A Commentary On
AN INTEGRATED ANALYSIS OF NURSE STAFFING AND RELATED VARIABLES: EFFECTS ON PATIENT OUTCOMES

by Arlene Mei H. Pinpin

The journal article by Leah L. Curtin entitled, “An Integrated Analysis of Nurse Staffing and Related Variables: Effects on Patient Outcomes,” found out that besides nurse staffing patterns, other variables may also affect patient outcomes. Some of the identified variables were clinical interaction, nurse-patient ratios, turnovers, nurses’ experience, and nurses’ education.

Because of the myriad factors affecting patient outcomes, it is important for hospital administrators to study, analyze and evaluate the effectiveness of nurse staffing and other vital factors that affect patient outcomes. Advice from researchers to the administrators were addressed by the author and they are as follows:

1. Employ sufficient nursing staff to meet the needs of patients without the use of overtime or excessive capacity expectations that may affect nurse health and patient outcomes.

2. The mix of full-time to part-time employees needs to increase (part-time staff should be used to cover unexpected or variable demands).

3. Ensure strong, cohesive, and knowledgeable teams to provide continuity of patient care and to create supportive work environments for nurses.

4. Reinvest in appropriately prepared managers and nurse clinical leadership.

5. Examine the roles and activities of front-line nurses to determine ways to increase the time available for patient care.

With appropriate nurse staffing, patients are not the only ones who gain benefits from it, in fact hospitals do too. Hospitals improve their reputations and save money by avoiding costly errors; they also experience decreasing turnover rates and patients’ length of stay. If appropriate nurse staffing is not realized due to the administrators’ failure to provide a pleasing working environment for nurses, then nurses will leave, patients will suffer, and in the end, hospitals will lose the money they are trying to save.

This journal article has kept me thinking about what nursing students and trainers should be like during their nursing schooling and training. Since a nurse’s education plays an important role in obtaining positive patient outcomes, students and trainers alike should give value to their education. A student giving value to their education does not simply mean complying with the school requirements, but more importantly, finishing tasks and requirements in honest and dignified ways. Trainers on the other hand, should not only serve as examples of professionalism but of competency as well. Students must be given hands-on experience of the concepts and skills that a professional nurse is expected to have. In general, the Philippine nursing schools' Related Learning Experience (RLE) Program needs a little modification. I have included a short description below regarding the partnership that must exist between the clinical instructors, nursing professionals, and affiliates:

· It must be emphasized to clinical instructors and staff nurses that affiliates are not merely volunteers who are tasked to do elementary tasks. Affiliates are expected to be educated by health professionals and get a hands-on experience on how interventions are implemented and evaluated.

· Nurses should not view nursing students as nuisance to their work. Affiliates must be viewed as partners and at the same time flourishing nurses who are also determined to deliver quality nursing care to patients. Therefore, professional nurses are compelled to teach nursing care techniques along with the clinical instructors.

· Nurses should be aware that the procedures done in the hospital setting are being observed by the students. Therefore, nurses must perform and communicate procedures in a clear manner. Endorsements should be communicated clearly not only to the nurse for the next shift but also to the students attending the endorsement period.

· Critical procedures must not be performed by students however, they should be welcome and allowed to observe and learn from the professional nurse who will perform it. Introductions and rationales may be communicated before the procedure so that the students will be able to follow the actual procedure when it is performed.

The health care providers must start working together for the advancement of health care in the Philippines. It is only when we put value into nursing education and continue to provide reasonable staffing systems in hospitals shall quality nurses be produced and retained in the nursing profession. When this happens, quality care will continue to be delivered and further developed for the benefit of both the clients and hospital institutions.


REFERENCE:
Curtin, L. (September 30, 2003) "An Integrated Analysis of Nurse Staffing and Related Variables: Effects on Patient Outcomes" Online Journal of Issues in Nursing. Vol.#8 No.3
Available: http://nursingworld.org/ojin/keynotes/speech3.htm