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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: 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: Robert Greenberg
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
The purpose of this study is to address the impact that mandatory nursing ratios have on hospitalized patient outcomes. This study will document the effect of patient outcomes and mortality rates within the hospitalized setting and its correlation of nursing staff to patient ratios. Based on documented studies there is a positive impact on the health of a hospitalized patient and the amount of time each nurse is able to spend with their patient. Data for this proposal will be gathered from a 440 bed acute care hospital located in southwestern Arizona. Tools for this study will include surveys for patients and nurses to be evaluated by hospital leaders, and acuity scales for nurses to measure the level of care required for each patient. The results will be used after a three month trial period allowing from modifications to better address issues that arise from this demographic. Previous studies gathered through literature reviews worldwide will be used to compare the results of this proposal.
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: 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: 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: 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: 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: Ali Kivel
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
The global issue is of the nursing shortage is having a major impact to patient satisfaction, outcomes, and the nursing clinical environment. As the shortage continues, nurses are expected to take on overwhelming patient workloads. Nurse to patient ratios are becoming high and it is having negative a negative impact on both patients and nurses. As, nurses are assigned to more patients the deliverance of care is at a lower quality. Patients are more likely to experience negative incidences during a hospital stay or become re-hospitalized due to issues the patients were previously hospitalized for. Re-hospitalization can occur when the patients are not treated to the best ability or are not thoroughly educated on post hospital care. The time a nurse has to spend with each patient on teaching and care is cut when the workload is at an overwhelming high. It is shown that hospitalized patient experience more falls and the risk of hospital acquired infections are increased because the nurse cannot provide an adequate amount of attention. Patient safety and delivering quality care is a priority to nurses and must be taken seriously. Nurses cannot provide satisfactory care when there is an overwhelming patient workload. As workloads increase nursing job satisfaction is decreasing. The stress and risk of burnout become easily experienced. The retention of nurses is a priority as many are leaving the profession due to inadequate work environments. Patients are hospitalized with more comorbidities than ever and acuity is at an all time high. Nurse to patient ratios must be adjusted for the intense level of care. With mandated patient ratios patient outcomes are better and nurse job satisfaction is higher.
Author: Seth Ronning
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
The business of nursing is to provide care for those who are ill or injured and require enhanced levels of care that require great attention and detail to the patients in their charge. To be able to provide high quality and safe patient care nurses need a work environment that fosters the ability to do so. The effect that a nurses' workload can have on the patient outcomes and the nurses own outcomes are significant. Numerous studies show a significant association with nurse to patient staff ratios and patient outcomes including mortality rates. 'Surgical patients had higher risk adjusted mortality and nurses had higher burnout than those nurses with less of a work load' (Purcell, Kutash, and Cobb 2011, pages 715). There is no consistency from state to state within the United States regarding the methods used to create nursing assignments within the hospital settings, more specifically within Medical/Surgical units. California is the only state with a legally mandated nurse to patient ratio, and this mandate has been related to significantly lower adverse patient outcomes (Aiken and others 2010), including a 25'26% decrease in mortality rates (Twigg, Duffield, Rapley, and Finn 2010). Utilizing the current research that shows the positive effects that the California staffing mandate has had on patient and nurse outcomes in addition to the vast amounts of research the display a strong relationship between nurse to patient ratios and patient and nurse outcomes, a suggestion to create legislation to mandate a nurse to patient ratio on Medical/Surgical units and even hospital wide is suggested for the national level and more specifically within the state of Oregon. Multiple articles were reviewed for the purposes of this paper and the findings of the research conducted that a mandated nurse to patient ratio would effectively improve patient and nurse outcomes in terms of decreased mortality rates and other adverse outcomes for patients and decreased burn out and improved job satisfaction for nurses. It is further suggested that the legislation for a staffing mandate follow the mandate outlined in the California staffing model.
Author: Stephanie Mello
Publisher:
ISBN:
Category : Burn out (Psychology)
Languages : en
Pages : 0
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Book Description
The objective of this proposal is the mandatory implementation of nurse-to-patient staffing ratios nationally. Implementation of mandatory staffing at a national level requires state and federal legislation to be passed. This legislation would mandate a change in staffing from the current suggested safe guidelines to a government mandate requiring hospitals to adhere to safe staffing ratios. Currently the state of California is the only state with legislatively mandated staffing ratios. According to research, past and present inadequate nurse-to-patient ratios have resulted in adverse patient outcomes, nurse job dissatisfaction, burnout and turnover, all of which impact health care facilities financially as well as carry costly physiological and psychosocial implications for patients and families affected by adverse outcomes. This proposal supports the state and federal implementation of mandatory staffing ratio models similar to that of California's legislation AB394. Due to the magnitude and regulatory aspect of this change, partnering with national and state nursing organizations such as the American Nurses Association and the Nevada Nurses Association will be crucial in getting legislation passed, disseminating evidence and evaluation of the implemented change. Through the use of quantitative and qualitative research the need for change has already been established. Going forward as future legislation is passed, the continued use of these types of studies will be used to gather and assess data regarding the successes, barriers and failures of implementing mandatory staffing ratios to ensure the continued safety and satisfaction of patients and nursing staff.
