Dialysis organizations would be another opponent to the change due to the cost. aising the costs of treatment might be necessary to hire new nurses. Dialysis clinics, because of their small size, often have fewer resources than large hospitals and the increased cost of wages of new hires would place a an additional stress on the unit's already limited budget, perhaps if estimates by the American Hospital Association are correct, as much as $270 million dollars a year.

Elaborate on potential negatives that individuals or groups might bring up in discussions and how you would counteract this.

Some nurses, despite their generally strong feelings in favor of the proposal because of their workload, may fear having to take a pay cut, or have overtime hours cut, because of the increased costs and influx of new nurses. Administrators may adopt a different type of change-resistance technique, and simply assert that it cannot be…...

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References

The American Nurses Association. (2008). ANA.

Retrieved Oct 9, 2008 at  http://www.nursingworld.org/ 

In our hands: how hospital leaders can build a thriving workforce. (May 2007).

American Hospital Association, Commission on Workforce for Hospitals and Health

Nurse-Patient atio on Care Quality
Nurse Patient atio

The Impact of Nurse to Patient atio on Healthcare Quality

The Impact of Nurse to Patient atio on Healthcare Quality

It would be hard to understate the importance of a high nurse to patient ratio (NP) for patient and staff safety, as well as quality of care. While there are a number of different nursing factors that can influence these outcomes, including nursing education, experience, skills mix, contact time, frequency of interactions, and type of inpatient unit, the NP has been the focus of considerable interest in part because it can be easily quantified (reviewed by Sidani, Manojlovich, and Covel, 2010). This review will examine the empirical evidence for the importance of NP in determining patient and staff safety, as well as quality of care. Towards this goal, research articles obtained from the Library of Medicine will be reviewed in detail and compared to the…...

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References

Aiken, Linda H., Clarke, Sean P., Sloane, Douglas M., Sochalski, Julie, and Silber, Jeffrey H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993.

Despins, Laurel A., Scott-Cawiezell, Jill, and Rouder, Jeffrey N. (2009). Detectiion of patient risk by nurses: A theoretical framework. Journal of Advanced Nursing, 66(2), 465-474.

Duffield, Christine, Diers, Donna, O'Brien-Pallas, Linda, Aisbett, Chris, Roche, Michael, King, Madeleine et al. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24, 244-255.

Institute of Medicine. (2000). To Err is Human: Building a Safer Health System. Online: National Academy Press. Retrieved 18 Apr. 2013 from http://www.iom.edu/Reports/1999/To-Err-is-Human-Building-A-Safer-Health-System.aspx.

Staffing in Nursing
Staffing and Other Nursing Issues

The main topic of this paper is staffing related to the field of nursing, here it is very important to realize a correct balance between the demand of nurses and available nurses at any medical facility. Since the duty of any medical professional like a doctor requires much assistance from a subordinate such as nurse therefore it is vital for any organization to fulfill this requirement in a way that best suits all parties involved especially the patients. This paper will focus on many different aspects related to the issues of staffing and will also shed some light on some of the difficulties of keeping a low or high number of required nurses.

The emphasis here would also be on many different aspects related to staffing such as the economical perspective, the quality perspective of any medical organization and so on. The paper is divided…...

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References

Aiken, L.H., Clarke, P.S., Sloane, D.M., Sochalski, J. Silber, J.H. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout and Job Dissatisfaction. Original Contribution, Vol 288, 16.

Cook, A., Gaynor, M., Stephens, M., Taylor, L. (2010). The effect of hospital nurse staffing on patient health outcomes. National bureau of economic research, 31.

Cimiotti, J., Aiken, L., Sloane, D., Evans, S. (2012).

Nurse staffing, burnout and healthcare-associated infection.

