The nurses are the care providers who are at the front. They are more close to the patients than the other care providers. The patients also feel more comfortable to define their problems to the nursing staff. Identification and provision of the right number of staff according to the need is critical for safe care delivery to the patients. It will also prevent burning out of nurses because of work overload. The federal government of America has contemplated a law 42 Code of Federal Regulations (42CFR 482.23(b) that requires that all the hospitals in the US need to arranged experienced registered nurses, licensed practical (vocational) nurses and other care providers according to the needs of the patients. So far only California has worked over this act while other states have failed. This practice needs to be changed to provide full flash care to the patients who are their right (ANA, 2017).
There are certain stakeholders who are part of this circle. These include patients, nurses, doctors, hospital management and government authorities. The patients are the primary stakeholders to whom the care is provided. The patients can file complaints about the difficulties they face with the lower staff. They can provide their feedback as well. The nurses are the primary care providers. Less staff means more chances of infection and patient’s mismanagement. Nurses can do it by presenting it to the hospital management via feedbacks, meetings, seminars, and presentations. The government works for the betterment of people so that they will agree with this change and can do it by the policy change. Doctors support the provision of optimum care for the patient so that they will be part of the change by contacting the management. The aim of hospital management is to provide holistic care to the patients to decline disease burden in society so they will agree to this plan and can do it with the aid of policy change and implementation (Welton, 2007).
|VII. Expert Opinions|
Vol 13(3), 113-116.
|VII. Expert Opinions.|
mandated minimum nurse-to-patient
Ratios in hospitals. Journal of Loyola of Los Angeles Law Review.
The article “It’s time to improve ratios” has presented its notion of making equal staff: patient ratio under cover of a campaign. It is an expert opinion. They also proposed the integration of skill mix where the registered nurses and midwives will work with clinical nurses and midwives for better patient outcomes. Assistant nurses and midwives should only be used when needed (Lamp, 2017).
The study “Nurse-Perceived Patient Adverse Events depend on Nursing Workload” has shown the relationship between increased workload of nurses and patients adverse outcomes. It’s a nonexperimental study. The study has found that as much as the workload is increased on the nurses; poorer patient outcomes are noticed. This was related to the performance of non-nursing tasks by nurses (Kang J, Kim C, Lee S. 2016).
The study “Professional Collaboration: Who Should Determine Safe Staffing for Nurses?” has provided the impact of certain factors which affect the ability of nurses to work in the hospital. It’s an expert opinion. These factors include socio-cultural forces, political forces, economic forces and ethical forces. They have applied Kingdon’s model that emphasizes that policymakers when are engaged in policymaking do not consider all these factors (Keller et al., 2013).
The study “Nurse staffing issues are just the tip of the iceberg: A qualitative study of nurses’ perceptions of nurse staffing” has presented that the staffing issues which are presented are the only tip of the iceberg. It’s a qualitative study. The nurses identified many factors which have affected their ability to perform and have increased risk of fall for patients. These factors include some staff, admission process, discharge process and acuity of patients (Van Oostveen, Mathijssen, Vermeulen, 2015).
The article “spread too thin: the case for federally mandated minimum nurse-to-patient ratios in hospitals” is expert opinion. It has presented the fact that enough nurse staff is necessary for the optimum performance in a clinical setting from patient safety to organizational and financial performances. There are many hospitals that do not have an adequate staff which has compromised the health care of the patient (Kuwata, K, 2016).
The best practice will be consideration of all the factors which can affect the staff: patient ratio distribution. These include physical, social, financial, economic, social and political factors.
The change will be provided with the aid of Lippitt’s change theory.
Whenever a change is implemented to a place, resistance is seen by many factors. Lippit’s theory can help to overcome those barriers and help in the proper implementation of change in nursing practice. There are different phases in implementation of Lippitt’s change theory. Phase 1 involves the diagnosis of the problem that starts with the identification of the area of the problem which is les patient: staff ratio. Phase 2 involves the assessment of motivation and capability of change capacity in that particular area which means the motivation of stakeholders. Phase 3 involves assessment of the motivation and resources of the agent who is involved in change. This means the use of proper resources of the management and government Phase 4 underlies the selection of change objective or objectives which involves the involvement of stakeholders and the making of the plan. Phase 5 involves allocation of specific roles to the agents involved in change. Implementation of the plan occurs after this phase. Phase 6 involves maintenance of change and phase 7 involves termination of the helping relationship which means to run the program by the nurses and avoid help from management (Battilana & Casciaro, 2012).
There can be certain barriers in the implementation of change. This includes resistance by the people. The other barriers are lack of economic resources and non-coverage by policies (Mitchell, 2013).
The ethical consideration involves that dignity, worth and respect of the people can hurt. The rights, safety, and health of the people can be compromised. The decisions need to be taken for the safety and health promotion of the people.
ANA. (2017). Nurse Staffing. Nursingworld.org. Retrieved 4 September 2017, from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios
ANA. (2017). About Code of Ethics. Nursingworld.org. Retrieved 15 September 2017, from http://nursingworld.org/codeofethics
Battilana, J., & Casciaro, T. (2012). Change Agents, Networks, and Institutions: A Contingency Theory of Organizational Change. Academy Of Management Journal, 55(2), 381-398. http://dx.doi.org/10.5465/amj.2009.0891
Lamp.(2017). It’s time to improve ratios. The Lamp. 74(3): 8-15.
Kang J, Kim C, Lee S. (2016). Nurse-Perceived Patient Adverse Events depend on Nursing Workload. Journal of Osong Public Health and Research Perspectives. 7(1):56-62
Keller, Dulle, Kwiecinski, Altimier, Owens (2013). Professional Collaboration: Who Should Determine Safe Staffing for Nurses? Journal In Newborn and Infant Nursing Reviews
Kuwata, K (2016). Spread too thin: the case for federally mandated minimum nurse-to-patient Ratios in hospitals. Journal of Loyola of Los Angeles Law Review. 49(3),635-659.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37. http://dx.doi.org/10.7748/nm2013.04.20.1.32.e1013
Van Oostveen, Mathijssen, Vermeulen (2015). Nurse staffing issues are just the tip of the iceberg: A qualitative study of nurses’ perceptions of nurse staffing. In International Journal of Nursing Studies. 52(8),1300-1309.
Welton, J. (2007). Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach. The Online Journal Of Issues In Nursing, 12(3), 1. http://dx.doi.org/10.3912/OJIN.Vol12No03Man01