Effects of Short Staffing of Nurses on the Quality of Care and Safety of the Patients - Case Study Example

THE EFFECTS OF SHORT STAFFING OF NURSES ON THE QUALITY OF CARE AND SAFETY OF THE PATIENTS Background Short staffing refers to availability of inadequate number of personnel in a particular organisation. Most of the researchers focus on the negative influences of short staffing of the nurses on the safety and wellbeing of the patients. According to various studies in the healthcare sector, the safety of the patients correlates directly with short staffing of nurses in hospitals (Vincent, 2010). In this case, short staffing of the care giving personnel results to adverse effects on the patients health in a healthcare environment. In addition, research indicates that patients suffer minimum complications and recuperate faster when they obtain adequate nursing care at the hospital. Furthermore, a rise in the ratio of patients to nurses in a hospital translates to the occurrence of medical errors, job dissatisfaction, increase in unsafe levels and high rates of nurse turnover. Short staffing of the nurses occurs because of various factors (Rcn.org.uk, 2015). First, shortage of nursing graduates from various schools in the country leads to the shortfall of nurse personnel in various healthcare facilities. Increased investment in the healthcare sector by private and public organisation contributes to enhancing the scarcity of nurses in a country. The demand for nurses in United Kingdom supersedes the rate at which the learning institutions are producing nursing graduates (Rcn.org.uk, 2015). There is a significant rate of nurse care shortfall in various hospitals in the country (Barron, 2009). Secondly, brain drain contributes to the shortage of nurses in the United Kingdom (Evans and Mullen, 2009). Most of the nurses acquire training in the country and move their practices to other countries such as United States, Canada and Australia (Waterson, 2014.). The level of staffing in different hospitals across the country is influenced by the government policies regarding the operations of the healthcare facilities. However, the organisational structures of various hospitals determine the level of staffing of the caregiver nurses (Bullock, Clark and Rycroft-Malone, 2012). Thirdly, the cost of hiring adequate nurses in a particular hospital influences the patient to nurse ratio. Most administrators evaluate the budgetary factors before implementing various initiatives of acquiring additional caregiver nurses at the hospital. Nursing staffing depends on the effectiveness of the administration in providing reliable and safe healthcare to the patient. The management of different hospital aspire to provide the public with appropriate care in order to promote the health of the society (Yarbro, Wujcik and Gobel, 2011). The direct correlation between nurses staffing and safety of the patients is an essential consideration of the majority of the managers in different healthcare facilities. Adequate staffing of the nurses in hospitals promotes the welfare and safety of the patients. Various patients’ care and treatment aspects are affected by inadequate staffing of the nurses. First, the safety of the nurses regarding their prescription is influenced by the absence of adequate nurses in a healthcare facility (Tingle and Bark, 2011). Different safety incidences occur in various healthcare facilities in United Kingdom due to lack of adequate nurse staffing (Chang and Mark, 2011). Ineffective blood transfusion practices in the hospital occur due to the absence of nurses to observe the patients (Mason, Leavitt and Chaffee, 2013). Nurses are responsible for preparing the patients for a blood transfusion process. Severe effects on the health of the patients occur because of failure by nurses to respond to the patient’s reactions to a particular blood group (. These instances occur because of insufficient staffing of nurses in the hospitals. In addition, ineffective storage of vaccines by the nurses affects the recipients of the vaccines in preventive healthcare department (Evans and Mullen, 2009). The preventive health care is an essential part of community health in the country. It entails various initiatives for promoting the health of the society through a preventative approach. Nurses are responsible for ensuring vaccines are stored effectively in order to promote the health and safety of the patients (Mason, Leavitt and Chaffee, 2013). The lack of adequate nurses in a particular hospital might lead to ineffective storage of vaccines, which influences the safety of the patients (Bullock, Clark and Rycroft-Malone, 2012). For example, failure to the cold store the vaccines affects their functionality in the body, which risks the safety of the patient. In addition, ineffective storage of the vaccines might interfere with their composition, which reacts with the patients’ body after administration (Masters, 2014). The nurses also examine the patients before an operation in order to identify specific issues. Identification various health conditions of the patients before an operation is crucial in establishing the appropriate anaesthesia to use and the