Inpatient atio and Morale
E: INPATIENT ATIO AND MOALE

Emergency oom: Nurse to Patient atio and Morale

Nurse to patient ratios in health institutions is one of the most influential factors in health providence, in any country's health sector. Two states of the aforementioned aspect would comprise of either high or low ratios. The former demonstrates poor patient outcomes that would imply high mortality rates and dissatisfied clientele. On the contrary, the latter would ensure quality patient outcome and positive feedback from patients. The ratio has an impact on cost effectiveness and also nurse turnover rates were highly influenced by the ratios that sometimes dictated the working conditions of these nurses. A recommendation to increase the number of nurses by various implementations needed to be taken sequential would be the ultimate solution. This would be despite the cost that these procedures would reflect, meaning that the budget need to be compromised to endow…...

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Related to the above is the workload at the job-level. Here the type of job is an important consideration in morale. Job-level workloads are linked to stress and low morale in nurses in multiple units (Freedman and O'Brien-Pallas, 1998). Often this comparison is made on the basis of unit, for example and ICU unit verses an ER unit, but there are probably various contextual factors within the ER unit that are related to differing perceptions of workload. The research has not looked strongly at the contextual factors with a unit that can affect morale and this would be an interesting question to address. Of course one of the factors that of concern at the patient level is the clinical condition of the patient. There is actually good research that has developed measures of workload based on the patient's clinical condition such as the Therapeutic Intervention Scoring System (Cullen, Civetta, Briggs, & Ferrara, 1974). Such measures could be employed for the current proposed question.

Nurses report that one of the biggest issues for them in an ER setting is the issue of patient centered care. Certainly, the modern healthcare professional's role is not limited to only assisting the doctor in procedures, however. Instead, the contemporary professional takes on a partnership role with both the doctor and patient as advocate caregiver, teacher, researcher, counselor, and case manager. The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the client's dignity. In order for one to be an effective caregiver, the patient must be treated in a holistic manner. Proper communication and advocacy is another role that the modern caregiver assumes when providing quality care. For the purposes of our essay, the two terms, advocacy and communication, are often interchangeable, since one is the result of the other, and vice versa (Kozier, Erb, & Blais, 1997). Therefore, it is extremely important to ascertain how the ER setting can be improved to decrease stress levels of ER Nurses and, at the same time, increase morale. The study could be targeted as finding the optimal balance of the above factors that would reduce stress and help to keep morale among the nurses at its peak.

Getting back to previously stated

Nurse-to-Patient atios in Illinois
The Facts

For many years the ongoing nursing shortage has required nurses to work longer hours and care for more patients, causing many of them to make fatal and near-fatal mistakes on the job that could have otherwise been avoided. Illinois has attempted to remedy this situation by enacting The Nurse Staffing by Patient Acuity Law on August 24, 2007 ("The Nurse Staffing by Patient Acuity Law," 2012). ather than setting hard numbers for specific nurse to patient ratios, the law instead requires hospitals to enact staffing plans recommended by a committee of their nurses that is comprised of at least 50% direct-care staff nurses. The plans created by these committees must be reevaluated semi-annually so that their effectiveness can be gauged. The nurses on staff are responsible for continually monitoring the plans that have been put in place to ensure that patient needs are properly met, as…...

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References

Aiken, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., & Smith, H.L. (2010). Implications of the California nursing staff mandate for other states.

Health Services Research, 45(4), 904-921.

Nurse staffing by patient acuity law. (2012). Retrieved September 16, 2012, from:

 http://www.illinoisnurses.com/dotAsset/25925.pdf .

Evidence of this can be corroborated with a study conducted by the California Nurses Association, which found similar positive effects. At the same time, researchers found that reducing these ratios in various specialty environments inside the hospital (such as the ICU), improves the underlying amounts of care being provided dramatically. This is important, because it is verifying the positive effects that nurse to patient ratios are having on the industry. ("Does Mandating Nurse Patient Ratios Improve Care," 2010)
Clearly, the study that was conducted by article titled, Nursing Staff and Patient Mortality, highlights how various nurse to patient ratios, improves the quality of care being provided. The study is useful, because it examines the underlying affects of having various nurse to patient ratios at a facility or the lack of these regulations. As a result, the information that was collected and analyzed helps to highlight how hospitals can avoid the…...

