Effects of Nurse Staffing and Education: Mandated Nurse-Patient Ratios

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Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments

Summary: The researchers aimed to study how the hospital nurse staffing could influence patient mortality. Aiken, Cimiotti, and Sloane concluded that the relationship between staffing and patient outcomes can be different in various hospitals.

Research Elements: Aiken et al. (2011) studied the aspects of staffing in 665 hospitals and compared the results with the data on inpatient mortality. Thus, the findings can be discussed as representative.

Research Results: The researchers found that appropriate patient-to-nurse ratios can improve patient outcomes, decrease mortality, and add to patient satisfaction.

Significance: The findings are important to focus more on hospital nurse staffing in order to reduce hospital mortality. The results are valid to represent the connection between staff shortages and patient outcomes.

Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States

Summary: The researchers examined how improved nurse staffing could affect the patient care and satisfaction.

Research Elements: Aiken and Sermeus chose a cross-sectional study design that is effective to provide credible data on the large population in the European and US countries to discuss the tendency.

Research Results: The researchers found that the relationship between safety, quality of care, and satisfaction was great.

Significance: The research results are relevant to be applied in the hospital settings in the USA because the researchers proved the fact that full staffing and avoidance of shortages represent the effective low cost strategy to improve patient satisfaction.

Waiting management at the emergency department – a grounded theory study

Summary: The researchers focused on examining the quality of the care observed in emergency departments and on the factors that could influence the care, such as staff shortages.

Research Elements: Concentrating on collecting the data on the patient experience and satisfaction, the researchers conducted the qualitative study based on focus group interviews and supported it with collecting the quantitative data.

Research Results: The appropriate research design allowed discovering the factors that influenced patient satisfaction. The participants focused on the long waiting time and the lack of appropriate staff behavior or care.

Significance: The study is significant to provide the support for discussing the correlation between the waiting time in ED and patient satisfaction in terms of the staff shortages causing patient frustration and inadequate care.

Effect of mandated nurse–patient ratios on patient wait time and care time in the emergency department

Summary: Chan, Killeen, and Vilke examined the relationship between mandated nurse–patient ratios and the patient flow and satisfaction in emergency departments.

Research Elements: The researchers chose using the modern technologies to collect the data and focused on conducting the information with the help of electronic medical records and electronic systems used in two hospitals.

Research Results: Chan et al. (2012) found that the staffing directly influenced the patient wait time.

Significance: The results are applicable for hospital environments when decisions about staffing are made while ignoring state-mandated levels and standards.

Experience of being a low priority patient during waiting time at an emergency department

Summary: The researchers focused on examining the experience of patients who could be prioritized according to the priority rating. Low priority patients were discussed as having the longest waiting time in ED.

Research Elements: To study the problem, Dahlen, Westin, and Adolfsson adopted the phenomenological method and interviewed patients in ED. The method was selected effectively because it provided the opportunity to focus on the aspects of experience and satisfaction.

Research Results: It was found that lower priority patients felt dissatisfaction because of the lack of care and attention.

Significance: The study is significant to propose focusing on lower priority patients’ experience in ED to improve the overall quality of care and patient flow in hospitals.

Nine principles for improved nurse staffing

Summary: Dent reviewed the researches on the problem of nurse staffing and formulated principles for improving the work organization in hospitals.

Research Elements: Based on the literature review, Dent was able to examine the issue in detail in order to propose effective principles for improving the staff.

Research Results: Therefore, such variables as skill mix and number of nurses were discussed as important to influence the clinical management.

Significance: The article is important to provide guidelines for the effective organization of staff work in order to prevent burnout and shortages.

Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital

Summary: The researchers examined how staff absenteeism could lead to changes in the patient satisfaction and focused on the concept of burnout.

Research Elements: To research the problem, authors chose conducting the multilevel analysis and examining staff databases. The situation in only one hospital in France was examined.

Research Results: It was found that nurse absenteeism could influence the patient satisfaction significantly.

Significance: The study is important to affect the approaches in working with the staff in hospitals in order to avoid absenteeism or shortages and increase patient satisfaction.

US emergency department performance on wait time and length of visit

Summary: Horwitz aimed to study the relationship between the staff performance in emergency departments, wait time, and patient outcomes.

Research Elements: A retrospective cross-sectional study was chosen as a method. This design allowed focusing on a large number of patient visits to conclude about the relationship.

Research Results: Horwitz found that the percentage of hospitals that follow the recommended wait time in ED is rather low, and that fact influenced the quality of the care.

Significance: These results need to be referred to while organizing the work of ED to avoid long wait times and staff shortages.

Waiting in the emergency room: Patient and attendant satisfaction and perception

Summary: The researchers reviewed the tendencies in the sphere of emergency services with the focus on the waiting time and patient satisfaction.

Research Elements: Karaca, Erbil, and Özmen provided their conclusions referring to the literature review results.

Research Results: The authors concluded that the patient satisfaction directly depends on the wait time, and this factor is based on the staff organization.

Significance: The article provides important notes on the connection between the insufficient care in ED, long waiting time, and patient dissatisfaction.

Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing

Summary: The researchers reviewed the connection of high staffing and low staffing with the effective work of the whole hospital system.

Research Elements: McHugh, Berez, and Small identified the policies and the legal framework in the context of which it was important to discuss the problem of staffing. The effect of staffing on the system’s work was measured.

Research Results: It was stated that high staffing was a necessary requirement for the effective work of hospitals according to policies. Significance: The conclusions are significant to revise the staff norms and policies in hospitals to meet requirements.

A systematic review of triage-related interventions to improve patient flow in emergency departments

Summary: The researchers found that overcrowding in emergency rooms can influence the patient satisfaction, and these situations are directly associated with staffing.

Research Elements: The authors reviewed interventions in hospitals to improve the situation in emergency rooms with the focus on the systematic literature review. The researchers followed strict criteria to choose the most appropriate studies for reviewing.

Research Results: The examined interventions were analyzed and grouped to choose the most effective ones.

Significance: The proposed interventions can reduce waiting time and length of stay, improve the staff work, and increase patient satisfaction.

Minimizing ED waiting times and improving patient flow and experience of care

Summary: The article proposed interventions and improvements of the ED waiting time to influence the patient experience.

Research Elements: The research is valid because it includes both pre- and post-intervention data analysis.

Research Results: The study results are comprehensive to propose interventions that could address staffing issues in ED directly.

Significance: The article is important to support the idea of improving the emergency patients’ experience with references to new interventions on high staffing and workload.

Stimpfel, A., Sloane, D., & Aiken, L. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.

Summary: Stimpfel, Sloane, and Aiken focused on discussing how long work shifts associated with staff shortages could influence the quality of care and the level of the patient satisfaction.

Research Elements: The researchers conducted the analysis of cross-sectional data for the period of 2005-2008 and related to the organization of the staff work.

Research Results: Focusing on the aspects of burnout, shift length, and staff shortages, the researchers concluded about the role of shift lengths for quality of care and staff attitudes.

Significance: The research is important to link extended work shifts with burnout caused by staff shortages, and then, with patient dissatisfaction.

Emergency department staffing: A separated continuous linear programming approach

Summary: Wang proposed the model for estimating the effective number of staff for emergency departments to guarantee or increase the patient satisfaction.

Research Elements: The strategy to design a model was effectively chosen by the author to address the typical challenges associated with the work in emergency departments.

Research Results: The outcome was the model to address ED overcrowding and low staffing.

Significance: The proposed staff work optimization model can be effectively used in hospitals to resolve the problem of low staffing and decreased patient satisfaction.

Optimizing emergency department front-end operations

Summary: Wiler presented the review of the scholar literature on the available interventions to improve the work of emergency departments.

Research Elements: The literature review was chosen as an effective tool to provide the qualitative information on the issue.

Research Results: The outcomes included the selection of interventions effective to improve the work of the staff, cope with staff shortages, manage the services, and add to the patient satisfaction. Significance: The article is important to assess interventions that can be effective to address the problem of staff shortage in ED.

References

Aiken, L., Cimiotti, J., & Sloane, D. (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care, 49(12), 1047-1053.

Aiken, L., & Sermeus, W. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344(1), e1717-e1732.

Burström, L., Starrin, B., Engström, M., & Thulesius, H. (2013). Waiting management at the emergency department – a grounded theory study. BMC Health Services Research, 13(1), 95-102.

Chan, T., Killeen, J., & Vilke, G. (2012). Effect of mandated nurse–patient ratios on patient wait time and care time in the emergency department. AEM, 17(5), 546-572.

Dahlen, D., Westin, L., & Adolfsson, A. (2012). Experience of being a low priority patient during waiting time at an emergency department. Psychology Research and Behavior Management, 5(2), 1–9.

Dent, B. (2015). Nine principles for improved nurse staffing. Nursing Economics, 33(1), 41-45.

Duclay, E., Hardouin, J., & Anthoine, E. (2014). Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital. Journal of Nursing Management, 3(2), 1-9.

Horwitz, L. (2010). US emergency department performance on wait time and length of visit. AEM, 55(2), 133-141.

Karaca, M., Erbil, B., & Özmen, M. (2011). Waiting in the emergency room: Patient and attendant satisfaction and perception. EJSS, 2(1), 1-4.

McHugh, M., Berez, J., & Small, D. (2013). Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. Health Affairs 32(10), 1740–1747.

Oredsson, S., Jonsson, H., Rognes, J., & Lind, L. (2011). A systematic review of triage-related interventions to improve patient flow in emergency departments. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 19(2), 43-52.

Sayah, A., Rogers, L., Devarajan, D., Kingsley-Rocker, L., & Lobon, L. (2014). Minimizing ED waiting times and improving patient flow and experience of care. Emergency Medicine International, 2(1), 1-9.

Stimpfel, A., Sloane, D., & Aiken, L. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.

Wang, X. (2013). Emergency department staffing: A separated continuous linear programming approach. Mathematical Problems in Engineering, 2(3), 1-9.

Wiler, J. (2010). Optimizing emergency department front-end operations. Annals of Emergency Medicine, 55(2), 142-162.

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