The And Discharge Assessment And Planning

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.

This week’s reflection paper focuses practice-based evidence and the operation of the theoretical framework of person-in-environment as each relates to discharge planning at UMPC Mercy Detoxification Unit (UPMC-MDU).

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.

Appropriate nurse staffing is a complex topic that has arisen as a nationwide healthcare issue within the profession of Registered Nurses (RN). To truly understand the concept of staffing one must understand that staffing and scheduling are often at times used interchangeably although Mensik (2014) noted a distinct difference between the two (p. 2). The American Nurse Association [ANA] (2012) has defined appropriate nurse staffing “as a match of registered nurse expertise with the needs of the recipient of nursing care services in the context of the practice setting and situation” (p. 6). Scheduling, in contrast, involves taking into account factors such as a unit’s historical census numbers along with anticipated surgical volumes

However, that is not always possible because their in-network hospital may not have a bed available. I have to make sure that all the outpatient providers are in-network with the insurance as well otherwise it will not be covered by the insurance and the patient will not be able to afford the cost of care. I thought having a hospitalist and working closely with the Kaiser case manager to address discharge planning needs helped maintain care quality and contain the cost of care. Successful discharge planning that reduces readmissions are high priority issues addressed in the healthcare reform agenda because it affects both quality and cost of care (Weiss et al., 2015). Weiss et al. (2015) also stated that "...hospitalized patients, regardless of risk status or the setting to which they are being discharged, require some

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.

There are a number of factors that contribute to the impact of the nursing shortage.

Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, nursing satisfaction and

This shortage was driven by a demand for more nurses as hospital use increased with better quality of life and higher health standards, developments in patient care technology and a reduced number of working hours for nurses as they sought better work/life

There are times that there is the one nurse that seems to be notoriously late for their shift or always calling off. The manager not mentoring this nurse on this behavior causes disruption within the unit and division. Not following policy in disciplinary actions causes a lot of unwanted disharmony amongst the nurses. If disruptive behavior continues being overlooked or if the behavior is endured for long periods of time causes even more dissonance. There needs to be a team accountablity plan in place for responsiblities and to renew personal

Staffing models play a significant part in the deliverance of care in a health system as it allows systems to put forth adequate staffing to provide a high level of care. The quality of care providers deliver is influenced by individual provider characteristics such as knowledge and experience, as well as human factors such as fatigue. The quality of care is also influenced by the health care organization or system, which involve not only staffing levels, but also patient need, the availability and organization of other staff and support services, and the climate and culture created by leaders in that setting. The same nurse may provide care of differing quality to patients with similar needs under variable staffing conditions and in different work environments. According to The National Center for Biotechnology Information, staffing and patient care quality and safety are directly related. Figure 1 generically illustrates staffing model framework and

According to an article submitted by Rosenfeld, 2009, the growing trends of an aging population require the need for more nursing services. In addition, there are insufficient numbers of facilities to train new nurses (Rosenfeld, 2009). The above issues pertaining to nursing shortages have created what is called a “nursing crisis” which have caused and will continue to cause dramatic shortages on a national basis.

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

It is likely that most people have heard about the nursing shortage for years now, and perhaps they believe it’s been fixed. However, the nursing profession is experiencing a reoccurring deficiency. According to Brian Hansen, (2002), there was a nation wide shortage in 2001 of 126,000 full-time registered nurses, but the shortage will surge to 808,000 by 2020 if something isn't done. This pattern is a persisting cycle of high vacancies followed by layoffs and a high over supply of registered nurses. Various factors contribute to the lack of nurses within the health care facilities, but today’s shortages are a little different. Many feel that this scarcity is severe and long-drawn-out. The four major issues contributing to

A continuous concern that continues to present itself within the healthcare environment is adequate staffing on nursing units. Most hospital organizations try their very best to accommodate staffing needs, though many units remain understaffed for an unspecified amount of time. Inadequate staffing can negatively affect patient outcomes, lead to nurse burnout, and decrease patient satisfaction scores. Combating this issue will require a great deal of effort, as many geographical face nursing shortages when seeking new graduates and qualified candidates. Employees may begin to feel that they are unable to pursue personal goals within a healthcare organization, due to inability to transfer as a result of staffing shortages. This often results in nursing seeking employment or career advancement outside of the organization or geographical area, which further intensifies ramification associated with inadequate staffing.