Clinical Scenario: Increase In Patient To Nurse Ratio

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Slutsky, J. (2005). Using evidence-based guidelines: Tools for improving practice. In B. F.-O. Melnyk, Evidence-based practice in nursing & healthcare. A guide to best practice (pp. 221-236). Philadelphia, PA: Lippincott, Williams & Wilkins.

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

doi:10.1037/cpb0000021 Melnyk, B.M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters

The authors Brady and Lewin discuss the concept of evidence- based practice and the current challenges. The authors describe evidenced- based practice (EBP) as the integration of three important components: evidence from research, clinical expertise, and patient values. They described with surprise the majority of nurses are not aware of current research findings to support their nursing practices. The authors found nurses rely on their experience, traditions, policies and procedures in their practice.

Striving for excellent patient care is the cornerstone of nursing. However, delivery of innovative care requires nurses to take initiative in finding issues and concerns in current clinical practices to promote change that leads to optimal patient outcomes. One current issue in clinical practice is the varying patient-to-nurse ratios (PNRs) amongst different hospitals (Aiken et al., 2012). Having high PNRs may lead to nurse burnout, medical errors, and ineffective nursing care (Aiken et al., 2012; Karavasiliadou & Athanasakis, 2014). The solution would be to regulate PNRs, especially in areas such as the emergency room. To initiate this change, a task force would have to be established to use current data and research as evidence to propose the change, implement the change and evaluate its effectiveness.

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

The object depicted above is the Fiske Reading Machine, a reading apparatus patented by Rear Admiral Bradley A. Fiske on January 5, 1926. The Fiske Reading Machine was an attempt to provide a way to read printed material that has been reduced in size. Bradley Allen Fiske was born in June 1854 in Lyons, New York. After graduating from the United States Naval Academy, he served aboard the gunboat USS Petrel. On board the Petrel, he used the rangefinder he had developed to calculate the distance to enemy ships during the Battle of Manila Bay in 1898, allowing American naval artillerymen to accurately target the Spanish ships.

When someone is hospitalized, they are often in their most vulnerable state. Whether you are the fearful individual being hospitalized, a concerned loved one, or the compassionate care provider, ensuring the patient receives the best possible care throughout their stay is a substantial concern. When receiving care and trusting a facility with the health of the individual involved, wouldn’t it be assumed that the amount of attention and level of care received would be unwavering throughout the nation? Would it be surprising to you to find out that the patient’s outcome may be different depending on in which state they are being cared for? Depending on the state in which the care is being received, there may not be a limit to how many other patients your nurse is assigned to, thus, limiting time and energy that nurse has to spend with each individual. While this fact is a scary one, there is evidence that thousands of lives could be saved if hospitals across the nation would implement change and mandate nurse to patient staffing ratios.

Nurse-Patient staffing ratios have created debate among health care professionals for years. Who determines where, when and how many patients a nurse can handle on any given shift? Who determines the acuity of the patients handled by the nurse? Does the floor nurse have a say in what she or he can feasibly handle during their shift? At what point does patient care begin to suffer? These questions and many others have led to federal and state legislation coming to light to better serve the care of a patient. “The varied agendas and the inability of nurses, hospital administrators, and financial experts to communicate toward a single purpose, as well as the complexity of meeting staffing needs, have moved the issue into the political arena (Hertel, 2012, p. 1)”. Several states have already instituted mandatory nurse-patient ratios. While you can debate for or against political involvement, I will look at many factors regarding care and safety of patients.

Evidence based practice has a great impact on health care system, nursing practice, teaching, and science. The necessity for evidence based quality enhancement and healthcare alteration underscores the requirement for redesigning and implementing care that is effectual, secure and competent (Stevens, K., Ma., 2013). The movement of evidence based practice commenced with the identification of the problems faced in healthcare system. The unacceptable gap between what we know and what we do in the patients care(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. 2001). The main intend of evidence based practice in health care is to provide the resources by which the most latest relevant evidence from research and studies can be judiciously

patient staffing ratios. One of the reasons inadequate nurse to patient ratios should be of public

In nursing, evidence based practice is the platform in which nursing skills and knowledge are built upon. Evidence based practice, as defined by the Academy of Medical-Surgical Nurses, is the “conscientious use of current best evidence in making decisions about patient care” (n.d.). The nurse, upon licensure, acknowledges the ability to facilitate patient care that incorporates all aspects of the evidence based practice model. In order for evidence-based practice to be maintained within health care institutions, it is essential that the nurse is able to function in manner that promotes best practice to provide effective, safe, high quality of care that is beneficial to the patient (Stevens, 2013).

Studies have shown that increase RN client ratios results in a reduction of 5.7% in patient days spent in hospital. The trend toward higher RN staffing levels has been shown to decrease avoidable never events such as inpatient falls and hospital acquired pressure ulcers. He, J. (2013).Too much burden on nurses tends to negatively affect productivity which compromises patient’s safety and quality of healthcare. In California, the mandatory nurse patient ratio was implemented at the time of severe registered nurse shortage and worsening of financial position of many hospitals. This legislature has been found to improve the health care system in many ways.

The gust of wind is complete different than someone left alone in life. A novel that analyzes  both is Margaret Mitchell Gone With The Wind, I just finished the book three days ago, and the book is something everyone  should read in the South. I am not really a fan of books based  during the civil war, but the book has characters that people can actually connect  too and  with real facts from  the Civil War.