Pediatric Nursing Shortage Essay

The cab atomic number 18t of pediatric Nurses (SPN) has been instrumental in advocating for high flavor, culturally sensitive, and comprehensive solicitude for children and families. The health complaint needs of pediatric patients present fantastic challenges due to different developmental stages, limited communication skills, and differences in epidemiology and approaches to treatment as compared to adults. Nurse staffing is a focus of major concern because of the impact of staffing patterns on patient strongty and character reference of disquiet. The advent of managed care, shortened hospital stays, and worldly concern reporting of quality measures demand that healthcare organizations objectively touch on and assess the quality of care delivered to children and families. Registered Nurses are the primary caregivers within the healthcare setting and are the prerequisite link in assisting patients and families with navigating and humanizing a highly technical and i mpersonal healthcare system. An organizations loading to high quality pediatric care is dependent upon appropriate staffing takes with adequately prepared draws and the implementation of collaborative, evidence-based arrange (Schwalenstocker, Bisarya, Lau, & Adebimpe, 2007).In 2007, members of the Public Policy Committee developed the Safe Staffing spot Statement. This document outlined recommendations for safe and effective care for care for children and their families. The position carryment was recently updated and is intended to serve as the material to assist organizations providing care to children in the implementation of evidenced based staffing plans to promote high-quality care. It is imperative that schools of nursing, healthcare institutions and pediatric nurses utilize this document as a resource to envision that appropriate educational activity, training, resources and effective staffing plans are provided to ensure the provision of safe, quality, customer fo cused care to pediatric patients and their families.Problem StatementFollowing a congressional request in 1993 for the Institute of Medicine (IOM) to study the adequacy of nurse staffing in hospitals and nursing homes, a 1996 IOM report recognized the importance of determining the appropriate nurse-patient ratios and distribution of skills to ensure patients pick up quality care. A September 1999 IOM report first called the publics attention to the problem of increase patient unwholesomeness and mortality related to errors occurring within healthcare delivery systems. Since that time there has been a growing tenseness on patient safety, process improvement and the potential effects of adequate staffing.Rationale and Supporting breedingResearch has continued to show the association between nursing staffing and amend patient outcomes (Aiken, et al, 2010 Kane, et al, 2007 Needleman, et al, 2006 Stanton, 2004 American cheek of Nurse Executives, 2003 Aiken, et al, 2002). In 2007 th e tike Health Corporation of America is association with the National Association of tikerens Hospitals and Related Institutions (NACHRI) and Medical Management Planning/BENCHmarking Effort for Networking Childrens Hospitals found increased nurse staffing was associated with improved patient/family experience with care and a reduced incidence of adverse outcomes. NACHRI also reported that The junction Commission found staffing levels had been a critical factor in 20 percent of sentinel events occurring everyplace a ten year period from 19952005 (Schwalenstocker, Bisarya, Lau & Adebimpe, 2007). Stratton (2008) found a reduction in the rate of pediatric central line blood stream infections with an increase in nursing staffing hours.Research conducted by Mark, Harless and Berman (2007) showed a statistically significant reduction in postoperative cardiopulmonary complications, pneumonia and infections in the pediatric population with increased RN staffing. In addition, nurse staffi ng levels have also been found to be a critical determinative of nurse job satisfaction (American Organization of Nurse Executives, 2003). During the 108th Session of Congress (2003-2004), The Registered Nurse Safe Staffing transaction was first introduced. The intent of the act is to hold hospitals accountable for the implementation of valid and reliable nurse staffing plans, victorious into consideration each hospital units unique needs and strengths. The Registered Nurse Safe Staffing bear was reintroduced in the 110th Congress (2007-2008) and further refined and reintroduced on June 15, 2010 under S.3491/H.R.5527 during the 111th Congress (American Nurses Association, 2010).The Society of Pediatric Nurses (SPN) believes the following additional factors are of critical importance regarding safe staffing for pediatric patients There are unique challenges with caring for children. These challenges include o Infants and young children are dependent upon adult caregivers and requ ire closer supervision. o Many children have not yet acquired the communication skills to warn clinicians about a potential misplay or verbalize possible adverse effects about their care. Medication administration is much more(prenominal) complex