Table of Contents
Introduction
It is no doubt that the USA is currently experiencing nurse shortage. Even though different regions are being affected at different rates with different requirements for nursing specialty areas, but the fact remains that the country experiences a shortage of Registered Nurses as a national problem (Roberts, 2013). Furthermore, the issue is expected even to worsen more in the next few decades. It is, therefore, necessary for healthcare organizations to adopt patient-focused staffing approach for a better nursing outcome. Taking into consideration the possible impact of the shortage on the health care system of USA, health care organizations have forwarded their concerns to the lawmakers within the central government for consideration. However, numerous factors have been put forth to offer an explanation to some of the causes of nursing shortage such as age increase for Registered Nurse (RN), insufficient staffing, job dissatisfaction, and patients’ demographic changes.
Problem
The main purpose of the study is to determine the core factors that are contributing to the nursing shortage as well as recommend appropriate solutions to eradicate the issue as a potential health care crisis.
Setting
The issue of aimless staffing in nursing has been a common problem within the setting of different health care organization. The study will thus review the relationship between the rate of patient falls and daily shift-to-shift variation in given staff level units within the healthcare organization setting in the USA.
Description
Besides, nurses within the health care setting have been for quite a while faced with the dilemma of accomplishing some of the most important strategies of their organizations. However, it has never been easy for them to fulfill a complete commitment to ensuring the culture of patient safety and positive environment for nursing as the major objective in patient-focused staffing approach.
Impact
Despite the requirements of adequate nurse staffing, variation in needs of patient and staff availability can also result into understaffing in nursing which would subsequently not only jeopardize the safety of the patient but also the quality of care services
Significance
The main significant of the capstone project issue is that it would, at last, propose effective approaches to nursing staffing that will majorly focus on ensuring high-quality care service and health safety to patients. This would subsequently contribute to a better nursing outcome.
Proposed solution
According to Brownie and Nancarrow (2013), patient in the health care organization have for quite awhile suffered poor care services due to reckless nurse staffing. Therefore, adopting patient-focused staffing approach will ensure that only the most suitable nurses with the positive attitude towards upholding the culture of better services and safety for patients are recruitment. Moreover, the problem of understaffing and ineffective nurse staffing would also be mitigated by recruiting only those nurses who are aware of their key duty to the safety of patient as well as the obligation of speaking up in good faith if they truly believe that their assignment to their patient might compromise the safety of such patients.
Literature Evaluation Table
Supervision and evaluation of the nursing outcome is a very critical aspect of the profession of nursing. Besides, measuring the level of patient satisfaction as well as the overall nursing outcome is a dynamic process since the nursing profession keeps on evolving within the health care setting as an industry. Therefore, this section of the essay paper explores some of the relevant sources that would provide an alternative solution to the problem of inappropriate staffing in nursing.
| Source | Research Methodology | Purpose | Result |
| Nelson, E. C., Batalden, P. B., Huber, T. P., Mohr, J. J., Godfrey, M. M., Headrick, L. A., & Wasson, J. H. (2002). Microsystems in health care: Part 1. Learning from high-performing front-line clinical units. The Joint Commission journal on quality improvement, 28(9), 472-493. | Qualitative | The research presented different ways through which nurses would learn on how to give quality health care while focusing on the patients’ care outcome. Also, the research article presented current existing relevant statistics on staffing in nursing aimed at improving the quality of patient care. | There is a tremendous increase in quality of health care within the institutions practicing patient-focused staffing approach. |
| Brownie, S., & Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical interventions in Aging, 8, 1. | Descriptive | The research study aimed at establishing and describing some of the effects of person-centered care both on a selected residents and the staff within aged care facilities | Health care quality outcomes particularly of the resident patients would be noted to have increased with an increased focus on services quality in staffing of the nurses in different facilities. |
| Potter, P., Wolf, L., Boxerman, S., Grayson, D., Sledge, J., Dunagan, C., & Evanoff, B. (2005). Understanding the cognitive work of nursing in the acute care environment. Journal of Nursing Administration, 35(7-8), 327-335. | Comparative | The research focused on understanding the cognitive work of nursing based on a comparison. These were to be conducted within the acute care environments. | The research study documented its findings that nursing plays key roles in shaping the cognitive behavior of patients and it is best achieved with more qualified nurses who are able to value their patients in terms of care and safety they require in different care facilities. |
| Valley, G. C. (2010). Relationships Between Nurse Staffing and Patient Outcome Variables (Doctoral dissertation, Ball State University). | Meta-analysis | The research study was purposefully conducted to offer a conclusive analysis of the relationship between nurse staffing and patient outcome based on the analysis of combined data from different reliable sources of nurse staffing and patient outcome. | The research was able to discover that there is a close and mutual relationship between the nature of nurse staffing and the patients’ outcome. The more the staffing becomes patients-centered, the more the quality of patient outcome increases. |
| Roberts, L. K. (2013). Mandatory Nurse-Patient Ratios and Nursing Outcomes Related to Patient Falls. | Correlation | The ratio of the patient to nurses’ number determines the quality of care given to the patients. This research aimed at establishing the correlation between the mandatory nurse-patient ratio and the nursing outcome in relation to patient falls | At the end of the research, it was discovered that the nursing outcome greatly increases with steady increasing of the nurse-patients ratio. The incidences of the patient falling decreased when more and qualified nurses were recruited with the aim of focusing on the care quality improvement. |
