Aging Presentation

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Nursing Shortage and Effect on Healthcare

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  • Aging Presentation

    1. 1. Nursing Shortage & Quality of Care in the Elderly <ul><li>Aging, Law, and Public Policy </li></ul>
    2. 2. Statistics Compared <ul><li>Today: 126,00 RN positions unfilled </li></ul><ul><li>2010: 275,000 shortfall </li></ul><ul><li>2020: 800,000 shortfall </li></ul><ul><li>2020: RN workforce predicted to be same size; 20% below workforce requirements </li></ul><ul><li>Today: Avg RN Age 45 years old; >40% over 50 </li></ul><ul><li>Age 65 and older expected to double b/w 2000 and 2025 </li></ul><ul><li>2020: 54 million; >16% of the population </li></ul><ul><li>2030: 20% of population </li></ul>
    3. 3. The Future of Health Care: Critical Inquiries <ul><li>Who will take care of you and your family in the future if nursing shortage remains and elderly population is to grow? </li></ul><ul><li>What will staffing ratios be in the future? </li></ul><ul><li>What implications does this have on the quality of care? </li></ul>
    4. 4. THE NURSING SHORTAGE: WHY NURSING ISN’T ON THE TOP TEN LIST OF GREATEST JOBS
    5. 5. BURNOUT! <ul><li>Long hours </li></ul><ul><li>High stress </li></ul><ul><li>Heavy responsibilities </li></ul><ul><li>Physical and Emotional exhaustion </li></ul>
    6. 7. Other Factors Associated with Nursing Shortage <ul><li>Low Incentives/Low Job Satisfaction </li></ul><ul><li>Low Salary relative to Job Requirements </li></ul><ul><li>Lack of Respect and Autonomy </li></ul><ul><li>Caregiver Work-Related Injuries </li></ul><ul><li>Nursing Faculty Shortage </li></ul>
    7. 8. How does the Nursing Shortage Affect Care in the Elderly? <ul><li>Studies demonstrate that the higher the nurse to patient ratio the greater risk to the patient </li></ul><ul><li>Typical Ratio: Med-Surg unit is 5-6 patients per 1 RN. </li></ul><ul><li>Secretary of Health and Human Services Survey: Strong relationship between nurse staffing and five outcomes: UTI’s, PNA, length of stay, upper GI bleeding, and shock. </li></ul><ul><li>Quality of Care diminished, negative outcomes more likely to occur </li></ul>
    8. 9. The Complex Elderly Patient <ul><li>50% of all inpatient acute care admissions are age 75 and older </li></ul><ul><li>Patients living longer with more serious medical problems and complex health histories </li></ul>
    9. 10. Quality of Care Diminished <ul><li>Pain Management </li></ul><ul><ul><li>Timely, effective pain management a problem with high ratios </li></ul></ul><ul><li>Medication Errors </li></ul><ul><ul><li>Patients are on an obscene amount of medications now </li></ul></ul><ul><ul><li>Not surprising more errors are occurring with less staff and more meds </li></ul></ul><ul><ul><li>Typical medication list is 2 pages long (multiply this by 5 or 6) and all meds generally due at the same time. </li></ul></ul><ul><ul><li>Passing medications becomes a race against the clock instead of educated decision making process. </li></ul></ul>
    10. 11. Quality of Care Diminished (cont.) <ul><li>Increasing risk for falls </li></ul><ul><ul><li>1 of 3 people >65 yrs fall each year </li></ul></ul><ul><ul><li>Falls in the hospital </li></ul></ul><ul><li>Increased risk for elder abuse/neglect </li></ul><ul><ul><li>May not be intentional </li></ul></ul><ul><ul><li>Inappropriate or unnecessary use of restraints. </li></ul></ul>
    11. 12. Solutions <ul><li>1999: California Assembly Bill 394 </li></ul><ul><ul><li>First state to enact mandated staffing ratios </li></ul></ul><ul><ul><li>Since then other states have followed </li></ul></ul><ul><li>2005: Registered Nurse Safe Staffing Act S.71 </li></ul><ul><ul><li>Requires all Medicare-participating hospitals to base staffing on acuity and RN input. </li></ul></ul><ul><li>Kaiser Model/Approach </li></ul><ul><ul><li>Overlapping shifts, lower ratios. </li></ul></ul>
    12. 13. Happy Thanksgiving! Questions, Comments

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