Nurse Reimbursement Summary

State-mandated nurse-to-patient ratios remains a controversial topic in healthcare. Sufficient nurse staffing is key to ensure adequate patient care, while scarce staffing effects patients’ safety and puts nurses at risk for burnout. Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. There are many factors to consider when determining staffing methods, such as cost, nurses’ satisfaction, patient outcomes and safety. Mandating ratios is one attempt at ensuring nurses’ workloads do not exceed what is needed for adequate patient care and safety. Throughout this paper, I will explore both the pros and cons of mandated nurse-to-patient ratios in order to resolve the question, does nurse to

Mandatory overtime is an issue faced by many nurses across the nation. It is seen as a solution to the nursing shortage crisis; however, it is not a sustainable solution as it has led to an increase in medical errors, increased patient mortality, decreased job satisfaction, nurse fatigue, and deficits in nurse’s work performance. Several states have enacted or are considering laws to prohibit this problem. According to Rubenfire, “This is something that's been going on in hospitals for a very long time,” Ruben noted. “But it is not as focused on as much in the past.”

A report by the Agency for Healthcare and Quality in America projected that hospitals involving increased levels of Registered Nurse (RN) staffing showed decreased degrees of substandard patient outcomes and increased nurse staffing ratios were linked with a 2% to 25% decrease in substandard outcomes (Mark & Stanton, 2010). As a result, education on nurse staffing and the influence on quality of patient care warrants evidence based decision on existing and forthcoming practices.

Due to hospital care reaching an all-time high in America, we need nurses now more than ever before. Currently in America, we have an issue with nurses having too many paperwork to fill out. In the article “We Need More Nurses” by Alexandra Robbins argues we need more nurses in the hospital. Nursing shortage has been a common issue throughout the world. Because of this issue others are being affected in many different ways. This issue is not only affecting the hospital, but also the patients. In the article “When Hospital Paperwork Crowds Out Hospital Care” by Theresa Brown argues that nurses have too much paperwork to fill out about their patients. Having too many paperwork takes away from the nurses getting involved with their patients. In my opinion, neither of the arguments are valid because they lacks supporting details .Even though Robbins and Brown are passion about their topic, they both did a great job using pathos

Large patient loads combined with a stressful work environment affects nurses’ abilities to provide quality healthcare. Patient safety should never be compromised. It is our responsibility to learn from research and improve our current nurse staffing ratios. Nurse staffing is key and affects all other outcomes. Without nurses administering the right treatment at the right time to the right patients, all other healthcare interventions are not effective. Improvement of nurse staffing levels will improve the quality of care our patients receive.

With a nurse shortage, patients are not getting the best quality care they should be getting. Archive stated that hospital nurse staffing, is a matter of major concern because of the effects it can have on patient safety and the quality care patients deserve. Nursing-sensitive outcomes is an indicator of the quality care and can be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention. Some unfortunate patient outcomes potentially sensitive to nursing care are shock, urinary tract infections (UTIs), pneumonia, longer hospital stays, upper gastrointestinal bleeding, failure to rescue, and 30-day mortality. Research has focused on negative rather than the positive patient outcomes for the simple reason that adverse outcomes are more likely to be documented in the medical record. This is important evidence because it gives us conditions and results of what can happen if patients get lower quality care. Patients’ are not having enough time getting checked up by a nurse, and nurses would miss some diagnostics. Patients are getting sick because of the poor care they are receiving from nurses. The care patients can get is affected by a nurse shortage, “Nursing workload definitely affects the time that a nurse can allot to various tasks. Under a heavy workload, nurses may not have sufficient time to perform tasks that can have a direct effect on patient safety. A heavy nursing workload can influence the care provider’s decision to perform various procedures. A heavy workload may also reduce the time spent by nurses collaborating and communicating with physicians, therefore affecting the quality of nurse-physician collaboration” (ncbi). This is important because it tells us that nurses wouldn 't have enough time to perform tasks that can affect the patients’ care. If nurses are being overworked because of a nurse shortage, then patients’ would not have the best quality care they would need, which can be a

Nurse retention is to provide staff with implements that will empower them in the workplace. Empowerment in organizational structures include power and opportunity. Employees with high levels of power are included in lines of information, support, resources and opportunities to learn and grow (Schwinger ET AL., 2010). In additional employees who have high levels of opportunity in their jobs tend to be more proactive problem solvers and accept change. When staff have opportunity and power, they are motivated, feel more in control, have increased wellbeing and have greater job satisfaction (Schwinger ET AL., 2010). These empowering features in the workplace will potentially promote job satisfaction, create greater productivity, and most importantly promote retention of valuable employees. The key to retention is creating and keeping an environment where all of the generations feel welcome and valued. There have four important things to staff retention in organizational is relationships, value, eengagement and health care organization policies.