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Bibliography

Does Mandating Nurse Patient Ratios Improve Care. (2010). Health Leaders Media. Retrieved from:http://www.healthleadersmedia.com/content/NRS-245408/Does-Mandating-NursePatient-Ratios-Improve-Care

Aiken, L. (2002).Hospital Nursing Staff and Patient Mortality. Journal of American Medial Association, 288 (16), 240 -- 247.

Clarke, S. (2003). Failure to Rescue. American Journal of Nursing, 103 (1), 42 -- 47.

Many advocates of the move feel that lower patient to nurse ratio would lead to additional savings because it would reduce nurse turnover rate, lawsuits, complications and length of stay. Nursing unions in the state of California have asked for a PTN ratio of 3 to 1. The health association however agreed on 5 to 1 which sound more reasonable than the originally proposed 10 to 1. (othberg, 2005)
Patient to nurse ratio when it is too high can definitely adversely affect care. And with baby boomers aging and needing healthcare, we know that number of people looking for healthcare will continue to rise in the coming years. However staff shortage continues to pose a serious problem. And unfortunately, the problem doesn't always lie with cost control. While it is true that most of the problems with staff shortage can be attributed to hospitals cutting down their costs and hence…...

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References

Michael Rothberg, 2005. Improving Nurse-to-Patient Staffing Ratios as a Cost-Effective Safety Intervention Med Care 2007;45: 571-578)

Patricia W. Stone, PhD,* Cathy Mooney-Kane,

Nurse Working Conditions and Patient Safety Outcomes.

Nursing profession is among the oldest in history. Currently, there is much debate that surrounds the profession because of the need for more trained nurses. In recent years the nursing shortage has become a major problem for the medical profession and has resulted in poor patient care and slower patient recover. The purpose of this discussion is to provide an in depth examination of the nursing profession. We will discuss the current state of the nursing profession, including the causes for the shortage and the solution. We will also explore the status of the nursing profession in Australia. Let us begin our discussion by providing a comprehensive definition of what is means to be a nurse.
Definition of a nurse

According to the American Heritage Dictionary, a nurse is defined as " a person trained to care for the sick or disabled under the supervision of a physician." (American Heritage Dictionary, 1982)…...

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References

American Heritage Dictionary. (1982) Second Edition.

A www.questia.com/PM.qst?action=openPageViewer&docId=5000534396

Bashford, A. (1997). Starch on the collar and sweat on the brow: self sacrifice and the status of work for nurses. Journal of Australian Studies, (52), 67+. Retrieved August 24, 2003, from Questia database,   http://www.questia.com .

Nursing Staff Levels Affect Patient Mortality
Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.

Litvak, E., Buerhaus, P.I., Davidoff, F., Long, M.C., McManus, M.L. & Berwick, D.M.

Date of publication: June 2005

Examination of the operational issues affecting health care delivery, including patient driven peaks in demand and effects of nursing shortages or inadequate staffing on clinical outcomes for patients.

esearch question and/or hypothesis:

In this study the researchers propose that increases in adverse clinical outcomes occur when hospital nurse staffing is inadequate. Further the researchers suggest that increases in census rates increase the potential for serious stresses for patients and nurses working in the field. Lastly the researchers suggest that if hospitals reduce unnecessary variability of staff levels in a hospital, the hospital can reduce the probability of negative patient outcomes, improve safety for patients and improve the overall quality of care.

Sample and Sample Size:

In this study the…...

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References:

Aikan, L.H., Clarke, S.P., Sloane, D.M, Sochalski, J. & Silber, J.H. (2002 -- Oct).

"Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction." JAMA, 288(16): 1987-93.

Halm, M., Peterson, M., Kandels, M., Sabo, J., Blalock, M., Braden, R., Gryczman, A.,

Krisko-Hagel, K., Larson, D., Lemay, D., Sisler, B., Strom, L., Topham, D. (2005 -- Sept). "Hospital nurse staffing and patient mortality, emotional exhaustion and job dissatisfaction." Clin Nurse Spec, 19(5): 241-5.

high turnover of nursing personnel. The three main risks associated with this issue are 1) poor quality care, 2) unhealthy work environments, and 3) negative financial performance.
The first risk -- poor quality care -- is the result of a high turnover of nurses, which can lead to inadequate staffing. When there are two few nurses on any given shift, patients receive less care and attention because the nurses on shift are stretched in too many directions at once. Patients are required to wait longer, especially in the E, which can be problematic for patients requiring immediate care. Such is what happened to Edith odriguez at King-Drew hospital in L.A: she died in the E lobby waiting area because of insufficient attention given her by an over-stretched staff (AP, 2007).

