Nurses call for a one to four staffing ratio to protect the safety of patients and colleagues

2014 ◽  
Vol 28 (32) ◽  
pp. 0-0
Keyword(s):  
Staffing Ratio

Association of Nursing Overtime, Nurse Staffing, and Unit Occupancy with Health Care–Associated Infections in the NICU

2017 ◽  
Vol 34 (10) ◽  
pp. 0996-1002 ◽  
Author(s):  
Régis Blais ◽  
Guy Lacroix ◽  
Michèle Cabot ◽  
Bruno Piedboeuf ◽  
Marc Beltempo
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Retrospective Cohort ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Nurse Staffing ◽  
Occupancy Rate ◽  
Staffing Ratio ◽  
Health Care Associated Infections ◽  
Occupancy Rates

Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care–associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database “Logibec” and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections. Adjusted odds ratios (aOR) that control for the latter factors and unit risk factors were also computed. Results A total of 122 (5%) infants developed a HCAI. The odds of having HCAI were higher on days that were preceded by a high nursing overtime ratio (aOR, 1.70; 95% confidence interval [95% CI], 1.05–2.75, quartile [Q]4 vs. Q1). High unit occupancy rates were not associated with increased odds of infection (aOR, 0.85; 95% CI, 0.47–1.51, Q4 vs. Q1) nor were higher available/recommended nurse ratios (aOR, 1.16; 95% CI, 0.67–1.99, Q4 vs. Q1). Conclusion Nursing overtime is associated with higher odds of HCAI in the NICU.

Physician hits the nail on the head over ‘safe’ staffing ratio

2012 ◽  
Vol 26 (23) ◽  
pp. 32-32
Author(s):  
Andrea Spyropoulos
Keyword(s):  
Staffing Ratio

Abstract WP409: Impact of Nursing Expertise and Staffing Ratio on Compliance with Post-tPA/Endovascular Patient Monitoring

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kelly Montgomery ◽  
Danielle Sindelar ◽  
Julie Fussner ◽  
Erin Supan ◽  
Cathy Sila
Keyword(s):  
Emergency Department ◽  
Medical Center ◽  
Diagnostic Testing ◽  
Vital Signs ◽  
Quality Improvement Initiative ◽  
Flow Sheet ◽  
University Hospitals ◽  
Patient Acuity ◽  
Staffing Ratio ◽  
Data Points

Introduction: In 2014, the Post-tPA/Endovascular nursing monitoring flow sheet was revised to harmonize with the NIHSS exam. The challenges to performance and documentation compliance posed by the intensity and frequency of assessments have been the focus of an ongoing quality improvement initiative. Methods: All Post-tPA/Endovascular monitoring flow sheets from June 2014- June 2016 at University Hospitals Case Medical Center were reviewed for presence of neurologic assessments, vital signs, and management of hypertension per protocol. Stroke staff conducted in-services on the enhanced assessments and modified NIHSS training and house staff mentored bedside RNs in performing the NIHSS. A tip sheet was developed for staff on the modified NIHSS and real time feedback was given on all outliers. Results: Of 459 patients, compliance with all of the 684 monitoring data points ranged from 67-100% in the Neuroscience ICU (Patient: RN ratio 2:1), 75-100% in the Neuro-Intermediate Unit (Patient: RN ratio 3:1) and 40-100% in the Emergency Department (Patient: RN ratio 4:1). Overall compliance to > 95% of data points was seen in all but 5 patients with missing flow sheets. Symptomatic hemorrhagic complications after IVtPA decreased from 6.5% to 2.7%. Root-cause analysis of missing data points revealed seven areas of opportunity: Interference by diagnostic testing (29%), during patient transportation (22%), and following endovascular treatment (15%) or due to travelling RNs (8%). Missing documentation was most frequent during the q15 minute phase due to the intensity of monitoring (11%)- with the Emergency Department the most vulnerable location- and less during the q30 minute (4%) or q1 hour (3%) assessments. Units with dedicated neuroscience nursing adjusted more rapidly to the revision compared to units that do not routinely perform such assessments. Conclusions: Optimum compliance with nursing assessments and monitoring occur when there is no interference with diagnostic testing or procedures, the patient needs were a high priority and the patient acuity was well matched to the RN staffing ratio. This data supports a care model where a neuroscience trained RN nurse transitions with the patient during the first 24 hours after tPA/Endovascular therapy.

‘Staffing ratio provides legal argument’

2007 ◽  
Vol 21 (19) ◽  
pp. 19-19
Author(s):  
Helen Caulfield
Keyword(s):  
Legal Argument ◽  
Staffing Ratio

scholarly journals A Bargain at Twice the Price? California Hospital Prices in the New Millennium

2009 ◽  
Vol 12 (1) ◽  
Author(s):  
Yaa Akosa Antwi ◽  
Martin S Gaynor ◽  
William B Vogt
Keyword(s):  
Hospital Costs ◽  
Nurse Staffing ◽  
Seismic Retrofit ◽  
Price Increase ◽  
Upward Trend ◽  
Annual Average ◽  
Staffing Ratio ◽  
The Cost ◽  
Nursing Staffing ◽  
California Hospital

We use data from California to document and offer possible explanations for the sharp increase in hospital prices charged to private payers after 1999. We find a downward trend in price for private pay patients in the 1990s and a rapid upward trend beginning in 1999, amounting to an annual average increase of 10.6% per year over 1999-2005. Prices in 2006 were almost double prices in 1999. By contrast, there was little discernable trend in prices for Medicare and Medicaid patients, although these prices varied from year-to-year. Surprisingly, the increase in prices is not correlated, geographically, with the change in hospital market concentration. For example, the greatest price rises came from hospitals in monopoly and highly concentrated counties which experienced little or no change over our sample period. Two recent California state hospital regulations, the seismic retrofit mandate and the mandatory nurse staffing ratio affected hospital costs. However, the cost increases due to the nursing staffing regulations are not large enough to account for the price increase, and the price increase is not substantially correlated with the costs of compliance with the seismic retrofit mandate. Therefore, the source of the near-doubling of California hospital prices remains something of a mystery.

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