Decision makers will need to determine how to best utilize nurses, technicians, and other professionals to close the gap in providing services to patients. Nurses require less time to train, are less expensive to train, cost less to employ, and can increase the efficiency and productivity of physicians who provide care to patients. The increase in the use of health care services as well as the increase in the number of venues where health care is provided has also increased the job opportunities for nurses and other members of the healthcare workforce. The demand for primary care services has stimulated the training of nurse practitioners, physician assistants, and certified nurse

Moreover, several studies have been conducted to examine the effects of low nurse staffing on patients hospitalization experiences, as well as its effect on nurse careers in the long run. A recent study by Frith, Anderson, Tseng, and Fong (2012) to explore the relationship between nurse staffing and medication errors, demonstrated that medication errors were higher in a cardiac care unit and non-cardiac care unit when staffing levels were lower. In addition, Frith et al. (2012) pointed out that medication errors increase by 18% for every 20% decrease in nurse staffing below the average due to failure to follow medication administration protocol As mentioned earlier, nurses perform the last and the most important step of medication administration. Thus, having adequate time to assess each patient efficiently and following the medication rights is critical to provide safe patient care and prevent errors.

Rothberg et al. (2005) did a cost-effectiveness analysis from the institutional perspective, using 2003 US dollars, comparing nurse to patient ratios ranging from 1:4 and 1:8. The approximate cost estimates were obtained from bureau of labor statistics and medical literature. To gain an incremental cost effectiveness of each nurse to patient ratio relative to the next higher nurse to patient ratio, the ratio was divided by the difference in total cost by the difference in 30 day mortality (Rothberg et al., 2005). Patient mortality rates and length of stay for different ratios were based from 2 large hospital level studies. The authors Rothberg et al, (2005) performed sensitivity analysis on independent variables like hourly compensation for nurses, relative risk of mortality, nurse dissatisfaction and decrease length of stay per

In order to run this facility and as the same be able to give the best care to their patients the company large team of employees.38 percent of the facility employees is nursing department ,this department cover all three shifts thus why it covers almost half of employees. The nursing department spending budgeted for year the 2014 was expected to be $2, 149, 14; this includes nurses, certified medication aides and certified nursing assistants. The actual nursing department spending was $1,541,322. Dietary was 12% of the expense, Maintenance and Utilities at 7%, housekeeping and activities were at 4% each and laundry at 1%. The other expenses include Property Insurance/taxes at 1%, Ancillary expenses which were 22%, general and administration, which was 9% and social servises was budgeted at

Nurses play an essential role in the healthcare industry. The nurse workforce is made up of licensed nurses: registered nurses (RNs), licensed vocational nurses (LVNs) and licensed practical nurses (LPNs), along with nurse aides. Registered nurses are responsible for assessments of patients’ needs, development of care plans, medication administration, and treatments, while licensed vocational nurses perform specific care under the delegation of the registered nurses and supervisions. Nursing aides perform activities of daily living (unskilled attention) to the patient. Adequate nursing staffing is essential to both patient care and outcomes, also to the retention of nurses while inadequate staffing creates problems for both the patients and

Since, one-third of the entire Canadian healthcare workforce consists of regulated nursing profession, it has been suggested that “as nurses goes, so goes the rest of the system” (CNAC, 2002, p 9). So, the healthcare delivery system requires good leadership for the enhancement of effective, productive and sustainable nursing workforce to address the nursing shortage. Since, retaining nurses in the workforce by decreasing nurse turnover could also decrease the healthcare costs, increase job satisfaction among nurse and enhance safe and quality patient care, it is vital to address the issue of nursing shortage by retaining nurses in the workforce now. Hence, my paper will argue that failure to focus on retention of nurses is a critical factor

There is a positive correlation between effective staffing of nurses and the quality of patient care and safety. As discussed earlier, nurses who work in safe and stress-free environments are more likely to keep their jobs, which leads to retention of the highly qualified and experienced registered nurses.

The nursing world with its strengthening economy and employment growth will create a critical shortage for nurses. Practicing registered nurses encounter short staffing in their workplace. It is a concern for nurses in their profession and personal well-being. There are increasing reports on the exploitation of mandatory overtime as a staffing mechanism. An unsafe staffing practice will result in harmful outcomes on patient care, medication errors, and eventually nurses leaving the bedside or the profession.