Quality Issues in Nursing

While huge strides have been continuously made in the health care field over the past century, quality issues still remain. The people who rely on quality nursing care are often vulnerable and frightened and it is important to continue to make improvements to patient care procedure and nursing policy in order to provide these patients with the best possible care.

Patient Care

• Health care facilities are notoriously understaffed. Often, a single nurse must provide medicating and wound care for nearly 20 patients at a time, all on a strict time schedule. Medications must be given at the same time each day and patients need plenty of time to rest, making completion of patient care tasks difficult on a good day and near-impossible on a hectic evening shift. The pressure that under-staffing places on a nurse can lead to dangerous medication errors, employee frustration and patient anxiety. Nursing assistants often operate in the same under-staffed environment, causing them to neglect important daily hygienic cares and care plan instructions because of time constraints and excessive patient load. This leads to increased incidents of pressure sores and patient accidents. When employees are out of work on sick leave, the issue of under-staffing becomes even more prominent, as remaining staff may rush care in an attempt to accomplish the absent employee's tasks in addition to their own. Patient care quality can be vastly increased simply by increasing on-duty nursing staff.

Universal Precautions

• Universal precautions policy and procedures are in place to prevent the spread of difficult and highly- contagious diseases, viruses and bacteria. Universal precautions maintain that hand-washing is the most effective method to prevent the spread of infection. However, according to a study conducted by the National Quality Forum, "hand-washing compliance rates in hospitals are generally less than 50 percent," greatly increasing the risk of patient-to-patient infection at the hands of doctors and nursing staff. In addition, if other aspects of universal precautions are ignored or not provided, such as gowns and face masks, the spread of infection becomes even more likely through contaminated clothing and incubated airborne infections within staff. Universal precautions must be continuously stressed and consistently used in order to ensure quality patient care.

Consistency

• Low pay and part-time allocations contribute to employee turn-over, notably in Licensed Practical Nurse (LPN) and Patient Care Assistant (PCA) and Certified Nurse Assistant (CNA) positions. This turnover often leads to inexperienced staff interaction with patients, especially in long-term care facilities where it is important for residents to feel comfortable with consistent care-givers and for staff to be knowledgeable about residents' specific needs. Frequent staff replacement can lead to anxiety and depression in residents, adversely affecting their physical and mental health. Better pay and full-time status with valuable employee benefits are necessary to make positions appealing to staff in the long term. Regular raises motivate employees and give them a sense of being valued and needed, which leads to less employee turnover and better overall patient care.