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, …show more content…
According to Mason, D.J., Gardner, D.B., Outlaw, F.H., & O’Grady, E.T. (2016), some of these factors include “the expertise of the nursing staff, availability of supportive personnel and other health professionals, good communication among the care team, and the nurse/patient ratio” (p. 516). Growing concern in the 1990s over the potential effects of the changes in nursing staff levels along with an increase in nursing union influence paved the way for the state of California to become the first state to pass legislation regarding minimum staffing levels for nurses in hospitals via the California Assembly Bill (AB) 394. The legislation, enacted in 1999, was applicable to both RNs and licensed vocational nurses (LVNs). In the early 2000s, research began to show a consistent relationship between the quality of care that patients received and the number of licensed nurses providing care (Mason, et al., 2016). Multiple other states have passed legislation regarding this policy issue as well; for example, Connecticut, Illinois, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Texas, Vermont, and Washington have all enacted legislation associated with safe nurse staffing levels (Emergency Nurses Association, 2014). There have also been multiple bills introduced to Congress on the federal level regarding this policy issue as well; for example, the Registered
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.
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.
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 project made use of the Nursing Teamwork Survey. This study design was meant to measure teamwork as demonstrated by nurses in patients’ settings. The national teamwork survey concentrates on the teamwork demonstrated by the nurses in their work
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.
This nurse is interested in the affects administrative decisions surrounding nurse staffing in regards to patient outcomes and nurses work satisfaction. This nurse began her research with a question in mind; “How do RN to patient ratios affect patient outcomes?” The search returned greater than 2000 articles related to Nurse Staffing and patient outcomes. Although, many of the abstracts supported the relevance of the topic the amount of material was excessive and the subject too broad. In an effort to create a list that would be more manageable, this nurse concluded her topic needed to be refined and constructed a much more concise and limited search until finally she constructed a PICOT question which yielded less results within a limited topic.
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
Purpose: The purpose of this speech is to inform my audience about the importance of safe nurse staffing that can help improve patient satisfaction, decrease patient complications, reduce nurse fatigue, improve nurse retention, decrease patient mortality, and reduce medical and medication error.
Since the IOM report in 1996, more research has been done showing better client outcomes with more favorable staffing of registered nurses (Cho, Ketefian, Barkauskas, & Smith, 2003, pp. 71-79). Therefore, S. 991: Registered Nurse Safe Staffing Act of 2003, 108th Congress: 2003-2004 was introduced in the Senate. This bill was to amend part D (Miscellaneous) of title XVIII (Medicare) of the Social Security Act (SSA) to:
If we know that adequate staffing levels will improve patient outcomes, how do we get there? Are mandated patient-to-nurse ratios the answer? The people of the state of California thought so in 2004, with the passage of Bill
It is not a secret that for many years there has been a detrimental nursing shortage in the United States. Factors that contribute to the unfortunate decrease in availability of nurses and other health care professionals can be attributed to a shortage of nursing school instructors which impacts enrollment into nursing schools, and many in the health care profession are nearing retirement age. The need for health care continues to steadily increase as the baby boomer generation ages. In order to meet these demands, there has to be adequate staff in the workplace. After an extended amount of time dealing with unsafe staff to patient ratio it has come the time to take action and devise solutions rather than letting patient care suffer. After comparing a variety of possible solutions, the most feasible was to create and implement a clear updated set of regulations, and formulate a law to enforce the same. The proposed solution will address the ineffectiveness of current health care staffing regulations, propose a law that will enforce safe staff to patient ratios, mandate that all parties involved in developing health care laws be members of the health care field themselves, and work to maintain a strict continuous reassessment phase to ensure that all changes remain beneficial. With the help of the entire health care community the implementation of this proposed solution will create a dramatic decrease in adverse patient outcomes while increasing patient and staff
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 nurses leave their first nursing job within a year, and over thirty-three percent leave within two years (Christine T. Kovner, 2014). Nursing turnover in combination with other important factors will be discussed in greater detail in the following paragraphs.
One professional organization that has been stepping up to the plate in regards to this issue is the American Nurses Association (ANA) and its Constituent & State Nurses Associations (C/SNA). The American Nurses Association (n.d.) role in this issue is to promote legislation that holds hospitals responsibility for developing and executing valid and reliable staffing plans. These plans are not to be confused with mandated ratios, which require fixed nurse to patient ratios. These plans are strictly based on each hospital’s unit unique circumstance and should evolve as the unit grows and changes.
One of the greatest challenges in healthcare, as well as the biggest threat to patient safety, is staffing and the nurse to patient ratio on hospital floors. Studies have shown that low staffing levels lead to increased mortality rates in patients, as well as multiple other adverse effects including falls and pressure ulcers. These adverse effects are all preventable, but policies on staffing must be in place to ensure safety for staff and patients.
Safety is a concern for people of all ages especially the elderly. There are many risks for the elderly and it is important for nurses to have the knowledge and skills to assess and help prevent injuries. Aside from monitory her respiratory, cardiac status and vitals, I want to assess for any risk for injury. According to Berman and Fransen and Snyder (2016) explained to add an overall general health history and examination to check for problems such as mobility, sensory or perceptual problems, cognitive thinking, emotionally how she is, and if there has been any past history of safety issues.