Staff Shortages And Patients Risk Essay

Hospitals have a lot of money coming in, however, they also have a lot of money going out. Hospitals are always trying to figure out ways they, and their workers can save money. In the clinical setting, I do see that supplies is being used efficiently and are not wasted. However, there are a few things that could be changed. For example, nurses use many different types of supplies, and have a list of things they need to get done. Staff Shortages And Patients Risk Essay. There have been a few times I have seen nurses waste small things such as syringes, needles, lines and more. These things may seem small, but when the hospital is going through hundreds of these a day, it can rack up a good amount of money wasted. Nurses get busy and can sometimes be in a hurry, so it is not always intentional.

At this facility where I have my practicum, it was said that supplies is not an issue. When they see they are low on something, they write it down on the supply list and then the next week they will receive what they needed. They say the supplies workers are very efficient and also good at asking about what they need and looking at their inventory. Fraud is avoided by double checking that the patient is not being charged for something they did not use, or that they were given. If something was not used for the patient that was going to be used, it is important to make sure that the patient is not being charged for it. Waste can be avoided with patient supply charges in a few ways. For example, not throwing away unused items and not charging them from things that they did not need, or use. Before reading the article, I was unaware of the many different types of staffing. Where I do my practicum, the type of staffing used is decentralized staffing. This is when “unit leaders determine the level of staffing needed before and during the shift, based on multiple factors. ” This is a good system to use, because the people in charge of the floor know how the floor runs. Therefor, they know how many people need to be there, and what people they do not. However, a downfall to this is that there is a chance for there to be a lock of consistency. Sometimes, the numbers may be off. There may not be enough nurses and therefor, each nurses has more patients. This then, can affect patient care.

ORDER A PLAGIARISM-FREE PAPER NOW

On the other hand, there is centralized staffing. This is when “One department is responsible for staffing all units, including call-in staff, call-off staff, and float staff. The pro to this kind of staffing is that there is equal opportunities for the staff. However, the downfall is that they are usually not very flexible. For example, if there is a problem and people can not be at work, or if there is a turn over, they are at a loss and do not have enough people to work. In the cost containment article, it is talked about who all pays for the health care. This includes, agencies, insurance company’s, and also people who used the healthcare, such as patients. However, even though they have several people and companies paying, there are still some parts that do not get paid.Staff Shortages And Patients Risk Essay.  It also talks about how the type of care the patient receives, it can affect the facility financially. If a patient did not receive the care they needed, and return 30 days, later, they hospital looses money because of this.

I think cost containment is important because it affects the facility you work for. If the worker’s facility are careful with care, supplies and much more, it can affect how the facility works. For example, they can afford to get new improvements that can affect patient care. To help with cost containment, I can make sure that I am giving the best care to my patients and making sure they are properly taken care of before being discharged. If they do not need to return because they are healthy, this can help the hospital tremendously. When the nurse to patient ratio, is high, this effects the type of care the patient receives.

The nurse can become busy trying to care for a heavy patient load, and miss things on patients, that can sometimes be life threatening. In the article “Nurse-Patient Ratios and Safe Staffing: 10 Ways Nurses Can Lead the Change”, it talks about how patients are having more problems with infections and falls due to the nurse and patient ratio. This is slowly started to change by making smaller nurse to patient ratios in hopes that patients will receive better care, and will have fewer hospital causing problems.

Globally, Magnetic status is becoming one of the targeted goals in many hospitals and to achieve this mission; quality assurance is gaining importance day by day. In that regard, administrators are ensuring quality care service by paramedical staffs. Among paramedical staffs, nurses are front-line caregiver, comprise larger professional group within health care setting and have been recognized by the public as the most trusted profession (Gallup & Jones, 2010 as cited in Tomajan, 2012). Furthermore, administrators also believe that nursing employees are the valuable source to sustain high quality of hospital.Staff Shortages And Patients Risk Essay.  Nevertheless, few opponents believe; quality assurance can be maintained in short nursing staff. I totally disagree, to retain hospital quality and to prevent detrimental effects on patient, staff and hospital; ample nursing staff is a crucial factor. In addition, from several decades, health researchers have reported association between adequate nurse staffing and positive hospital outcome (Clarke & Donaldson, 2008). Therefore, I strongly believe that shortage of nursing staff negatively impact quality assurance of a hospital on three major areas which are endanger of patient’s life, dissatisfaction of nursing staff and ineffective control of hospital cost.

