Rafferty, Clarke, Coles, Ball, James, Mckee And Aiken (2007)

Stanton, M. R. (2004, March). Hospital Nurse Staffing and Quality of Care. Research in Action. Rockville, MD, USA: Agency for Healthcare Research and Quality.

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).

The sample size was large enough since it brought together 2,545 nurses, from different nursing units. In addition, the selection of four different hospitals ensured that there was no bias and that any similarity in research findings could be considered as part of the study’s objectives (Brewer, 2006, p. 650).

Research Critique, Part 1: Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

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.

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.

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

with recommendations for changes needed in nursing. This was a response for the need to assess

Nurses are crucial in providing quality care in the health care industry. It is imperative to maintain the proper staffing ratio to ensure that nurses can maintain high quality care for their patients. Studies have shown that the increasing workload of nurses can be linked to increased patient deaths, medical errors, hospital-acquired infections, longer hospital stays, and many other complications. (National Nurses United n.d. ) Leaders and managers play a vital role in developing

Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation

In “Propaganda Techniques in Today 's Advertising” by Ann McClintock, the author discusses how Americans are being brainwashed by advertisements and the different techniques they use to catch our attention. Ads are simply everywhere we look, it is impossible to get through the day without seeing one. All advertising companies put tons of research into how consumers spend money or even vote. Once these companies finish their research, they create advertisements that appeal to the masses. The basic propaganda techniques that McClintock writes about are Name Calling, Glittering Generalities, Transfer, Testimonial, Plain Folks, Card Stacking, and Bandwagon. Each one of these propaganda techniques is used in specific ways by advertisers to sell their product or service to consumers. I have selected a political ad which uses the Glittering Generalities technique, a coffee ad that uses Transfer technique, a soda ad that uses the Testimonial technique, and a soup ad that uses the Name Calling technique.

Major studies in the last three decades have confirmed an association between the registered nurse to patient ratio and adverse patient outcomes such as mortality, morbidity, length of stay, failure to rescue (Hunt 19). For example, bed sores or patient falls, are considered an adverse outcome because it is a complication that occurred after the patient was admitted to a healthcare facility, Nonetheless, the key to

Contending with terrorism is not something that can be done overnight. It must be strategically thought out and well planned in order to implement the correct procedures. As supervisor of TSA the prevention plan I would put in place is first to analyze the level of security amongst the infrastructure (Schmalleger& Pittaro, 2009). Having firewalls in place gives that layer of protection from possible cyber terrorist, but this should not be the only line of defense (Schmalleger& Pittaro, 2009). Becoming familiar with the methods hackers use allows me to know the best computer security system to install as well as keeping my employee’s knowledgeable by offering mandatory classes in how to prevent cyber terrorism (Schmalleger& Pittaro, 2009).

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

Staffing deficits pose a direct threat of manifesting negative outcomes associated with the delivery of patient care. Anything or anyone that compromises patient care should be eradicated immediately. This author believes that staffing deficits remain a consistent issue due to lack of solutions that actively address the issue. This author believes that inadequate staffing is a major concern due to the degree of harm it can impose on patients. Adverse events associated with