surgery procedures. In addition, it enables the physicians to determine whether a surgery should proceed or terminated. Lack of adequate staffing of nurses in a hospital limits effective evaluation of the patients before surgery. This ineffectiveness leads to the occurrence of a surgery operation on individuals with certain conditions, which might lead to death or development of additional health issues (Reynard, Reynolds and Stevenson, 2009). . Shortage of nurses in various hospitals across the United Kingdom impacts on the quality of health care provided at the specified hospital. According to various researches on the quality of the healthcare, increasing the ratio of nurse to patient in a healthcare facility is essential to enhancing the quality of the healthcare services in the country. The patients care provided by the nurses is crucial to enhancing the quality of services in a particular hospital (Manias, 2009). Nurses observe the patients during the treatment process in order to determine their response to a particular treatment criterion (Unruh and Zhang, 2012). In addition, they administer appropriate medication to the patients in order to facilitate effective treatment of a particular infection (Porter-OGrady and Malloch, 2013). Enhancing Safety and Quality of health Services The health care services quality in the country correlates directly with the level of nurses staffing in various hospitals in the country. Nurses ensure the safety and welfare of the patients in a healthcare environment. Utilisation of observational and analytical techniques in examining the patients provides the nurses with an appropriate platform to enhance the quality of healthcare in the country. Quality of healthcare refers to the provision of efficient health services in various hospitals across the country (Holleran, 2010). In addition, it entails various aspects of promoting the welfare of the patients in a given healthcare facility. The measurement of the quality of the health care in different health facilities includes mortality rates, effective treatment, patients satisfaction, caregiving and medication. The health care quality is a crucial aspect of the healthcare sector in the United Kingdom because it promotes efficiency among various staffs at the facility (Fitzpatrick and Kazer, 2012). In addition, quality health care is essential in minimising mortality levels in the country, which is critical in enhancing the growth of the population (Nrls.npsa.nhs.uk, 2015). The aspect of the provision of care to the patients during treatment is essential in determining the care quality in United Kingdom. Nurses are responsible for giving the patients appropriate care during treatment in order to enhance their welfare and health (Heinz, 2004). Inadequate level of staffing of the nurses in a particular healthcare facility limits the effective provision of specialised care to the patients, which hinders the quality of health care. Short staffing of nurses in the healthcare sector limits the efficiency of nurses in providing personalised care to the patients, which limits the quality of health care (Gibbison et al., 2012). In addition, most of the nurses work for extra hours, which limit their morale in providing the patients with appropriate health care. Patients satisfaction is a measure of the effects of short staffing of nurses in the healthcare sector. A limited number of nurses in various hospitals across the country hinder efficient provision of healthcare services, which influences the level of patients satisfaction negatively. In this case, a limited number of nurses block patients satisfaction with the health care services, which limits the quality of health care (Gibbison et al., 2012). The quality of the services in various health facilities in United Kingdom are governed by different authorities such as the NHS, CQC and the National Sector Standards (NHS, 2015). The bodies highlight on various practices by the medical practitioners to enhance the safety of the patients. The NHS Constitution provides guidelines to medical practitioners regarding the safety of the patients. According to the constitution, the right medical professionals should treat the patients with appropriate care standards. In addition, the organization examines the operations of the different specialists in the health care sector (NHS, 2015). The patients also have the right to effective and appropriate medication and other treatment options in the organization. The constitution also highlights the need to promote ethical practices among their staff when interacting with the patients. In this case, the medical and nursing practitioners are required to maintain high levels of respect, confidentiality and consent in their dealings with the patients. On the other hand, the role of the Quality care commission is to enhance the safety of the patients in the healthcare sector. The commission sets the appropriate standards regarding the safety and quality of healthcare services in United Kingdom. Moreover, it ensures that care homes, hospitals, GP and dental surgeries, as well as other services in the healthcare sector, are provided effectively to the patients. The authority