Scholarly Paper # 4: Nurse Staffing
ASSIGNED READINGS AND RESOURCES:
Textbook:
Yoder-Wise, P.S. (2019) Leading and managing in nursing, 7th edition:
Chapter 13 “Staffing and Scheduling†pgs. 215-236
Website:
https://www.bon.texas.gov/faq_nursing_practice.asp
Videos:
Beyond Nurse Staffing Ratios, Creating A New Reality
Safe Staffing Ratios Protect Patients
Nurse Staffing and Patient Acuity
Journal Articles:
1. Carlisle, B., Perera, A., Stutzman, S. E., Brown-Cleere, S., Parwaiz, A., & Olson, D. M. (2020). Efficacy of using available data to examine nurse staffing ratios and quality of care metrics. Journal of Neuroscience Nursing, 52(2), 78-83.
2. Hill, B. (2020). Changes to nurse-to-patient ratios in intensive care during the pandemic. British Journal of Nursing, 29(21), 1238-1240.
3. Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA network open, 4(2), e2036469-e2036469.
Assignment Instructions:
After reviewing the resources above you will write a scholarly paper. Describes Nurse Staffing Guidelines for best practice. Provides supporting research when discussing the importance of staffing in this area and its correlation to:
Patient safety and positive patient outcomes
Staff Safety
Overtime
Consecutive Shifts
Patient Variables Affecting Staffing Decisions
Discusses the different Models for Nurse Staffing:
Acuity Based Staffing
Budget-Based Staffing
Nurse-Patient Ratio
Conclude your paper with reflection on how reading the Texas BON could affect your personal behavior as a BSN prepared nurse.
All papers should be written using full APA style— in-text references and a final reference list. Papers are limited to a total of 5 pages (which include the title page, and full reference list). No less than 6 references are expected. All references must be from professional sources. The majority of all references must be primary source, research/data based (MSU library), original articles. Yoder-Wise course text and Texas BON website must be included as two of the references in this assignment.
Scholarly Paper #4- Nursing Staffing Model
Describes Nurse Staffing Guidelines for best practice. Provides supporting research when discussing the importance of staffing in this area and its correlation to:
Patient safety and positive patient outcomes
Staff Safety
Overtime
Consecutive Shifts
Patient Variables Affecting Staffing Decisions
40
Discusses the different Models for Nurse Staffing:
Acuity Based Staffing
Budget-Based Staffing
Nurse-Patient Ratio
20
Reflects on how reading the TBON could affect your personal behavior as a BSN prepared nurse.
20
APA style— in-text references and a final reference list. Papers are limited to a total of 5 pages (which include the title page, and full reference list)
10
Minimum of 6 references. All references must be from professional sources. The majority of all references must be primary source, research/data based (MSU library), original articles. Yoder-Wise course text and Texas BON website must be included as one of the references in this assignment.
10
Total points
100
Scholarly Paper: Nurse Staffing
Student’s Name
Institutional Affiliations
Scholarly Paper: Nurse Staffing
Adhering to nurse staffing guidelines helps healthcare organizations to create a balance between the number of nurses and patients, thereby enhancing the achievement of quality patient care outcomes. Yoder-Wise (2019) identifies appropriate staffing as a critical requirement for ensuring both patient and nurse safety in healthcare organizations. Regulatory agencies such as state boards of nursing (BON) have documented staffing guidelines that are meant to promote patient and nurse safety and generate positive health outcomes. The purpose of this assignment is to describe Nurse Staffing Guidelines for best practice and how they influence patient safety, staff safety, and the choice of nurse staffing models.
The Importance of Staffing
Safe staffing ratios do not only protect patients but also prevent burnout among nurses and promote staff wellbeing. According to Carlisle et al. (2020), appropriate staffing is associated with increased patient safety and positive patient outcomes. Additionally, it allows nurses to spend sufficient time with patients addressing their unique needs thereby preventing incidences of death among patients. The positive association between appropriate staffing and positive patient outcomes explains why contemporary healthcare organizations utilize patient-reported outcomes to optimize staffing ratios within their settings (Carlisle et al., 2020).
The professional roles of nurses revolve around addressing patient needs and nurses can perform their roles effectively in a healthy working environment. As Shah et al. (2021) explain, poor staffing is associated with an increased prevalence of burnout in healthcare settings. For instance, an environment that compels nurses to provide care to several patients at a time makes nurses develop feelings of exhaustion, have diminished attitudes towards completing their roles, and display signs of reduced professional efficacy. Moreover, poor nurse staffing is one of the factors that influence nurses’ intentions to leave their organizations (Shah et al., 2021; Twigg et al., 2021). Generally, appropriate staffing causes nurses to feel comfortable as they perform their roles, a factor that leads to increased performance and positive patient outcomes.
