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Jessica Riley Ferris State University

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Determine risks of patient outcomes related to lack of adequate staffing. Understand causative factors to risks of safety and satisfaction. To increase staff ratios according to patient needs. Acknowledge barriers that hinder larger staff to patient ratios.

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Adverse Outcomes Urinary Tract Infections Medication Errors Procedure Errors Nosocomial Pneumonia Falls/Injury Skin Breakdown Infection Hospital Stays Re-admissions Shock Mortality (Vantage Point, 2009) A study conducted by Stanton (2004) showed that higher rates of RN staffing were associated with a 3- to 12-percent reduction in adverse outcomes.

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A hour increase in LPN hours per patient day was associated with a 15% increase in the odds of death and a 27% increase in the odds of sepsis (Glance et al., 2012, p. 4). Nurse aide staffing increases of hour decreased pneumonia odds by 8% (Glance et al., 2012).

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Nurses need to be available to provide these needs!

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NIGHTINGALES ENVIRONMENT THEORY Statements from Nightingale include: "Poor or difficult environments led to poor health and disease." "Environment could be altered to improve conditions so that the natural laws would allow healing to occur. Also, that the goal of nursing is to put the patient in the best condition for nature to act upon him. (Nursing Theories, 2012)

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Current Practice Lack of Policies Financial Influence Current Satisfaction Ratings Michigan vs. National ratings

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Rounding Frequency Absences Patient Acuity Outdated Budget cuts Lack of Fall Precaution Measures

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(Yale, n.d.)

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Quality and Safety Education for Nurses (QSEN) ANA Standards Standard 5B. Health Teaching and Health Promotion Standard 10. Quality of Practice Standard 16. Environmental Health Implementation of safety programs to minimize the risk to our patients. Scanning medications against an electronic medical record Increase frequency of monitoring Co-signatures of potentially harmful medications Fall risk evaluations

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References (Seminar) American Nurses Association. (2010). Nursing: Scope and standards of practice. Silver Spring, Md: American Nurses Association. American Nurses Association. (2013). Policy & Advocacy. Nurse staffing plans and ratios. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios Glance, L.G., Dick, A.W., Osler, T.M., Mukamel, D.B., Li, Y. & Stone, P.W. (2012). The association between nurse staffing and hospital outcomes in injured patients. BMC Health Services Research, 12(247), 1-8. doi:10.1186/1472-6963-12-247 Hospital Compare Quality of Care (2013). West Shore Medical Center: Hospital profile. Retrieved from http://www.medicare.gov/hospitalcompare/profile.aspx#profTab=1&ID=231335&loc=49660&lat=44.2205682&lng=- 86.1344697&AspxAutoDetectCookieSupport=1 Nursing Theories (2012) Theories of Florence Nightingale. Retrieved from http://currentnursing.com/nursing_theory/Florence_Nightingale_theory.htmlQSEN. (n.d.). About QSEN. Retrieved from http://qsen.org/about-qsen/

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References (Seminar) Stanton, M. W. (2004). Hospital Nurse Staffing and Quality of Care: Research in Action, Issue 14. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/services/nursestaffing/index.html The Health Foundation (2011). Research scan: Does improving safety culture affect patient outcomes? Retrieved from http://www.health.org.uk/public/cms/75/76/313/3078/does%20improving%20safety%20culture%20affect%20outcomes.pdf?realName= 7b1J1q.pdf Yale Case (n.d.). Root Cause Analysis Tools. Retrieved from http://nexus.som.yale.edu/ph-tanzania/?q=node/131