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Safe working Environment in skilled nursing Facility. Impact it can have on patient and facility (500)
Nursing care homes and residential care is a huge industry that provides different services to its residents, that involves the basic healthcare facilities to the basic facilities that include food, residence, cleaning services and basic toiletries services. Staff at nursing homes provide daily care to the patients, individually or in the form of teams. At this time around 2.8 million workers are employees at the nursing homes. Patients with different levels of dependability require different standards of care from the nursing staff. It is essential that all the services provided t the patients are unto standard so that they can be treated better. Thus Safety of the environment is really important in the nursing facilities that are not up to a high level for the patients but also for the nursing staff and employees.
It has been observed that rate of the injuries in the nursing staff and employees has been increased in the past few years at a rapid rate, these numbers are double in the workers at the nursing facilities then the workers working the other similar occupations. According to research, the number of fatal and non-fatal injuries has risen up to 8,559,000 per year that costs up to $186 billion. For the injuries and disease combines the cost has risen up to $67 billion ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ts9A0C5b","properties":{"formattedCitation":"(Leigh, 2011)","plainCitation":"(Leigh, 2011)","noteIndex":0},"citationItems":[{"id":1694,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/TU4MR3Q6"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/TU4MR3Q6"],"itemData":{"id":1694,"type":"article-journal","title":"Economic burden of occupational injury and illness in the United States","container-title":"The Milbank Quarterly","page":"728-772","volume":"89","issue":"4","source":"PubMed","abstract":"CONTEXT: The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007.\nMETHODS: This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category.\nFINDINGS: The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992.\nCONCLUSIONS: The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed.","DOI":"10.1111/j.1468-0009.2011.00648.x","ISSN":"1468-0009","note":"PMID: 22188353\nPMCID: PMC3250639","journalAbbreviation":"Milbank Q","language":"eng","author":[{"family":"Leigh","given":"J. Paul"}],"issued":{"date-parts":[["2011",12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Leigh, 2011). The medical costs and the indirect injuries cost have become as larger as the cost of cancer disease in patients. This is not just affecting the economy but also the performance of the health facilities. Worker's compensation covers less than 25% of the cost, so all the members of the society share these burdens. Thus it is really important to implement the safety standards in the nursing facilities to enhance and improve the level of care in the nursing homes.
Injured employees and nursing staff decrease the rate of availability of the nursing staff thus affects the level of care for the patients, which results in horrible health outcomes for the patients. Thus we can say the safety standards not only the effects of the cost of facilities in the nursing homes but also impacts the performance of the care facilities.
Research proves that high-performance teams are usually based on empowered employees that have updated job level knowledge relevant to their roles. Screening of the employees and the on the job training is an important investment that pays in the long term. It not only results in a high level of an efficient team of workers but also reduces the accident and injury level in the nursing facilities. Providing training to the employees and availability of the aiding equipment adds to the safety standards. Often while lifting the patients, nurses suffer through injuries, as lifting the patient is not an easy task, thus providing the nurses with the lifting devices will help reduce the injury rate.
Providing effective training, assistive devices is not enough to enhance safety standards. Often accidents happen due to lack of time available to the nursing staff to care for the patients. Accident rates become higher in facilities with a lower number of employees to deal with the work. Thus providing sufficient time to the staff for patient care duties can result in reducing the frequency of the injuries among the employees. For example, one nurse in short period of time won't be able to lift the patient easily with care but if the nurse has sufficient time or support from another nurse, they can manage the lifting the patient easily ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"TKqUhz5l","properties":{"formattedCitation":"(D\\uc0\\u8217{}Arcy, Sasai, & Stearns, 2012)","plainCitation":"(D’Arcy, Sasai, & Stearns, 2012)","noteIndex":0},"citationItems":[{"id":1697,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/UBIKCKNK"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/UBIKCKNK"],"itemData":{"id":1697,"type":"article-journal","title":"Do assistive devices, training, and workload affect injury incidence? Prevention efforts by nursing homes and back injuries among nursing assistants","container-title":"Journal of Advanced Nursing","page":"836-845","volume":"68","issue":"4","source":"PubMed","abstract":"AIMS: This paper is a report of a study of association between workplace injuries experienced by nursing assistants in nursing homes in the United States and four factors that may affect injury rates: initial nursing assistant training, training at the current facility, lifting devices, and time to execute daily duties.\nBACKGROUND: High injury rates among nursing personnel have been reported in multiple settings across countries. The existing literature is divided on the effectiveness of training and assistive devices in reducing injury rates among nursing assistants.\nMETHODS: We examined associations between whether or not the nursing assistant has experienced an injury and four key factors: quality of initial injury prevention training, injury prevention training at current facility, lift availability and whether or not the nursing assistant has sufficient time to complete resident activities of daily living. We estimated a survey-weighted logit model using 2004 National Nursing Assistant Survey data.\nRESULTS/FINDINGS: The odds of an injury in the past year were lower among nursing assistants who reported always having a lift available when needed (41% lower odds), available facility training to reduce workplace injuries (39%), and sufficient time to complete resident activities of daily living (35%). Quality of initial training to prevent work injuries was not significantly associated with injury status.\nCONCLUSION: Regions without widespread access to lifting devices may be able to reduce injury rates by increasing the availability of lifting devices. The potential for reductions in injury rates in the United States is greatest from improving training and ensuring adequate time for resident care, as most facilities currently have lifts available.","DOI":"10.1111/j.1365-2648.2011.05785.x","ISSN":"1365-2648","note":"PMID: 21787370\nPMCID: PMC3203326","shortTitle":"Do assistive devices, training, and workload affect injury incidence?","journalAbbreviation":"J Adv Nurs","language":"eng","author":[{"family":"D'Arcy","given":"Laura P."},{"family":"Sasai","given":"Yasuko"},{"family":"Stearns","given":"Sally C."}],"issued":{"date-parts":[["2012",4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (D’Arcy, Sasai, & Stearns, 2012).
