NUR 621 What are some of the key differences for a staffing model in a skilled nursing facility as compared to a medical-surgical unit in the hospital?

NUR 621 What are some of the key differences for a staffing model in a skilled nursing facility as compared to a medical-surgical unit in the hospital?

NUR 621 What are some of the key differences for a staffing model in a skilled nursing facility as compared to a medical-surgical unit in the hospital?

Healthcare workers are the backbone of any healthcare organization. “Staffing is the cornerstone of human resource management” (Theriault et al., 2019). For healthcare organizations to thrive and function at their best, adequate, qualified employees must provide continuous, high-quality, safe patient care. Competent and adequate staffing in healthcare facilities increases and promotes positive patient outcomes, decreases readmissions, decreases errors and safety events, improves the patient experience, and improves facility ratings. “Healthcare is labor-intensive, requiring the expertise and efforts of nurses and other health care providers to assess and manage the care of consumers needing health care services” (Penner, 2017). Staffing and scheduling sometimes present as a complex issue due to the challenges faced by different healthcare organizations, such as short staffing, patient acuity, patient capacity, budgeting, and lack of adequate finances.

Staffing varies between a skilled-nursing facility versus a medical-surgical unit in a hospital. Both units require staffing for twenty-four hours per day for seven days per week, but the medical-surgical unit is an acute setting with more rapid patient turnover while the nursing facility is more chronic and long-term. Based on the acuity and services required, an acute inpatient hospital unit requires more nurses, such as RNs, while a skilled-nursing facility requires fewer nurses and more support staff such as nurses’ aides.

 

There are three types of staffing models budget base, nurse-patient ratio, and patient acuity (My American Nurse 2014). Some facilities use a combination of staff models depending on the unit’s needs or the facility. Staffing has been and continues to be a considerable challenge for many healthcare facilities and organizations worldwide. Quality patient care and patient safety should be one of the top priorities when staffing is considered. Other factors to be considered when addressing staffing needs are call-offs, sick leave, emergencies, admissions, discharges, patient capacity, and patient acuity.

 

References

 

My American Nurse. (2014). What every nurse should know about staffing. https://www.myamericannurse.com/what-every-nurse-should-know-about-staffing/amp/

 

Penner, S. J. (2017). Economics and Financial Management for Nurses and Nurse Leaders (3rd ed.). Springer Publishing Company. ISBN: 978-0-8261-6001-0

 

Theriault, M., Dubois, C., Silva, B. and Prud’homme, A. (2019). Nurse staffing models in acute care: A descriptive study. Nursing Open, 6(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650648/#_ffn_sectitle

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This writer is all in favor of nurse-to-patient ratio regulations. California is one of the only states that has officially established laws and regulations regarding the nurse-to-patient mandate. Because of the lack of federal mandate regarding nurse-to-patient ratios, registered nurses (RNs) are consistently required to care for more patients than is safe, compromising patient care and outcomes (National Nurses United, n.d.). Safe patient care has shown positive outcomes for the patient, the nurse, and healthcare organizations. Patients have a right to receive the best care every time; care should be safe, high-quality, patient-centered, and holistic. How can patient care be all of the above when sometimes a nurse is required to care for up to 8 and more patients in an acute care setting? Presently this writer’s facility’s maximum nurse-to-patient ratio on any shift on a medical/surgical/telemetry floor is seven patients; this can be unsafe for both patient and nurse, especially when there is not enough or no support staff to assist. Short staffage has been a chronic issue in healthcare, and the present pandemic has put an even further strain on the situation. The nurse-to-patient ratio continues to be a concerning topic for nurses across the USA.

 

Reference

 

National Nurses United. (n.d.). National campaign for safe RN-to-patient staffing ratios. https://www.nationalnursesunited.org/ratios#:~:text=There%20are%20no%20federal%20mandates,and%20negatively%20impacting%20patient%20outcomes.

Health care organizations must always be committed to delivering quality care. Achieving this goal requires adequate and skilled staffing to ensure that health care providers can address patient needs as situations obligate. Staffing models are effective tools for measuring work and determining the labor hours needed in a facility. They differ according to the facility and workload, among other factors.

