Introduction
The field of healthcare involves many issues since it deals not only with the health of the public but also with the cooperation and well-being of healthcare professionals. If there are problems in the hospital’s teams, such as conflicts, excessive workload, or staffing issues, clients will be directly impacted due to the reduced quality of care. The issue of staffing, especially in nursing, which can be considered one of the pillars of healthcare, can have an adverse effect on patients’ experiences. While much has been done in the past two decades to solve the issue of staffing levels, the problem persists and continues to affect patient outcomes, increasing the levels of mortality and infections.
Background
Prior to discussing the significance of the issue to nursing, it is crucial to delve deeper into its background. The high frequency of patient injury connected with the provision of medical treatment was brought to the world’s attention in a fundamental report by the U.S. Institute of Medicine released in 1999 (Aiken et al., 2018). It was projected that among the leading five causes of mortality in the United States were medical mistakes (Aiken et al., 2018). Following this, the World Health Organization established the World Alliance for Patient Safety to promote international solutions to decreasing patient injury, which was deemed a major contributor to the burden of illness internationally (Aiken et al., 2018). As a result, the issue of staffing levels only started gaining attention recently.
At the given moment, many experts agree that nurses are crucial to patient treatment and improvements in the quality of care. However, as found by Shang and colleagues (2019), strong but conflicting evidence that better nurse staffing is associated with a decreased incidence of HAIs was first discovered in the 2008 study by Stone and colleagues. The conflicting results were caused, in part, by the use of highly aggregated staffing metrics, the inability to pinpoint the degree of staffing that specific patients experienced, and the absence of adequate controls for patient-level risk (Shang et al., 2019). Moreover, the authors must consider how long an HAI takes to develop (Shang et al., 2019). With more progress done in the field, it is now recognized that nurse staffing levels have a direct effect on patient outcomes, as will be seen in the following section. The issue brings more attention to both hospitals and policymakers.
Significance in Nursing
As was determined earlier, nurses are among the fundamental components of the healthcare system. Therefore, it is essential to look at how their workplace and staffing affect the standard healthcare system and patient safety. Insufficient nurse staffing in acute care hospitals is linked to adverse outcomes such as patient falls, healthcare-associated infections, prescription mistakes, and in-hospital mortality, according to a growing body of research (Haegdorens et al., 2019). There is a lower chance that a hospitalized patient will pass away within 30 days of admission when there is better nurse staffing and an increased number of nurses with a bachelor’s degree (Haegdorens et al., 2019). Thus, better staffing contributes to low mortality rates among patients.
However, when looking into the ways in which better staffing can be critical, improved surveillance must be emphasized. One nursing duty commonly overlooked when the workload is heavy is patient observation (Haegdorens et al., 2019). Delayed patient deterioration may lead to sudden mortality or cardiac arrest that requires CPR (Haegdorens et al., 2019). Additionally, minimal evidence of decreased patient mortality has been seen despite continuous surveillance for the early diagnosis of worsening symptoms in general ward patients without enhancing nurse staffing (Yoon, 2022). In other words, increasing nurse staffing is essential to prevent negative patient outcomes. Shorter hospitalizations, fewer readmissions after release, and lower mortality have all been linked to higher nurse staffing (Yoon, 2022). Therefore, sufficient nursing staffing levels are crucial for better surveillance and patient outcomes.
PICOT Question
In adult acute care settings (P), does an increase in nurse staffing levels (I), compared to current staffing levels (C), lead to improved patient outcomes, such as decreased rates of healthcare-associated infections, lower patient mortality rates, and decreased medical errors (O), within a six-month timeframe (T)?
Conclusion
In summary, although significant progress has been made over the past two decades to address the issue of staffing levels, the issue still exists and continues to negatively impact patient outcomes by raising infection and death rates. In a groundbreaking report issued in 1999, the U.S. Institute of Medicine called attention to the high incidence of patient injuries associated with the delivery of medical care. Additional research has been done in the area, and it is now understood that nurse staffing levels directly affect patient outcomes. It is critical to increase nurse staffing to avoid adverse patient outcomes. Higher nurse staffing has been associated with shorter hospital stays, fewer readmissions following discharge, and reduced death rates. In light of this, adequate nursing staffing levels are essential for improved monitoring and, ultimately, for better patient outcomes.
References
Aiken, L. H., Ceron, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A.,… & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327. Web.
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: An observational multicentre study. BMC Health Services Research, 19(1), 1-9. Web.
Shang, J., Needleman, J., Liu, J., Larson, E., & Stone, P. W. (2019). Nurse staffing and healthcare-associated infection, unit-level analysis. The Journal of Nursing Administration, 49(5), 260–265. Web.
Yoon, H. J. (2022). The effect of nurse staffing on satient outcomes in acute care hospitals in Korea. International Journal of Environmental Research and Public Health, 19(23), 15566. Web.