Posted: December 27th, 2022
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
I work in a nursing home part-time. There is a nursing shortage currently possibly due to Covid 19, as some nurses I know are laid off and abusing the unemployment extra money. It could also be the facility that constantly had problems stemming from management. There is an average of 75 residents in the facility at any given time. The nursing home utilized trained medical assistants (TMA) on a medication cart during some shifts and two licensed nurses in the building at night, LPNs and 2-3 CNAs. There is an abundance of office people that only work from 9-5 and have all weekends off. When nurses in hospitals complain of nursing to staff ratio, they have nothing in nursing homes. I feel that after you have lived your entire life working, raising a family, and contributing to society—you deserve better than going to a nursing home. The residents may or may not get bathed regularly, the food is horrible and not nutritional, and many things fall through the cracks. One thing that would be beneficial is if management used the Management Information System outlined in the text to develop routine reports for decision making (McGonigle & Garver Mastrian, 2018). A periodic report used by management could schedule CNAs and nursing staff according to resident needs
My other job is comprehensive home care. We are in the dark ages as we still use paper charting. I have tried to suggest using an electronic system so I would be able to bring a laptop to my client’s homes when assessing them. Sweeney reiterates, “Providers who do not typically use an EHR are now finding themselves in a learning curve while still maintaining their patient caseload and providing comprehensive care (para 4).” Our home care agency just changed the entire paperwork trail for the third time in three years, and electronic records would save time and money in the long run. The home care agency did incorporate electronic training in the field staff as home care is a rural entity. Some of my clients are veterans. The Veteran Administration uses telehealth and other components to keep their patients in communication with the providers, such as electronic scales and blood pressure monitors that send data directly to their provider. A few clients also have IPads to communicate face to face. In The Future of Home Health Care: Workshop Summary (Demiris, Kaushal, & Nilsen, 2015),
Nilsen noted that the workshop started from the assumption that technology could enhance health outside of hospitals and nursing homes by improving and sustaining health and increasing the quality of life; by allowing people to live at home longer; by reducing health care costs, especially the cost of unnecessary hospitalizations and rehospitalizations; and by reducing the strain on the health care workforce and family caregivers Nursing Staffing Essay – The Application of Data to Problem-Solving Discussion. Further, the participants looked for ways to use technology’s strengths to facilitate communication and data collection.
Since working home care after starting in a nursing home and assisted living, I strive to keep my clients healthier in their home, hoping they can enjoy living out their lives in the place they have worked hard to achieve.
Demiris, G., Kaushal, R., & Nilsen, W. J. (2015, August 4). The Future of Home Health Care: Workshop Summary. (N. A. Press, Producer) Retrieved 2021, from NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.: https://www.ncbi.nlm.nih.gov/books/NBK315926/?report=printable
McGonigle, D., & Garver Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge (Fourth ed.). (J. &. Learning, Ed.) Retrieved 2021
Sweeney, J. (2017, Winter). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles Nursing Staffing Essay – The Application of Data to Problem-Solving Discussion.
Your post concerning the staffing issues and nursing homes hit home with me. As a teenager, I volunteered once a week on the weekends at a local nursing home. I would spend time with the residents, and they would typically want to sit and talk, or occasionally they would ask me to read to them. You could tell, though, that they just wanted to spend time with someone. It was heartbreaking to hear their life stories, to know that they have gone through and then see that no one visits them. Your statement that the residents deserve better than a life in a nursing home is true in many cases.
Nevertheless, the disappointing truth is that people need skilled facilities and nursing homes in many cases as they age. Data from the Nursing Home Abuse Center (2019) states that 1.4 million people live in nursing homes in the United States. According to the National Institute of Aging (2021), skilled living facilities are needed for services that include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available Nursing Staffing Essay – The Application of Data to Problem-Solving Discussion.
Since data shows there is a significant need for skilled facilities to provide various services to the elderly, the least we can do is provide proper care. Proper care will not happen without adequate staffing. The evidence that proper staffing is crucial in health care is staggering. Data and research repeatedly demonstrate that staffing ratios affect every aspect of patient care, including length of stay and mortality rate. Even though I already responded to our classmate Joseph with this information, I will include the information for you again for reference. Halm et al. (2005) indicates a direct correlation between staffing ratios and patient mortality rates. Griffiths et al. (2018) directly correlate staffing ratios and patients’ length of stay.
For supervisors still not convinced that staffing at nursing homes is crucial, they should refer to the guidelines set forth by Medicare and Medicaid. The Reform of Requirements for Long-Term Care Facilities Act, which went into effect as of November 28, 2016, has precise wording for nursing home staff ratios (Centers for Medicare and Medicaid Services, 2021). This Act states that a nursing home “must have sufficient nursing staff with the appropriate competencies and skill sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable level of physical, mental, and psychosocial well-being of each resident, as determined by resident assessment and individual plans of care in considering the number, acuity, and diagnoses of the facility’s resident population in accordance with the facility assessment required at Section 483.70(e)” (Cornell Law, 2021).
Hopefully, one day we will see a time when nursing homes have the staff they need, and the patients obtain the care they deserve Nursing Staffing Essay – The Application of Data to Problem-Solving Discussion.
Centers for Medicare and Medicaid Services. (2021, April 9). Nursing Homes | CMS. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes
Cho, E., Park, J., Choi, M., Lee, H. S., & Kim, E. Y. (2017). Associations of Nurse Staffing and Education With the Length of Stay of Surgical Patients. Journal of Nursing Scholarship, 50(2), 210–218. https://doi.org/10.1111/jnu.12366
Cornell Law. (2021). 42 CFR § 483.35 – Nursing services. LII / Legal Information Institute. https://www.law.cornell.edu/cfr/text/42/483.35#:%7E:text=%C2%A7%20483.35%20Nursing%20services.,-The%20facility%20must&text=(3)%20The%20facility%20must%20ensure,in%20the%20plan%20of%20care.
Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., Iongh, A. D., Jones, J., Kovacs, C., Maruotti, A., Meredith, P., Prytherch, D., Saucedo, A. R., Redfern, O., Schmidt, P., Sinden, N., & Smith, G. (2018). Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study. Health Services and Delivery Research, 6(38), 1–120. https://doi.org/10.3310/hsdr06380
Halm, M., Peterson, M., Kandels, M., Sabo, J., Blalock, M., Braden, R., Gryczman, A., Krisko-hagel, K., Larson, D., Lemay, D., Sisler, B., Strom, L., & Topham, D. (2005). Hospital Nurse Staffing and Patient Mortality, Emotional Exhaustion, and Job Dissatisfaction. Clinical Nurse Specialist, 19(5), 241–251. https://doi.org/10.1097/00002800-200509000-00007
National Institute of Aging. (2021). Residential Facilities, Assisted Living, and Nursing Homes. https://www.nia.nih.gov/health/residential-facilities-assisted-living-and-nursing-homes
Nursing Home Abuse Center. (2019, October 18). Facts and Statistics about U.S. Nursing Homes. https://www.nursinghomeabusecenter.org/informative/facts-statistics-nursing-homes/#:%7E:text=Across%20the%20U.S.%2C%20there%20are,are%2085%2D94%20years%20old Nursing Staffing Essay – The Application of Data to Problem-Solving Discussion.
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