Improving Patient Care And Quality Of Health Care

Over the last decades both public and private hospitals have been experiencing severe financial situations (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The financial shortage is associated with delay or even lack of governmental sponsorship and competition from their rivals. Enacting the policy will mount financial pressure on these hospitals that are on cost-cutting strategies. The salaries and wages of nurses are dominating the costs of operation in the hospitals and therefore adding more staff to correct the understaffing will be like creating another problem (Goddard, 2003). Contrary, Empirical studies prove that adequate nurse staffing produces better outcomes for both the staffs and the patients (Donaldson & Shapiro, 2010). These do not mean that the financial performance of the health centers will be at stake. Quality is associated with profitability. Understaffing leads to increased workloads, fatigue and job dissatisfaction. These situations that can be corrected on the implementation of proper staffing policies (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The policy aims at offering quality service, reasonable patient-doctor ratios, reducing high mortality rates, improving the health of patients through proper examination and disease diagnosis among other

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.

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

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 purpose of this article is to discuss appropriate nurse staffing and staffing ratios and its impact on patient care. Although the issue is just not about numbers as we discuss staffing we begin to see how complex the issue has become over the years. Many factors can affect appropriate nurse staffing ratios. As we investigate nurse staffing ratios we can see the importance of finding the right mix and number of nurses to provide quality care for patients.

Current nurse-to-patient ratios is a topic that has constant focus on today’s patient outcomes and safety. There have be many studies and there continues to be studies done on how a higher nurse to patient ratio effects not only patient and nurse safety and patient outcomes once they leave the hospital, but also patient mortality rates as well. When a nurse has been assigned more of a patient load than they can safely handle, whether it be because of a large patient volume or patient acuity, patients suffer and the quality of care declines. With the higher ratio,

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.

One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,

With a shortage of nurses, the care and safety of patients may become compromised. The nurses themselves may be having feelings of dissatisfaction, overwhelm and distress. Nurses who may become overwhelmed with the high number of patients may become frustrated and burnt out. And inadequate staff of nurses may lead to a negative impact on the patient’s outcome. The quality of care the patients may receive in facilities with low staffing may be poor.

In an article published by Applied Nursing Research the authors point out that nurse staffing is related to patient outcomes, “lower levels of RN staffing are associated with higher rates of OPSN (Outcomes Potentially Sensitive to Nursing) in both medical and surgical patients treated in hospitals, U.S. Medicare, and other publically available administrative data” (Duffield et al., 2011, p. 245). The writer of this paper researched 5 relevant articles regarding the relationship between nurse to patient ratio, morbidity, and mortality, every article related similar information. “A systematic review of 102 studies concluded that increased RN staffing levels are associated with lower rates of morbidity and mortality” (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013, p. 2).

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Nursing is the powerhouse in the delivery of safe, quality patient-centered care in the healthcare industry. To ensure continued safety of the patient and nursing staff, the issue of inadequate staffing must be addressed. Consequently, patient’s mortality rate has been linked to the level of nursing staff utilized in ensuring an utmost outcome (Aiken, 2011). This paper will outline the issue associated with inadequate nurse to patient staffing ratios in the hospital setting; essential factors such as economic, social, ethical and political and legal affecting the issue will be established; current legislature and stakeholders will be ascertained and policy option, evaluation of bill and the results of analysis will be reviewed.

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

Nurses are crucial in providing quality care in the health care industry. It is imperative to maintain the proper staffing ratio to ensure that nurses can maintain high quality care for their patients. Studies have shown that the increasing workload of nurses can be linked to increased patient deaths, medical errors, hospital-acquired infections, longer hospital stays, and many other complications. (National Nurses United n.d. ) Leaders and managers play a vital role in developing

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