Thus improving safety is immensely dependent on the training, employee numbers, adequate timings and the facilitating equipment, provided to the nursing homes and their staffs.
Value of teamwork, and innovative practices using higher performance teams. (250)
Research proves that working in teams result in better patient outcomes, thus nursing teams should be considered as an important strategy, which leads to better quality care and lowers costs. Following are the main reasons due to which nursing care facilities and homes should pay attention to top teamwork, to ensure the best possible outcomes for the patients.
Increases quality in meeting the patient’s need
Often nursing staff need to deal with difficult tasks require help from more employees. For example, for turning the patients over more than one nurse is required. Turning the patient after some time is really important as it avoids the risk of pressure ulcers in the patients. Depending upon the patient's condition and weight, it becomes difficult for one nurse to turn the patient. Thus by working in a team, this task can be made easy, and the patient's quality for care will also increase. Teamwork enhances the productivity of the facilities and reduces the time of delivery of services.
Improves responsiveness
More people in the team result in increased response rate. Thus in case of an emergency or any change, more eyes and ears can interpret the situation and deal with it better than one individual. Teams are crucial in situations when the patient's condition changes quickly and requires an increased response rate from the members of the care facility.
Reduces the risk of accidents
Working team increases the sharing of knowledge and information among the health service providers regarding the needs of the patient, which helps in the treatment and care of the patient. This also reduces the possibility of medical errors during treatment and patient care. By reducing the risk of errors, teamwork results in a decreased cost of care in the healthcare facilities due to reduces error rate ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sZXmIzCa","properties":{"formattedCitation":"(Mukamel, Cai, & Temkin-Greener, 2009)","plainCitation":"(Mukamel, Cai, & Temkin-Greener, 2009)","noteIndex":0},"citationItems":[{"id":1691,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/BF3TSVRG"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/BF3TSVRG"],"itemData":{"id":1691,"type":"article-journal","title":"Cost Implications of Organizing Nursing Home Workforce in Teams","container-title":"Health Services Research","page":"1309-1325","volume":"44","issue":"4","source":"PubMed Central","abstract":"Objective\nTo estimate the costs associated with formal and self-managed daily practice teams in nursing homes.\n\nData Sources/Study Setting\nMedicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers.\n\nStudy Design\nA retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors.\n\nData Collection\nFormal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports.\n\nPrincipal Findings\nFormal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians.\n\nConclusions\nOrganization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.","DOI":"10.1111/j.1475-6773.2009.00980.x","ISSN":"0017-9124","note":"PMID: 19486181\nPMCID: PMC2739030","journalAbbreviation":"Health Serv Res","author":[{"family":"Mukamel","given":"Dana B"},{"family":"Cai","given":"Shubing"},{"family":"Temkin-Greener","given":"Helena"}],"issued":{"date-parts":[["2009",8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mukamel, Cai, & Temkin-Greener, 2009).
Thus working in teams ensure that all the tasks are performed up to the mark and results in better patient outcomes.
References
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY D’Arcy, L. P., Sasai, Y., & Stearns, S. C. (2012). Do assistive devices, training, and workload affect injury incidence? Prevention efforts by nursing homes and back injuries among nursing assistants. Journal of Advanced Nursing, 68(4), 836–845. https://doi.org/10.1111/j.1365-2648.2011.05785.x
Leigh, J. P. (2011). Economic burden of occupational injury and illness in the United States. The Milbank Quarterly, 89(4), 728–772. https://doi.org/10.1111/j.1468-0009.2011.00648.x
Mukamel, D. B., Cai, S., & Temkin-Greener, H. (2009). Cost Implications of Organizing Nursing Home Workforce in Teams. Health Services Research, 44(4), 1309–1325. https://doi.org/10.1111/j.1475-6773.2009.00980.x
