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Excerpt from Term Paper: In fact, across the country, hospital RNs are increasingly forced to work in an atmosphere in which they are understaffed, overworked, and charged with responsibilities wholly unrelated to direct patient care.
This is a phenomenon illustrated in alarming detail in the article "Identifying Nurse Staffing and Patient Outcome Relationships: A Guide for Change in Care Delivery," published in the July-August, issue of Nursing Economics, in which a solid connection between inadequate RN staffing and negative patient outcomes is presented.
Most also realize that this understaffing is the result of the popular administrative notion that the higher the RN percentage in any given facility, the higher hospital costs rise Potter, Barr, McSweeney, Sledge, Although, it is true that higher RN concentrations in any given facility must necessarily increase cost in the short-term, there remains the question of whether, in consideration of the detrimental effect reductions in RN staffing has on patient outcomethe current definition of "cost" is one-dimensional.
Although it is tempting to fall into the trap of weighing, perhaps, too heavily on financial considerations in hospital policy decisions, particularly concerning RN staffing, the nature of the hospital as a "caring" institution must be upheld. Not only is this absolutely essential in defending the quality of health care offered to patients, but it is also ultimately more cost effective in reducing the very real financial repercussions that arise out of negative patient outcomes -- which include factors such as "measures of patient falls, medication errors, self-reported symptom management, self-care and health status, and post-discharge patient satisfaction Potter, Barr, McSweeney, Sledge.
However, it is tempting to question whether these so called "negative patient outcomes," described in the Nursing Economics article previously mentioned, are even related to the ratio of RN to patient in any particular unit.
Understanding that a causal relationship between nurse staffing and patient outcome was under question, Potter, Barr, McSweeney, and Sledge sought to clarify the relationship between the two variables in their study. According to the authors: The purposes of the main study were to determine baseline values of patient outcome measures and the relationship of nurse staffing at the unit level to patient outcomes in the acute care, inpatient setting, while adjusting for acuity level and percentage of float nurses on the unit.
The findings regarding outcome measures would serve as a baseline for evaluating changes in care delivery to be undertaken within the hospital Potter, Barr, McSweeney, and Sledge. Further, the study authors defined the term "outcome" specifically as follows: This definition of patient outcome is particularly important in that it can be interpreted as a concept in any number of ways.
Therefore, in response to this issue, the study authors specifically defined "patient outcome" as above, while specifically selecting those outcome indicators that most lend themselves to statistical analysis. In all, the study included a total of 3, patients. They were questioned concerning their overall "satisfaction," based on "communication, respect, coordination of care, nursing care, discharge process, advocation, and patient compassionate care Potter, Barr, McSweeney, and Sledge.
They also measured staffing data, as well as levels of patient acuity and adjusted the data distribution according to float percentages and acuity. The outcome was striking and definitive. Overall, the study found: The percentage of RN hours negatively correlated with patient pain and self-care ability Further, although the study did not find that there was a correlation between RN staffing and the medication and fall indices, the study did find that, "Total hours of nursing care per patient day were negatively correlated with patient distress, willingness and ability to care for self, the indexes of symptom management and self-care, and the fall index," therefore, the larger the amount of nursing hours "by all categories of nursing personnel are associated with less patient distress, fewer problems with symptom management," falls, and successful self-care.
Interestingly, the findings of this study closely mirror another study focusing on virtually the same topic, described in the JONA article, "The Relationship Between Nurse Staffing and Patient Outcomes. The reason that this article is interesting is not only because the outcome seems to closely relate to the previous study, but that it seems to indicate the universality of the negative relationship between high patient to nurse ratios and patient outcomes represented by mortality across cultural and national lines the study was conducted in Thailand.
Specifically, the study found that, based on the nursing staff variables used in the study: If, then, this is the case, and the reduction in nursing staff results in negative patient outcomes even if adjusted for compounding variableswhy are nursing staffs continually downsized and padded with relatively unskilled "unlicensed assistive personnel," or UAPs?
After all, according to the Thailand study, which cited the logic of the American Nurses Association: When there is adequate staff, nurses can spend more time with each patient in every aspect of patient care, while time constraints can increase the probability of mistakes my creating a busy, stressful environment with distractions and interruptions that adversely affect quality of care Sacichay-Akkadachanunt, Scalzi, and Jawad.
Although, previous to these studies, many would assert that such a statement made by the American Nurses Association might be imbibed with significant amounts of self-interest, the outcomes of both "Identifying Nurse Staffing and Patient Outcome Relationships: A Guide for Change in Care Delivery," as well as….Care of a Group of Patients Care of a Group Bluegrass Community and Technical College Critical Criteria #1: Assessment and Prioritizing Patient Care Client # 1 is a 71 year old female who was hospitalized on 1/23/13 with an admitting diagnosis of hyperglycemia, weakness and dehydration.
With the effect to balance the demand of patient needs in health care, many considerations are made including adjustment with budgets, decreasing excessive . Nursing Care Plan and Specimens Essay Words | 4 Pages Analysis and Action Plan: Adams 5, Inpatient Rehab Unit Savetria Nicole Palmer Walden University NURS Section 13, Topics in Clinical Nursing September 21, Quality is a broad term that encompasses various aspects of nursing care (Montolvo, ).
Oct 14, · The most consistent positive outcome of interventions to improve self care has been improvement in self-efficacy,8 an use of discretionary surgery without apparent adverse effects on health outcomes or satisfaction. H. Provider-patient interaction in diabetes care: effects on patient self-care and outcomes.
A systematic. Question 1 answer.
As a medical trainee in an internship program, l was tasked with taking care of patients medication, offering assistance in emergency situations and departments, assessing patient’s response to medication, and managing patients symptoms in line with their values and preferences (Marilyn & Bradford, ).
The nurse may be faced with a patients who does just that and needs her nursing care, but the nurse thinks the patient is a time waster and looking for attention. This could leave the nurse in a dilemma, if her beliefs and options were that strong, she would need to evaluate her thoughts, step back and decide how she will give unbiased care.