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- Nurse Staffing Ratios
Journal Article > Study
Detection of missed injuries in a pediatric trauma center with the addition of acute care pediatric nurse practitioners.
Resler J, Hackworth J, Mayo E, Rouse TM. J Trauma Nurs. 2014;21:272-275.
Missed injuries and delayed diagnoses are a relatively common problem in trauma care. This study describes a 150% increase in the number of documented missed injuries that were caught following the introduction of acute care nurse practitioners on a pediatric trauma service. The authors attribute the uptick in identified missed injuries to better charting and follow-up examinations.
Journal Article > Study
Buerhaus PI, Donelan K, Ulrich BT, Norman L. DesRoches C, Dittus R. Health Aff (Millwood). 2007;26:853-862.
Prior research has demonstrated a link between lower nurse staffing, increased mortality rates, and worsened performance on patient safety outcomes. This study surveyed registered nurses, physicians, and hospital chief executive officers (CEOs) and chief nursing officers (CNOs) regarding their perception of the impact of nursing shortages on patient safety and quality of care. While all respondents agreed that the current nursing shortage is serious, physicians and CEOs generally did not believe nursing shortages were closely linked to failure to detect patient complications or worsened patient safety overall. The study is limited by a relatively low response rate, especially among CEOs, but the results do indicate persistent cultural differences among health care professionals regarding approaches to improving safety.
Journal Article > Commentary
Sachs BP. JAMA. 2005;294:833-840.
Part of a series in JAMA entitled Clinical Crossroads, this case study discusses the unfortunate events surrounding a 38-year-old woman's presentation to a labor and delivery unit. The case details a seemingly routine full-term pregnancy that rapidly evolved into a course of complications, ultimately leading to a fetal death, a hysterectomy, and a prolonged hospital course. The discussion shares the experience through the eyes of the patient, her husband, and the primary obstetrician. Further exploration of the case identified several specific factors and broader systems issues that contributed to the events. The author shares how this particular institution responded with overarching changes, including a greater emphasis on teamwork, communication, and appropriate staffing of labor and delivery units to promote safety.