbreaks of bloodstream infections”(p 1). Mandated staffing ratios have shown to have many positives but they are not without flaws.

Those up on the hill have responded with a charge of state and national bills pointed at bringing in a booming healthcare industry that 's pretty much free-for-all. For their part, the networks don 't see what the entire objection is about. They say productiveness and peoples request will keep their guidelines just and within ones means. "The networks are trying not only for cost, but also for class and peoples’ satisfaction. It 's a patron service industry when you get right down to it. The network points to their absolute success in bringing down costs and keeping the mass of network enrollees happy. Each month people across the nation join a network, so it 's plain that, Network care is here to stay in one shape or another.

Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown that more infections like UTI, pneumonia, shock or cardiac arrest increases when patients receive fewer hours of nursing care. Medication errors and unsafe hand washing techniques were found more in increased patient workloads. Unsafe staffing gave more job dissatisfaction, job burnout and more nurses quit or drove nurses away from nursing. This increased mandatory overtime and increased nurse shortage. According to survey of California state

The article that I selected for this week’s review focuses on the reaction of hospitals over the most recent draft of the GOP healthcare bill, The Better Care Reconciliation Act. The bill stands to generate major cuts to Medicaid funding. The bill, which was just released today, is already drawing up skepticism and opposition by hospital groups. Rick Pollack, president and CEO of the American Hospital Association, stated, “If enacted, the Better Care Reconciliation Act would mean real consequences for real people — among them people with chronic conditions such as cancer, individuals with disabilities who need long-term services and support, and the elderly" (Leonard, 2017). Those who are in most need of healthcare services and are on Medicaid

DaVita, Italian for "giving life," was originally known as Total Renal Care (TRC). Employees who also voted on the company’s core values chose the name. In 1999, on the brink of bankruptcy, Kent Thirty became the Chairman and CEO of DaVita. He lead the company on an ambitious restructuring plans that ten years later has transformed the company into a Fortune 500 company with over $ 6.1 billion in annual revenues. DaVita has grown to a population of over 34,000 teammates and serves approximately 118,000 dialysis patients weekly. DaVita provided services at over 1,500 outpatient dialysis centers and at 720 hospitals in 2009. Kent Thiry has led the company since 1999. DaVita has achieved over 11 straight years of improved clinical outcomes and financial results. In 2004, Gambro 's U.S.- based clinics was acquired by Da Vita doubling DaVita 's outpatient clinics. As of 2011, DaVita employs over 41,000 and provides services at more than 1,800 dialysis centers. In 2009, DaVita moved it 's corporate headquarters to Denver from El Segundo, California. Denver was chosen due to its central location, mass transit, talent pool, cost of living, and quality of life. CEO Kent Thiry states that "DaVita was looking for two equally important things in a new home. Number one, that we find an environment that was good for the company to pursue its business. Number two, that we find an environment where our people could live great lives". DaVita is the second largest provider of dialysis in

With Nurses required to take so many patients there are events happening that could be prevented. A nurse comes onto shift, gets their assignments from the charge nurse and receives report the previous nurse. They learn that patient one has had a hip surgery and is somewhat confused because of their age. Patient two is getting hourly blood glucose checks, and patient three has every Q2 hour pain medications, and the other three patients have been stable with not a lot of needs overall. The nurse is three hours into the shift and is still yet to see two of the patients, when one of the certified nursing assistants on the unit hollers for help. They run into the room to see that their patient that has had hip surgery and is confused had had a fall. Which leads to a whole new list of things that must be assessed. Falls are something that happen much too often in the hospital setting due to lack of nurse staffing. “Three of four studies on the proportion of RNs reported significant effects. The three cohort studies showed that higher proportions of RNs were significantly related to lower numbers of patient falls. More specifically, small effect sizes were reported for medical/surgical and critical care units (Patrician et al., 2011) and for step

The agency serves inter-city Memphis and aid adults that suffer from kidney failure. Some main factors of kidney disease are diabetes, most common, and high blood pressure, secondary cause. The normal age range of the clients the agency help is between 30 years old and up (Kidney failure/ESRD, 2017). The clients Fresenius experience injustices pertaining to the access of treatment and the ability to pay for treatment. Most individuals that have kidney disease are 50 years old, so that lack transportation to dialysis clinics. Also, since the individuals live in poverty-stricken environments, it is harder to find the necessary aid to pay for health care

It was 0730; I stepped off the elevator after two 12-hour NOC shifts, instead of being tired and eager to go home, I headed to the cafeteria. As I walked toward the cafeteria, I had a huge smile with thoughts of excitement and satisfaction. For my Senior Preceptorship, I am assigned to work on the Tower 8 Transplant/Metabolic/Telemetry Unit at UC Davis Medical Center (UCDMC). My experience with the Tower 8 Unit has given me the opportunity to collaborate and work under the guidance of a registered nurse. According to the California Board of Registered Nursing, (2013) under “Observation of signs and symptoms of illness, reactions to treatment, general behavior or general physical condition,” I am able to implement intervention based on my observations of abnormalities. Not only am I refining my clinical skills and utilizing effective communication, I learned the required specific policies and procedures for renal transplant patients. According to Bonuel and Cesario, (2013), “The care of a patient undergoing renal transplant is complex and centered on critically assessing renal function, administering immune-suppressive therapy, observing the function of the newly transplanted kidney, monitoring fluid and electrolyte balance, preventing sources of infection, detecting early signs of complications and rejection, and managing and supporting the patient and family through the recovery phase.” I agree with this statement as I am learning the transplant nursing culture and the

It’s often said that if a company grows too fast, both employees and customers will experience growing pains. But preparation, along with the help and support from ARA leadership, ensured that the Regional Dialysis Center of Mesquite, located just outside of Dallas, Texas, experienced only success.

According to the study titled Safety in Numbers (Aiken, 2010), California nurses expressed increased satisfaction with their workload after implementation of Assembly Bill 394. Mandated staffing levels is strongly linked to positive workforce environments among RNs. Safe staffing also impacts the retention of experienced RNs. Nurses with more tenure in the workforce are more experienced and better prepared to provide care to critically ill patients. Encouraging nurses to stay within the profession by mandating ratios improves job satisfaction, staff morale, and has proven to save the lives of patients by decreasing patient mortality. Adequate staffing has given RNs more time for patient teaching,

The University of Pennsylvania Hospital in Philadelphia has a kidney dialysis machine which can serve the functions of a healthy kidney for patients with kidney disease. Kidney disease occurs when the organ no longer functions and waste products begin to build up within the body. This disease can lead to anemia, high blood pressure, and nerve damage. In the process of kidney dialysis, there are catheters which are connected to veins through a vein graft which is attached to the tubes of the dialysis machine. In essence, blood is simply being pumped into the machine where waste products are filtered out. Then the ‘clean’ blood is pumped back into our body through a vein graft. There are ten possible candidates with chronic kidney disease who could potentially be granted access to the kidney dialysis machine. There are only two time slots, so the candidates will be assessed according to condition and other factors as to who is allowed to use the machine. I believe that Steve should be one of the two patients who is granted access to