The first negative impact is to put patient’s life in danger. With short-staff, best nursing practices and high quality care seems unrealistic because workload is too much on staff. Hence, nurses unable to give proper attention towards their patients which increase the risk of medical errors such as: medication errors, falls, pressure sores, and hospital acquire diseases and infections. Annually at nursing division of Aga Khan University Hospital; 72 to 78 medication errors report due to workload and short staffing (Khowaja et al., 2008). Ultimately, these careless fatal errors result in patients’ death; Houle & Fleece (2012) report shows that nearly 100,000 people die annually in U.S hospitals from medical errors. Besides that, to carry out multiple tasks; nurses force to cut their attention towards patients and omit essential tasks which are ethically unacceptable also worsening patient’s condition. The reasons behind emerging poor practice environment by nursing staff are insufficient timing and staffing (Schubert et al., 2008). In short, elevation of errors and staff negligence towards their work increases the risk of patient’s death, impede hospital quality and dissatisfy the patients. Staff Shortages And Patients Risk Essay.

Second negative impact is staff dissatisfaction. Staff wellbeing and job gratification are needed aspects to maintain hospital quality. Mostly in short-staff units, head nurse are using double duty strategy in-order to complete tasks. Such units overburden the employees with work and long hours that eventually create exhaustion, frustration, tension, and reduce staff wellbeing (Ball, 2010). In my nursing career, most of the time I force by team leaders for recurrent doubles duties, which create huge stress in my life. Moreover, inadequate staffing with long hours duty destructs the healthy working environment and provokes occupational illnesses and injuries such as needle prick, fatigue, physical and mental strain (Bae, 2012). Simultaneously, employee unfitness contributes in low attendance, poor performance and increase absenteeism which negatively affect hospital performance graph. Current evidences also indicate physical and mental wellness of nursing staff is essential to provide best patient care (Bae, 2012). In brief, work exhaustion and risk of occupational injuries and illnesses ascend in short-staff which eventually aggravate poor hospital quality.

Third negative impact is ineffective hospital cost containment. Short nursing staffs have following detrimental impacts on organization cost. Firstly, medical errors increase the patient length of stay that burden on patient as well as hospital cost.Staff Shortages And Patients Risk Essay.  Therefore, to develop adequate staffing and improve working condition are the effective interventions to reduced patient length of stay (McHug & Ma, 2013). Secondly, job dissatisfaction and unfitness of employees increase resignation, turnover and temporary supplemental staff that result in gaining the staff hiring cost of hospital. Thus, short staffing is costly to the health service in terms of: turnover cost, back cover of absent staff and unfilled vacancies (Schubert et al., 2008). Thirdly, patient dissatisfaction with care delivery decreases the hospital fame and market value which lead to decline in admission rate. U.S reports show that one third hospitals will be close by 2020 because of its poor quality service and cost control they cannot compete in a globally competent market (Houle &Fleece, 2012). Hence, due to these three impacts, organization unable to assure its quality and productivity.

However, some people belief that quality assurance doesn’t negatively impact by inadequate staffing. In that regard, few opponents believe are as follows: first, patient’s safety can be achieved in short-staff as quality care has association with staff competence and knowledge not its level. Therefore, competent nurse manager can handle short-staff unit by utilizing different strategies such as apply functional health nursing care delivery model to provide quick, efficient and less economical care to patient with minimum registered nurses(RNs). In functional nursing, tasks are assigned to nursing staff according to their respective qualifications, for instance; RNs do medications and nursing assistants do hygiene care (Dubois, 2012). Furthermore, ongoing audit and monitoring of staff by managerial personnel prevents from all short cuts and ensure quality work as; audit helps in improving staff performance and persuades quality care (Ball, 2010). Second claim is that employees are more satisfying in short staffing as they can easily avail development opportunities such as training and education sessions.  Staff Shortages And Patients Risk Essay.Along with, pooling and mixing of staff strategies helpful in developing staff by exposure to other unit and reduce the workload. Several observational studies support the view that staff pooling and rich mixing of qualified personnel are associated with better clinical outcomes and improved hospital quality (Dubois & Singh, 2009). Moreover, earned leaves strategy also beneficial to relief the staff from workload and give ease. Third claim is that low-staff hospitals are advantageous for cost containment such as: the rate of salary increment among staff is comparatively higher than surplus staff unit, which also leads to increase in job satisfaction and retention. Furthermore, ongoing performance appraisal motivate the staffs to improve their work performance which results in enhancing quality care and patient satisfaction with health care services which ultimately increase the hospital market value and admission rate.

Find out how NursingAnswers.net can help you!
Our nursing and healthcare experts are ready and waiting to assist with any writing project you may have, from simple essay plans, through to full nursing dissertations.

