SAFE STAFFING AS IT RELATES TO PATIENT SATISFACTION AND

SAFETYAre We There Yet?

Vicki Tarnow

American Sentinel

University

Poses significant problems at the clinical level Increases nurse dissatisfaction and burnout Impacts mortality and morbidity Impacts patient satisfaction Increases workload on the nurse Impacts healthcare costs and the budget Safety

Waters, A. (2012). It is time we took a firm stand in the battle for safe staff levels [serial online]. Nursing Standard, 26(50), 16-19. Retrieved fromhttp://content.ebscohost.com/pdf27_28/pdf/2012/4ER/15Aug12/78945798.pdfT=P&P=AN&K=2011666759&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeqLY4yOvsOLCmr0yep65SsK64SLKWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

UNSAFE STAFFING

PURPOSE

To gain insight into unsafe staffing as it relates to: Inadequate staffing Nurse burnout Employment dissatisfaction Higher turnover rates Patient safety Decrease over-all patient satisfaction scores

American Nurse Association. (2014). Nurse staffing. Retrieved June 27,2014, from http://www.nursingworld.org

IMPACTS ON NURSING CARE AND PATIENT OUTCOMES

How understaffing impacts nursing and patient outcomes Higher incidence of falls Increased infection rates Medication Errors Nurse burnout due to being overworked Deaths

Waters, A. (2012). It is time we took a firm stand in the battle for safe staff levels [serial online]. Nursing Standard, 26(50), 16-19. Retrieved from http://content.ebscohost.com/pdf27_28/pdf/2012/4ER/15Aug12/78945798.pdfT=P&P=AN&K=2011666759&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeqLY4yOvsOLCmr0yep65SsK64SLKWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

SOLUTIONS

Safe nurse-patient ratios save money Nurses to drive staffing decisions Mandating a separate budget for nursing Legislators to pass minimal staffing guidelines law Effective communication through accountability Reducing errors through the synergy model Taking a firm stand against unsafe staffing

Goetz, K., Janney, M., & Ramsey, K. (2011). When nursing takes ownership of financial outcomes: Achieving exceptional financial performance through leadership, strategy, and execution [Journal]. Nursing Economic$, 29(4), 173-182. Retrieved from http://content.ebscohost.com/pdf25_26/pdf/2011/22R/01Jul11/64468966.pdf?T=P&P=AN&K=2011245686&S=R&D=c8h&EbscoContent=dGJyMNHX8kSep7A4yOvqOLCmr0yep69Srq64S7WWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

ACCOUNTABILITY MODEL

The accountability model is Powerful framework that holds others accountable Helps to establish key expectations Manages unmet expectations Provides support and reinforcement Promotes learning Communication is vital part to upholding accountability

Goetz, K., Janney, M., & Ramsey, K. (2011). When nursing takes ownership of financial outcomes: Achieving exceptional financial performance through leadership, strategy, and execution [Journal]. Nursing Economic$, 29(4), 173-182. Retrieved from http://content.ebscohost.com/pdf25_26/pdf/2011/22R/01Jul11/64468966.pdf?T=P&P=AN&K=2011245686&S=R&D=c8h&EbscoContent=dGJyMNHX8kSep7A4yOvqOLCmr0yep69Srq64S7WWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

SYNERGY MODEL

Synergy model for patient care Can apply to nursing practice by training Nursing needs the knowledge and skills Essential element of healing practice System provides quality patient care A form of income improvement Provides optimal level of wellness

Kohr, L. M., Hickey, P. A., & Q.Curley, M. A. (2012). Building a nursing productivity measure based on the synergy model: First step [Journal]. American Journal of Critical Care, 21(6), 420-431. http://dx.doi.org/10.4037/ajcc2012859

BATTLE FOR SAFE STAFFING

Professionals must take a stance Improve the care offered Reduce cost Decrease length of stays Improve staff retention Decrease poor performance Decrease nurse turnover

Waters, A. (2012). It is time we took a firm stand in the battle for safe staff levels [serial online]. Nursing Standard, 26(50), 16-19. Retrieved from http://content.ebscohost.com/pdf27_28/pdf/2012/4ER/15Aug12/78945798.pdfT=P&P=AN&K=2011666759&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeqLY4yOvsOLCmr0yep65SsK64SLKWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

