Safe Staffing
Most nurses joined the nursing profession because they are science orientated and are compassionate for other individuals. There is no feeling more satisfying than when a nurse can deliver good quality medical care to his/her patients. A thank you goes a long way for a caregiver such as a nurse. When a nurse is unable to provide good quality medical care to a patient because of understaffing it is a defeating, failing feeling that nurse feels because he/she was unable to help the patient not only get better but feel better as well. A nurse’s job entails much more than passing medications and assessing patients. One of the most important tasks a nurse must do is to be an advocate for their patients and their families. Patients and families are at their most vulnerable when they are in the hospital and are not feeling well. Today hospitals are being run like a big business, but the patients and families still deserve and need high-quality medical care and professionalism from the staff at all times. There is a fine line between being able to give high-quality medical care and being profitable so that the hospital can expand and stay updated.
Coalitions allow nurses the opportunity to come together to discusses how to more efficiently serve patients and their families so that they will remain safe and receive quality care (Chamberlain College of Nursing, 2017). Most people have had an experience with the health care system of some sort whether it is working for the health care system or being a patient or a family member of a patient. Speaking with the patients and families to gather information about their experiences while being treated and being an advocate for them while addressing a policymaker is an excellent way to provide examples of what the politician’s constituents are thinking. Allowing the politicians to hear about several individuals experiences will help them to step into the role of being a person in that situation and will enable them to understand better how understaffing affects not only employees, but also the patient, families, and the hospital. Supporting the issue of safe staffing by providing empirical evidence, along with social media information of what the constitutes in their district desire, and also what has been implemented in this matter at this current time will help the policymakers to want to become vested in the issue of safe staffing.
Key Strategies
One must provide examples to the policy makers of what occurs when a medical facility chooses to understaff through empirical evidence. Providing examples of how understaffing effects the patient population, their families the staff and the hospital, will prove that safe staffing is beneficial in the long run. Providing empirical evidence that will support the need for specific staff to patient ratios for each unit within the hospital will help to solidify the issue for the politician, so they will understand how the various constituents are affected by safe staffing. It will also be beneficial to have empirical evidence showing the outcome of safe staffing. The process of policy change does not occur quickly; it sometimes takes years. Therefore it is beneficial for one to stay current with any changes that may happen and notify the legislator with the information promptly. A coalition that continues to research and gather data on the safe staffing issue is the most critical way a nurse may be an advocate for all of the patients. Be prepared when going to see the policymaker by providing information of what has already been accomplished on the issue at hand and what else needs to be performed to attain your goal. Providing the policymakers with information about the policy, who it effects, and how it affects them is how one will gain the politicians attention.
According to the American Nursing Association, n.d., Federal regulation, 42 Code of Federal Regulations (42CFR 482.23(b), requires hospitals that accept Medicare, to have a particular number of registered nurses, licensed practical nurses, and other medical staff to provide care. Congress has not upheld the Federal regulation, 42 Code of Federal Regulations (42CFR 482.23(b); therefore, some states have implemented nurse to patient ratios to keep their patients safe. States have developed several different ways of understanding and providing the proper nurse to patient ratios, which include having nurses to assess the needs for staffing according to the patient population for that particular unit (Nurse Staffing, n.d.).
Another way to ensure safe nurse to patient ratios is for the coalitions to talk to the politicians so that they will enforce the law for the nurse to patient ratio for each state. Executing a law that mandates each medical facility to provide staffing plans and supplying that information to the public along with providing the information to the Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission, n.d.). At this point, there is not a law or an enforced policy for safe staffing in Indiana. Many hospitals within Indiana have implemented policies concerning nurse to patient ratios. However, the plans are created for an ideal situation and do not plan for the patient or family that needs more emotional care or for the patient that does not tolerate pain well. Many factors can have an impact on how much time is required to provide quality care to each patient. Examples that may cause more time to be spent with the patient is if the patient is scared, is having surgery the next morning or just had surgery, needs assistant getting up each time, and requires more Intravenous medications such as antibiotics, blood thinners, or pain medications. Assigning nurse to patient ratios based on an acuity tool that is devised and unique to each unit, the nurse to patient ratios will be more accurate, and quality of care will be given to each patient.
I will be contacting my legislator through an email and then asking to have a face to face conversation if she can find the time in her busy schedule for me. If she is not able to fit me in promptly, I will ask to speak with her in a phone conversation to discuss my policy priority issue of safe staffing. My plan of action is first to explain what my issue is and it’s importance by giving examples of what affects that understaffing a unit has on the patients, families, nursing staff and the hospital. Next, I will discuss what the benefits of having the proper nurse to patient ratios will have for all that is concerned. Finally, I will explain what laws have been made nationally and statewide and then make suggestions for implementation of the law in the state of Indiana. While having the conversation, I will allow time for my policymaker to ask questions and make suggestions. I will briefly go back over everything that we discussed to solidify what I think should be done.