since weight based dosing is needed o for most medications (Kaushal, et al, 2001). The raciness and intensity of nursing resources required to care for children have been growing steadily (Monsen & Finley, 2007 NACHRI, 2003).Of the 14.1 million children in the US living in beggary, 1 in 10 lack health care coverage (Childrens Defense Fund, 2010). Childhood poverty contributes to deficits in primary and preventative health care and results in increased healthcare issues and higher avidness for these children (Childrens Defense Fund, 2002). Pediatric nurses practice in many settings including hospitals, schools, homes, clinics, long term care facilities, and public health centers. The multitude of settings and the wide range of resource s acquirable in each setting greatly adjoin the type and number of nursing staff required to care for any given patient population. The level of experience of nursing staff, unit layout, and level of ancillary support must be considered when establishing the staffing needs and appointee plan for any given unit (Institute of Medicine, 2010 American Nurses Association, 2007).Society of Pediatric Nurses Position/RecommendationsSPN believes that all children and their families should receive safe, high quality, culturally sensitive, family-centered care in an environment that supports the development of the child and promotes excellence in nursing care. As an exponent for patients, families, and the pediatric nursing profession, SPN endorses the following recommendations 1. Staffing is a complex issue composed of six-fold variables (American Organization of Nurse Executives, 2003). No single published ratio for nursing staffing is automatically applicable in all settings where child ren receive care. Published recommendations for staffing ratios must be carefully evaluated for the particular pediatric setting since these ratios whitethorn inadvertently minimize the complexity and multitude of issues that must be considered in the care of pediatric patients and their families.2. The master copy registered nurse must be considered an essential member of the team providing care for children and their families staffing plans must reflect this alert role (American Nurses Credentialing Center, 2003). 3. Healthcare institutions should develop valid and reliable staffing plans (American Nurses Association, 2010) and patient assignments should promote developmentally appropriate, high quality care for children and families. Nursing leadership, registered nurses and other designated nursing staff should be involved in the development of staffing plans and worthy preparation of staff for the patient populations cared for within the facility (Joint Commission, 2010).4. While the specific details of these staffing plans will take leave with individual patient needs and facility resources, SPN believes the following factors should be considered in all staffing situations Number and acuity of the patient population. a. Assessment of patient needs including special developmental, physiological, psychosocial, and learning needs of children and their families. b. Availability of specialized pediatric equipment and supplies to provide the necessary care and the availability of other support services such as respiratory care, child life, social services, and spiritual care (American Academy of Pediatrics, 2006, 2004a, 2004b, 1998). c. Level of education, competency, and the extent of experience and specialized pediatric training of available staff. d. Family involvement and/or the familys special needs related to meeting the healthcare needs of the child (American Academy of Pediatrics, 2006 Lewandowski & Tessler, 2003).e. Comparable pediatric staffing b enchmark data and/or staffing guidelines from other pediatric focused professional organizations should be integrated into developing staffing plans if at all possible (National Association of neonatal Nurses 2008 American Nurses Association, 2008 American Academy of Pediatrics 2006, 2004a, 2004b, 1998 NACHRI, 2003). 5. Nurses caring for pediatric patients must have appropriate education and experience to demonstrate competency in the care of this highly specialized patient population.The core concepts as cited in the following sources should be included in education and training Pediatric Nursing backcloth and Standards of Pediatric Nursing Practice (American Nurses Association, 2008) Position Statement on Family Centered Care subject area in the Nursing Education Curriculum (Society of Pediatric Nurses, 2008) Position Statement on Child Health Content in the Undergraduate Curriculum (Society of Pediatric Nurses, 2007) Core Curriculum for the Nursing Care of Children and Their Fa milies (Broome & Rollins, 1999) Standards and Guidelines for Pre-Licensure and Early professed(prenominal) Education for the Nursing Care of Children and Their Families (Woodring, 1998).6. Organizations and nursing staff providing care for pediatric patients should commit to ongoing maintenance of nursing staffs clinical competency through continuing education that ensures a modern knowledge base of issues and trends in pediatric care delivery. 