Safe Staffing In Nursing

In the past two decades, there has been a push for appropriate staff to client ratios. However, measuring client needs and nursing efforts have been around since 1922 (Lewinski-Corwin, 1922, pp. 603-606). The earliest recorded effort was by the New York Academy of Medicine. Superintendents and nurses from ten training schools documented the time spent providing bedside care. From complied information, the researchers revealed each client required an average of five hours and four minutes of care in a 24-hour period. From these observations, they evaluated staffing issues in New York City. At that time, none of the hospitals were sufficiently staffed (Lewinski-Corwin, 1922, pp. 603-606).

Mulloy, D. F., & Hughes, R. G. (2008). Patient safety & quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

I am writing to you in regard to safe patient ratio bill titled Safe Nurse Staffing for Patient Safety and Quality Care Act. My name is Angelina David and I am a registered nurse and practicing in the surgical intensive care unit. I am also enrolled in the Adult nurse practitioner program to further advance my knowledge in nursing. One thing I have learned is that as nurses no matter what the level of care or which facility you are practicing; patients’ safety is our number one priority. Patients’ safety and their quality of care have improved over the year. However, oftentimes nurses are still placed into a situation where it is unsafe to practice because they are required to care for more patients than it is safe.

The first case scenario presented in this project reflect the significance of gaps between nursing programs and textbooks, organizations’ policies and procedures, published literature, and the actual practice. Some of the gaps refer to nursing programs and textbooks based on an ideal nursing profession, the autonomy of healthcare organizations to establish their specific policies and procedures, traditional policies and procedures unsupported by evidence-based practice (EBP), and the individual and organizational barriers that influence the breach between the published literature and the real-world. Literature review was used to demonstrate the negative personal and professional consequences triggered from these gaps when the nurse is employed in the healthcare system. In addition, the paper suggests how improving a “Culture of Safety”, preventing an unsafe environment, and promoting Continuous Quality Improvement activities enhance the overall health care quality and safety. The second case scenario provides guidelines to the ethical dilemma of the impaired nurse, signs and symptoms of impairment, ethical and legal obligations, common reasons for not reporting, and failing to report consequences.

Presently in the health care field there is a push for safe nurse to patient ratios in acute care settings to provide quality and safe practices that will reduce the risk of complications and adverse effects as the acuity of patients continue to increase. As patients are staying in acute care facilities for less time resulting in the need for continued care after discharge. The fluctuation of higher rates of acuity of patients in the skilled nursing faculties and nursing home setting are placing higher demand on staffing, which is already at higher ratio levels of nurse to patient.

One of the practice concerns is Safe staffing level –identify that safe staffing can impact the safety and quality of patient care. Unseemly staffing level jeopardize patient health and safety causing nurse pressure , fatigue , injury and decrease ability to distribute patient safe care Nurses enveloped the largest health care workforce in most countries. Few reasons why nurses left the work force due to unsafe staffing level. Nurses felt overworked and underpaid. Sometimes they cannot take off on special or emergent situation, schedules are not fairly approved, or just simply other people need change. These are few reasons, but influential reasons, nurses are burned out and overworked. A safe staffing ratio of 1 nurse to 6-7 patients in

Safe and adequate nurse staffing levels are an essential part of the health care policy in providing safe and high level of quality care for patients. Nurses play a fundamental role in the health care system in delivering quality care and safe guarding patients both in the hospital and in the community settings. Most evidence-based studies associated lower patient mortality rate with safe nurse staffing levels. Although, healthcare organisation stress nurses’ on providing high quality care but financial cost of the health care organisation is first taken into consideration (Sheward et al 2005). Consequently, the surgical wards nurse staffing levels are experiencing severe shortage of nurses with increased workload causing “burnout” and high

The dispute on safe nurse staffing has remained ongoing issue in the healthcare world. Competency is

