SUN – Short Staffing puts Patients at Risk

1 in 3 registered nurses says patients are "frequently" put at risk due to short-staffing

[April 1, 2015]

Among those who said they were aware of times on their unit when patients were put at risk due to short-staffing, 86 percent said this happened at least “occasionally”. 41.7 percent said it happened frequently, up from 34 percent in 2014.

This shows widespread concern among registered nurses about the impact of short-staffing on patients. The survey data suggests that patients are regularly put at risk due to short-staffing.

We know that patients are coming into the system sicker and with more complex needs that require appropriate staffing. This is having a significant impact on patients – when appropriate staffing is not in place, we know changes in the patient conditions are missed, pain medications and treatments are delayed or missed.

We have seen an increase in registered nursing numbers and education seats but the supply is not keeping up with the demand – we are seeing more and more registered nurses being removed from the bedside to do more non-nursing functions and replaced with less expertise, experience, and education. This has a direct impact on the quality of care patients receive and puts patients at unnecessary risk.

Registered nurses are doing the best they can but at the end of the day they are being asked to do more with less and that has a direct impact on our patients’ lives and the quality of care they receive.

These concerns are more than registered nurses being unhappy at work – this is about their professional practice being compromised and that translates into patients being unintentionally put at risk and a decline in patient safety and quality of care. We have nurses who have been nursing for 40 years who have said this is the worst things have been – there has been ebbs and flows but today’s overall work environment is the worst it has been in their careers. These very sentiments are being echoed all across the province – some areas are doing rather well yet others are struggling.

The entire province is dependent on the healthcare system and when registered nurses feel their ability to provide the highest quality of care is compromised that has a direct impact on everyone.

What needs to change?

Staffing levels – but it is more than just increasing nursing numbers in general. It’s about …

making sure registered nurses are a part of healthcare team at the bedside;
appropriate staffing levels and educational preparation based on patient numbers, acuity and complexity;
making sure the entire healthcare team has the support they need in order to provide the highest quality of care;
making sure we have registered nurses replacing registered nurses;
making sure we have the research, evidence and national standards guiding our decision making; and
including the registered nurses in meaningful and tangible discussions about changes to models of care or processes at the front end, not after the fact.

One critical area where staffing levels need to be addressed is in long term care – and again not staffing in general, but rather the number of registered nurses caring for this very complex patient population with very specific needs and requirements.

Registered nurses working in long term care are telling us that on a good day they good up towards 30 patients for on registered nurse on a bad day it could be over 100 patients per registered nurse. This is not right, nor is it safe for the patients in their care.

We need to make sure we have the right care provider caring for the right patient at the right time.

We need minimum care standards based on research and evidence, educational preparations and national standards.

Join the conversation on Facebook – Have you experienced short-staffing? How often does this happen and what impact does it have on the care that you and your colleagues are able to deliver?

3 in 4 registered nurses say they are aware of times patients have been put at risk due to short staffing.

[March 31, 2015] Responses were strongest among registered nurses under 35 years old (86 percent said yes), those working in rural integrated facilities (88 percent said yes), regional hospitals (84 percent), and base hospitals (82.5 percent), as well as long-term care facilities (80 percent said yes).

1 in 4 registered nurses having considered leaving profession

Leaving_Profession_InfoGraphic_Blue_PDF.jpg1 in 3 registered nurses says safety and quality of care has deteriorated

[March 25, 2015] Registered nurses continue to have positive overall assessments of the quality and safety of the patient care that is delivered in their own workplaces and practice settings. However, a concerning proportion of those surveyed in 2015 reported that both quality and safety had declined in the past 12 months. They attributed this trend to staffing levels, patient volumes, and the rising acuity and complexity of patient care needs.

A strong majority (71.9%) of survey respondents rate the quality of patient care delivered in their workplace positively, as either Good (47.4%) or Very Good (24.5%).

A smaller but still significant majority (62.7%) also rate the safety of patient care delivered in their workplaces positively, as either Safe (39.9%) or Very Safe (22.8%).

Despite the relatively positive view of the quality and safety of patient care delivered in their workplaces, a large proportion of surveyed registered nurses feel that things are going in the wrong direction, and that care standards are being eroded.

In the 2015 survey, 1 in 3 (33%) thought that the safety of patient care had deteriorated in the last 12 months, while almost 3 in 10 (28.2%) thought that the quality of patient care had declined in the last year. Only 1 in 10 thought that either quality or safety had improved in the previous 12 months.

Among those who gave negative assessments of the direction of patient care, the most important reasons were “Registered nurse staffing levels,” “The number of patients requiring care,” and “The seriousness and complexity of patient care needs”.

Survey details

The survey was conducted February 17 to March 1, 2015.
It was conducted by the firm Praxis Analytics.
It was conducted by telephone with 804 randomly selected SUN members.
It has a margin of error of plus or minus 3.3% at the 95% confidence level.

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