7. Organizations should work to establish practice environments characterized by idle communication, teamwork, and effective collaborative problem solving to address nurse staffing issues and ensure safe, effective care for children and families. 8. Nurses are encouraged to assume professional accountability for their own practice. Nurses have accountability for the following Being an advocate for the role of the registered professional nurse Being knowledgeable of state practice acts Being knowledgeable of the mechanisms available to add ress potential staffing issuesReferencesAiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A., Spetz, J. & Smith, H. L. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45(4), 904-921. Aiken L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993. American Academy of Pediatrics(2006). Child life services. Pediatrics, 118(4) 1757-1763. American Academy of Pediatrics (2004b). Levels of neonatal care. Pediatrics 114(5) 1342-1347. American Academy of Pediatrics (2004a). Guidelines and levels of care for pediatric intensive care units. Pediatrics 114(4) 1114-1125. American Academy of Pediatrics (1998). Facilities and equipment for the care of pediatric patients in a community hospital. Pediatrics 101(6) 1089-1090.American Nurses Associ ation. (2010). Safe staffing saves lives. federal legislation Registered nurse safe staffing act. Retrieved on-line(a) February 13, 2011. http//www.safestaffingsaveslives.org/whatisANAdoing/federallegislation.aspx?css=print American Nurses Association (2008). Pediatric nursing Scope and standards of practice. Washington DC Author. American Nurses Association. (2007). precipitous care staffing. Nursings legislative and regulatory initiatives for the 110th Congress Appropriate staffing. Retrieved on-line February 13, 2011. http//www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/Federal/legis/AcuteCare.aspx. American Nurses Credentialing Center. (2003). The magnet recognition program for excellence in nursing service health care organization, instructions and application process. Pub MAGMAN03. Washington, DC Author. American Organization of Nurse Executives (2003). AONE policy statement on mandated staffing ratios. Retrieved on-line January 21, 2011. http//www.aone.org/aone/ advocacy/ps_ratios.html. Broome, M. & Rollins, J. (Eds.). (1999). Core curriculum for the nursing care of children and their families. Pittman, NJ Jannetti Publications. Childrens Defense Fund. (2010). The state of Americas children 2010. Retrieved on line February 13, 2011. http//www.childrensdefense.org/child-research-data-publications/data/state-of-americas-children2010-report.html. Childrens Defense Fund. (2002). Basic facts on poverty. Child Poverty FAQs. Washington DC Author. Institute of Medicine. (2010). The future of nursing leading change, advancing health. Report brief 2010. Washington DC Author. Institute of Medicine. (1999). To err is human Building a safer health care system. Washington, DC Author. Joint Commission. (2010). Joint commission accreditation resources Accreditation manager plus. Retrieved on-line February 21, 2011.http//qvcsql01/JCRAMP/Frame.aspx.Kane, R. L., Shamliyan, T. A., Mueller, C., Duval, S., Wilt, T. J. (2007). The association of registered nurse staffing levels and patient outcomes. Systematic retread and meta-analysis. Medical Care, 45(12) 1195-1204. Kaushal, R., Bates, D.W., Landrigan, C., McKenna, K. J., Clapp, M. D., Federico, F., Goldman, D. A. (2001). Medication errors and adverse drug events in pediatric inpatients. Journal of the American Medical Association, 285(16), 2114-2120. Lewandowski, L. A. & Tessler, M. D. (Eds.). (2003). Family-centered care Putting it into action The SPN/ANA guide to family-centered care. Washington DC American Nurses Publishing. Mark, B. A., Harless, D. W., Berman, W. F. (2007). Nurse staffing and adverse events in hospitalized children. Policy, politics & Nursing Practice, 8(2) 83-92. Monsen, R. B., Finley, S. (2007). Shortage of nurses and child health. Journal of Pediatric Nursing, 22(3), 231-232). National Association of Childrens Hospitals and Related Institutions. (2003). clinical practices service program Benchmark data. Available from www.childrenshospitals.net/nachri. National Association of Neonatal Nurses (2008). Minimum RN staffing in NICUs. Retrieved online February 11, 2011. http//www.nann.org/pdf/08_3009_rev.pdf. Needleman, J., Buerhaus, P. I., Stewart, M., Zelevinsky, K., Soeren, M. (2006). Nurse staffing in hospitals Is there a business case for quality? Health Affairs, 25(1) 204-211. Schwalenstocker, E., Bisarya, H., Lau, S. & Adebimpe, O. (2007). Nursing-sensitive indicators for childrens hospital care quality Indicators are essential, but further testing is needed for use in comparing hospital performance. A white paper prepared by the Pediatric Data part Systems (PediQS) Collaborative. September 2007. Retrieved on line February 8, 2011 http//www.childrenshospitals.net/AM/Template.cfm?Section=Site_Map3&Template=/CM/ContentDisp lay.cfm&ContentID=29730. Society of Pediatric Nurses. (2008). Position statement on family centered care content in the nursing education curriculum. 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