A staffing model for a skilled nursing facility and a medical-surgical unit in a facility differs in numbers and the

NUR 621 What are some of the key differences for a staffing model in a skilled nursing facility as compared to a medical-surgical unit in the hospital
NUR 621 What are some of the key differences for a staffing model in a skilled nursing facility as compared to a medical-surgical unit in the hospital

overall approach to health care delivery. Regarding numbers, the nurse-patient ratio is the primary reference, and the optimal ratio for a medical-surgical unit in the hospital is 1:4 or 1:5 (Assaye et al., 2020). The ratio changes in skilled nursing facilities since they deal with different patient groups whose complexity of illnesses differs profoundly. The ratio is higher, and health care providers can monitor more than five patients.

The other difference between the staffing models is the approaches used in patient care. Typically, primary nursing is highly effective for staff in medical-surgical units. Primary nursing is characterized by commitment to providing continuous care and ensuring that health care providers assigned to a particular patient are not changed within the care duration (Moura et al., 2020). A skilled nursing facility can apply other approaches for staffing, such as the acuity-based approach. Here, the number of staff required depends on the care intensity that a patient demands (Long, 2020). The maximum number of patients that a nurse can handle does not apply in skilled nursing facilities.

Nurse staffing models are frameworks for guiding health care organizations on the number of nurses required in a facility. They ensure that roles are assigned as situations necessitate and according to nurses’ skills and availability, among other factors. Nurse-patient ratio and patient care approaches differentiate a staffing model for a skilled nursing facility and a medical-surgical unit in a hospital.

References

Assaye, A. M., Wiechula, R., Schultz, T. J., & Feo, R. (2020). Nurse staffing models in medical‐surgical units of acute care settings: A cross‐sectional study. International Journal of Nursing Practice26(1), e12812. https://doi.org/10.1111/ijn.12812

Long, N. (2020). Acuity-based staffing: Improving patient outcomes and staff satisfaction. The University of Texas at Tyler. https://scholarworks.uttyler.edu/nursing_msn/8/

Moura, E. C. C., Lima, M. B., Peres, A. M., Lopez, V., Batista, M. E. M., & Braga, F. D. C. S. A. G. (2020). Relationship between the implementation of primary nursing model and the reduction of missed nursing care. Journal of Nursing Management28(8), 2103-2112. https://doi.org/10.1111/jonm.12846

First, I would like to differentiate between a skilled facility and a surgical unit hospital. A surgical unit is where patients who are suffering from an acute ailment or injury go to seek treatment. This means that patients who go to a surgical unit normally go there to receive treatment for a acute diseases that normally last for a short period of time. A nursing home or a skilled facility is where patients go to seek treatment for chronic diseases. This means that they normally go there for a long duration of time, where treatment involves managing the condition of an ailment for the long-term (Cassidy et al.,2019).

Some of the things that one needs to consider when staffing a facility include; determining the patients’ level of acuity and care needs, determining the necessary staffing needs to meet the residents care ,and finally determining the necessary staffing level according the acuity of the patients. Research has showed that RNs provides a higher quality of care than the other nursing staff like LPNs and NAs. In most part due to their higher training and education level. Most medical and surgical units in the hospital where most of the patients require a higher quality of care hire RNs to take care of their patients. Most of the nursing staff that work in skilled facilities are RNs and NAs. The RNs are normally assigned to patients with higher acuity, while the LPNs are normally assigned to patients with lower acuity. Research has showed that most healthcare facilities are short-staffed which negatively impacts the care their patients receive in these facilities. Numerous studies have shown that the number of staffing in a facility reflects the quality of care the patients receive in that facility (Healthcare risk management, 2019). In other words, a facility that is adequately staffed provides a better quality of care to its patients than the one that is poorly staffed.

Reference:

Cassidy, Jessica, Munari, Dana, Forbes, Damon, Remick, Kyle & Martin, Matthew. (2019). Surge or submerge? Predicting nurse staffing, medical hold capacity, and maximal patient care capabilities in the combat environment. Journal of Trauma and Acute Care Surgery, 87, S152-S158. https://doi.org/10.1097/TA.0000000000002283

Staff fatigue can be a compliance risk, too. (2015). Healthcare Risk Management, 37(3), 28.