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Jessica Riley Ferris State University

What are the effects o f staffing ratios on safety and satisfaction of patients in the hospital?. Jessica Riley Ferris State University. Learning Objectives. Determine risks of patient outcomes related to lack of adequate staffing.

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Jessica Riley Ferris State University

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  1. What are the effects of staffing ratios on safety and satisfaction of patients in the hospital? Jessica Riley Ferris State University

  2. Learning Objectives • Determine risks of patient outcomes related to lack of adequate staffing. • Understand causative factors to risks of safety and satisfaction. • To increase staff ratios according to patient needs. • Acknowledge barriers that hinder larger staff to patient ratios.

  3. Risks That Threaten Patient Safety Adverse Outcomes Urinary Tract Infections MedicationErrors Procedure Errors Nosocomial Pneumonia Falls/Injury Skin Breakdown Infection Hospital Stays Re-admissions Shock Mortality (Vantage Point, 2009) A study conducted by Stanton (2004) showed that higher rates of RN staffing were associated with a 3- to 12-percent reduction in adverse outcomes.

  4. Evidence Article • “A ¼ hour increase in LPN hours per patient day was associated with a 15% increase in the odds of death and a 27% increase in the odds of sepsis” (Glance et al., 2012, p. 4). • Nurse aide staffing increases of ¼ hour decreased pneumonia odds by 8% (Glance et al., 2012).

  5. T H E O R I E S Maslow’s Hierarchy of Needs Nurses need to be available to provide these needs!

  6. T H E O R I E S • •Statements from Nightingale include: • "Poor or difficult environments led to poor health and disease." • "Environment could be altered to improve conditions so that the natural laws would allow healing to occur.“ • Also, that the goal of nursing is “to put the patient in the best condition for nature to act upon him”. Nightingale’s Environment Theory (Nursing Theories, 2012)

  7. T H E O R I E S • Unfreezing • Movement • Refreezing • . Kurt Lewin’sChange Theory

  8. Assessment of the Health Care Environment • Current Practice • Lack of Policies • Financial Influence • Current Satisfaction Ratings • Michigan vs. National ratings

  9. Implications and Consequences • Nursing • Patient • Hospital

  10. Root Cause Analysis Staffing Policies Rounding Frequency Absences Unsatisfactory Staff Ratios Lead to Threats to Patient Outcomes/Safety Fall Precaution Measures Patient Acuity Outdated Budget cuts Lack of Research Revenue

  11. Root Cause Analysis (Yale, n.d.)

  12. Quality and Safety Education for Nurses (QSEN) • ANA Standards • Standard 5B. Health Teaching and Health Promotion • Standard 10. Quality of Practice • Standard 16. Environmental Health • Implementation of safety programs to minimize the risk to our patients.   • Scanning medications against an electronic medical record • Increase frequency of monitoring • Co-signatures of  potentially harmful medications • Fall risk evaluations Recommendations

  13. References References (Seminar) American Nurses Association. (2010). Nursing: Scope and standards of practice. Silver Spring, Md: American Nurses Association. American Nurses Association. (2013). Policy & Advocacy. Nurse staffing plans and ratios. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios Glance, L.G., Dick, A.W., Osler, T.M., Mukamel, D.B., Li, Y. & Stone, P.W. (2012). The association between nurse staffing and hospital outcomes in injured patients. BMC Health Services Research, 12(247), 1-8. doi:10.1186/1472-6963-12-247 Hospital Compare Quality of Care (2013). West Shore Medical Center: Hospital profile. Retrieved from http://www.medicare.gov/hospitalcompare/profile.aspx#profTab=1&ID=231335&loc=49660&lat=44.2205682&lng =-86.1344697&AspxAutoDetectCookieSupport=1 Nursing Theories (2012) Theories of Florence Nightingale. Retrieved from http://currentnursing.com/nursing_theory/Florence_Nightingale_theory.htmlQSEN. (n.d.). About QSEN. Retrieved from http://qsen.org/about-qsen/

  14. References • References (Seminar) • Stanton, M. W. (2004). Hospital Nurse Staffing and Quality of Care: Research in Action, Issue 14. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/services/nursestaffing/index.html • The Health Foundation (2011). Research scan: Does improving safety culture affect patient outcomes? Retrieved from http://www.health.org.uk/public/cms/75/76/313/3078/does%20improving%20safety%20culture%20affect%20outcomes.pdf?realName=7b1J1q.pdf • Yale Case (n.d.). Root Cause Analysis Tools. Retrieved from http://nexus.som.yale.edu/ph-tanzania/?q=node/131

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