View our services
Undoubtedly, there are people who believe quality assurance is depending on staff competence however, studies prove that only competence can’t be successfully work for quality assurance in under-staff unit because short staffing with long hours duty is a considerable challenge for competent nurse to perform safe care (Staffing and Patient Safety, 2013). Additionally, functional nursing model involves fragmented care deliver by untrained staffs and less RNs which negatively impact quality care (Dubois, 2012). Furthermore, in short staff, its overburden and barely difficult decision for manager to send staffs in training session and for earned leaves. Besides that, staff pooling has negative consequences on hospital quality because nurses generally do not like to ¬‚oat to other units and hesitate to work proficiently in unfamiliar environment which eventually arise patient safety issues (Ferlise & Baggot, 2009 as cited in Wang & Gupta, n.d.). Staff Shortages And Patients Risk Essay. Lastly, due to hospital acquired injury and illness many attendants accuse the hospital and refuse to pay treatment costs which eventually decrease the hospital reputation, admissions and cost control. Hence; evidences show investment in nursing force help to reduce patient stay and improve health outcomes (Ball, 2010).

In conclusion, the success of quality assurance is entirely depending on adequate nursing staffing because it helps to prevent from harmful effects on patient life, staff well-being and hospital cost containment. Moreover, quality assurance increases the market value of hospital and helps to get magnet recognition for that reasons various hospitals are improving the adequacy of front-line staffing i.e. nurse. “Worldwide, hospitals are operating optimum nursing staff to overcome negative patient outcome and enhance hospital quality” (Schubert et al., 2008). Therefore, it is one of the nursing management responsibilities to make sure adequate nursing staff in order to uphold hospital excellence and quality.

Nursing staff scarcity constitutes a widespread issue across several segments of the healthcare sector. It is often a challenge to find an adequate number of qualified nursing professionals for meeting staffing requirements. Nursing professionals represent a crucial part of healthcare teams and facilities. A dearth of qualified nurses may leave a healthcare facility vulnerable. Furthermore, because of staff shortages, existing workers are usually expected to work more than normal. A key concern with regard to this shortage and the resultant workload on the existing workforce is: Continuance of safety practices within healthcare organizations may be impacted eventually. This may successively lead to perpetual hospital vulnerability. Overworked nursing staff members or those who are made to take care of a greater number of clients (patients) have to typically make sacrifices. They can’t focus sufficiently on individual patients, as is necessary for ensuring satisfactory nursing care. Thus, patient safety is impacted, as are the healthcare organization and its stakeholders, from a broader perspective. Staff Shortages And Patients Risk Essay.

Quality and risk management are an essential and basic element of several healthcare facilities. Personnel turnover and satisfaction are major issues for all organizational risk mitigation strategies. Several research works have been performed on this subject, thus enhancing the possibility that mitigation strategies will prove more effective; also, one can construct implementation strategies on sound evidence-based research. Improving satisfaction levels of workforce ensures low personnel turnover rates; turnover leaves organizations susceptible. A large number of best-practices have been devised, which have proven their ability to enhance job satisfaction. For instance, employee training levels have been found to correlate to overall satisfaction of individuals with their jobs (Schmidt, 2007). Thus, a study of factors linked to personnel satisfaction may be the perfect basis for developing a hospital risk management strategy.

Major Issue

A key problem linked to patient care rationing is the associated negative publicity. In numerous circles, the ‘healthcare rationing’ notion is frequently a politically and emotionally charged topic. People fail to understand implicit rationing pattern frequency. But irrespective of people’s views regarding care rationing, it is quite a common process. In a Texas research, nearly all participants reported some level of rationing in a minimum of one nursing activity, while a majority of the participants rationed several activities. Moreover, rationing preference trends support the accomplishment of tasks aimed at meeting the immediate physiological requirements of patients over other tasks (Jones, 2015). Nursing staff has to personally decide on the areas it is best to commit their time to, at different points in their entire workday, as well as how to prioritize specific issues they are faced with.

Despite implicit rationing now being a widespread practice, one will come across numerous situations wherein it may be exaggerated because of inadequate resources, thereby making the organization susceptible.Staff Shortages And Patients Risk Essay.  For instance, researches into this area suggest that nursing staff constantly ration their care and time, and this seriously threatens patient care quality and, subsequently, patient safety. Areas like hygiene, patient mobilization, patient assistance, feeding, communication, discharge planning, patient education, care documentation and surveillance are frequently omitted or inadequately handled (Papastavrou, 2013). Often, appropriate patient care levels represent a somewhat subjective measure, but with resource shortage, implicit care rationing will more likely be interpreted as a practice more in keeping with patient neglect and inferior health outcomes, resulting in organizational and stakeholders susceptibility towards major connected issues or errors.