The risk management solution to this first issue is to develop a temporary pool of nurses who can work on an…...

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References

AP. (2007). Woman dies in ER lobby as 911 refuses to help. NBCNews. Retrieved from  http://www.nbcnews.com/id/19207050/ns/health-health_care/t/woman-dies-er-lobby-refuses-help/#.V0XO57grLIU 

Den, H., Deanne, N., & Belschak, F. D. (2012). When Does Transformational Leadership Enhance Employee Proactive Behavior? The Role of Autonomy and Role Breadth Self-Efficacy. Journal of Applied Psychology, 97(1), 194-202.

Geiger-Brown, J. (2010). Is it time to pull the plug on 12-hour shifts? Part 1. The evidence. Journal of Nursing Administration, 40(3): 100-102.

Ihan, M., et al. (2006). Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication. Journal of Advanced Nursing, 56(5): 563-568.

Evidence Based Practice University of Illinois Evidence Based Medicine Resources: Lessons Learned
From the search resources I learned that in evidence based medicine, patient values comprising of their unique concerns, preferences, and expectations introduced to the clinical encounter ought to be integrated in determining the ideal care for patient. This integration will guarantee that the individual patient’s clinical state, the clinical setting and best patient outcome prevail in ideal decisions on optimal service delivery to the patient (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996).
The second aspect learned is that in order to integrate Evidence-Based Nursing and clinical care, there is the need for a basic comprehension of the attributes related to the inherent published evidence. Resources in Evidence-Based Practice are categorized in a hierarchy relating to the quality of the research or evidence. In Evidence-Based Practice, decisions making on best care to patient are not just basically guided by selecting the highest…...

Essay Topic Examples 1. The Evolution of Nursing Services: A Historical erspective:
    Explore how nursing services have changed and improved over time, examining the historical milestones, the influence of wars and pandemics, and the development of nursing education and practice standards.

2. The Role of Technology in Modern Nursing Services:
    Discuss the integration of technology in nursing practice, including electronic health records, telehealth services, and advanced medical equipment, and how these technological advancements enhance patient care.

3. Ethical Considerations in Nursing Services:
    Evaluate the ethical dilemmas nurses face in their practice, such as patient consent, confidentiality, and end-of-life care, and how nursing professionals navigate these challenges to uphold ethical standards.

4. Impact of Nursing Services on atient Outcomes:
    Analyze the direct correlation between quality nursing services and patient outcomes, using evidence-based research to highlight the importance of nurse staffing levels, education, and work environment on recovery and satisfaction rates.

5. The Future of Nursing Services and Health Care Delivery:
    redict…...

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Primary Sources

American Nurses Association. Nursing: Scope and Standards of Practice, 3rd ed., American Nurses Association, 2015.

Nightingale, Florence. Notes on Nursing: What It Is, and What It Is Not, Harrison, 1859.

Donabedian, Avedis. The Quality of Care: How Can It Be Assessed?, JAMA, vol. 260, no. 12, 1988, pp. 1743-1748.

Buerhaus, Peter I., et al. Nursing Solutions: Demographic and Systemic Challenges to Future Nursing Services, Health Affairs, vol. 17, no. 1, 1998, pp. 95-103.

International Council of Nurses. ICN Framework of Competencies for the Generalist Nurse, International Council of Nurses, 2003.

Nurse atio
Lowering the Nurse/Patient atio: A simple Step for Improving Care

Nursing is far from a static profession or discipline, and is in fact in a constant state of progression and change. Not all of these changes are necessarily for the better; increased healthcare demands, decreased abilities to pay for many patients and institutions, and a host of other factors can contribute to negative changes in the nursing work environment. When such factors arise it becomes all the more important for effective nursing researchers and practitioners to identify and advocate positive changes to the practice and the profession of nursing that can help combat the negative factors and ensure a consistent quality of care. In the current era of an ongoing shortage of nurses n the face of increasing demand and the approaching depletion of available nurses due to the aging population of nurses themselves, addressing the nurse-to-patient ratio that is…...

