Risk Management and Safety; Safe Staffing Rations

Risk Management & Safety: Safe Staffing Ratios Risk Management & Safety: Safe Staffing Ratios Introduction: Importance ● ● ● ● ● Quality improvement and risk management correlate with safe patient care and successful organizations. Adequate staffing directly affects outcomes. The Joint Commission strives to guide organizations towards safe and quality practices. Barriers exist that may impact accreditation Quality improvement models like Plan Do Study Act help leaders to implement positive change. Nurse leaders must be competent in a variety of skills to successfully implement healthy change. Introduction: Sections ● Safe staffing ratios Impact on quality and safe care at patient and organizational levels. ● The Joint Commission regulations Staffing ratios impact on compliance. ● Plan-Do-Study-Act Application to safe staffing. ● Nurse leader competencies Promotion of safe staffing practices. ● Conclusion Safe Staffing Ratios Increased patient loads endanger both patients and nurses; negatively impacting quality of care, job satisfaction, and organizational success. ● ● ● ● ● Medical errors are the 3rd leading cause of death in the US. When providers are overwhelmed, there are decreased response rates and success of CPR. When adequately staffed, there are decreased rates of occupational hazards. Nurses seek employment in caring and healthier workplaces. Organizations are left to compensate and manage. Implications of Unsafe Staffing Ratios Point of Care Higher rates of patient mortality Increased readmission rates Longer inpatient stays Increased risk of error ● ● ● ● Organizational Higher nursing turnover Increased costs Loss of productivity Substitution of less qualified staff The Joint Commission & Safe Staffing Defined area of intervention to improve safety (The Joint Commission, 2022). Appropriate staffing and workload Lower patient mortality rates and medical errors Improved patient satisfaction Decreased turnover “...interventions to improve safety for patients often also improve safety for workers” (The Joint Commission, 2022). Since July 1, 2002, accredited organizations are required to base staffing ratios on specific clinical indicators (The Joint Commission, 2022). Variables Affecting JCO Compliance Cost Limitations to staffing access. Limitations to training. Limitations to resources. In terms of staffing ratios… Variables Affecting JCO Compliance ● Lack of defined standards ● ● No current measurement on specified nurse to patient ratios. Specialities vs. general care needs. In terms of staffing ratios… Variables Affecting JCO Compliance Unpredictable circumstances COVID Nursing shortage Unit census In terms of staffing ratios… Plan-Do-Study-Act Closed loop quality improvement model ● ● ● Plan: team development, discussion of policies, prioritization of needs, training. Do: implementation of changes. Study: analyze and compare results, summarize and discuss areas that need modified. Act: implement modified plan or decide to restart process. Advantages: ● ● Enhanced knowledge of organizational improvement processes. Objective of normal operations and emphasized quality. Shared responsibilities and interprofessional communication. Team members feel included and knowledgeable. PDSA & Safe Staffing Compliance P D S A Build interprofessional team (nurses, doctors, ancillary providers, management). Research current staffing ratio issues and organizational policies on staffing. Brainstorm and outline patient acuity guide for units to follow. Develop education on acuity and train staff on making assignments,