inspects different health facilities in the country in order to establish their adherence to the quality and safety standards in the practice. Surgical operations are the most sensitive treatment approaches used physicians in the modern healthcare facilities (NHS, 2015). The role of the nurses during pre-operation and post-operation procedure is crucial in enhancing the safety of the patients. In this case, lack of enough nurses in a particular hospital promotes ineffectiveness in the preparation and observation of the patients during and after operations (Unruh and Zhang, 2012). Failure by the nurses to prepare and observe the patients leads to various health conditions, which might risk the life of the patients. Placement of the nasogastric feeding tubes in different patients is essential in enhancing the safety of the patients during the treatment process (Porter-OGrady and Malloch, 2013). Lack of adequate nurses in a hospital setup limits effective observation and care provision to the patients, which might result in misplaced feeding tubes. Misplacement of the tubes limits feeding of the patient that might cause death or other health complications The objective of the essay is to establish a solution to the issue of safety and quality of services provided in the health care sector in the country. The guidelines provided by the CQC and the constitution of NHS are essential to achieving the objective. The criteria for enhancing the safety of the patient are achieved by recruiting additional staff in the healthcare sector. In addition, the morale of the staff is enhanced to promote their effectiveness in providing appropriate care services (Nice.org.uk, 2014). First, individuals are recruited and trained adequately regarding different approaches to improving the quality of care in the healthcare environment. The training process entails various activities such as providing additional tuition to the existing staff and giving graduates from different various nursing institutions with adequate exposure to the aspects of the field (Mason, Leavitt and Chaffee, 2013). Transformative style of leadership is applicable in enhancing performance in the healthcare staff. The leadership style allows managers to recruit additional personnel in the healthcare setup in order to improve performance (SQUIRES et al., 2010). The outcome of the training should enhance the efficiency and reliability of the staff in providing safe and quality services to the patients. The training focuses on enhancing the concepts of teamwork among the healthcare workers, which is effective in the provision of quality healthcare services. Nurses from other regions in Europe are undertaking an additional course in caregiving to enhance the skill in the United Kingdoms healthcare environment. The additional course enables the nurses to adhere to the safety and quality standards provided by the NHS and CQC authorities in the country. A democratic approach to leadership is essential in promoting performance among the human resources in a healthcare environment. The staffs are provided with an appropriate opportunity to hire their views regarding the level of staffing in particular healthcare set up (Kelly, 2012). The democratic style is however not applicable in this context because it limits the effective utilization of appropriate leadership criteria in the healthcare setup. The behavioural leadership theory is crucial in reducing the effects of understaffing in the healthcare sector. The theory entails various initiatives of hiring and training competent individuals to enhance performance in the workplace. The theory highlights that good leadership traits are created and not in-born (Rigolosi, 2013). In this case, the aspects of good leadership occur because of training in a particular field. The leaders provide appropriate guidance to the graduates regarding different aspects of the healthcare sector in United Kingdom. In addition, the leaders supervise the progress of the staff in enhancing the quality and safety of the healthcare services in their practice. The training process is undertaking under the supervision of the leaders in different healthcare organizations and facilities in the country in order to promote its quality. The outcome of the project is examined through various ways. First, the nurses are provided with a test at the end of the training to evaluation their acquisition of the relevant concepts of the training. In addition, the nurses are monitored by the supervisors in different healthcare setups to determine the effectiveness of training in promoting the safety and quality of services in healthcare setup (Mason, Leavitt and Chaffee, 2013). The safety and quality of the services delivered by the nursing staff are examined based on the guidelines of CQC in order to establish the effectiveness of the recruitment and training process. The problem of nurses shortage in various healthcare environments is prevalent I n United Kingdom because of the scarcity of trained nurses in the country. In addition, the health department experiences the highest level of brain drain from United Kingdom to other countries such as Australia and Canada (NHS, 2015). The