| Janiszewski Goodin, H. (2003). The nursing shortage in the United States of America: an integrative review of the literature. Journal of advanced nursing, 43(4), 335-343. | Descriptive research | The study focused on descriptively establishing the causes and effects of nurse shortages in the patients’ care outcome | The research was able to discover that the quality of health care given to the patient in health care institutions declines terribly with the increase in the shortage of nurses. |
| Cox, P., Willis, W. K., & Coustasse, A. (2014). The American Epidemic: The US Nursing Shortage and Turnover Problem. | Longitudinal study | This research aimed at repeatedly observing USA epidemic of Nursing Shortage and its effects on patients turnover | It was established that poor nurse staffing is associated with acute nurse shortage which contributes to poor turnover of patients in the affected healthcare facilities |
| Kane, R. L., Shamliyan, T., Mueller, C., Duval, S., & Wilt, T. J. (2007). Nurse staffing and quality of patient care. Evid Rep Technol Assess (Full Rep), 151, 1-115. | Qualitative | The study was conducted to establish the qualitative relationship between nurse staffing and patient outcome or the care services rendered to the patient in health care institutions. | The research was able to find out that patient outcome is directly related to the patients’ outcome. Good nurse staffing will ensure an enhanced quality of care services to patients. |
PICOT Statement
Following the increased decline in the quality of patient health care in most of the care facility within the United States, a study has been conducted to establish the impact of adopting patient-focused nurse staffing approach on the patient outcome. PICOT statement; use of patient-focused nurse staffing approach would greatly increase the quality of care services to patients in most of the health care organizations. The issue of poor health care services for the patient has been one of the challenges facing the healthcare system of the USA and it has created a terrible gap in the health care sector, which has also increased hugely. Thus, in order to improve patient care outcome, this study provides staffing system, which would ensure the recruitment of nurses with the required qualification.
(P) For nearly a decade, the issue of nurse shortage has compelled the nurse staffing union to recruit nurses to various health care organizations without any performance evaluation. This has led quite a number of these institutions into offering poor nursing services. The study has, therefore, involved interviewing of both nurses and patients from different health care institutions. However, through this study, the solution can be obtained. Only nurses that have obtained National Registration certificates should be employed so as to ensure the recruitment of qualified nursing staff. Moreover, nursing should also be closely monitored to ensure quality care services are offered to patients.
(I) As it has been mentioned earlier on, nurse shortage is the major genesis of poor nurse staffing in most of the health care institutions. It is the key factor that has led most of the care facilities to recruit even poorly trained nurses who would not deliver quality services to the patients. Therefore, the most important intervention proposed by the research study is the establishment standardized education programs in nursing to ensure graduation of more qualified nurses. In addition, health care facilities should ensure recruitment of only those nurses who are qualified.
(C) The study involved comparison of both nursing practices and nurse staffing in the United States to those of other countries like Japan and India (Brownie and Nancarrow, 2013). By carrying out the comparison, the research was able to establish a number of factors as the key contributors to poor care services in most health care institutions. The poor nursing education program, improper supervision and demographic changes are some of the factors.
(O) Patient care services including monitoring patients for possible falls are currently being observed to the latter in each and every care centers. Nursing education being one of the most important backbones for quality nursing services, a number of nursing education centers has responded by restructuring their nursing programs so as to match the required national education standards in nursing. Health care institutions had also responded by retrenching the unqualified nurses and replacing them with more qualified nurses.
(T) The pre and post intervention of study did not take more than one year before achieving a significant outcome in the selected health care facilities in the USA. The research results proved that one of the main reasons that make nurses to offer poor services to patients is the improper staffing. Most of the institutions have been able to appreciate the importance of patient-focused staffing approach and would ensure high-quality care services are offered to patients by recruiting well-trained nurses who value their patients.
We can do it today.
- Brownie, S., & Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical interventions in Aging, 8, 1.
- Cox, P., Willis, W. K., & Coustasse, A. (2014). The American Epidemic: The US Nursing Shortage and Turnover Problem.
- Janiszewski Goodin, H. (2003). The nursing shortage in the United States of America: an integrative review of the literature. Journal of advanced nursing, 43(4), 335-343.
- Kane, R. L., Shamliyan, T., Mueller, C., Duval, S., & Wilt, T. J. (2007). Nurse staffing and quality of patient care. Evid Rep Technol Assess (Full Rep), 151, 1-115.
- Nelson, E. C., Batalden, P. B., Huber, T. P., Mohr, J. J., Godfrey, M. M., Headrick, L. A., & Wasson, J. H. (2002). Microsystems in health care: Part 1. Learning from high-performing front-line clinical units. The Joint Commission journal on quality improvement, 28(9), 472-493.
- Potter, P., Wolf, L., Boxerman, S., Grayson, D., Sledge, J., Dunagan, C., & Evanoff, B. (2005). Understanding the cognitive work of nursing in the acute care environment. Journal of Nursing Administration, 35(7-8), 327-335.
- Roberts, L. K. (2013). Mandatory Nurse-Patient Ratios and Nursing Outcomes Related to Patient Falls.
- Valley, G. C. (2010). Relationships Between Nurse Staffing and Patient Outcome Variables (Doctoral dissertation, Ball State University).