Why Do Nurses Understake Or Malpractice

Pamela F. Cipriano, President of American Nurses Association was in disbelief to see how she has tried to enforce the Nightingale pledge of keeping patients free from harm was failed because medical errors are the third leading cause of death in the United States. As of now ANA has conducted yearlong campaign named “Safety 360 It Starts with You” in order to reduce and take measurable advances to protect the welfare of nurses and workers. It is one of campaign that the ANA comes with that is in support to both the nurses and patients. However, in the real-world nurses are stress and fatigue due to patient ratio. In my workplace, which is a state hospital, they have full time nurses on call where nurses work more than 70 hours a week. The nurses

Extensive research has shown that there is a correlation between staffing and patient ratio and patient outcomes. Better outcomes particularly are shown with lower patient to nurse ratio. However staffing issues remain an ongoing concern which greatly impacts the safety of the nurse and their patients, and also impacts cost of healthcare. Evidence shows that adequate staffing causes reduction in mortality, nurse burnout and job satisfaction, and reduction in medical errors.

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

Nurses find themselves in the middle of a complex health care system between the financial side and patient safety. A professional nurse’s goal is to provide safe, quality, patient care. However, nurses often fail to meet this goal due to the variability in patient acuity, the unpredictable workload of nurses, and institutional budget constraints (ANA, 2014). According to the American Nurses Association (2014) research shows that lower staffing levels of registered nurses correlate with poor patient outcomes, as well as negative nurse outcomes, such as physical injury and ‘burnout.’

For every additional patient added to a nurse's workload, a hospital's death rate has been shown to increase by 7 percent, meaning that if a nurse is responsible for four patients and then has her care load doubled, there is a 31 percent increase in the patient death rate for the hospital. The percent increase is even higher for critical need patients. As many as 98,000 patients die each year from medical errors and ensuring high nurse-to-patient ratios is an essential component of reducing that rate.

Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown that more infections like UTI, pneumonia, shock or cardiac arrest increases when patients receive fewer hours of nursing care. Medication errors and unsafe hand washing techniques were found more in increased patient workloads. Unsafe staffing gave more job dissatisfaction, job burnout and more nurses quit or drove nurses away from nursing. This increased mandatory overtime and increased nurse shortage. According to survey of California state

Safe nursing ratios provide better outcomes for patients and provide better working conditions for nursing staff. Unsafe nursing to patient ratios have detrimental and negative outcomes in the nursing care that patients can receive in the hospital. For example, medications that are administered to patients late can alter their drug administration schedule. The late administration of cardiac drugs can be detrimental to patients’ well-being because this can cause a failure in maintaining the drugs therapeutic serum levels and consequently increasing the likelihood of arrhythmias. High patient to nurse ratios can also cause nurse burnout. Nurse burnout is precipitated by the increased physical and emotional exhaustion from being assigned too many patients depending on the type of floor that one is working. This causes nursing staff to leaves the nursing field due to the undue stress and look for positions that aren’t as stressful. This will only contribute to the nursing shortage. Patient hospital stays can also be effected due to the number of days that a patient stays in the hospital. This leads to an extended number of days in the hospital which can cause a loss of money that insurances would not agree to pay. The safety of the patients need to be a nurse’s priority and this can be a great cause of concern with an unsafe number of patients being cared for by the nurse. As nurse timing becomes a priority, it becomes important to be able to take care of each patient that is

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.

The harsh reality of understaffing in healthcare centers is a real and prevalent issue. Nurses are being forced to compromise care due to being given responsibility over too many patients at a time. The New England Journal of Medicine (Needleman et al., 2002) explains how staffing issues are linked to adverse patient outcomes. This includes length of stay in

The purpose of this paper is to illustrate and demonstrate the significance of lowering the nurse to patient ratio, while implementing quality health improvements. Today’s complex healthcare system faces a number of difficulties that affect the quality of patient care and safety. Current nurse to patient ratios are of increasing focus in today’s healthcare system. Nursing staffing ratios have an effect on numerous areas within nursing; however, one of the most profound is the effect on the quality of care delivered to the patients. For example, medication errors and prevention are important in all aspects of care. Appropriate time is needed to administer medications; however, with overworked nurses and overextended patients loads, nurses are pressed for time. Nurses have the opportunity and responsibility to make sure that their patients obtain quality of care through interventions that keep patient safety a priority. Strategies should include keeping nursing staffed at adequate levels and appropriate to the type of patient care. Furthermore, the patient’s acuity and the nurse’s assignment should be taken into consideration.

As a result, overtime can compromise patients ' health or safety. Medical residents cited fatigue as a cause for their serious mistakes in four out of 10 cases (Boodman 2001), and two studies linked infection outbreaks at hospitals to overtime work (Arnow et al. 1982; and Russell et al. 1983). Indeed, the California Nurses Association reports that more nurses are refusing to work in hospitals with unsafe conditions, in which they include being forced to work unplanned overtime. The American Nurses Association (ANA), in a national survey of 7,300 of its members, found, disturbingly, that 56% of nurses believe that the time they have available for care for each patient has decreased, and 75% feel that the quality of patient care at their own facility has decreased in the last two years. The cited inadequate staffing as the chief reason.

According to The Journal of the Medication Association (2002), Hospitals, which routinely staff with 1:8 nurses to patient ratios, experience five additional deaths per 1,000 patients than those with 1:4 nurse to patient ratio. Safe nurse staffing ratios has been a significant issue that, registered nurse professionals have been struggling to overcome for many years. In the randomized research study, “Nurse Staffing Levels and The Quality Care in Hospitals”, by Needleman, J, Buerhaus, P, Maureen, S, and Zelevinsky, K, administrative data was collected from hospitals based in 11 states, to determine the correlation between the amount of care provided by nurses, safe staffing levels, and adverse patient outcomes. According to this study, “Among

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)

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.

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