In their efforts to promote patient and staff safety as well as improved patient outcomes, state boards of nursing have documented staffing guidelines to regulate inappropriate staffing practices such as issuing mandatory overtime and imposing burdensome consecutive shifts for nurses. Mandatory overtime undermines the nurse’s responsibility to provide quality and safe patient care. The Texas Board of Nursing has developed a clear legislation called “Refusal of Mandatory Overtime” which prohibits hospitals from requiring nurses to work mandatory overtime. The also allows nurses to refuse to work mandatory overtime (Texas Board of Nursing, n.d.). Additionally, it has documented rules that define the number of shifts or work hours that nurses should be allowed to work to enable them to effectively perform their duty of promoting a safe environment and providing safe care that is aligned with clinical expertise, level of education, and professional experience. The board makes reference to the Institute of Medicine (IOM) recommendations on consecutive shifts. Based on these recommendations, healthcare organizations should limit nursing working hours to no more than 12.5 hours in 24 hours, 60 hours in one week, or 3 consecutive days of 12-hour shifts (Texas Board of Nursing, n.d.). These guidelines demonstrate the board’s commitment to both patient and staff safety.
Patient variables have an influence on staffing decisions in healthcare settings. For example, the rise in the volume of patients in a nursing unit will influence the organization’s leadership to increase staffing in that unit and vice versa. Additionally, changes in patients’ needs such as the need to handle patients with complex and severe diseases like the coronavirus disease 2019 (COVID-19) may compel an organization to deploy more nurses to a healthcare facility (Hill, 2020). When patient volume increases, a decision to hire more nurses will help to create a balance nurse-to-patient ratio. Besides, a decision to hire more nurses in complex patient scenarios allows nurses to take more time with patients who need more personalized care thereby promoting patient safety (Yonder-Wise, 2019).
Different Models for Nurse Staffing
Healthcare organizations usually use varied models of nurse staffing depending on patients’ needs, organizational capabilities, as well as their mission, vision, and goals. Examples of nurse staffing models used by contemporary healthcare organizations include acuity-based staffing, budget-based staffing, and nurse-to-patient ratio. Acuity-based staffing is a staffing model where an organization allocates resources on the basis of patients’ needs but not their numbers. Essentially, assigning nurses duties based on patients’ needs ensures that patients receive person-centered care that generates positive health outcomes (Han et al., 2021). On the other hand, budget-based staffing is a model of staffing where an organization’s decisions regarding where to place resources are influenced by the available budget. While budget staffing ensures the appropriate use of available finances, it may undermine patient and nurse safety in a setting that requires extra numbers of nurses. According to Yonder-Wise (2019), the nurse-patient ratio is a staffing model where nurses are assigned a specific number of patients at any given time in a unit. This staffing model helps to prevent burnout and ensures that patients receive quality care from the nurses (Hill, 2020). Healthcare organizations should adhere to nurse staffing guidelines and consider issues related to patient and staff safety when selecting appropriate staffing models.
Conclusion
Reading the Texas BON has positively affected my personal behavior as a BSN-prepared nurse. Precisely, I now understand the regulations appropriate for nurse staffing and my duty in supporting their implementation. The key issues learned from the board’s website are related to mandatory overtime, consecutive shifts/work hours, staffing ratios, and floating to unfamiliar practice settings. Ideally, by completing this assignment, I have learned that safe staffing should not be viewed in terms of numbers or ratios only. Rather, it is important to understand that the concept also encompasses ensuring a proper mix of experience, education, and skills. Most importantly, I have learned that healthcare organizations should adhere to nurse staffing guidelines and consider issues related to patient and staff safety when selecting appropriate staffing models for their settings.
References
Carlisle, B., Perera, A., Stutzman, S. E., Brown-Cleere, S., Parwaiz, A., & Olson, D. M. (2020). Efficacy of using available data to examine nurse staffing ratios and quality of care metrics. Journal of Neuroscience Nursing, 52(2), 78-83. https://doi.org/10.1097/JNN.0000000000000499.
Han, X., Pittman, P., & Barnow, B. (2021). Alternative Approaches to Ensuring Adequate Nurse Staffing: The Effect of State Legislation on Hospital Nurse Staffing. Medical Care, 59(Suppl 5), S463–S470. https://doi.org/10.1097/MLR.0000000000001614
Twigg, D. E., Whitehead, L., Doleman, G., & El-Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12), 4599–4611. https://doi.org/10.1111/jan.14909
Hill, B. (2020). Changes to nurse-to-patient ratios in intensive care during the pandemic. British Journal of Nursing, 29(21), 1238-1240. https://doi.org/10.12968/bjon.2020.29.21.1238.
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469.
Texas Board of Nursing. (n.d.). Frequently asked questions: Nursing practice. https://www.bon.texas.gov/faq_nursing_practice.asp
Yoder-Wise, P.S. (2019). Leading and managing in nursing, 7th edition. Mosby.