Nurse Staffing And Quality Improvement

Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press.

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).

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

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,

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.

​The highest priority in most hospitals across America is patient satisfaction. Patient satisfaction begins the moment the patient steps in the hospital doors although nurses hold a majority of the responsibility. The face to face interactions between nurse and patient on a day to day basis naturally puts nurses at the front line. Nurses are there to answer questions for the patient’s while making them as safe and comfortable as possible. There are a lot of factors to take in to account while determing satisfaction in the hospital. A common debate in the medical field is if there is an

Mary, a 79 year old patient has gotten up from bed without assistance to use the restroom. She falls on the way and hits her head leaving her with a huge laceration and possible subdural damage. This is the third fall this month on the unit; changes must be made in order to address the policies to prevent falls. Policy changes are one of the many issues that a quality improvement nurse will address in her field.

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

As leaders in nursing, charge nurses and nurse managers benefit from the results of acuity assessments. The results of acuity level supported charge nurses in assigning patients to nurses based on those results. For instance, lacking the use of a patient classification system can elevate the nurse’s workload and compromise the care provided (Andrade et al., 2017); this supports the importance of understanding a patient’s acuity level. Making appropriate nursing assignments was an important component for improving patient cares, as evidenced in the literature research. It was indicated that, nurse managers use acuity tools as a way to create a balanced workload when assigning nurses to patients as it could better the outcomes of care (Brennan, 2012). An acuity assessment tool works hand in hand on providing balanced workloads, leading to improved patient

Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation

Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.

Low nurse staffing levels are credited for the reduced rates of patient outcome. Therefore, there is a need for improved nurse staffing levels to meet the growing demand for health care delivery services in the hospitals. Currently, there is the need for higher staffing levels to serve the growing global population. However, improving the staff levels is not as straightforward and easy as it sounds in theory. Staffing levels are low in most states in the US and most countries in the world. The main factors that contribute to the low staffing levels include but not limited to the big gap between the number of registered nurse and the industry requirement and the rising needs of the acuity patients present in the US today. In other words, there

Nurses are known as the heart of health care. Being a nurse is a demanding job that requires commitment, but does not lack rewards. A fact stated by the American Association of Colleges of Nurses claims that “Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation 's long-term care” (“Nursing Fact Sheet”). With many roles throughout the healthcare system as a whole, nurses are a large, very important role that interacts with every other part of the health care system. They have great qualities that not everyone has. They are highly compassionate, caring, professional, diligent and understanding individuals. A nurse experiences people at their worst and still care for patients in a way that no one else would. All these honest points prove that nurses are the most important members of the health care system because, nurses spend the most time with patients, nurses are the managers of patient care; they are teachers and are great with conflict resolution.