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References

Adomat, R., Dip, P. & Hewison, A. (2004). Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches. Journal of Nursing Management 12(5): 299-308.

Hassan, Z., Pryor, E., Autrey, P. & Turner, J. (2009). Hand Hygiene Compliance and Nurse-Patient Ratio Using Videotaping and Self Report. Infectious Diseases in Clinical Practice 17(4): 243-7.

Kane, R., Shamliyan, T., Mueller, C., Duval, S. & Wilt, T. (2007). The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis. Medical Care 45(12): 1195-204.

Nursing Fatigue
NURN 480 Clinical Activity Plan for Nursing Fatigue Project

Meet with preceptor. (2 hours)

Determine stakeholders. (1 hour)

Develop an in-depth interview protocol and survey questionnaire regarding experience with nursing fatigue. (4 hours)

Conduct the in-depth interviews and administer the survey. (20 hours)

Analyze data using constant comparison method and triangulation. (9 hours)

Conduct member checks with select interviewees to clarify interpretation and findings. (16 hours)

Find supporting research articles from various lines of research to use when synthesizing information. (6 hours)

Correlate research related HP 2020 issues and LHIs. (2 hours)

Plan activities correlated to selected course objectives that will best highlight learnings about nursing fatigue. (6 hours)

Correlate the Living Tree of Nursing Theory with project. (2 hours)

Complete research on topic of nursing fatigue. (4)

Write the final paper on the topic of nursing fatigue (6).

Total = 78 hours (Including research and writing time)

NURN 480 Topical Outline -- Nursing Fatigue

I. Introduction

a. Describe and define nursing fatigue

b. Brief discussion…...

Nursing Leadership and Management and Field Experience
Nursing Leadership and Management Field Experience

Problem Identification

The problem identified concerns about patient safety and satisfaction arising out of shortage in nurse staffing. In the contemporary times, staffing has become a major issue concerning nurses, generally, and in this paper we attend to the issue in outpatient clinical settings. This problem of under-staffing of nurses has assumed significant importance and needs to urgent attention, as it has an influence on the satisfaction of the patients and more significantly their safety. An outpatient clinic cannot run if the patients have no desire or wish to go there. In addition, it becomes hazardous in risking the lives of the patients. The purpose of this research is to research the cause of understaffing on outpatient clinics together with the influences it has on patient safety and care. Additionally, the project encompasses examining the perspective of the existing personnel…...

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References

Gardner, J., & Walton, J. (2011). Striving to Be Heard and Recognized: Nurse Solutions for Improvement in the Outpatient Hemodialysis Work Environment. Nephrology Nursing Journal, 38(3), 239-253 15p.

Haas, S. A. (2016). Developing Staffing Models to Support Population Health Management and Quality Outcomes in Ambulatory Care Settings. Nursing Economic$, 34(3), 126-13

Halbesleben, Jonathon, Bonnie Wakefield, Douglas Wakefield, and Lynn Cooper. "Western Journal of Nursing Research." Western Journal of Nursing Research. 30(5) (2008): 560-577.

Kalisch, B., Tschannen, D., & Hee Lee, K. (2012). Missed nursing care, staffing, and patient falls. Journal of Nursing Care Quality, 27(1), 6-12.

1. The impact of evidence-based practice on patient outcomes in nursing care
2. Strategies for effectively managing medication administration errors in the healthcare setting
3. The role of cultural competence in promoting holistic care for diverse patient populations
4. Implementing fall prevention measures in the hospital setting to reduce patient injuries
5. Utilizing technology to enhance patient education and engagement in self-care management
6. Addressing ethical dilemmas in nursing practice through effective communication and decision-making
7. Implementing strategies to improve nurse to patient ratios and workload management for better patient outcomes
8. The importance of interprofessional collaboration in promoting safe and effective care delivery
9. Implementing quality improvement....