Smart Nursing: Nurse Retention And Improvement Strategies

There are several procedures that help to maintain this health and safety however they can all vary between settings for example, health and safety procedures will be slightly different and more focused on certain areas in hospitals and especially in paediatric ward compared to in drop-in centres where the needs and risk to service users are slightly different.

Patient safety experts have demonstrated that “patient safety increases when teamwork and collaboration skills are taught and empowered; when teamwork and collaboration are not present, medical errors will result” (Creasia & Friberg, 201, p. 348). As a nurse, it is imperative to collaborate with other interdisciplinary members in health care and also strive to research and implement evidence-based practices. Evidence-based practice is necessary to “ensure the highest quality of cost-effective care and the best patient outcomes” (Fineout-Overholt, 2011, para. 16). With a collaborative and innovative attitude on safe health care practices, an increase in patient safety and effectiveness of care will

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.

The purpose of this paper is to explore the relationship between nurses' duty hours, and patient outcome, emphasizing increased negative risk from nurse fatigue, relating to patient injury or death.

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

During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.

However, he explains that it’s tough to change a medicine culture since the senior physicians always rank themselves higher and other lower positions rank below. Kalb explains doctors tend to refuse to follow the directions for safety and continue finishing tasks in the way they’re used to. Central-line infection is one of the major causes for fatal death, noted Kalb. Even though changes were made, that safety procedure such as washing hands is necessary, but people aren’t dedicated their time to adapt to these changes. He states that Dr. Gary Kaplan gave his staff members to report concern throughout the system even if it’s a smallest mistake. Kalb explains in order to reduce risks, doctors must learn skills to safety procedure and teamwork techniques from the beginning of their education, having chance to interact with real life situations with team members by using their technical skills.

Quality improvement efforts and risk management are complementary, and together are key modules of clinical governance. Risk management reinforces quality management in healthcare. This leads to:

I find it overwhelming that the majority of the research literature (studies, surveys and reports believe nursing plays the pivotal role in changing the face of health care and improving quality care and patient safety. In order for the future of health care to change, changes must begin at the top with stakeholders, the hierarchy and nursing management, nurses as leaders within their organizations. According to Disch J. (2008), nurses as leaders within their organizations need to also step forward, CNEs have the background, perspective, and platform to help their organizations seriously tackle safety issues that jeopardize patient care and that face nurses and their colleagues daily, and are the essential building blocks of all health systems--and

Safety is a condition characterized by minimal risk of harm coupled with protection from potential harm. In health care, patient safety involves instituting mitigation measures to prevent potential adverse events. Unfortunately, the existence of potential adverse events is only recognized after such an event has occurred. Reporting an adverse event, therefore, is the first step towards developing mitigation measures. However, some nurses fear reporting adverse events, because they erroneously believe they will be penalized for the occurrence of such an event. I believe, reporting the occurrence of an adverse event should be rewarded, since it is the initial stage of preventing future events.

that while nurses plays a very important role in improving the health care system of the country,

In order for hospital units to maintain somewhat safe ratios a sliding scale approach formula is used by a lot of units across America. An article from The Journal of Nursing Administration on Nurse Labor Data: The Collection and Interpretation of Nurse-To-Patient Ratios states that “almost all units used a sliding scale approach to account for census changes” (Minnick & Mion, 2009, para. 23). If the minimum ratio is four patients to one nurse for said unit the admission of more patients beyond the minimum ratio requires that an additional RN is needed in order to rebalance the ratios to meet 4:1 (Minnick & Mion, 2009). The example sliding scale formula mentioned above may not always work as favorably as nurse managers would like it to. The more patients with high acuities are admitted the more caseloads the nurses have to take on, more so if the unit is short staffed and there are no extra nurses that can be called in to lessen the workload. This in turn can cause fatigue and stress levels to rise amongst patient care workers and as a result may have adverse effects on their patients including increasing risk for errors, failure to rescue, and increased risk of mortality. To put this into reality a study was done regarding how much patients are at risk when a nurses’ patient workload exceeds what is considered safe based on the acuity of the patients the nurse is caring

The success of patient safety, prognosis and improve health outcomes within the nursing profession is dependent upon proficient communication. When communication is not proficient, patient safety and wellness is compromised (Gore et al., 2015). There are numerous safety issues that can arise from inapt communication within nursing. Two issues that have the potential to impact patient care and safety are hand-off communication errors and cultural competence. Mitigating these safety issues within the nursing profession will be vital to improving and maintaining patient safety and promote positive health outcomes.

Communication is described as the interchange of information, thoughts, and feelings between individuals using dialog or other methods (Kourkouta, & Papathanasiou, 2014). Communication between patients, nurses, and other healthcare professionals can influence the patient outcome subsequently, understanding what establishes an effective communication will be beneficial for nurses and other healthcare professionals. Having the skills to articulate efficiently exists beyond having verbal skills. According to Wright (2012), to establish effective communication, a nurse should develop the use of nonverbal cues such as body language, demonstrating active listening skills to facilitate assurance that the interaction remains successful, and having

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). They need to be cognizant of not only their mistakes, but the mistakes of those making the decisions before them. Therefore, nurses should not be constantly asked to work overtime because that is how mistakes are missed or made (Kelley, 2004). Nurses should sharpen their saws between shifts and their days off, only then can they perform their absolute