Effects of Short Staffing and on Patient and Nurse Outcomes in Healthcare

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Abstract

The nurse to patient ratio is a factor that affects the care activities. The number of patients a nurse attends to determines the nature of behavior and consistency in care administration. The effects of short staffing a health care unit are associated with secondary complications, such as, the increased rates of heart attacks, several medical errors in acute care sections, and respiratory infections. The problem also affects the levels of morbidity and mortality recorded in the administrative records. There exists an association between the patients outcomes, nursing burnout, and the staffing levels in health facilities. Staff capacity management is an important aspect of managing the labor workforce in organizations. When implemented in nursing and the health sector, it creates essential insights into the resources utilized by nurses and health practitioners, such as, the staff and equipment. This research was conducted to determine the effects of short staffing in nursing, patient outcomes, and the nurse to patient ratio. The research outlined the effects emanating from short staffing and presents a solution built on supervision, retention, and recruitment of practitioners based on the nature of the facility services offered. There are several concepts of the problem that need to be understood and analyzed to assist in establishing a sustainable strategy. A long-term organizations commitment is necessary for determining the establishment of a long-lasting solution. In this paper, the problems associated with the low staffing levels in health care facilities, such as, the patient outcomes in acute care units has been highlighted. Knowledge of the effects and the possible solutions is required when creating a safe environment for patients and nurses. The research further employed a review of the literature related to the topic and conducted a keen study of the hospital administrative data, producing a clear understanding of the notion of the short staffing in nursing. The results of this research ascertains that there exists an association between the patient outcomes and nurse to patient ratio, however using supervision, retention, and recruitment could assist in management of these complications and effects.

Keywords: short staffing, nurse patient ratio, burnout, patient outcomes, morbidity and mortality, quality nursing care, nursing management, nursing, knowledge, intellectual capital, human capital, structural capital, recruitment, retention, work environment, employer support

Effects of Short Staffing and on Patient and Nurse Outcomes in Healthcare

Introduction

The concept of nurse staffing is a vital consideration for patients safety and outcomes. When a patient visits a hospital, the care process starts from the time the diagnosis starts. The expected outcome will depend on the nature of the services the client will be subjected. A keen analysis of the procedure ascertains that the quality and quantity of treatment process affects the results about the path of life recovery. Whenever the health practitioners are limited in a facility, then the numbers of nurse-sensitive results are witnessed. The nurse to patient ratio is a factor that affects the care activities. The number of patients a nurse attends to determines the nature of behavior and consistency in care administration ADDIN RW.CITE{{409 LLin,JanitaP.C. 2015}}(L Lin, Janita P. C., 2015). The effects of short staffing a health unit are associated with secondary complications, such as, the increased rates of heart attacks, several medical errors in acute care sections, and respiratory infections ADDIN RW.CITE{{390 Beeler,MichaelF. 2014}}(Beeler, Aleman, & Carter, 2014). The problem also affects the levels of morbidity and mortality recorded in the administrative records. The critical care units such as the elderly sections, pediatric wards, mental illness patients, and intensive care units are subjected to in-hospital infections that increase the inefficiency in care facilities ADDIN RW.CITE{{398 Schilling,Peter 2011}}(Schilling, Dougherty, & Goulet, 2011).

The factors that are associated to nurse staffing levels and patient outcomes are external in nature. The number of registered nurses determines the number of practitioners stationed in each unit per state regulations ADDIN RW.CITE{{392 Bowblis,JohnR. 2015}}(Bowblis, 2015). The application of short-time nursing services in emergency services and pandemic outbreaks is a factor that determines the range of recruitment and retention of nursing specialists ADDIN RW.CITE{{390 Beeler,MichaelF. 2014}}(Beeler et al., 2014). The study conducted by L Lin, 2015, found that nursing school capacities also influence the rate of training in nursing by maintaining a fixed function. The decision made depends on the facility available in the training facilities and the availability of competent skills and other resources to impart modern and adaptable skills necessary for a sustainable nursing culture. The changing patient requirement and new health complication affect the staffing levels, specifically in the special care and skilled units ADDIN RW.CITE{{409 LLin,JanitaP.C. 2015}}(L Lin, Janita P. C., 2015). Improved technology and automation of services render some previous training obsolete and this affects the skills the trained nurses can offer. Immigration and healthcare management policy in a country determines the number of staff available in a specific hospital ADDIN RW.CITE{{405 Namaganda,G. 2015}}(Namaganda, Oketcho, Maniple, & Viadro, 2015). The state of the economy affects the number of hired nurses in a state because of increased expenditure and budgetary allocations that go beyond sustainable levels (Bowblis, 2015).

