Nursing Group Project

This is a group project for a case study, please read the article I attach carefully. I was only responsible for 1 slide – which is recommendation 1. My teammate has already finished recommendation 2, which is increasing nursing staff, so you should think about a different recommendation.

I also attach our group slides so far, my part is recommendation #1.

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Group Project instruction– You are the C- Suite of St. Joseph Hospital and the California Nurses Association (a nurse’s union) has just released the report below. Prepare a PowerPoint of about 10 pages not including title pages, references, and appendices describing what arguments you would make to employees, what actions you might take and what directions you might give to your leadership team given that you are responsible for the organization’s delivery of care, but also prefer to retain a non-unionized workforce.  Use data and information to support your position.

Reading: California Nurses Association and National Nurses United. 2015. Falling from Grace: St. Joseph Health RNs Raise Ethical and Patient Care Concerns.

Below is the slide notes for recommendation #2 (that has finished by my teammate), you should do a different idea but similar format:

-Situation
Roughly 50% of all nurses report they are assigned more patients than California’s ratio law allows
As a result, this incites the following three consequences in the current SITUATION:
7% increase in 30-day mortality rate (Aiken, 2002)
Also saw 7% increase in failure to rescue
11% increase in readmission rates (Mass nurses, 2013)
For every patient over the 4:1 ratio
28% increase in adverse events (Mass General, 2007)
Such as medication errors, nerve injuries, infections, etc.

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Solution
Three effects derived from proposed SOLUTION to increase number of RNs:
11-14% decrease in surgical deaths (Aiken, 2010)
Result of decreased nurse to patient ratio
Save and average of $14,400 per diagnosis for readmitted patients (Vie Healthcare Consulting, 2020)
Based on 2016 data
According to U.S. Bureau of Labor and Statistics, the median wage for registered nurses in California during 2020 was just over $75,000 [75330]
This means that the elimination of the cost of just 5 readmission cases per year could effectively offset the cost of hiring (1) additional RN
Nurses could spend 42% more time on direct patient care (SJH nurses)
Also ties into readmission rates:
The national cost of readmission for Medicare patients was estimated to be $26 billion in 2019
Of this, roughly $17 million, or 65%, was assessed to be avoidable by higher quality care or increased staff attention

Increase RN staffing
The facts of the hospitals’ shortcomings:
Roughly 50% of all nurses report they are assigned more patients than California’s ratio law allows
Study shows increased 30-day mortality + increased risk of failure-to-rescue with high patient to nurse ratios (Aiken, 2002)
California’s legal ratio has been proven to significantly reduce deaths (By 11-14% when employed in states like Pennsylvania and New Jersey) (Aiken, 2010)
92% report staffing is not sufficient for permitted breaks over course of day
Study shows reducing patient load drastically reduces number of complications
Every child with common conditions assigned to a nurse greater than 4 resulted in an 11% increased risk of readmission (Mass Nurses, 2013)

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48% increase in risk of readmission in same scenario for children recovering from basic surgeries
Readmission rates increased similarly for each additional patient, spiking 5-10% in patients with heart failure, heart attacks, and pneumonia
Unnecessary readmissions cause nurses to spend less than 42% of their time on direct patient care
Mass Gen found that 10% increase in number of patients assigned to a nurse correlates to a 28% increase in adverse events (such as medication errors, nerve injuries, infections, etc.)
California Dept of Pub Health also levies administrative penalties worth $100,000
20 penalties assigned in less than 10 years results in $2,000,000 of losses
Pros for improved RN staffing:
Improved staffing ratios can reduce death rates by 11-14% (Aiken, 2010)
Unnecessary readmissions causes two problems:
Forces nurses to spend less than 42% of time on direct patient care
Readmission rates cause decreased operating revenues and increased operating expenses
Average readmission cost for any diagnosis in 2016 was $14,400 (link – Vie Healthcare)
Cost of hospital readmission of Medicare patients = $26 billion; $17 billion determined to be avoidable with proper care the first time
This means that over 65% of readmission costs could be prevented by higher quality care and increased staff attention (link – General Medicine)

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Study published in 2019 by NCBI shows that a 1% decrease in hospital readmission rates for myocardial infarction correlates with roughly a $50 increase in operating revenues per patient
Reduction in adverse events could improve Leapfrog score, reputation, etc.
[would need to providence evidence of this happening or possible financial benefit] For more information on Nursing Group Project check out: https://www.britannica.com/science/nursing

Attachment: SJHS Falling from Grace Case Study Group Project slides

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