approach to resolving the issue in the country relies on extensive recruitment of the trained nurses and provision of exposure to nursing scholars in different learning institutions across the country. The selected approach has various advantages and challenges based on the outcome of the Swot Analysis and other management tools (Kelly, 2012). Swot Analysis The swot analysis is an essential tool for evaluation of the advantages and limitations of the approach of resolving the issue of staff shortage in healthcare setup. The strengths of the approach of training and recruiting additional staff includes enhancement of skills and efficiency at the workplace (Kelly, 2012). The training process provides the practicing nurses with adequate and reliable regarding the aspects of providing safe and quality care to the patient. The concept of providing additional training to the practicing nurses exposes them to the different environment of the nursing g field. In addition, the criterion helps to enhance the skills of the fresh graduates from various institutions, which is crucial in improving the safety and quality of the healthcare services. Recruitment of additional nurses in the healthcare sector is crucial in enhancing the effectiveness in service provision (Kelly, 2012). The trainees acquire reliable exposure regarding the concept of safety and quality in the healthcare environment. The industrial exposure provided to the trainees is essential in promoting their effectiveness in delivering safe and quality healthcare services. The weakness of the criteria entails the costs of training and hiring additional staff in the healthcare sector. The initiative of hiring addition additional nurses translates to an increase in the operational costs because of the increased remuneration. Moreover, recruitment of additional nurses in various health care facilities in the country promotes congestion among the workers. The resources in the healthcare sector are stretched due to additional staff in a particular healthcare facility. The healthcare facilities in U.K are designed to handle a particular number of physicians and nurses in order to minimize congestion in the hospitals. In this context, hiring of additional staff promotes congestion, which might limit individual performance among the workers (Kelly, 2012). The opportunity availed by the criterion of training and recruiting additional staff in the healthcare sector entails the improvement in the safety and quality of the services provided in the sector. The concept of providing nursing graduates with exposure is crucial in enhancing their performance in the healthcare sector (Mason, Leavitt and Chaffee, 2013). The exposure enables the nurses to practice effectively in the sector, which facilitates the quality of the healthcare services. Furthermore, the weakness of the strategy is the aspect of scarcity of nurses in the country. The aspect of globalization promotes the movement of professionals from the United Kingdom to other countries in the world. Most of the trained nurses in the country migrate to United States and Canada after graduating which limits effective implementation of the technique (Mason, Leavitt and Chaffee, 2013). In addition, a large number of nursing learners in United Kingdom originate from developing and developed economies in the world. The nurses relocate to their respective countries after completing the training and exposure, which promotes the scarcity of nurses in the country. Mission and Vision and Purpose The vision of the strategy is promoting the quality and safety of healthcare services in the country. The mission of the management and leadership approach is to enhance the skills and number of nurses in various health care facilities in order to promote quality and safety of the services. The purpose of the approach is to increase the number of nurses in various health care facilities in U.K to enhance the quality and safety of the healthcare services. The approach also entails the provision of exposure and training to fresh graduates from various nursing institutions in the country (Masters, 2014). Climate The relationship between the quality of health care and the level of nurses staffing in the country is direct according to the existing research on the issue (Nrls.npsa.nhs.uk, 2015). Various factors determine the relationship between the quality of health care and the level of nurses staffing in the country (Gallin and Ognibene, 2012). Lack of enough nurses in the health care sector contributes in enhancing the rate of mortality among the patients (Aiken, 2002). Inadequate nurses in a particular healthcare environment are the major contributing factor to the high mortality rates in hospitals. Most patients die because of the lack of reliable care and observation by the nurses (Hickey, 2010). The nurses are responsible for examining the patients during the treatment period in order to enhance effective treatment. In such a case, the reduced number of nurses in a particular hospital influences various aspects of patients observation and analysis (Aiken et al., 2009). The limited number of nurses in a particular hospital hinders adequate observation and