Capstone Project: Safe Nurse to Patient Ratio
State and federal laws and regulations require that healthcare institutions such as hospitals and clinics who take part in Medicaid and Medicare, to ensure that they operate under an adequate number of certified registered, vocational nurses and other staff that provide nursing services as required. As such, this regulation tends to be viewed differently from state to state. Therefore, this research is geared towards evaluating the consequences of nurse-patient ratios, particularly of its effect on older patient outcomes. Therefore, the research was guided by a problem statement exhibited in a PICOT format (P-population, I- intervention, C- comparison O-outcome, T- time) stated as: Is there a relationship that exists between the increasing the nurse-patient ratio and better patient outcomes in the American health care system in the last decade.Capstone Project: Safe Nurse to Patient Ratio
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According to Shekelle (2013), it is evident that a small percentage of patients die while hospitalized or shortly after hospitalization. As such, research suggests that this can be prevented through increasing the number of nurses per patient (Falk & Wallin, 2016; H. Aiken, P. Clarke, M. Sloane, Sochlaski, & H. Silber, 2002; Shekelle, 2013a, 2013b, 2013c; Taylor, 1993). Furthermore, a less nurse-patient ratio in the most hospitals has resulted in more re-admissions while high-level nurse-patient levels have led to fewer readmissions (Lasater & McHugh, 2016).
Therefore, readmissions and deaths associated with less nurse to patient ratio have been a significant problem within the American healthcare system. According to the American Nurse Association federal regulation, 42 Code of Federal Regulations stipulates that hospitals need adequate certified nurses to cater for the American populace. As such, ANA as an agency supports this model in the sense that nurses are empowered to creating staffing plans in their respective units which in turn can create change within this unit.Capstone Project: Safe Nurse to Patient Ratio
Furthermore, evidence-based research suggests that increasing the number of nurses per patient leads to fewer deaths and readmissions in hospitals. A study by Falk and Wallin (2016) suggests that intensive care, being one of the most resource-intensive types of nursing care, need higher staffing levels to better patient outcomes. As such, this research stipulates that increasing the nurse-patient ratio leads to better patient outcomes regarding lowering the level of re-admissions as well as death rates.
PICOT Question Analysis
As stipulated earlier, this research is guided by a problem statement in the form of a PICOT question stating, “Is there a relationship that exists between the increasing the nurse-patient ratio and better patient outcomes in the American health care system in the last decade?. In this case, the population relates to patients in a care unit, the evidence-based intervention, in this instance, relates to increasing the number of nurse-patient ratios. On the other hand, outcome relates to lowering readmissions and death rates, and time relates to the last ten years.
Federal regulations regard staffing as part of the nursing practice and should be practice in all hospitals across the national boundaries. Furthermore, agencies such as the ANA supports the federal regulations through offering educational opportunities for nurses to gain management skills. As a national problem, nurse staffing has resulted to more re-admission and increased patient deaths during or after hospitalization. As such, it is imperative to improve patient outcomes through increasing the number of nurses per patient. Additionally, evidence based solutions have been put in place that indicates an improvement of patient outcomes through increasing the nursing staff in hospitals.
Falk, A.-C., & Wallin, E.-M. (2016). Quality of patient care in the critical care unit in relation to nurse patient ratio: A descriptive study. Intensive & Critical Care Nursing, 35, 74–9. https://doi.org/10.1016/j.iccn.2016.01.002 Capstone Project: Safe Nurse to Patient Ratio
H. Aiken, L., P. Clarke, S., M. Sloane, D., Sochlaski, J., & H. Silber, J. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. JAMA: The Journal of the American Medical Association, 288(16), 1987–1993. https://doi.org/10.1001/jama.288.16.1987
Lasater, K. B., & McHugh, M. D. (2016). Nurse staffing and the work environment linked to readmissions among older adults following elective total hip and knee replacement. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care / ISQua, 28(February), mzw007-. https://doi.org/10.1093/intqhc/mzw007
Shekelle, P. G. (2013a). Nurse-patient ratios as a patient safety strategy: A systematic review. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-158-5-201303051-00007
Shekelle, P. G. (2013b). Nurse–Patient Ratios as a Patient Safety Strategy. Annals of Internal Medicine, 158(5_Part_2), 404. https://doi.org/10.7326/0003-4819-158-5-201303051-00007
Shekelle, P. G. (2013c). Nurse–Patient Ratios as a Patient Safety StrategyA Systematic Review. Annals of Internal Medicine, 158(5_Part_2), 404–409. https://doi.org/10.7326/0003-4819-158-5-201303051-00007
Taylor, M. (1993). The nurse-patient relationship. Senior Nurse, 13(5), 14–18. https://doi.org/10.1177/0894318409332789
Capstone Project: Safe Nurse to Patient Ratio