Please reply to this discussion by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. Competing needs in health care not only affect patient care, but decreases patient and nurse satisfaction; furthermore, it contributes to the effect of nurse burnout. In the article “The effects of nurse staffing on hospital performance: competitive versus less competitive markets” the author Everhart, Neff, Al-Amin, Nogle, and Weech-Maldonado reported that when hospitals who are facing financial uncertainty and choose to reduce their nurse staffing in attempts to increase profitability. This strategy has been found to compromise the quality of patient care and nurse related outcomes. In the article “Nurse staffing and nurse outcomes: A systematic review and meta-analysis” the author Shin, Park, and Bae reported they found a relationship between nurse staffing and nurse outcomes. The nurse outcomes that they reviewed were nurse burnout, job dissatisfaction, intent to leave, and needle stick injuries and patient outcomes such as mortality rate, hospital-acquired pneumonia, unplanned extubation, and cardiac arrest in intensive care units. Through their systematic review, they found that the majority of studies determined a distinct correlation between lower staffing ratios and negative nurse outcomes as well as negative patient outcomes. They determined that through their analysis that human resources can use this as an advocate for justifying better nurse staffing and can help set a nurse staffing policy for better outcomes. I experienced this in person this year. We had JACHO come to our hospital and put a conditional hold on our accreditation to bring several things up to JACHO standards and through all of the transitions and new policies many nurses choose to change jobs and quit that left our hospital in a serious nursing shortage. The scary part is all of a sudden on the psych acute unit we would 2 nurses for 16 patients. As you can see with only 2nurses on shift this means every nurse is tripled with some patients being severely critically ill. This makes for very unsafe working conditions for the nurses and patients as some shifts you would not take a break for the full 12 hours. Nurse burnout became evident and just like the story in the article by Hartrick Doane and Varcoe (2015), they discuss a nurse who during shift change became enraged about her coffee cup getting chipped and for her after a long and difficult shift had found that to be the last straw and it caused her emotions to boil over. Hospitals need to find ways to help keep educated nursing staff and increase job satisfaction. According to May, Bazzoli, and Gerland (2006), they stated that policy-makers can help to guide the ways hospitals respond to nursing shortages by aiming to shape recruitment and retention strategies with quality improvement such as the Magnet Recognition Program. According to Platts (2018), the American Nurses Credentialing Center developed a program called the Magnet Recognition program that identifies excellence in nursing and acknowledges health care organizations who focus on three goals of promoting a supportive environment for quality nursing practice, excellence in nursing care of patients, and the use of best practices by staff. Magnet status is recognized not only by consumers, but health care staff as a high distinction that recognizes high quality of nursing care of patients and high nurse job satisfaction. It’s very extremely difficult to obtain but once achieved it is well worth all the effort. Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital performance: competitive versus less competitive markets. Health Care Management Review, 38(2), 146-155. doi:10.1097/HMR.0b013e318257292b Hartrick Doane, G., & Varcoe, C. (2015). How to nurse: Relational inquiry with individuals and families in changing health and health care contexts. Philadelphia, PA: Wolters Kluwer. As quoted in Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html. May, J., Bazzoli, G., & Gerland, A. (2006). Hospitals’ responses to nurse staffing shortages. doi.org/10.1377/hlthaff.25.w316. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.w316 Platts, B. A. (2018). Magnet Excellence—One Hospital’s Experience. Journal of Hospital Librarianship, 18(2), 136–144. https://doi-org.ezp.waldenulibrary.org/10.1080/15323269.2018.1437504 Shin, S., Park, J.-H., & Bae, S.-H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273–282. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2017.12.002
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