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Author: Chelsea Cameron
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
Nursing practice is solely focused on patient outcome and patient safety. In order for patients to receive the highest quality of care, nursing staff must be able to provide these patients with their undivided attention. There is an overwhelming amount of research/data that shows the direct correlation between nurse staffing (id est nurse-to-patient) ratios and positive patient outcomes. This study takes place in Albuquerque, New Mexico at the Presbyterian Hospital, on the unit Adult Progressive Care 1 (APC1). Based on data collected and mere observation, quality of care and patient safety suffer when nursing staff is required to care for many high acuity patients at one time. Nursing staff on APC1 are generally assigned five patients, and more often than not these patients are of high acuity. In the acute care setting, nurse-to-patient ratio's should be 1:4 (one nurse per four patients) due to the following observations: the need for thoroughly and accurately performed and documented patient assessments and rounding, many extensive medication passes (id est scheduled and as needed (PRN) medications), preparation for tests and procedures, patient education (id est plan of care, medication, procedural, and safety), and patient advocacy. With the high nurse-to-patient ratios seen on APC1, one can see that accuracy, proper follow-up and adequate time spent with patients is hindered. Not only do the patients overall outcome suffer, but the job satisfaction of the nurse suffer. APC1, on average, sees nurse turn around every 1 to 3 years. With this type of turn around, Presbyterian cannot accomplish their goal of hiring the nurse for the lifetime of his/her career. This problem needs to be presented with an effective strategy, goal, implementation process, and evaluation process, to the hospitals management team. After successful implementation of the proposed changes, it is the writers hope to disseminate these changes not only hospital wide, but statewide.
Author: Chelsea Cameron
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
Nursing practice is solely focused on patient outcome and patient safety. In order for patients to receive the highest quality of care, nursing staff must be able to provide these patients with their undivided attention. There is an overwhelming amount of research/data that shows the direct correlation between nurse staffing (id est nurse-to-patient) ratios and positive patient outcomes. This study takes place in Albuquerque, New Mexico at the Presbyterian Hospital, on the unit Adult Progressive Care 1 (APC1). Based on data collected and mere observation, quality of care and patient safety suffer when nursing staff is required to care for many high acuity patients at one time. Nursing staff on APC1 are generally assigned five patients, and more often than not these patients are of high acuity. In the acute care setting, nurse-to-patient ratio's should be 1:4 (one nurse per four patients) due to the following observations: the need for thoroughly and accurately performed and documented patient assessments and rounding, many extensive medication passes (id est scheduled and as needed (PRN) medications), preparation for tests and procedures, patient education (id est plan of care, medication, procedural, and safety), and patient advocacy. With the high nurse-to-patient ratios seen on APC1, one can see that accuracy, proper follow-up and adequate time spent with patients is hindered. Not only do the patients overall outcome suffer, but the job satisfaction of the nurse suffer. APC1, on average, sees nurse turn around every 1 to 3 years. With this type of turn around, Presbyterian cannot accomplish their goal of hiring the nurse for the lifetime of his/her career. This problem needs to be presented with an effective strategy, goal, implementation process, and evaluation process, to the hospitals management team. After successful implementation of the proposed changes, it is the writers hope to disseminate these changes not only hospital wide, but statewide.
Author: Ronda Hughes
Publisher: Department of Health and Human Services
ISBN:
Category : Medical
Languages : en
Pages : 592
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Book Description
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Author: Suzanne Gordon
Publisher: Cornell University Press
ISBN: 0801464935
Category : Medical
Languages : en
Pages : 288
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Book Description
Legally mandated nurse-to-patient ratios are one of the most controversial topics in health care today. Ratio advocates believe that minimum staffing levels are essential for quality care, better working conditions, and higher rates of RN recruitment and retention that would alleviate the current global nursing shortage. Opponents claim that ratios will unfairly burden hospital budgets, while reducing management flexibility in addressing patient needs. Safety in Numbers is the first book to examine the arguments for and against ratios. Utilizing survey data, interviews, and other original research, Suzanne Gordon, John Buchanan, and Tanya Bretherton weigh the cost, benefits, and effectiveness of ratios in California and the state of Victoria in Australia, the two places where RN staffing levels have been mandated the longest. They show how hospital cost cutting and layoffs in the 1990s created larger workloads and deteriorating conditions for both nurses and their patients-leading nursing organizations to embrace staffing level regulation. The authors provide an in-depth account of the difficult but ultimately successful campaigns waged by nurses and their allies to win mandated ratios. Safety in Numbers then reports on how nurses, hospital administrators, and health care policymakers handled ratio implementation. With at least fourteen states in the United States and several other countries now considering staffing level regulation, this balanced assessment of the impact of ratios on patient outcomes and RN job performance and satisfaction could not be timelier. The authors' history and analysis of the nurse-to-patient ratios debate will be welcomed as an invaluable guide for patient advocates, nurses, health care managers, public officials, and anyone else concerned about the quality of patient care in the United States and the world.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309187362
Category : Medical
Languages : en
