1. DEFINITION OF THE COMBINATORIAL OPTIMIZATION PROBLEM.
Combinatorial optimization is defined as a combination of techniques of combinatorial operation research, linear programming and the theory of algorithms in the field of applied mathematics. The main aim of combinatorial optimization studies is to find an optimal solution from a finite set of objects.. Besides that, it solves optimization problems over discrete structures. Artificial intelligence, software engineering, , mathematics and machine learning are several fields which have been applying the combinatorial optimization techniques.
From the literature studies, according to F. Neumann, C. Witt, the goal of combinatorial optimization problem is either minimizing or maximizing a
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Their level of quality is similar. The last rows of these tables indicate that regular nurse shortages are well distributed over the weeks and that it is equal to zero on Monday and Friday of each week. The row 'supervising personnel shortage' indicates that obj 4 is satisfied. Furthermore, it is easy to verify that days off are grouped for Nurses 3, 4, and 5, and weekends off are extended for Nurses 1 and 2. Finally, special requests for days off and for consecutive working days are fulfilled. Needless to say, the head-nurse was fully satisfied with these schedules.
(ii) Cutting-stock problem
DEFINITION:
The cutting-stock problem is defined as a nondeterministic polynomial time –complete optimization problem and also an integer linear programming problem. It is a technique to find optimum cutting patterns. There are one and two dimensional cutting stock problems.
Based on the literature studies, the Russian economist, Kantorovich(1960) has given the first formulation of cutting stock problem. Next, Gilmore(1961) and Gomory(1963) described their delayed pattern generation technique for solving the one dimensional minimization problem using linear programming.
BASIC MATHEMATICAL
These gaps need to be identified to help achieve the business needs. One major flaw with the current ordering system is that nurses are not collecting all orders from residents, neither the kitchen has direct contact with residents. This is largely due to nursing staff being disorganised and not asking each individual within a timely fashion and kitchen staff not being able to leave the kitchen since they are busy preparing meal before the right time. Another contributing factor is that as some residents are restricted to their rooms, they have less regular contact with nursing staff. When these orders are not collected and delivered in time, it can result in stressful situations for kitchen staff.
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.
According to Stanton, low-staffed hospitals resulted in higher incidences of poor patient outcomes. Such as, UTIs, pneumonia, and fall. However, poor patient outcomes not only result from short-staffed nurses, but can also result from inadequate nursing assistants as well. NAs play a great role in providing basic daily care of patients. These professionals are very crucial in the healthcare industry but sadly, there are NA shortages.
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.
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
Buchan and Aiken (2008) stated that the nurses shortage problems may be due to the nurses that not willing to work as a nurse under the current conditions in working environment. A real shortage is circumstances where experienced people are not available for a certain vacancies due to some reasons (Wildschut&Mqolozana, 2008). A news article written by Salma Khalikin in Straits Times stated that according to current situation Singapore may not be able to create enough nurses for upcoming years. The impact of nurses shortage may causes increase work load for nurses which subsequently may increase the risk for nurses made errors in clinical, the risk of increase hospital acquired infections which cause by viral, bacterial, and fungal pathogens. More over the impact of shortage of nurses may also increase death rate, and also increase the risk of occupation injuries and exposure in working environments.
To find a valuable solution for a difficulty it is essential to assess how the problem functions. The current cognitions,
Further research stated that the American Nurses’ Association have guidelines for making decisions on staffing, which “suggest that the number and acuity of the patients, the level of staff working
how could one expect to receive proper treatment in hospital when your nurse has more than 8 patients to care for which could lead to higher chances of negligence due to sheer exhaustion from over worked nurses. The possibility of patient- procedure- equipment related accidents would be higher. The problem of understaffing could be looked from the perspective of
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.”
Understaffing in hospitals is a major problem that has been affecting healthcare workers and patients for many years. I have chosen to highlight understaffing as a patient safety issue because of the consequences that can arise from it. Shortages in staffing can result in an increase of infection rates (Stone et al., 2007) leading to complications and poorer patient outcomes (Needleman et al. 2002). This particular issue is of interest to me because I have experienced and witnessed it myself. As a midwifery student in a busy maternity hospital, I can appreciate the hard work and dedication each midwife gives to their patients.
Nursing Shortage is a problem we all should be aware of. There are many factors that may lead to a nursing shortage, such as having stressful and unsafe working environments, and our nurses are being overworked. This is a problem we should be aware of because it is affecting the patient care. Nurses would not have enough time to stay with a patient if they have more patients to worry about. Nurses play a big role in our hospitals and communities, “Nurses play significant roles in hospitals, clinics and private practices.
Keywords: nursing, short staffing, burnout Effects of Short-Staffing in the Nursing Profession
For flexibility, most nurses today prefer working fewer days per week longer hours per day. The data results of today concludes that longer work days of 10 hours or more proves to be a detrimental to the patient as well
Just like a saw needs to stop being used in order to be sharpened, a nurse needs time off to recuperate; it’s as simple as that (Covey, 1989). It is important not to burn the candle at both ends, working more than the designated shifts and longer than 12 hours should be avoided. An example used regarding medication errors and working too many hours involves a nurse working a double shift on a pediatric oncology unit didn’t correctly prime an IV line and caused cardiac arrest in a patient (Kelley, 2004). Although nurses work three days a week, their hours remain the same as other full time employees that work the typical 5 day schedule. A nurse’s time off should be valued because they are the last line for patient care, they are the ones administering the medication the doctor prescribes and the pharmacy makes (Kelley, 2004).