Per Bowblis, 2015, the solution towards the mitigation of the problem is necessary and possible. The states and stakeholders have set legislative measures meant to address the inadequacy of the staffing of nurses in health facilities. The strategies presented are inclined towards increasing the nurse to patient levels in hospitals with a high number of patients and offering exceptional acute care services ADDIN RW.CITE{{392 Bowblis,JohnR. 2015}}(Bowblis, 2015). It is worth to note that the study by Maenhout & Vanhoucke, 2013, mentions that the diversity of health organization regarding structure, level, and services provided affects the methodology to be employed in reducing the short staffing effects. The one-size-fits-all phenomenon cannot be used in the health sector because of the complex needs of each facility that are different and unique. Any model that is to be considered as the best strategy to solve the shortcomings should be wholesome and based on a short study of that health center. The plan should incorporate the patients acuity, the layout of the facility, and the auxiliary services and resources allocated to the unit ADDIN RW.CITE{{402 Maenhout,Broos 2013}}(Maenhout & Vanhoucke, 2013). The factor of skill and experience is vital in determining the extent to which the short staffing has affected service delivery in that hospital. The appropriate balance of competences acquired through education and training is another consideration when designing a model ADDIN RW.CITE{{409 LLin,JanitaP.C. 2015}}(L Lin, Janita P. C., 2015).

Problem Description

This research was conducted to determine the effects of short staffing in nursing, patient outcomes, and the nurse to patient ratio. There exists an association between the patients outcomes, nursing burnout, and the staffing levels in health facilities. Maenhout & Vanhoucke, 2013, indicates that staff capacity management is an important aspect of managing the labor workforce in organizations. When implemented in nursing and the health care sector, it creates essential insights into the resources utilized by nurses and health practitioner, such as, the staff and equipment. The management choices on the quality levels and quantity outputs for nurse staffing are determining the nature of hospital budgets ADDIN RW.CITE{{402 Maenhout,Broos 2013}}(Maenhout & Vanhoucke, 2013). The Two factors also determine the baseline to be applied in nursing requirements and patient services within a hospital unit. Short staffing in nursing is associated with critical outcomes in patients with acute conditions ADDIN RW.CITE{{400 Hugonnet,S. 2007}}(Hugonnet, Uckay, & Pittet, 2007). Increased morbidity and mortality rates to low staffing levels in cases, such as, mental illness, pediatric conditions, and elderly patients is affected by the decrease of nurse to patient ratios ADDIN RW.CITE{{398 Schilling,Peter 2011}}(Schilling et al., 2011). Therefore, the research seeks to outline the effects emanating from short staffing in nursing and present a solution based on supervision, retention, and recruitment of practitioners based on the nature of the facility services offered.

PICOT Problem Statement

A PICOT question was developed in identifying the theme of this paper. The P is the population being considered. Population: Patients in the health care settings seeking or undergoing treatment in health care facilities. I is for intervention. Intervention: Effectiveness of appropriate staffing levels and nurse to patient ratios in regards to quality of care and nurse satisfaction. The C indicates the comparison. Comparison: Ineffective staffing levels and low nurse to patient ratios effecting quality of care and nurse satisfaction. The O will be significant to the outcome. Outcome: When staffing and nurse to patient ratios are appropriate, this will lead to a decreased rate of morbidity and mortality with increased quality of care and nurse job satisfaction. The T will represent the timeframe associated with the problem being researched. Time: Registration through discharge. Finally the full PICOT question is realized for the purpose of research. Among patients in health care facilities does effective staffing and nurse to patient ratios lead to a decreased rate of morbidity and mortality with increased quality of care and nurse job satisfaction, compared to a decreased nurse to patient ratio and inadequate staffing when seeking or undergoing treatment.

Gravity of the Problem

It is important to understand that the staffing problem cannot just be solved when perceived as the common number agenda. There are several concepts of the problem that need to be understood and analyzed to assist in establishing a sustainable strategy. A long-term organizational commitment is necessary for determining the establishment of a long-lasting solution. Per the American Association of Critical Care Nurses, 2005, nurses in...