administration of medication to the patients, which limits the quality of healthcare in the country (Hess, 2012). Conclusion Healthcare sector is among the most sensitive aspects of the United Kingdom’s economy because it helps in safeguarding the population from infections in order to enhance production. Various researches on the effects of short staffing of nurses in the country to the safety of the patient and quality of healthcare indicate a direct correlation (Shippee-Rice, Fetzer and Long, 2012). Nurses play a critical role in the healthcare sector because they provide the patients with appropriate care during treatment. Short staffing of nurses in the healthcare sector leads to poor provision of medication and observation of the patients, which might result in severe safety risks to the patients. In addition, the quality of health care is examined through various aspects such as mortality rates, patients satisfaction and care provision. Poor staffing of nurses in the healthcare sector promotes the level of patients mortality due to a reduction in the personalised care provided to the patients (SQUIRES et al., 2010). In addition, the rates of patients satisfaction decrease rapidly in hospitals with short staffing of nurses. The management in the healthcare facilities implements various policies to provide adequate guidance on the issue of staffing of nurses. References Aiken, L., Clarke, S., Sloane, D., Lake, E. and Cheney, T. (2009). Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes. JONA: The Journal of Nursing Administration, 39(Supplement), pp.S45-S51. Barron, K. (2009). Patient Safety: Sixth Report of Session 2008-09 - Volume I: Report, Together with Formal Minutes. July 2009. Bullock, I., Clark, J. and Rycroft-Malone, J. 2012. Adult nursing practice. Oxford: Oxford University Press. Chang, Y. and Mark, B. 2011. Effects of Learning Climate and Registered Nurse Staffing on Medication Errors. Nursing Research, 60(1), pp.32-39. Cherry, B. and Jacob, S. 2012. Contemporary nursing. Evans, S. and Mullen, P. (2009). Verbal orders drug therapy and prescription in a UK ICU setting. Critical Care, 13(Suppl 1), p.P482. Fitzpatrick, J. and Kazer, M. (2012). Encyclopedia of nursing research. New York, NY: Springer Pub. Gallin, J. and Ognibene, F. (2012). Principles and practice of clinical research. London: Elsevier/Academic Press. Gibbison, B., Sheikh, A., McShane, P., Haddow, C. and Soar, J. (2012). Anaphylaxis admissions to UK critical care units between 2005 and 2009. Anaesthesia, 67(8), pp.833-839. Hess, D. (2012). Respiratory care. Sudbury, Mass.: Jones & Bartlett Learning. Hickey, P. (2010). Increasing nurse staffing levels in cardiac surgery centres appears to be a cost-effective patient safety intervention. Evidence-Based Nursing, 13(4), pp.102-102. Holleran, R. (2010). ASTNA patient transport. St. Louis, Mo.: Mosby. Kelly, P. and Tazbir, J. 2011. Essentials of nursing leadership & management. Kelly, P. (2012). Nursing leadership & management. Clifton Park, NY: Cengage Learning. Manias, E. (2009). Errors in administration of parenteral medications are a serious safety problem in intensive care units. Australian Critical Care, 22(3), pp.141-143. Mason, D., Leavitt, J. and Chaffee, M. 2013. Policy & politics in nursing and health care. Masters, K. 2014. Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Learning. NHS, (2015). Health watchdogs and authorities. Retrieved 25 March 2015, from http://www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/carequalitycommission.aspx Nice.org.uk, (2014). Safe staffing for nursing in adult inpatient wards in acute hospitals | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/guidance/sg1 [Accessed 15 Mar. 2015]. Nrls.npsa.nhs.uk, (2015). Patient Safety - Directory of Organisation Patient Safety Incident Reports. [online] Available at: http://www.nrls.npsa.nhs.uk/patient-safety-data/organisation-patient-safety-incident-reports/directory/ [Accessed 15 Mar. 2015]. Porter-OGrady, T. and Malloch, K. 2013. Leadership in nursing practice. Burlington, Mass.: Jones & Bartlett Learning. Rcn.org.uk, (2015). Patient safety and human factors - RCN. [online] Available at: http://www.rcn.org.uk/development/practice/patient_safety [Accessed 15 Mar. 2015]. Reynard, J., Reynolds, J. and Stevenson, P. (2009). Practical patient safety. Oxford: Oxford University Press. Rigolosi, E. 2013. Management and leadership in nursing and health care. New York: Springer. Shippee-Rice, R., Fetzer, S. and Long, J. 2012. Gerioperative nursing care. New York: Springer. SQUIRES, M., TOURANGEAU, A., SPENCE LASCHINGER, H. and DORAN, D. 2010. The link between leadership and safety outcomes in hospitals. Journal of Nursing Management, 18(8), pp.914-925. Tingle, J. and Bark, P. (2011). Patient Safety, Law Policy and Practice. Routledge. Unruh, L. and Zhang, N. 2012. Nurse Staffing and patient safety in hospitals: new variable and longitudinal approaches. Nursing Research, 1(61), pp.3-12. Vincent, C. 2010. Patient Safety. New York, NY: John Wiley & Sons. Waterson, P. (2014.). Patient safety culture. Yarbro, C., Wujcik, D. and Gobel, B. (2011). Cancer nursing. Sudbury, Mass.: Jones and Bartlett Publishers. Read More