Pages : 485
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Book Description
Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
Author: Amanda Martinez
Publisher:
ISBN:
Category : Employee retention
Languages : en
Pages : 0
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Book Description
Positive patient outcomes are directly related to quality of care received and there is a vast amount of research that determines the relationship between nurse staffing ratios and patient outcomes. The problem observed in this study is a facility in which there is a high acuity and high nurse-to-patient ratio assignments. The quality of care decreases due to the nurse having so many patients, typically six, and so much to do and assess for each one. Due to the negative patient outcomes and stress of nurses not being able to complete every task, especially not on time. With at least four extensive medication passes per patient and ordered tasks for each patient throughout the day, one can observe how the nurses ability to turn six patients every two hours on the hour, providing them with prompt PRN medications for pain, and performing tasks as proper as they should be performed is hindered. The nurse-to-patient ratio in the acute care setting should be 1:4 (one nurse per four patients), no exceptions. The problem associated with this plan is that the facility does not want to spend the money on hiring and having more nurses per shift. The facility provides staffing according to Hours Per Patient Day or HPPD. The problem with this system is that the HPPD has a set number and only the number of patients determines the staffing, not the acuity level of the patients. The problem needs to be presented to administration and management along the company chain with an exceptional and effective strategy, goal, implementation process, and evaluation process. After one year of implementation, data collected and obtained will be compared with data from one-year prior to determine the difference in results. The results will compare occurrence of wounds, medication errors, hospital-associated infections, falls and injuries, all associated costs with each as well as patient satisfaction surveys and nurse job satisfaction surveys. The results will be disseminated in an effective and appropriate manner.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175704
Category : Medical
Languages : en
Pages : 558
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Book Description
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Author: Cecile A. Emanuel
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
Health care in the United States as well as other international health care facilities have undergone or are undergoing major reform in the delivery and practice of patient care. Health care facilities are being closely scrutinized and reimbursements are now tied to the quality of services provided Centers for Medicare and Medicaid Services. (2013, April 10). Value based purchasing or value placed on quality of care provided has now become modus operandi for hospitals being compensated. Hospitals and health care providers have delivered patient care reflective upon the ethics and principles that have guided practice over the years. Concerned with the financial impact the quality of care delivered may have on future performance, health care providers are seeking avenues that will impact the best quality of care and perception of health care delivered to patients. One of the largest impacts on patient satisfaction lies with the interaction and care delivered by nurses. The high nurse patient/ ratio invariably affects the time the nurse has to spend in this care delivery which can have a negative impact on patients' safety and their perception of care. This research focuses on the impact the nurse/ patient ratio has on patient satisfaction and outcomes, the nurse satisfaction in the work environment and the effect this all has on the patient survey scores. Patient survey scores, also known as hospital consumer assessment of hehealth careroviders (HCAHPS) are now being used as one of the tools tied to reimbursements of health care facilities by the Centers for Medicaid and Medicare Services and other organizations responsible for financial compensations in other countries. An analysis of available research on the current nurse/patient staffing ratio being used in most hospitals identifies three areas that should be of concern to hospital administrators and senior leaders: poor patient outcomes, lower patient and nurse satisfaction and lower scores on national patient surveys.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309495474
Category : Medical
Languages : en
Pages : 335
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Book Description
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Author: Alex J. Weigle
Publisher:
ISBN:
Category : Continuum of care
Languages : en
Pages : 0
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Book Description
There is a long, ongoing debate, discussing the effects of nurse staffing on patient outcomes, the incidence of adverse patient events, and patient satisfaction with care. Nurse staffing issues also effect the nurse's perceived quality of care, the rate of burnout, and job satisfaction. Studies done throughout the world, show a significant association between nurses working with large patient loads, and various adverse events and outcomes for the patient and nurse. To combat this, California Legislators introduced mandatory nurse-patient ratios for each type of unit in the hospital setting. Additional research has been done in the United States and around the world linking positive patient outcomes, decreased incidence of adverse patient events, and increased patient satisfaction when mandatory nurse-patient ratios identical or similar to those in California hospitals are initiated. Mandatory nurse-patient ratios also have been proven to increase nurse job satisfaction and their perceived quality of care. This research study will propose a solution to this nursing issue, and provide an implementation, evaluation, and dissemination plan. Included will also be a review of supporting literature and various tools to be used to educate and collect data from key stakeholders and study participants.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309208955
Category : Medical
Languages : en
Pages : 700
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Book Description
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
