Nursing Shortages and the Impact on Quality Health Care

 A persisting quality concern in the majority of health care settings involves shortages in skilled employees, especially nurses. As the baby boomer generation grows older, the need for registered nurses (RN’s) and certified nursing assistants (CNA’s) has been increasing yearly. The shortage of nurses is anticipated to near a deficit of almost a million nurses in the next few years which presents a threat with the potential to negatively impact national health care quality (May, 2006). Complicating the shortage and quality concerns is the inability for schools and universities to increase nursing enrollment levels. According to Patrician, many unfavorable patient outcomes are preventable in health care facilities and are affected by inadequate RN and CNA staffing levels or overutilization of staff (2011).

Another contributing factor for deficiency of quality nursing levels is the lack of reimbursement and funding received by some health care facilities. Organizations that have the ability to hire more nurses fail to do so at times based on financial inefficiencies (Harrington, 2012). Instead of costing a health care facility more money by hiring another qualified nurse, preexisting nursing staff may be expected to work longer hours or more days consecutively. The largest concern with this practice is that the quality of care decreases directly as the amount of consecutive hours of (nurse) work increases (May, 2006). Patient quality care decreases through inability to properly transport patients, through medication errors, infection oversight, increased ulcers, and cross-contamination. According to Harrington, the larger hospitals have quality issues surrounding RN and CNA shortages but nursing homes experience more shortages and are more likely to overwork nursing staff which has more probability to lead to unintentional staff actions “that cause harm or jeopardy” to nursing home patients (2012).

As colleges and universities attempt to expand enrollment and keep up with the growing demand for RN’s and CNA’s, the U.S. job market that is willing to accept qualified nursing staff is growing at the same or faster rate. Quality standards for each health care facility are currently measured and compared to industry standards in the nation, state, and county. When the nursing shortage continues into the future, there will have to be some substantial organizational overhauls made by administrators and executives to keep quality standards at a historically acceptable level. Industry quality standards will undoubtedly decrease in time (if/when these trends continue) and future standards may receive better quality indicators and benchmarks by looking into the past instead of comparing with the rest of the understaffed health care industry.

 References:

Harrington, C., Olney, B., Carrillo, H., & Kang, T. (2012). Nurse staffing and deficiencies in the largest for-profit nursing home chains and chains owned by private equity companies. Health Services Research, 47(1 Pt 1), 106-128. doi:10.1111/j.1475-6773.2011.01311.x 

May, J., Bazzoli, G., & Gerland, A. (2006). Hospitals' responses to nurse staffing shortages. Health Affairs (Project Hope), 25(4), W316-W323. 

Patrician, P., Loan, L., McCarthy, M., Fridman, M., Donaldson, N., Bingham, M., & Brosch, L. (2011). The association of shift-level nurse staffing with adverse patient events. The Journal Of Nursing