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Low Nurse Staffing Levels Can Lead To Missed Vital Signs and Hospital Mortality

Having enough nurses to provide safe care to patients in hospital wards has been a major worry for the NHS in recent years. This nursing shortage increases the risk of omitted nursing care which may result in hospital-acquired conditions and increased morbidity and mortality. These poor patient outcomes are costly both in a financial sense and an emotional sense for patients, families, and staff.



Crisis in Nurse Staffing Levels

Our existing nursing workforce of 5.9 million RN, LPN and LVNs are on average 52 years old. With retirement age right around the corner, the number of active nurses will rapidly decline over the next decade, just behind the aging baby boomers, all 80 million of them, who will begin consuming more health care with each passing year. To make matters worse, today's hospital patients are sicker than they were 20 years ago. [2]

To add, nurses are increasingly working 12-hour hours. This plan allows nurses to work three days each week, potentially improving work-life balance and flexibility. Actual shift lengths, however, are frequently variable due to swings in patient needs and unplanned personnel changes.

As a result, nurses are frequently required to work unscheduled overtime beyond the intended shift duration. Nurses are at danger of exhaustion and burnout when long shifts are combined with overtime, shifts that alternate between day and night duty, and consecutive shifts, which may jeopardize patient safety.


Nurse Staffing Levels Can Lead to Missed Vital Signs

During a shift, nurses are assigned the enormous responsibility of managing the care of several patients. Patients they care for may have a variety of diseases, varying levels of acuity, and may or may not be ambulatory. In other words, they can be quite complex, and the assignments they receive are not necessarily divided with acuity as the primary focus.

A number of studies have investigated whether delayed or incomplete nursing work (commonly referred to as 'missed care') provides a plausible causal mechanism leading to poorer patient outcomes, because nurses do not have the capacity to perform all essential care when staffing levels are low. Since recording vital signs monitoring is a core feature of nursing practice and a critical component of patient surveillance: infrequent monitoring can lead to missed indicators of clinical deterioration, resulting in delays in giving corrective medication. [patients' vital signs1]

In a retrospective longitudinal observational study published in NIHR Journals showed that despite the limitations of relying on nurse reports, the evidence suggesting a link between nurse staffing levels and missed care is largely consistent. What it means is that more missed care are reported when staffing levels are low which can increase the risk of patient mortality.

In order to assure that patients receive the best possible care, it is important for agencies and other stockholders to understand the impact of low nurse staffing levels on patient care. Providing critical information on how to improve patient outcomes while also highlighting the importance of adequate nurse staffing levels in hospitals can help provide a safe and quality experience for patients.


Integrating Continuous Vital Signs Patient Monitoring Systems

Hospitals are gradually implementing initiatives to improve nurse workflow which can include newer vital signs monitoring technologies, phone and EMR integration and a host of other new technologies that are currently available in today’s market. The incorporation of new technology and treatment approaches into clinical care has the potential to significantly improve workflow design and efficiency. [1] Additionally, improving workflow can impact patient safety, nursing satisfaction, patient satisfaction, and improve patient outcomes.

In terms of patient monitoring, ViSi Mobile is a vital signs surveillance monitoring solution that continuously displays all vital signs, including continuous noninvasive blood pressure, which has previously not been available for general care units. Continuous vital signs monitoring enhances nursing workflow by reducing the time required to collect and document vital signs and streamlines the nurses ability to prioritize patient care based on acuity. The alarm limits are configurable to accommodate differing patient populations and can be adjusted at the patient level as needed during interventions to avoid non actionable alarms. The alarms that are actionable, can be sent directly to the nursing staff to ensure early identification and treatment of patient deterioration.

This monitoring technology, combined with its ability to integrate with both the patient’s electronic health record and the nurses’ mobiles devices to effectively deliver actionable alarms, as well as allow for visualization of patient vital signs trends which are available at the RVD (Remote Visual Display), creates a workflow that focuses on patient safety and streamlines nursing workflow.

Adequate staffing is definitely of major importance but when paired with a system that can ease alarm burden and clinical workflow, further complications can be avoided.


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Filed Under: Vital Signs