Supplemental Nursing Case Study

The purpose of this paper is to discuss the problems related to inappropriate nurse-patient ratios and provide suggestions that may improve the problem. The American Nurses Association advocates for proper number of nursing staff for delivery of quality patient care. However, hospitals are faced with problems related to decreasing staff levels. The Registered Nurse Safe Staffing Act of 2015 provides for patient protection by establishing safe staffing levels. This bill requires the staff nurse to be actively involved on committees and in the development of unit-based staffing plans. The formation of the Protest of Assignment allows nurses to advocate for change to ensure proper patient care. Nurse recruitment is another challenge that is

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

Nursing shortage has been a global problem that need to be eradicated in order to promote patient care and improve care outcomes. Nursing shortage in America has caused a lot of negative impact on the nurses, patients and nursing profession. It has caused a lot of dissatisfaction on the part of the nurses and the patients (Nardi & Gyurko, 2013). Nurses are prone to injuries, stress and burn-out as a result of nursing shortages. They engaged in working long hours to compensate their coworkers and ensure completion of assigned jobs. They end up breaking down emotionally, physically and psychologically due to poor work-environment and

Registered nurses are an integral part of the healthcare system, and make up the largest number of healthcare professionals. According to the Bureau of Labor Statistics (2015) “The employment rate for registered nurses is expected to grow by 16% between 2014 and 2024”. This is more than double the average rate of growth for a profession. The rapid growth rate can be attributed in part to better management of chronic diseases and the baby boomer generation. The growth in the nursing profession is paramount, however the demographics of the nursing population does not mirror the demographics of the population served.

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.

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

The U.S. Bureau of Labor Statistics (USBLS) estimates the need for 439,300 registered nurses (RN) from 2014 to 2024, equating to a 16% increase in employment opportunities (USBLS, 2015). Approximately 30% of new RNs leave their first jobs with less than a year of hire and 525,000 nurses are expected to retire from 2012 to 2022- a demand totaled to around 1 million jobs by 2022. This increase is attributed to retiring baby boomers, turnovers, healthcare reform, and the increasing aging population (Kiel, 2012; USBLS, 2013). Control over the retirement of baby boomers is unrealistic, however, nursing turnover can be regulated.

Dr. Linda Aiken is the leading researcher in nursing staffing rates within the United States (Kerfoot & Douglas, 2013). She suggests that each state follows California’s example of conducting research to determine a minimum staffing ratio and making it a law (Kerfoot & Douglas, 2013). The California legislation enhanced nurse staffing in hospitals across the state and improved the patient care results of millions of patients (Kerfoot & Douglas, 2013). After the bill went into effect, job satisfaction increased, and the nursing shortage ended (Kerfoot & Douglas, 2013).

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.

While the US has more nurses and physicians than ever before, upcoming retirements and a dysfunctional workplace are creating clinical shortages that can become more severe than the industry can bear (Woods, D. 2009). According to research, half of all nurses working today were born during the baby-boomer years. Therefore, the workforce is aging at a rapid rate. As such, in efforts to prevent a mass exodus from the profession, healthcare organizations leaders are exploring innovative ways to keep experienced nurses (Larson, J, 2009). The average age of registered nurses has risen from 41 in 2002 to 48 in 2006(Bolton-Burnes L. 2007). Even more troubling, in 2006, 45% of hospital-employed RNs

Understaffing has become a major problem throughout our country, being that it often results in leads to unsafe conditions,avoidable death and injuries, and the possibility of a nurse being unhappy with his or her job.At the point when nurses are compelled to work with such high nurse - to -patient proportions, patients are exposed to death ,diseases, harm, or get sent home too early without sufficient training about how to deal with their ailment. A major reason for the understaffing of hospitals and specialized care home is for the simple fact that it is more cost efficient.Laws regarding how many nurses should be required per unit varies from state to state.Studies have been undertaken to correlate nurse understaffing and nursing fatigue. Those studies have uncovered that these two issues adversely affect the nature of care given to an individual which is the, patient to nurse ratio and operational expenses in facilities such as hospitals and specialized care facilities.For an example a national study that was published in a recent JAMA-Pediatrics issue and funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative and the National Institute of Nursing Research reached the conclusions that an obscure amount of neonatal intensive care units, or NICU’s, throughout the country provide adequate quantities of nurses to meet national rules and that the units administering to the most children are additionally the most understaffed, putting the wellbeing of fundamentally sick infants at risk.One of the study authors were Eileen Lake, who is a nursing professor and associate director of the Center for Health

Due to the nature of the business, two of the biggest issues the Specialty Nurse Company face when trying to hire new nurses are the distance to the clients’ homes and the nurses’ schedule. Employees have to make their own way to client’s homes to make their visits. This means they need to consider the time and gas demands of travelling and the reliability of their transportation. Clients and their families also want their nurses to live close by. Typically, nurses want a full time, 40 hours per week schedule; however, this rarely matches the client’s needs. Clients need the nurse for a few hours a day, or they need them throughout the day every day. They also want the same nurse every day. Specialty Nurse Company does not want to pay overtime and looks to hire more part time workers to cover the extra hours.

The financial cost of losing a single nurse has been calculated as equal to double the annual salary of a single nurse. Various studies reveal that each hospital in America is losing almost $300, 000 per year because of nurse turn-over. Nurse turn-over can negatively impact the health care system in many ways such as poor quality of patient care, increased medication error, hospital acquired infection, prolonged patient stay at hospital, and increased staffing cost. Many factors contribute to nurse turn-over such as workload, absence of career opportunities, poor work recognition, and lack of communication with management about issues (Hunt, 2009).

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.