Literature Review
Shekelle (2013) reports a small percentage of hospitalized patients die during or shortly after hospitalization. Evidence suggests that some proportion of these deaths could probably be prevented with more nursing care (Shekelle, 2013). In a study completed from 168 nonfederal adult general hospitals in Pennsylvania it was concluded that in hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction(Aiken et al.). According to Hinno, Partanen, & Vehvilamen-Julkumen,(2012) nurse staffing is a matter of major concern internationally because of its effects on patient safety
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Sochalski (2012) reports workload played a role in these quality assessments, but it was the consequences of workload, such as the reports of unfinished nursing at the end of the last shift and the frequency of adverse events among patients, that played a much more prominent role. Nurses' vigilance at the bedside is essential to their ability to ensure patient safety. It is logical; therefore, that assigning increasing numbers of patients eventually compromises nurses' ability to provide safe care (Sochalski, 2012) A study done by Tubbs-cooley, Cimiotti, Silber, & Sloane (2013) revealed Children treated in hospitals with pediatric staffing ratios of 1 : 4 or less were significantly less likely to be readmitted within 15–30 days. According to Kutney-Lee, McHugh, Sloane, & Cimiotti (2012) patients’ reports of satisfaction are higher in hospitals where nurses practice in better work environments or with more favorable patient-to-nurse ratios. According to Yakeusheva (2016) better staffing can allow nurses to perform better surveillance, spend more time with patients, and detect complications earlier; leading to favorable patient outcomes. Many correlation studies support the association between better nurse
Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).
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
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,
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
A manager should make sure that the resources that are provided to the staff are useful, effective, and helpful. The manager should ensure that they have the adequate amount of resources and tools in order to complete there work and job. When it comes to the issue of nurse staffing ratios, the manager has the responsibility of making sure that the unit is staffed to meet the demands of the patients and there level of care, or acuity (GCU, 2011). Utilizing there skills in leadership, quality care, people and communication can all be of benefit. Leadership skills, such as leading by example, are necessary for nurse managers. Quality care skills can be beneficial to gather the necessary data and provide adequate staffing to promote and improve overall performance. People skills are used to interview new employees and hopefully increase staffing
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,
The role of a family nurse practitioner is a fundamental portion of the future of healthcare. The role is clearly not as understood by other healthcare professionals as needed which results in the disagreement if the role of a family nurse practitioner is even required for primary care. As people are getting older, the need for medical professionals that can provide patient care to our ever growing population increases. The need for the role of family nurse practitioners will grow too. The role of the family nurse practitioner, the ability of the FNP to be able to transition into their role.
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 recent years, the healthcare industry has seen a significant decline in the quality of patient care it provides. This has been the result of reduced staffing levels, overworked nurses, and an extremely high nurse to patient ratio. The importance of nurse staffing in hospital settings is an issue of great controversy. Too much staff results in costs that are too great for the facility to bear, but too little staffing results in patient care that is greatly hindered. Moreover, the shaky economy has led to widespread budget cuts; this, combined with the financial pressures associated with Medicare and private insurance companies have forced facilities to make due with fewer
Nursing is the powerhouse in the delivery of safe, quality patient-centered care in the healthcare industry. To ensure continued safety of the patient and nursing staff, the issue of inadequate staffing must be addressed. Consequently, patient’s mortality rate has been linked to the level of nursing staff utilized in ensuring an utmost outcome (Aiken, 2011). This paper will outline the issue associated with inadequate nurse to patient staffing ratios in the hospital setting; essential factors such as economic, social, ethical and political and legal affecting the issue will be established; current legislature and stakeholders will be ascertained and policy option, evaluation of bill and the results of analysis will be reviewed.
The study also found that Americans scheduled for routine surgeries run a 31 percent greater risk of dying if they are admitted to a hospital with a severe shortage of nurses. That’s approximately one-fifth of the up to 98,000
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.
In the interview the question about any advice she wanted to offer was asked, with a big smile on her face, I am sure, she responded that the field is “wide open” ("Nursing Informatics as a Career," 2011) she continued on to say, if you are a self-starter it
According to Canadian Nurses Association(2009), human health resources have stated that by the end of 2011 Canada will experience shortage of 78 000 registered Nurses (RN) and shortage of 113 000 nurses by the end of 2016. Globally there will be shortage of 4.3 million health care workers. It was also shown that approximately 38% of new graduate nurses leave their workforce within the first year of employment (Lavoie-Tremblay, Wright, Desforges, Gelinas, Drevniok & Marchionni, 2008). According to registered Nurses Association of Ontario (2011), full time positions of RN dropped to 57.9 % in 2010 from 58.9% in 2009. With the current trend it is expected that the Canadian Nursing shortage will increase significantly. In
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