The Impact of Insufficient Registered Nurses on Patient Care in Acute Care Hospitals in the UK

INTRODUCTION

This study intends to explore the impact of insufficient registered nurses on patient care in acute care hospitals in the UK. Notably, there has been a shortage of registered nurses, which has been associated with various negative implication in the delivery of care. My motivation to study this topic was derived from the experience gained in placement. During the day shift they were short of staff and it was only two registered nurses that were on duty that day with 24 bed in the ward. Notably, the nurses were struggling to provide quality care to patient as 12 patients were allocated per a registered nurse. The two nurses overworked that day, a factor that made them unhappy about the working environment. Even though a nurse assistant and I assisted in the care given to patients, it was not enough as we were limited to some tasks. As such, this study intends to explore the effects of the shortage of registered nurses and the different strategies that can be used to tackle this problem among the healthcare settings in order to improve the quality of care we deliver to patient.

The purpose of the study is to explore the impact of insufficient registered nurses on patient care in acute care hospitals in the UK. It also ensures that the NHS is aware of the need for changes in the healthcare sector, particularly in regard to the number of nurses to promote the delivery of services. As such, this study creates awareness and a possible avenue of solving registered nurse shortages, especially within acute hospitals.

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PLACE AN ORDER

The largest group of professionals in the global healthcare system are registered nurses (RN). (Monahan, 2015). Worldwide, there are approximately 19.3million nurses (Flinkman et al., 2013). Nursing vacancies are increasing exponentially in the UK. The English National Health Service (NHS) nursing workforce had 41,000 RN vacancies in October 2018, alongside an 11.8% vacancy rate, which was 9% higher than in 2017 (NHS Improvement, 2018).

Insufficient RN staffing has been suggested as a strong causative factor for preventable deaths and deficiencies in English hospital-care (Francis, 2013; Keogh, 2013). Many individuals have researched on the impact of nursing on patient care, but very few have concentrated on the shortage that has derailed healthcare provision within the United Kingdom. The topic becomes a matter of interest globally since there is an urge to achieve universal health(Aiken et al., 2007). In NHS hospitals, there is a bigdissimilarity of patient-to-RN ratios, thus meaning that one RN cares for a large number of patients, and this has been linked to higher in-hospital mortality-rate (MR) (Aiken et al., 2014; Griffiths et al., 2016; Rafferty et al., 2007). Empirical evidence from many studies worldwide including the UK suggest that low RN-staffing-levels (RN-SLs) are associated with mortality (Aiken et al., 2012;Aiken et al., 2014; Griffiths et al., 2016). Whereas there are fewer studies that associate low RN-SLs with missed care or low patient-care quality (Aiken, Clarke and Sloane, 2002; Aiken et al., 2012; Sochalski, 2004).

Insufficient nurse registration has derailed issuance of professional care to acute patients in most hospitals worldwide. Low nurse-patient ratio indicates that something has to be done to promote provision of quality healthcare services. In the United Kingdom, there are over 300000 registered nurses who offer the required care to patients, especially within acute hospitals. Aged patients need more patient care than younger generations within the United Kingdom. In the elderly wards, nurses are required to provide the required support for such individuals to heal, unfortunately, the number of nurse availed in such wards is not enough to suffice the need(Cardona-Morrell, 2016; Petersen, Antonsen and Rasmussen. 2016). The eventual impact is that the quality of care is compromised, which sometimes leads to deaths in various hospitals within the United Kingdom (Aiken et al., 2007). The government of the United Kingdom and all stakeholders in the healthcare sector should team in a bid to find a sustainable solution.

Research also suggests that low RN-SLs, low nursing-care quality and eroding skills-mix in hospitals are associated with adverse-outcomes, e.g. falls, mortality, hospital re-admissions, pneumonia, infections, medication-errors and pressure ulcers. (Ausserhofer et al., 2013; Griffith et al., 2016; Kane et al., 2007; Schubert et al., 2008). Whereas increasing RN-SLs was associated with lower adverse-outcome rates (Griffith et al., 2016; Kane et al., 2007). Initially, NHS workforce initiatives blamed the hospital-care and quality deficiencies on “uncaring nurses” (Smith, 2012