https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440316/?report=classic
The article I chose is a study done for the purpose of
determining the relationship between missed nursing care and the frequency of
hospital readmission. The study was performed
using data from 419 acute care hospitals in the US which included nurse
staffing, patient data, and readmission of patients with heart failure within
30 days of discharge from the hospital. The
results of the study indicate that due to frequently missed nursing care and
tasks left undone during the nursing shift, there is approximately one in five
older patients with heart failure that are readmitted within 30 days of
discharge. The study shows that frequently missed nursing care include; talking
to and comforting patients, developing and updating care plans, and educating
patients and families.
The prevalence of missed care is linked to workloads,
environments, nurse to patient ratio, inadequate resources available, and lack
of time. The study shows that nurses
working in more favorable conditions are less likely to report missing care
during their shift, which reduces the number of hospital readmission.
Some interventions that have improved nursing quality
of care are better staffing ratios, technology improvements for documenting,
monetary incentives, investments in staff development, and adequate managerial
resources.
I chose this article based on personal and
professional reasons. During my clinical
experience this semester, I’ve seen how nurse to patient ratio seems to affect
the quality of care that patients receive.
Many of the nurses I have worked with seemed to be overloaded with
documentation and caring for several patients that required more direct care
than they were able to give due to their ratio of patients to care for. There were several occasions that the nurses
were required to stay passed their scheduled shift to complete
documentation. I also learned a lot
about time management in the hospital while caring for patients and trying to
complete paperwork. Hopefully, that will
improve with time. I also chose this
article because of my personal experience with the nursing care of my
mother. She was in the SICU after a
major surgery for over 3 weeks and did not have a good prognosis after the
surgery. I believe that her quality of
care was directly related to the SICU nurses having a lower patient ratio than
med-surge nurses. She received thorough care
from the SICU nurses and made it through an extremely complicated
recovery. She was transferred from SICU
to a med surge floor and died of aspiration 3 days later. There were several occasions during those 3
days that the nursing care was inadequate which could be due to the higher
patient ratio. That experience is one
that drives me to give the best care I possibly can to the clinical patients
that I have cared for.
This is a great article Karen!! From my personal experience with being in the clinical setting the nurse to patient ratio on a typical med-surg floor is too high for the patient to receive the care they need. I have also seen situations where the nurses are working over just to get their documenting finished. Although it does seem that many times the nurses work over it is often due to employees being late or calling in. I have seen numerous accounts of employees that should have gone home at 7 or 7:30 still waiting to do hand-off report to a nurse who hasn't shown up yet. Which brings me to your comment about time management. This is the most important characteristic that a nurse needs to hone. And it begins with being at work before shift begins so you can properly prepare. It seems if you're running late that you will be behind all day. The patients are the ones that suffer for this in the long-term. I think if we set a goal to document as we work and have a timeline for each day then we should be better nurses, even when situations arise that cannot be avoided. With proper time management and documenting as we work the situations can be properly handled and the patients can be taken care of with the quality of care that we would want to receive for ourselves or for our families. Thanks for sharing your story Karen! You will be an excellent nurse because of the passion you have for actually caring for the patients themselves.
ReplyDeleteI agree with you Karen. The patient load that the nurses I have worked with during clinical has been upwards of six to eight patients. They are responsible for providing total patient care along with documenting and charting what was done for the patient. I believe this absolutely leads to missed needs. The patients who are lower on the priority scale seem to get less quality care because the higher priority patients come first and require much of the nurses time. Like Addie said, time management is key. Charting throughout the day, ensuring that you have your priorities and supplies in order for the day and maintaining a daily schedule can contribute to quality care. I feel like delegation is also a key factor in quality care. Knowing what your patient’s needs and knowing what can be delegated to the nursing assistant can be a time saving factor. Thanks for sharing!
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