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Nurse-Patient Ratios and Patient Outcomes

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Tamara Carroll

on 21 March 2016

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Transcript of Nurse-Patient Ratios and Patient Outcomes

Nurse-Patient Ratios and Patient Outcomes
Nurse-Patient Ratios and Patient Outcomes
Tamara J. Carroll
Tennessee State University
LIterature Review

Why is this relevant?
Things can be seriously bad!
I'm seriously not joking...
Before my shift...
After my shift...
Historically speaking...
Is THIS WHAT FLORENCE NIGHTINGALE THOUGHT THINGS WOULD BE LIKE?
LET'S GET SERIOUS!
FACTS:

1996: IOM PUBLISHES "NURSE STAFFING IN HOSPITALS AND NURSING HOMES: IS IT ADEQUATE?"


PROGRESS? MAYBE...BUT NOT REALLY.
During the 1980’s, hospitals underwent profound changes as clinical, administrative, and financial factors altered how hospitals functioned” (Serratt et al., 2014).
HCAHPS SCORES
PATIENT SATISFACTION
HOW DOES THIS AFFECT PATIENT CARE?
"A small percentage of patients die during hospitalization or shortly thereafter, and it is widely believed that more or better nursing care could prevent some of these deaths” (Shekelle, 2013). "
PICOT QUESTION...
In the acute care setting, do high nurse-patient ratios (high numbers of patients assigned to nurses) compared to low nurse-patient ratios (low numbers of patients assigned to nurses) have different effects on adult patient outcomes?
KEYWORDS
NURSE-PATIENT RATIOS
PATIENT OUTCOMES
ADVERSE EVENTS
ACUTE CARE
UNITED STATES
NURSE-PATIENT RATIO MANDATES
NURSE STAFFING
"HOUSTON, WE HAVE A PROBLEM!"
LEVELS OF EVIDENCE
REVIEW OF LITERATURE
ARTICLE ONE:
State of the Science: The Relationship Between Nurse Staffing and Patient Outcomes
(Brennan, Daly & Jones, 2013)
Article Two:
Nurse-patient ratios as a patient safety strategy
(Shekelle, 2013)
Review of Literature
ARTICLE THREE:
Enforcement of hospital staff regulations: progress or stalemate
(Serratt, 2014)
ARTICLE FOUR:
Comparability of nurse staffing measures in examining the relationship between RN staffing and unit-acquired pressure ulcers: a unit-level descriptive, correlational study
(Choi & Staggs, 2014)
Review of Literature
Article Five:
ARTICLE SIX:
The association of nurse-to-patient ratio with mortality and preventable complications following aortic valve replacement
(Arkin et al., 2014)
Validation of the Perceived Implicit Rationing of Nursing Care Instrument
(Jones, 2014)
Consistencies and Contradictions
A few studies support the idea that higher nurse-patient ratios cause adverse effects on patient outcomes, while other studies present the idea that there are no differences in patient outcomes when considering low or high nurse patient ratios.
Consistencies and Contradictions
All the studies done on nurse-patient ratios and patient outcomes can never rule out the effects of high nurse-patient ratios compared to low nurse-patient ratios.
Conclusions and Recommendations
Future research is completed based on a theoretical foundation that includes standardized definitions and evaluations of nurse staffing methods, organizational characteristics, process of care and unit level contexual factors.
Conclusions and Recommendations
Studies assessing intentional change to staffing ratios for nurses be done.
High-quality evidence to come from a time series analysis or a controlled before-and-after study if correct variables serve as a conceptual framework on increased staffing.
Conclusions and Recommendations
Discrepancies in staffing and staffing plans result in substantial monetary fines.
As Advanced Practice Nurses...
staying current on all healthcare policy issues including staffing issues
But what about now?
When adequate information is available, present it to nurse managers and directors.

Emphasize that changes be made in order to provide quality patient care.
Then, what?
References
(available upon request)
Full transcript