Just a few proofs that better staffing provides better outcomes:
http://www.ahrq.gov/research/findings/factsheets/services/nursestaffing/index.html
- Lower levels of hospital nurse staffing are associated with more adverse outcomes.
- Patients have higher acuity, yet the skill levels of the nursing staff have declined.
- Higher acuity patients and added responsibilities increase nurse workload.
- Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
- Hiring more RNs does not decrease profits.
- Higher levels of nurse staffing could have positive impact on both quality of care and nurse satisfaction.
Additional Studies and websites:
Saint Joseph’s is part of the Resurrection Health Care system, which assembled committees across the system to develop standards and assign weights to different patient types.
Mary Anne Harper, clinical manager of maternal child services, explains that before launching the program, her department discussed the amount of time nurses spend on the various patient types in maternal-child nursing, e.g., a normal newborn. The weights assigned were reviewed and agreed upon by the entire system.
Once the program was implemented, she says it was fairly easy to roll out to nurses. Two hours before the end of their shift, nurses enter information about their patients into the computer system. They select attributes for patients from lists already entered, such as whether patients are receiving blood transfusions or have total care needs, whether they are in isolation, and so on. The program assigns a weight to each patient that indicates the acuity needs.
“The charge nurse on each shift will review after everyone has entered,” says Harper. “They run a report to determine needs. How many people are level 1 acuity, how many people are level 2, etc. The charge nurse looks at the numbers and determines her staffing needs.”
Harper says the charge nurse may find the unit has a lot of patients with high acuity, which may mean they need more nurses. Sometimes they may have low acuity—for example, if a lot of patients are simply waiting to go home—and may need fewer nurses.
Just another clue that staffing SHOULD be based on patient needs/acuity
Acuity Systems Dialogue and Patient Classification System Essentials
"Aiken and colleagues found that when nurse-to-patient ratios go from 1:6 to 1:4, patient death rates decreased by 2.3 per 1000 patients. Cho et al found lower rates of urinary tract infections, pneumonia, upper gastrointestinal bleeding, and shorter hospital stays"
http://www.ena.org/practice-research/Documents/StaffingGuideline/Harper_2007.pdf
This is just from floor staffing, THINK of how many sentinel events can be averted in an ICU with proper staffing and acuity levels.
The Association of Registered Nurse Staffing Levels and Patient Outcomes
http://www.ona.org.3pdns.korax.net/documents/File/pdf/KaneRNStaffingPatientOutcomesMedCare.pdf
Acuity Systems Dialogue and Patient Classification System Essentials
"Aiken and colleagues found that when nurse-to-patient ratios go from 1:6 to 1:4, patient death rates decreased by 2.3 per 1000 patients. Cho et al found lower rates of urinary tract infections, pneumonia, upper gastrointestinal bleeding, and shorter hospital stays"
http://www.ena.org/practice-research/Documents/StaffingGuideline/Harper_2007.pdf
This is just from floor staffing, THINK of how many sentinel events can be averted in an ICU with proper staffing and acuity levels.
The Association of Registered Nurse Staffing Levels and Patient Outcomes
http://www.ona.org.3pdns.korax.net/documents/File/pdf/KaneRNStaffingPatientOutcomesMedCare.pdf
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