Once the suggested changes are made, the bill is developed and is proposed to the senator. The senator is made aware of the need for this particular change and how it makes changes in the current proposal. Once the senator introduces the bill in the senate, the bill is referred to appropriate committee and printed in the introduced form. During committee action people are given a chance to be heard. The committee and the various aspect of the problem hear the witnesses; during this process the nurses and different supporting organization can be introduced. If the bill is tabled, it will move forward to the house floor and the debate will take place on the bill. At the end the house is ready to vote for the bill and if passed it will go the

Nursing is an ever evolving profession and standards for nursing care are continuously changing. Nursing has evolved over the past two centuries into a profession that is well respected, but one that is vital to society. The purpose of this paper is to examine the best practices for optimal patient health outcomes in in respect to safe nurse to patient staffing ratios. There are many points to consider including safety and quality of care, as well as ethical and legal issues. Nurse to patient staffing ratios whether positive or negative, help to determine safe, ethical, and legal patient care. In today’s nursing practice, there are several factors which can impact nurse staffing decisions in relation to patient census. These factors include professional liabilities, healthcare administration, economics, and political opinions. All of these factors combined, are significantly delaying the establishment of safe and ethical guidelines for safe nurse to patient ratios. Many nurses are experiencing burnout. Some patients are suffering from inadequate care, while healthcare costs continue to steadily rise. Poor patient outcomes, based on the nurse-patient staffing ratios are contributing to the ever increasing cost of healthcare.

Quality and safety practice has been the goal of nursing in terms of caring for patients. The goals of measuring health care safety and quality are to assess the impact of health care on determine outcomes and also to evaluate the extent to which health care fulfil the processes based on scientific evidence or conform to professional consensus and is consistency with patient

Quality and safety competencies as a component of the nursing academic curriculum became a focus of reflection and debate after the publication of the Institute of Medicine (IOM) reports in 2000 and 2003. The IOM reports found clinical education was out dated with the changing healthcare systems, and patient populations. The Quality and Safety Education for Nurses (QSEN) framework represents a national effort to redesign nursing education around knowledge, skills, and attitudes, which are crucial to improve patient safety (Cronenwett et al., 2007). Developed with funding from the Robert Wood Johnson Foundation and building on the IOM reports, QSEN created a new paradigm for nursing education.

In nursing, “patient safety and quality of care are two of the main cornerstones of nursing practice” (Hunt, 2012). It is the nurse’s responsibility to make every effort to provide a safe environment and care for patients without making errors. In an effort to keep patients’ safety intact, “The Joint Commission and the Agency for Healthcare Research and Quality developed standards for healthcare organizations to employ in an effort to reduce the number of errors” (Hunt, 2012). Robert Wood Johnson Foundation developed a project in 2005, which would eventually become the Quality and Safety Education for Nurses (QSEN) competencies (Hunt, 2012). The QSEN competencies were developed to ensure quality patient centered care. They are: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (QSEN Institute, 2014). These competencies have been implemented in an attempt to decrease sentinel events. However, sentinel events continue to occur, especially when nurses become careless (Hutchinson et al., 2009, p. 2).

The notes provided in the book are important; they can be used as a foundation when providing care and be very beneficial for healing. In fact, some form of many of Florence Nightingale’s ideas are currently being used in practice. However, many of the ideas mentioned could be difficult to implement for a nurse with multiple patients. For instance, Florence Nightingale says a good nurse ensures that nothing squeaks, cracks, or makes a sound and that a person asleep should not be woken (Nightingale, 2007). In the hospital setting, it is good to cluster care together to allow the patient to rest, but that is almost impossible. Although nurses strive to do their best to reduce noise and promote a healing environment, in some inpatient settings these tasks can be

To put simply, safety in health care is keeping patients and health care professionals free from harm. In health care, safety does not only pertain to the patient, but to all of the staff as well. Although this is important, it is critical that nurses are safe, since they usually interact with the patients the most. If a nurse does not follow correct safety and health practices, they may cause harm to the patient or themselves, which may end up in a lawsuit