Being The Change Tell the world

Report
Being The Change: Safer Nurse
to Patient Ratio’s
Gina L. Gilmore, RN
James Madison University
Inadequate Nurse to Patient Ratio’s Have Been
Linked to:
• Increased Medication Error’s 6
• Increase Patient Complications6
• Increase Mortality1
• Decrease Patient Satisfaction5
• Decrease Nurse Satisfaction7
• Increase Nurse Burnout1
• Reduced Nurse Retention 1
H. R. 1821, The Registered Nurse Safe
Staffing ACT of 2013
April 30, 2013 during the 113th 1st session of Congress in the House of
Representatives a bill known as the Registered Nurse Safe Staffing Act
was introduced.
10 findings by Congress were reported.
Establishment includes amendment of the Social Security Act (42 U.S.C.
1395cc, written into part of the Patient Protection and the Affordable
Care Act (Public Law 111-148).
Guidelines for implementation of nurse staffing plan, requirements,
reporting, responsibilities, and penalties outlined.
H.R. 1821--113th Congress: Registered Nurse Safe Staffing Act of 2013. (2013). In www.GovTrack.us. Retrieved from
https://www.govtrack.us/congress/bills/113/hr1821/text
H. R. 1821, The Registered Nurse Safe
Staffing ACT: 10 Findings by Congress
1) Higher staffing levels of experienced registered nurses directly relates to
2)
3)
4)
5)
less negative patient outcomes.7
Sub-optimal staffing is linked to increased incidences of in hospital patient
mortalities.1
Health care worker fatigue is a major safety hazard.6
A reduction in adverse events was found when an optimum skill mix of
registered nurses was present.7
Value based payment programs use key measures like Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) showed
improved patient satisfaction scores as appropriate nursing levels were
reached.5
H. R. 1821, The Registered Nurse Safe Staffing
ACT: 10 Findings by Congress continued:
6) Appropriate staffing of nurses costs significantly less than the adverse events
experienced by patients that nurses are vital in preventing.5
7) Cost benefit analysis shows higher nurse staffing generates payor savings.5
8) Improved nurse staffing leads to a decrease in incidence of catheter aquired
urinary tract infections.1
9) There is a negative impact on healthful work environments when nurses are
unable to perform because of poor work conditions caused by
understaffing.7
10) The Federal Government has a compelling interest in the promotion of safety
for patients which are directly affected by safe staffing levels of registered
nurses.
H.R. 1821--113th Congress: Registered Nurse Safe Staffing Act of 2013. (2013). In www.GovTrack.us. Retrieved from
https://www.govtrack.us/congress/bills/113/hr1821/text
What Can You Do?
• Become Educated About The
Facts
• Join a Professional Nursing
Organization
• Use Your Voice To Create Agency
• Write To Your Congressman
• Learn About Workforce Advocacy
• Tell Others About The Registered
Nurse Safe Staffing Act (H.R.
1821)
American Nurses Association (ANA), 2013
Safe Staffing
Impacts
Patient
Safety
Quality of
Care
Incidence of
Infection
Hospital
Readmission
Falls
Patient Days
Nurse Fatigue
Pneumonia
Patient
Satisfaction
Scores
Decreased
Burnout
Pressure
Ulcer
Prevention
Medical
Errors
Quality
Improvement
Improved
Retention
Mortality
Fewer
Complications
Reduction In
Cost
The Code of Ethics for Nurses
• Nurses are responsible articulating
nursing values
Improved
Patient
Outcomes
• Maintaining the integrity of the
profession and its practice
• Shaping Social Policy
• Nurses can work individually or
Improved
Patient
Satisfaction
collectively through political action
to bring about social change,
reshaping health care policy and
legislation to affect accessibility,
quality, and cost of health care.
American Nurses Association.(2001).Code of ethics for nurses with interpretive statements. (2001). Washington, D.C.
Appropriate
Nurse
Staffing
Decreased
Costs
Increased
Nurse
Satisfaction
American Nurses Association (ANA) Tools
• Research
• Take Action for Safe Staffing
• Staffing Bill Introduced to
• Workforce Advocacy Tools
Congress
• ANA’s Principles for Nurse
Staffing
http://www.nursingworld.org/
My Tell The World Project
For my tell the world project I wrote to Representative Eric
Cantor to urge him to cosponsor the Registered Nurse Safe Staffing
Act (H.R. 1821). I shared with him some of the links that have been
discovered between patient outcomes and staffing ratios. I told him
of the key concerns that nurses face day to day at the bedside. I
spoke of the impending nursing shortage, nurse retention, and
nurse satisfaction . I shared how the increasing workloads and
rising acuities of patients are affected when nurses have more than
8 patients. I also shared that research shows that there are lower
mortalities, shorter hospital stays, reduced costs and complications
when ratios are lower. I urged him to support us as a profession to
help create safe work environments for patient care.
Conclusion
Healthcare is ever in motion, we as nurses are at the front line and must be
actively involved and ever vigilant in the changes that take place around us.
Nurse driven research has yielded what we now know, that patient safety is
directly related to the quality of care that nurses are able to provide. In order for
quality care to be provided, and patient and nurse satisfaction, nurse: patient
ratios are critical to outcomes.
http://kizie.com/blog/meditation.html
References
1. Aiken, L. H. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. The
Journal of the American Medical Association. 288(16): 87-93 doi:10.1001/jama.288.16.1987
2. American Nurses Association.(2001).Code of ethics for nurses with interpretive statements. (2001).
Washington, D.C.
3. American Nurses Association. (2013). The American Nurses Association World of Nursing. Retrieved from
http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NurseStaffing
4. H.R. 1821--113th Congress: Registered Nurse Safe Staffing Act of 2013. (2013). In www.GovTrack.us.
Retrieved from https://www.govtrack.us/congress/bills/113/hr1821/text
5. Rothberg, M. B., Abraham, I., Lindenauer, P. K., & Rose, D. N. (2005). Improving nurse-to-patient staffing ratios
as a cost-effective safety intervention. Medical care, 43, 785–791. doi:10.1097/01.mlr.0000170408.35854.fa
6. Shekelle, P. G. (2013). Nurse-patient ratios as a patient safety strategy: a systematic review. Annals of internal
medicine, 158, 404–9. doi:10.7326/0003-4819-158-5-201303051-00007
7. Wallace, B., (2013). Nurse staffing and patient safety: What's your perspective? Nursing Management.
44(6):49-51. doi: 10.1097/01.NUMA.0000430.50335.51

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