Inadequate Nurse Staffing Kristen Osip Learning Objectives Define

Inadequate Nurse Staffing Kristen Osip

Learning Objectives Ø Define inadequate nurse staffing and understand its relation to nursing practice. Ø Recognize the factors that affect nurse staffing decisions. Ø Discuss the correlation of theory with this nursing issue. Ø Identify how different aspects of the healthcare environment impact inadequate nurse staffing. Ø Describe the consequences associated with the identified problem. Ø Utilize the ANA & QSEN to explain how specific interventions can improve quality and safety with regards to nurse staffing.

Introduction Ø What is inadequate nurse staffing?

Influencing Factors Quality & safety considerations Intensity of situation Range of conditions Budget considerations Legislative and regulatory requirements Severity of illness Policies & procedures requirements Family situation/needs Experience level of staff Number of RNs Admissions, DCs, & transfers Number of patients

Introduction Ø Why is this important to us as nurses? Ø Safety Ø Quality Ø Health Ø Professional responsibility

Theory Base Ø Nursing Theory Ø Kolcaba’s Theory of Comfort RELIEF EASE TRANSCENDENCE COMFORT

Theory Base Ø Psychology Theory Base

Assessment of the Health Care Environment Ø Systems Framework ØPolicies Ø Hospital-based Ø Budget-based staffing Ø Nurse-Patient Ratio Ø Patient Acuity

Assessment of the Health Care Environment Ø Systems Framework ØCurrent Legislation Ø Mandated Nurse-to-Patient Ratios Ø Registered Nurse Safe Staffing Act

Current Legislation

Current Legislation Michigan Safe Patient Care Act Written staffing plan Minimum Staffing Fines Ban nurse-to-patient ratios committees (50% nurses) for violations mandatory overtime

Assessment of the Health Care Environment Ø Systems Framework Ø Resources Ø Finances/employees/supplemental Ø Quality and safety issues Ø Nurses & patients suffer Ø Underlying assumptions Ø Accountability Ø Not a nursing responsibility Ø Outside nursing scope of practice staff

Policies/Legislation Resources Inconsistent Financial Insufficient Technological Inadequate Staffing RCA Nursing shortage Current trends Staff/Patients

Implications/Complications/Inferences Implications/Complications Nurses Patients Hospitals https: //www. youtube. com/watch? v=Vphp. Kp. UD 9 so Inferences Impact is huge Change needs to happen

Recommendations for Quality and Safety Improvements ANA Standards Standard 8: Education Standard 9: Evidence-Based Practice & Research Standard 11: Communication http: //www. massnurses. org/fi les/file/Labor. Action/Unsafe. Staffing. Form. pdf https: //www. youtube. com/wa tch? v=t. EUcac. Jmvk 0 QSEN Competencies Teamwork Safety and Collaboration

Resources Aiken, L. H. , Clark S. P. , Sloan D. M. , Sochalski J. & Silber J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987– 93. American Nurses Association. (2015). Nurse staffing. Nursing World. Retrieved from http: //www. nursingworld. org/Main. Menu. Categories/The. Practiceof. Professional. Nursing/Nurse. Staffing? css=print American Nurses Association. (2010). Nursing: scope and standards of practice (2 nd ed. ). Silver Spring, MD: American Nurses Association. Dorning, J. (2014). Safe-staffing ratios: Benefitting nurses and patients. Department for Professional Employees Research Department, 1 -7. Retrieved from http: //dpeaflcio. org/programs-publications/issue-fact-sheets/safe-staffingratios-benefiting-nurses-and-patients/. Maville, J. & Huerta, C. (2012). Health promotion in nursing. Clifton Park, NY: Delmar Michigan Nurses Association. (2015). Safe patient care fact sheet. Retrieved from http: //www. minurses. org/files/Legislation/Fact%20 Sheets/Fact. Sheet. Safe. Patient. Care. pdf Mensik, J. (2014). What every nurse should know about staffing. American Nurse Today 9(2), 1 -11. Nurse-to-patient staffing ratio regulations: Regulations effective January 1, 2004. (2004). Retrieved from http: //www. cdph. ca. gov/services/DPOPP/regs/Pages/N 2 PRegulations. sapx West, G. , Patrician, P. A. , & Loan, L. (2012). Staffing matters-every shift: data from the Military Nursing Outcomes Database can be used to demonstrate that the right number and mix of nurses prevent errors. American Journal of Nursing, 112(12), 22 -27.