Care rationing by nurses — a term used to refer to holding back or failing to perform specific care activities owing to scarcity of resources — is a moral as well as economic challenge. The challenge is economic in nature because patient care delivery occurs within numerous socioeconomic constraints; further, multiple nursing components have to be budgeted. Rationing has a moral aspect to it as it entails judgments potentially at odds with professional and personal standards (Papastavrou, 2013). As per the ‘missed care’ theory, the choice of completing, delaying or omitting care elements is governed by an inner factor that includes attitudes, beliefs, and values held by nurses, with regard to their responsibilities and roles, shaping their behaviors.

Three Potential Impacts of Risks and How They Affect Stakeholders

Shortage of nursing staff is linked to poor patient survival rates among seriously sick patients. Duffin’s (2014) research revealed that as many as 7 extra patients per hundred patients could be saved, if nurses increased in number from 4 to 6 for every patient. Researchers found that survival rates increased with a larger nursing staff because they could devote more time to critically sick patients compared to other healthcare providers, and will more likely be able to identify early indications of patient deterioration. A second reason for survival rate growth is: less permanent nurses implies increased dependence on agency nurses who might not be familiar with all components of organizational operations and might not be adequately qualified / experienced. Staff Shortages And Patients Risk Essay.

Besides its effects on care delivery quality and patient safety, scarcity of nursing staff reduces healthcare facilities’ patient treatment capacity. A new research carried out for the AHA (American Hospital Association) witnessed participants reporting that nursing staff scarcity has led to overcrowding of their emergency departments (38%); emergency patient diversion (25%); decreased staffed beds in hospitals (23%); service and program stoppage (17%); and elective surgery cancellation (10%). About 60% of study participants reported that nursing workforce believes that providing superior-quality patient care in the present day is tough, owing to workforce scarcities.

In case of healthcare settings that have a high nurse-patient ratio, patients face innumerable issues: they contract infections, die, suffer injuries, or are discharged from hospital too early without being imparted sufficient information with regard to how they must manage their injury or disease. This results in them returning to the healthcare facility, more ill than when they left it. Having fewer patients per nurse ensures better patient care. Also, patients will have a greater likelihood of better understanding how to handle their diabetes, use crutches, and look for symptoms of brain injury or infection, which helps them understand when they are to seek medical assistance and avoid further deterioration or illness. The presence of too many patients will lead nurses to be neglectful when it comes to intercepting and preventing errors, increasing patient injuries and mortality rates. Staff Shortages And Patients Risk Essay.Further, when nurses get more time for advocating with insurance firms, doctors, or others with regard to patient care plans for ensuring patients get whatever they need, patients’ health status will more likely improve.

ORDER A PLAGIARISM-FREE PAPER NOW

Interventions and Alternatives

An intervention to tackle the nurse shortage issue would be to improve nursing staff satisfaction and, as a result, retention. Following enactment of California’s staffing legislation, nursing workforce retention and satisfaction rates were analyzed. From 2004 to 2008, satisfaction levels of registered nurses serving in acute care settings rose (Tellez & Seago, 2013). This finding’s significance is: with aging and subsequent retirement of the nation’s nursing workforce, the healthcare sector will experience a scarcity of qualified nurses for addressing growing demands on the sector, created by Obamacare. This pressurizes the healthcare structure of the nation, leaving few nurses with more patients than they can handle. California State’s staffing law functions to tackle this growing pressure. Nurses who have been a part of the healthcare workforce for a longer duration will certainly be more experienced as well as better equipped to deliver care to patients suffering critical illness. Urging nurses to remain in the field through mandating ratios will enhance workforce morale and job satisfaction. This has been found to lower patient mortality rates. Research works conducted following the implementation of the California government’s AB394 have revealed increased nurse satisfaction with their workplace climate. Ample staffing affords registered nurses the time to educate their patients.

Another intervention for addressing the problem of nursing workforce scarcity is providing visionary and stable nursing leaders. Aside from their direct negative impacts on the field of nursing, the 1990s’ restructuring programs had a second long-term impact — on nursing in hospitals (Joint Commission, 2002). Staff Shortages And Patients Risk Essay. The initiatives unintentionally brought nursing leadership to an end. This isn’t a trivial issue, given that nurse leaders, on account of the position they hold, are required to meet the frequently contradictory goals of clinical and administrative departments and patch up these conflicts so as to benefit patients as well as nurses nearly every single day. Solving this issue is the responsibility of trustee leaders, hospital management, and doctors. It is the inherent duty of nursing professionals to make critical decisions. Nurse leaders must accept delegated power as well as offer it to their subordinates. They may also have a central part to play in constructing healthcare teams, and cultivating a collaborative culture that calls for and rewards superior-quality and safe patient care.

Yet another alternative to resolving the issue of nursing workforce shortage is filling vacant posts. The dearth of nurses and its implications for the healthcare sector in the decades to come has created a torrent of proposals and nursing staff recruitment activities.  Staff Shortages And Patients Risk Essay.