Empirical Evidence
There have been several evidence-based research studies done on safe staffing by registered nurses, and most agree that adequate staffing of nurse to patient ratios helps to provide quality care to the patients, retain nurses longer, and keeps patients coming back to the facility. While understaffing endangers patients, pushes nurse to leave their positions and prevents patients from returning to the facility for other treatments (Safe-Staffing Ratios: Benefiting Nurses and Patients, n.d.).
Nurses with a b
achelor’s degree along with decreasing a nurses’ workload by one patient, will reduce the chance of a patient dying by 7% with every 10% increase in bachelor’s degree nurses and staffing ratios of no more than six (Aiken, Sloane, Bruyneel, Van den Heede, Griffiths, Busse, Sermeus, 2014).
A research study conducted by The Agency for Healthcare Research and Quality, which part of the U.S. Department of Health and Human Services, found that once the staffing law went into effect in California, patients had fewer injuries happen The length of stay for the patient decreased significantly. The results of this type of study have been replicated in many other studies (RatiosNews, S. S., n.d.).
According to RatiosNews, S. S., n.d., in the United States The Affordable Care Act (ACA), penalizes hospitals with high rates of readmissions. Research has shown that hospitals that maintain higher nurse to patient staffing ratios have a 25 percent less chance of being penalized by the ACA for significant amounts of readmissions, than hospitals that are understaffing, but otherwise, have similar conditions.
Impact and Importance of a Successful Visit
When visiting the policymaker, it is useful to research your topic extensively so that you can convey the seriousness of your issue and allow time to address any questions the politician may have. It is also favorable to know both sides of your topic and how it will affect the medical facilities (Gardner, 2015). Once all of the information is gathered one must organize it and make sure the message you want to deliver is concise, clear, and to the point. One must present the facts clearly and quickly. When presenting your policy, it is useful to engage as many senses as possible to have a lasting impact. Powerpoint is an effective tool to use during the presentation because it involves vision and hearing. Bringing lunch for the policymaker will affect taste, touch, and smell. Storytelling will also enlist the policymaker to be more involved because they are better able to relate to what you are communicating to them. Most people have either been in the hospital or have had a loved one in the hospital. Therefore, they will have a mutual interest in the policy. It is likely that the policymaker will have a similar story that they will be able to share with you making the social connection stronger.
Conclusion
If healthcare facilities implement safe nurse to patient ratios at all times, I think it will have a positive effect on nurses, patients, families of the patients and the healthcare facility.
To ensure that there will be adequate staffing with the proper amount of nurses to give high quality of care, it would be beneficial to have nurses on call for each shift to cover the needs of the unit in case of call offs and for when more patients are admitted. It is also helpful for the nurses for each particular floor to decide how many nurses are needed for each shift. Using a Without a good balance things such as; staff dissatisfaction, increase call offs, and nursing burnout can occur. The patients and families will have, a decrease in injuries, reduced medication errors, and overall satisfaction will increase with proper staffing. When the staff perceives staffing as inadequate, it will affect the entire hospital, both personally and professionally, triggering responses that influence approaches to patient care, unit operations, and relationships (http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/MandatoryNursetoPatientRatios.html, n.d.).
Reference
Aiken, L.H., Sloane, D.M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Sermeus, W. (2014, May 24). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383 (9931), 1824–1830. Retrieved from: http://thelancet.com/journals/lancet/article/PIIS0140
-6736(13)62631-8/abstract
Chamberlain College of Nursing. (2017). NR-506 Week 3: Policy-priority selection [Online lesson]. Downers Grove, IL: DeVry Education Group
The Joint Commission. (n.d.). Retrieved from https://www.jointcommission.org/facts_about_patient_safety/
Nurse Staffing. (n.d.). Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios
(n.d.). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/MandatoryNursetoPatientRatios.html
RatiosNews, S. S. (n.d.). News. Retrieved June 04, 2017, from http://www.nationalnursesunited.org/news/entry/widespread-understaffing-of-nurses-increases-risk-to-patients
Safe-Staffing Ratios: Benefiting Nurses and Patients. (n.d.). Retrieved from http://dpeaflcio.org/programs-publications/issue-fact-sheets/safe-staffing-ratios-benefiting-nurses-and-patients/
References
Ball J.E., Griffiths P., Rafferty A.M., Lindqvist R., Murrells T. & Tishelman C. (2016) A cross-sectional study of ‘care left undone’ on nursing shifts in hospitals. Journal of Advanced Nursing 72(9), 2086–2097. doi: 10.1111/jan.12976
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