Improving Patient Safety
Introduction
The quality of healthcare services and the quality of healthcare outcomes are greatly dependent upon staffing ratios and efficient bedside reporting during handoffs. In acute care settings, for instance, nurses can get overwhelmed because patients in acute care settings usually require high levels of care. To minimize challenges that may arise from insufficient patient-nurse ratios and infrequent bedside reporting, experts suggest that healthcare institutions should increase staffing ratios. This suggestion stems from the fact that inefficient staffing ratios result in health professionals being overworked, and inefficient bedside reporting can lead to medical errors. This essay describes a picot statement that relates to the improvement of patient care in acute settings through efficient nursing ratios.
PICOT Components
P This component describes the focus population. In this case, the focus population is patients in acute care
I This component describes the interventions to increase patient safety: Increasing staffing ratios and efficient bedside reporting.
C This component describes the contrasting factors that could jeopardize the safety of patients in acute care: Insufficient staffing rations and bedside reporting.
O This component describes the expected outcomes of care interventions, which is improved care and safety of patients
T This component describes the time element, which in this case, is the time of patient hospitalization.
PICOT Question
How can sufficient staff-patient ratios and efficient bedside reporting (I) at the time of hospitalization (T) contribute to improved care and safety (O) of acute-care patients (P), as compared to when staff-patient ratios and bedside reporting is insufficient (C)?
Importance of Sufficient Staffing Ratios
One of the factors that facilitate quality and safe care in acute settings is good communication during handoffs and bedside reporting. Patient handoff involves the essential transfer of information when care responsibility shifts from one provider to another. Bedside reporting, on the other hand, is a term used to describe the change of shift between oncoming providers and off going providers. During handoff and bedside reporting, providers must ensure that they transfer all the necessary information in order to facilitate continuity of care. One of the causes of medical errors is communication breakdowns. The reason for this is that during handoffs and bedside reporting, certain crucial information about the patient’s care is transferred to incoming providers. If communication is not clear enough or if certain crucial details are withheld, then the continuity of care is affected, and this is something that can result in medical errors. To increase the quality of care and care outcomes in acute care settings, therefore, nursing professionals must ensure that they effectively communicate all details pertaining to the health of patients in acute care.
A number of factors mar the process of patient handoff and bedside reporting. When the number of nurses in a healthcare setting is not sufficient, the few available nurses are forced to do more work for longer periods of time. Sometimes, the few nurses become so overwhelmed that they avoid sickbeds. When this happens, even handoffs become affected, and incoming nurses may not be provided with all details about treatment plans, thus endangering the safety of patients, the quality of care, and the continuity of care. In other words, a collaboration between off-going nurses and incoming nurses becomes difficult because of insufficient staffing ratios, which lead to high exhaustion due to increased workloads. The risk of patients dying also increases when healthcare settings have insufficient patient-staff ratios.
Implications for the Nursing Profession
As explained in the section above, sufficient nurse-patient ratios and effective bedside reporting during handoff are very critical in ensuring that the safety of patients is maximized. With good staffing ratios, medical errors are minimized, patient care is maximized, and nurses are able to achieve job satisfaction. On the other hand, insufficient patient-nurse ratios and inefficient bedside reporting during handoff can increase mortality rates. For these reasons, therefore, healthcare agencies must come up with strategies to minimize the number of patients that get hospitalized for acute care. When the Affordable care Act was signed into law, one of its main goals was to minimize hospitalization rates. Re-hospitalization is perceived to be a sign of the poor quality of patient care.
But with good ratios, healthcare services, and the safety of nurses also increases because the presence of more nurses also means that the probability of adverse effects occurring is minimized. Some of the signs or indications of poor staffing ratios in healthcare institutions or facilities include increased fall rates among acute patients, increased re-hospitalization rates, high mortality rates, and high nurse turnover rates; these are also the adverse effects insufficient staffing ratios. On the other hand, the indicators of good or excellent staffing ratios include decreased medical errors, patient satisfaction, and decreased costs of medical services, high quality of healthcare services and outcomes, sufficient bedside reporting during patient handoff, among other advantages of benefits. To maximize benefits and minimize bad effects, therefore, healthcare institutions must work on increasing their nurse ratios.
The vigilance of nurses is very important in ensuring the safety of patients by the bedside. Therefore, assigning more and more work to already strained nurses compromises their ability to deliver quality and safe care. When the number of patients assigned to nurses increases, the safety of patients is also put at risk. The reason for this is that overworked nurses are at risk of being stressed and burned-out, factors that often result in a medical mistake. Hospitals and other health providers must, therefore, hire more nurses instead of overworking the few nurses they have in the hope that they will save on costs. Hiring more nurses is even less costly in the long run because it leads to reduced errors, satisfied nurses, low nurse turnovers, satisfied patients, among other factors. But when the opposite of this is true, health providers risk losing public trust.
Conclusion
The purpose of this essay was to analyze a PICOT statement related to the improvement of patient care in acute care settings. As explained, staffing ratios play a significant role in ensuring the quality of healthcare services and the quality of care that patients receive. When a healthcare facility has enough staffing ratios, its benefits are many, ranging from improved quality of care, satisfied patients and nurses, reduced errors in healthcare, low mortality rates, among others. The consequences of having insufficient staffing rations, on the other hand, include high nurse turnover, poor care, poor collaboration between providers, etc. to maximize benefits and to minimize risks. Therefore, health institutions and facilities must consider increasing their staffing ratios instead of overworking their already strained care providers. Doing this will ensure that nurses have time to rest and take care of themselves and, in the process, be more vigilant by the bedside. Instead of assigning more patients to nurses, health providers should consider increasing their ratios to enhance efficiency. The move might be costly, but it will eventually pay off.
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