Effective Communication And Patient Safety

In a different review of literature on staffing and patient outcomes, Heinz (2004) describes the relationships between staffing and mortality, length of stay, and complications of patients. At first the article paints a clear picture of the future of nursing as it starts to feel the shortage which is approaching due to aging of present nurses, lowered nursing school admissions, and other hospital issues including financial hardships. In looking at the impact of ratios on mortality there were five different studies identified that showed that the lower the ratio, the lower the risk of mortality of patients. A patient's length of stay was also influenced negatively with higher nurse-to-patient ratios and positively with specialized units and care from nurses. The impact of staffing on patient complications also showed that there was an inverse relationship between the two. Heinz concludes that the key to solving these problems in nursing and reducing negative patient outcomes is nursing recruitment and retention (Heinz, 2004).

Within a health care setting communication is a necessity. This communication not only includes the need for professional communication but also the way in which information is shared to the patient and to other healthcare workers. Another important aspect of health care worker such as a nurse is the effectiveness off a handover. Within the video, Effective Communication in nursing these three aspects of communication (Professional communication, provision of information and handover) were seen and will be analysed further, within this essay. These will be analysed through the three aspects, the care of the patient, the image of the individual nurse and the health outcomes of the patient. All of these three aspects of communication are vitally important to the overall patient needs.

Inadequate nurse staffing is commonly cited as a factor in unanticipated hospital events (ANA, 2015), whereas higher staffing levels are related to lower rates of negative patient outcomes (Registered Nurse Safe Staffing Act [RNSSA] of 2015, 2015; MN study links nurse staffing to patient outcomes, 2015). For example, inappropriate nurse staffing can result in increased infections such as pneumonia, shock, cardiac arrest, and urinary tract infections (Stanton, 2004), longer hospital stays, medication errors, falls, injuries, and death (ANA, 2015; Stanton, 2004).

One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,

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,

Extensive research has shown that there is a correlation between staffing and patient ratio and patient outcomes. Better outcomes particularly are shown with lower patient to nurse ratio. However staffing issues remain an ongoing concern which greatly impacts the safety of the nurse and their patients, and also impacts cost of healthcare. Evidence shows that adequate staffing causes reduction in mortality, nurse burnout and job satisfaction, and reduction in medical errors.

The purpose of this paper is to illustrate and demonstrate the significance of lowering the nurse to patient ratio, while implementing quality health improvements. Today’s complex healthcare system faces a number of difficulties that affect the quality of patient care and safety. Current nurse to patient ratios are of increasing focus in today’s healthcare system. Nursing staffing ratios have an effect on numerous areas within nursing; however, one of the most profound is the effect on the quality of care delivered to the patients. For example, medication errors and prevention are important in all aspects of care. Appropriate time is needed to administer medications; however, with overworked nurses and overextended patients loads, nurses are pressed for time. Nurses have the opportunity and responsibility to make sure that their patients obtain quality of care through interventions that keep patient safety a priority. Strategies should include keeping nursing staffed at adequate levels and appropriate to the type of patient care. Furthermore, the patient’s acuity and the nurse’s assignment should be taken into consideration.

Staffing may be expressed as the number of staff members required for providing care to a particular number of patients, or it can describe the way in which human resources are used in a particular setting (Groher-Murray & Langan, 2011, p 273). Theoretically, when sufficient structural inputs are placed, better outcomes are produced. As the nurse in charge it is important to make sure that there is sufficient and trained staff not only for safety but for legal reasons. The unit I currently work for has a staff to patient ratio of one nurse for every 12 patients, and one patient care technician to every 4 patients. If I were nurse manager I would address this issue for not only safety, but for the nurse so they do not develop work related stress or burnout. As a manager, portraying positive attitude and motivating staff will help with staffing issues. Positive feedbacks and words of encouragement help with the staffing morale.

In the health care industry, nurse to patient ratios is often a controversial issue related to the cost involved to maintain a safe staffing level. Registered nurses know and continue to reiterate the importance of safe staffing levels in health care facilities. However, reductions in nursing budgets, coupled with the expanding nursing shortage, have resulted in a reduction of available nursing staff. As a result, the nursing staff at most health care facilities are forced to work longer hours with more acutely ill patients. Consequently, patient care is compromised and this ultimately perpetuates the nursing shortage because of this negative work environment.

How many patients can a nurse effectively care for at the same time? The complexity of that question has caused it to be quite difficult to answer. In the hospital setting today, managers are found being forced to create guidelines for staffing based on numbers instead of needs. These new staffing models are established based on nurse to patient ratios. Therefore, patient census is the primary determining element for justification of available health care providers per shift (Artz, 2005). Acuity of patients and experience of providers are no longer factors that are being considered, and these nurse to patient ratios do not always provide a safe environment. Research has shown that these ineffective nurse to patient ratios are contributing to inadequate patient care (Sochalski, 2004). A new approach for nursing staffing needs to be put enacted for the furtherance of quality of care, patient safety, nurse satisfaction and the overall healthcare environment.

According to The Journal of the Medication Association (2002), Hospitals, which routinely staff with 1:8 nurses to patient ratios, experience five additional deaths per 1,000 patients than those with 1:4 nurse to patient ratio. Safe nurse staffing ratios has been a significant issue that, registered nurse professionals have been struggling to overcome for many years. In the randomized research study, “Nurse Staffing Levels and The Quality Care in Hospitals”, by Needleman, J, Buerhaus, P, Maureen, S, and Zelevinsky, K, administrative data was collected from hospitals based in 11 states, to determine the correlation between the amount of care provided by nurses, safe staffing levels, and adverse patient outcomes. According to this study, “Among

Measures have already been implemented in intensive care units (ICU) in order to ensure patient safety and there is now a maximum ratio of one nurse to two patients (Nurse, n.d.). Many patients from intensive care floors are originally from medical-surgical units due to serious complications. This means that a typical nurse on a med-surg unit could be dealing with one or two patients that may need very close monitoring, and due to the nurse’s workload these patients may not receive the care they need. Should the ratio of nurses to patients on medical-surgical units be decreased in order to promote greater patient safety?

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

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.