HIERARCHY OF EVIDENCE

The hierarchy of studies for obtaining evidence: Systematic review of randomized controlled trials(RCT’s) Ranking system used in evidence –based practice Describes the strength of the results measured Hierarchy is dependent on the problem researched Methodological procedure Base of the pyramid

Polit, D. F., & Beck, C. T. (2012). Introduction to Nursing Research in an Evidence-Based Practice Environment. In Nursing Research generating and assessing evidence and nursing practice (9th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

HIERARCHY OF EVIDENCE

Literature review: Expert Opinion Level VII Nonrandomized control trial Level III Systematic review and correlation study Level III Utilized both qualitative and quantitative methodology Research question must be clearly defined Hierarchy provides framework for ranking evidence Researchers needs to consider the research question

Polit, D. F., & Beck, C. T. (2012). Introduction to Nursing Research in an Evidence-Based Practice Environment. In Nursing Research generating and assessing evidence and nursing practice (9th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

WAYS TO IMPLEMENT IN AN ACUTE CARE SETTING

Form a nurse staffing steering committee : Survey Develop tools based upon results Obtain input from the front line staff Committee members to help with the design Mandate training for all staff Formulate a minimal staffing guideline and policy

Longenecker, C.O., & Longenecker,P.D. (2014). Why hospital improvement efforts fail: A view from the front line. [Journal] Journal of Healthcare Management, 59(2), 147-157 Retrieved from: http://content.ebscohost.com/pdf29_30/pdf/2014/37I/01Mar14/95274939.pdf?T=P&P=AN&K=2012526350&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeprc4v%2BvlOLCmr0yep69Sr624TbOWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

CONCLUSION

More research required Convey the leading standards of care Cost effective Produces a positive conclusion Way to confirm the assimilation of evidence Scientific knowledge Promotes quality of care and security

Polit, D. F., & Beck, C. T. (2012). Introduction to Nursing Research in an Evidence-Based Practice Environment. In Nursing Research generating and assessing evidence and nursing practice (9th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

REFERENCES

American Nurse Association. (2014). Nurse staffing. Retrieved June 27,2014, from http://www.nursingworld.org

Goetz, K., Janney, M., & Ramsey, K. (2011). When nursing takes ownership of financial outcomes: Achieving exceptional financial performance through leadership, strategy, and execution [Journal]. Nursing Economic$, 29(4), 173-182. Retrieved from http://content.ebscohost.com/pdf25_26/pdf/2011/22R/01Jul11/64468966.pdf?T=P&P=AN&K=2011245686&S=R&D=c8h&EbscoContent=dGJyMNHX8kSep7A4yOvqOLCmr0yep69Srq64S7WWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

Kohr, L. M., Hickey, P. A., & Q.Curley, M. A. (2012). Building a nursing productivity measure based on the synergy model: First step [Journal]. American Journal of Critical Care, 21(6), 420-431. http://dx.doi.org/10.4037/ajcc2012859

Longenecker, C.O., & Longenecker,P.D. (2014). Why hospital improvement efforts fail: A view from the front line. [Journal] Journal of Healthcare Management, 59(2), 147-157 Retrieved from: http://content.ebscohost.com/pdf29_30/pdf/2014/37I/01Mar14/95274939.pdf?T=P&P=AN&K=2012526350&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeprc4v%2BvlOLCmr0yep69Sr624TbOWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

REFERENCES

Polit, D. F., & Beck, C. T. (2012). Introduction to Nursing Research in an Evidence-Based Practice Environment. In Nursing Research generating and assessing evidence and nursing practice (9th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Waters, A. (2012). It is time we took a firm stand in the battle for safe staff levels [serial online]. Nursing Standard, 26(50), 16-19. Retrieved from http://content.ebscohost.com/pdf27_28/pdf/2012/4ER/15Aug12/78945798.pdf?T=P&P=AN&K=2011666759&S=R&D=c8h&EbscoContent=dGJyMNHX8kSeqLY4yOvsOLCmr0yep65SsK64SLKWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA

Wattenbarger, C. (2013). Improving patient satisfaction scores [Journal]. Healthcare Traveler, 20(7), 6. Retrieved from http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=2011936177&S=R&D=c8h&EbscoContent=dGJyMMTo50SeprY4v%2BvlOLCmr0yeqK5SsK24TLaWxWXS&ContentCustomer=dGJyMPGnsUi2rrBIuePfgeyx44Dt6fIA