Patient Staffing

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

Neither nurse managers nor hospital administration will comprise of that 55%. This makes good sense. Nurses providing direct care will implement and assist in design of plan. In designating the appropriate number of registered nurses to each unit for each shift will greatly improve services rendered, thus, maximizing patient care and increasing positive patient satisfaction

In the first medical surgical unit, it is forecasted there will be 14,007 patient days in 2015 with the 5:1 ratio, there needs to be 2,802 staff members in this unit. In the second medical surgical unit, there will be 14,086 patient days in 2015 and will need 2,817 staff members. The third unit will have 10,846 patient days and will need 2,170 staff members to meet the standard ratio. The final unit will have 9,936 patient days in 2016 and will need 1,987 staff members.

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.

Charge Nurses Staffed with Patients After completing clinical hours on a Medical-Surgical unit in Aria Jefferson Health Hospital for ten weeks, one of the problems that came to light was the fact that charge nurses are staffed with patients despite their responsibilities as a resource to the floor. This is a result of the unit having a shortage of nurses. Generally, the day shift has five nurses that are fully staffed about five or six patients, while the night shift usually has four nurses working which means they all have six patients. Yet for both shifts, charge nurses generally are staffed with five or six patients and are expected to complete their duties as the lead nurse for the shift, too.

From the point of view of hospital management, mandatory overtime is seen as a method to fill staff shortages. According to Yoder-Wise (2015), professional nursing associations, along with provincial governments, provide guidelines for hospital unit staffing requirements related to the minimal number of regulated nurses on a unit at any given time (p. 288). In order to meet these requirements, nursing management must often implement mandatory overtime to ensure the appropriate staff-to-patient ratios on the unit are satisfied.

As the health care administrator, responsible for staffing levels I will conduct and analysis to determine the number staff members required for each department to run efficiently. Upon completion, each employee will be assigned to 8-hour shifts five days per week. Since there will be adequate coverage for each shift that will eliminate the need to have people working over-time which will be a cost saving measure. Now that the staffing levels are ideal this allows patients to receive the necessary medical care which will increase their satisfaction with the health care organization. By having each person working a standard work week without having to do overtime to meet the needs of the department will reduce stress and the possibility of them

The goal is to get the most out of the fewest staff members and still provide high level quality care. The staffing may differ from unit to units depending on the acuity of the patients and the volume of the patients that require care. The number of staff required to perform day to day operations can change due to illness or vacations, so there must be plans in place to factors for this. The use of pool nurses or offering overtime can be an option, but both have some drawbacks. The use of a pool nurse that may not be as familiar with the unit or the equipment can limit either the number of patients care for or the level of care provided. The nurse that is in an overtime situation can become fatigued and the risk for errors increases, as well as, the financial burden it places on the facility. “Professional nurses are responsible and accountable for individual practice and understanding the consequences of fatigue in preserving integrity and safety” (Dent, 2015, p. 44). Many facilities that have staffing issues utilize particular staffing patterns that allow for the most available staff when the volume is at its pinnacle and the reduce staff during slower periods. The nurse manager also must take into account breaks and lunches to keep their staff nourished and elevate moral. The relief for a lunch or break can be a deciding factor in the retention of a seasoned professional nurse. The manager also must maintain productivity on the unit, it is an ongoing balancing-act to keep staff and patients happy, as well as, administration related to the

The study made specific mention of patient outcomes, but failed to identify a true relationship between staffing and patient outcomes. The study focused almost exclusively on RN staffing and failure to rescue or turnover. The algorithm used was vague and only estimated the likelihood of patients that developed a hospital acquired complication would be at risk for death. My proposed question is; what factors lead to hospital acquired complications on units with high patient turnover? This question would have allowed researchers to highlight the issue of decreased staffing levels on patients with high turnover rates.

There are three staffing models, budget based in which nursing staff is allocated to nursing hours per patient day. Another method is nurse to patient ratio in which the number of nurses per number of patients. Lastly, and I think most importantly is patient acuity in which patient characteristics are used to determine a shift’s staffing needs. My organization uses a combination of methods and taking the overall staffing approach to their specific needs of the unit. There can be concerns about appropriate and safe staffing when only financial approach is taken without considering such as patient acuity, and

This study will utilize a stratified, randomized, placebo-controlled, pretest-posttest design with an intention to treat analysis. Patient enrollment will take place over a course of 6 months. Prior to randomization to subject groups, all participants will complete the Numeric Rating Scale for Pain (NRS-11). To ensure similar baseline pain scores between the treatment and control groups, subjects will be stratified into three groups based on their baseline pain scores: no –to –mild pain (0-3), moderate pain (4-6), and severe pain (7-10). Subjects from each pain level group will then be randomly assigned to either the standard of care group (SC) with placebo or the treatment group (SCK) consisting of standard of care with Kinesio taping

AMN Healthcare operates only in the U.S., and the primary market in which AMN Healthcare competes is the healthcare staffing. According to the staffing industry analysis, healthcare staffing market will grow at 6% in 2017 with an estimated market size of $15.5 billion (A mixed outlook for healthcare staffing). Healthcare industry is the largest industry, and it is the biggest employer in the country, these two factors made healthcare staffing and workforce solutions market as one of the very competitive markets in the United States. AMN completes with small and players in national, regional and local markets and still, it was able to hold on to its place as the market leader with 11% market share. Below is the list of top ten healthcare staffing

Higher patient turnover occurs on 6,9 of shifts despite the proportion was 14.9% on day shifts, 5 on evening shifts and 0.2% on night shifts. The risk of death increased 2% each time a patient is exposed to shifts with below target RN staffing. The average patient in the study was expose three nursing shifts with below target staffing result in a 6% higher risk of mortality than patients with no exposhir to below target staffing. The risk of mortality was 4% higher when a patient was exposed to a high-turnover

The bill sets the specific requirements for nurses to no more than 4 patients on medical-surgical units, psychiatric units, and other specialty units. It also defines the number of patients per nurse for the other various units of the hospital as well as

According to Provision four, “the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care” (Fowler, p.41, 2008). As far as accountability goes the nurse manager and the facility are both responsible for the lack of proper staffing. Although administration told Susan to deal with. She took it upon herself to implement the schedule change without any authorization from her superiors and without regards to patient safety. It is unfortunate, but being short staffed has become a norm in most health care facilities. The best option for me would have been to quit. But unfortunately this option is idealistic and not realistic. Susan should have pressured administration to hire experienced per diem nurses from an agency. Another option would be to take nurses from another unit that is adequately staffed to work during their days of being short staffed.