Running head: ADVANCED NURSING PRACTICE FIELD EXPERIENCE 1 Advanced Nursing Practice Field Experience Western Governors University
ADVANCED NURSING PRACTICE FIELD EXPERIENCE 2 Advanced Nursing Practice Field Experience A1. Purpose and Summary The purpose of the change recommendation that will be further described is to help bring attention to the nurse to patient staffing ratio. Research published in the May 2015 issue of International Archives of Occupational and Environmental suggests that higher nurse-to-patient ratios in hospitals might reduce nurse injury rates by one-third (TS, 2015). Increased restrictions on overall budget costs result in reduced staffing, limited supplies, and lack of upgraded facilities. This raises concern as the quality of care if most adversely affected (Chin How, 2003). The purpose of the consultation regarding nurse to patient ratio is the identify and address the risks to the patient and to plan a corrective solution. In addition, the intended result of this recommended change is to bring awareness to the increased risk of patient care due to the lack of adequate nurse staffing. The initial consultation began with observing the current staff as they handed off and reported care to the oncoming shift staff. During this observation, the phrases, “…I wasn’t able to complete that task” , “…if you have time”, “…I didn’t have time to…”, were heard being said several nurses coming from different backgrounds that could be described as new hire, experienced, well organized, highly educated, compassionate, thorough, reliable, and overworked. The nurse lead for the Medical Telemetry Unit described staffing on the floor as “a
ADVANCED NURSING PRACTICE FIELD EXPERIENCE 3 puzzle that you try to put together as someone is taking it apart behind you.” When I inquired as to what she meant by that, she elaborated, “As soon as you have adequate staffing for the patient load for this 48 bed unit, multiple patients will be admitted and or discharged resulting in nurses that are either left with a very light patient load or very heavy. Depending on the census at markers throughout the day, staff is adjusted throughout the hospital meaning they are floated to another unit that has a higher need, called off before their shift, called off and sent home during their shift, or are expected to take on more patients to accommodate the nurses that are placed in the previous two situations.” The nurse lead was able to show me a floating list of censuses with staff that she referred to as the schedule audit tracker. The decisions on patient staffing needs are based on acuities which is a tool used to determine the patient needs and care time required by a nurse. The acuity value for the patient population on that unit determines the quantity of nurses are needed. The flaw in this valuation is that it lacks the personal component of what each individual patient needs and how that time increase affects the assigned nurse and the other patients she is caring for.