Trends in Nursing

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The level of safety of hospitalized patients and the degree of quality care that they receive has more to do than fixed nurse-to-patient ratios. It has been well established in the literature that when nursing workload increase to unmanageable levels; whether it be from the addition of patients, increases in acuity, or from high levels of fluctuation in patient turnover, that nurses ability to perform patient surveillance is disordered, putting patients in undue risk (Needleman, et. al, 2011). Increasingly, studies continue to show links in patient deaths and adverse events to inadequate nurse staffing levels in acute care hospitals (Needleman, et. al., 2002;
Aiken et. al., 2002; Needleman,, 2011). In terms of adverse events, higher levels of nurse staffing, measured in nursing hours worked per patient day have been associated with reduced rates of failure-to-rescue and hospital acquired infections (Needleman, et. al., 2002). Failure-to-rescue is labeled as postoperative death from complications such as
“pneumonia, shock or cardiac arrest, upper gastrointestinal bleeding, sepsis or deep vein thrombosis—for which early identification by nurses and medical and nursing interventions can influence the risk of death” (Needleman, et. al, 2002, pg. 1717). Other conditions seen in higher rates of occurrence with inadequate nurse staffing include urinary tract infections, pressure ulcers and wound infections (Needleman, 2002).
Moreover, lengthier hospital stays, which are attributed to increased costs, have also been associated with understaffing (Needleman, 2002). Conversely, adequate nurse staffing levels lead to better patient outcomes. It has been determined that increasing staffing by just one nurse per patient day resulted in a reduction in hospital acquired pneumonia by 19 percent, cases of septicemia by 16 percent, and lower rates of respiratory
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