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Abstract
Nurse staffing is very important to the delivery of high quality patient care and that staffing has impacts on quality and safety. Research has established that there are a number of challenges that affect quality nursing care, including the rate of turnover of the nursing staff and nurse shortage. This promotes quality improvement and health care. When nurses have fewer patients, they intercept and prevent errors, thus fewer errors or deaths are less likely to be experienced. A well-staffed health institution provides better services because nurses have enough time to not only provide person-centered care, but to also have care plan for individual patients to make sure the each of patients needs is met. Staffing problem can be resolved by increasing the number of registered nurses (RN) in the health care facility.
Introduction
The phases for the project are: defining the problem, the relevance of the problem needs practice change and quality improvement, the purpose of the project, the proposed solution for the project, and the proposed implementation plan.
Description of the Issue/Problem related to Patient Care Quality
The increasing cases of nurse turnover and shortage affect the quality and safety of healthcare (Hayes et al., 2012; Royal Nursing College, 2010), leading to multiple consequences in health care facilities (Garrett, 2008; McGahan, Kucharski & Coyer, 2012). Duffin (2012) established that small nurse-patient ratios increase the rates of hospital-related mortalities and morbidities and increased adverse clinical events (Gillen, 2012). Inadequate staffing inherent in majority of the hospital wards undermines the delivery of holistic care (Morgan & Lynn, 2009; Gale & Schaffer, 2009) and meeting needs of patients (Garrett, 2008)
Description of Solution
The proposed solution is to increase the number of RN in the health care facility to enhance clinical outcomes. The rationale behind this decision is that individual and system factors affect the quality of care besides staffing levels (Gunusen, Ustun & Gigliotti, 2009). Gillen (2012) contends that the sheer increase in the number of nurses does not automatically translate to a high-quality and safe patient care. In contrast, Kalisch, Gosselin, and Choi (2012) have argued that an increase in the levels of staffing can only be effective if health facilities address the other issues that affect the quality of care. This allows patient centered care which ensures quality improvement (Pelzang, 2013; Robinson, Callister, Berry & Dearing, 2008).
The Neuman Systems Model (made of person, health, environment, and nursing) will support the proposed changes because it stresses on the importance of holistic care (Gunusen et al., 2009). Issues like heavy workloads cause burnout among nurses, increased absenteeism, staff turnover, dissatisfaction, and depersonalization (Kalisch, Gosselin & Choi, 2012; Unruh & Ning, 2012), hence the importance of systems and procedures (Kane et al., 2012). The model will address the challenges and provide ideas that can improve the present scope of nursing care and handle the mentioned problems (Gunusen et al., 2009; Varnell et al., 2008).
Conclusion
There are a number of challenges that affect the quality of nursing care. Examples include nursing turnover and shortages. This problem can be solved by increasing the number of registered nurses in the health care facility. From the gathered points, nurse staffing is very essential to the delivery of high quality patient care and that staffing has impacts on quality and safety. High number of nurses allows health institutions to deliver nursing care through person-centered approaches, hence high quality improvement and health care.
References
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Gale, B., & Schaffer, M. (2009). Organizational readiness for evidence-based practice. The Journal of Nursing Administration, 39(2), 9197.
Garrett, C. (2008). The effect of nurse staffing patterns on medical errors and nurse burnout. AORN Journal, 87(6), 1191-1204.
Gillen, S. (2012). Most nurses are struggling with inadequate staffing, survey shows. Nursing Standard, 26(34), 9.
Gunusen, N. P., Ustun, B., & Gigliotti, E. (2009). Conceptualization of burnout from the perspective of the Neuman systems model. Nursing Science Quarterly, 22(3), 200-204.
Hayes, L. J., OBrien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F.,& North, N. (2012). Nurse turnover: A literature review An update. International Journal of Nursing Studies, (49), 887-905.
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Kane, R. L., Shamilyan, T. A., Mueller, C., Duvall, S., & Wilt, T. L. (2012). The association of registered nurse staffing levels and patient outcomes. Medical Care, 45, 1195- 1204.
McGahan, M., Kucharski, G., & Coyer, F. (2012). Nurse staffing levels and the incidence of mortality and morbidity in the adult intensive care unit: A literature review. Australian Critical Care, 25, 64-77.
Morgan, J. C., & Lynn, M. R. (2009). Satisfaction in nursing in the context of shortage. Journal of Nursing Management, 17(3), 401-410.
Pelzang,R. (2013). Time to learn: understanding patient-centred care. British Journal of Nursing, 19(14), 912-917.
Robinson J. H., Callister L. C., Berry, J A., & Dearing K. A. (2008). Patient-centered care and adherence: Definitions and applications to improve outcomes. J Am Acad Nurse Pract 20(12), 600-607.
Royal Nursing College. (2010). Guidance on safe nurse staffing levels in the UK. Web.
Unruh, L., & Ning, J.Z. (2012). Nurse staffing and patient safety in hospitals: New variable and longitudinal approaches. Nursing Research, 61(1), 3-12.
Varnell, G., Haas, B., Duke, G., & Hudson, K. (2008). Effect of an educational intervention on attitudes toward and implementation of evidence-based practice. Worldviews on Evidence-Based Nursing, 5(4), 172181.
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