The impact of the nurse shortage on personalized care
The COVID pandemic has exposed the desperate need to address the nurse shortage. The US has been suffering from a nurse shortage for over a decade. In 2022, the shortfall is expected to exceed 1.1 million which amounts to about 27% of the workforce [1,2]. As a short-term solution, hospitals in the US are offering $25k signing bonus to nurses who fill open positions [3]. As the demand for nurses continues to surge, travelling nurses are filling the gap. However, where travelling nurses (or short-term nurses) were seasonally used by hospitals (during the flu season), staffed nurses are quitting their jobs to triple their salary while travelling. Indeed, travelling nurses saw a 35 percent growth in 2020, with an additional 40 percent growth expected [4]. In addition to a lean workforce, the nurse-to-patient ratio is unsafe, both for nurses and patients. The National Nurses United and other associations are lobbying for mandates regulating the number of nurses to patient [5]. The lack of a staffing mandate results in RNs treating more patients than is safe, compromising patient care and patient outcome. California is the only state in the US which regulates the RN-to-patient ratio. If all hospitals were to increase RN staffing to match the best staffed hospitals in the country, 5,000 in-hospital patient deaths and 60,000 adverse patient outcomes could be avoided [6]. Furthermore, for each additional surgical patient in an RN’s workload above the baseline (1:4 or one nurse per 4 patients), the likelihood of patient death within 30 days increases by 7% [7].
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Higher workloads impact patient care, safety, and patient outcomes at numerous levels. As a result of high patient to nurse ratios, nurses are unable to properly communicate with patients [8]; they have less time to discuss and collaborate with physicians; errors in patient care occur such as medication administration and finally, they have less time to execute essential tasks such as monitoring vital signs. Indeed, Data collected in a U.S. study [8] indicates that 73.4% of nurses reported missing at least one activity on their last shift (on average 2.7 of 12 required care activities per shift).
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On average, it takes up to six minutes and twenty-six seconds (06:26) for a nurse to take and record the vital signs of a single patient [9]. When vital signs monitoring is repeated across multiple patients on multiple occasions, the workload for this simple task can become overwhelming and detract from more value-added responsibilities. The time between clinical assessments can be critical as warning signs of deteriorating health conditions may occur before symptoms appear and medical staff is made aware, possibly causing health complications, or relapse and readmission to the ICU in the best-case scenario. Since fluctuations in vital signs occur before adverse events, it is imperative to detect them in a timely manner to enable early and adequate intervention. Insufficient staffing (as is the case in most health institutions) can have detrimental effects regarding patient outcome.
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Current methodology for the clinical collection and monitoring of vital signs are monotonous, tedious and time consuming. Neteera’s continuous patient monitoring platform provides a continuum of care outside high acuity departments to ultimately improve patient outcome and enables personalized care. Neteera improves workflow efficiency by eliminating the time needed to physically monitor patients and sounding device-based alerts when a patients’ vital signs fall outside predefined parameters. The ability to assess the health status of a patient at any given time can have tremendous significance for overworked, burnt out and stressed nurses.
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The power of passive, continuous patient monitoring becomes particularly valuable when nurses and doctors are making personalized care decisions. Looking into a patient's historical biodata allows caregivers to better understand the impact of medications, environment, or other treatment modalities.
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This passive, real-time monitoring extends the caregivers’ clinical reach, freeing nurses from routine tasks to spend more time with patients. In clinical settings, the Neteera Nurses Station enables real-time monitoring of multiple patients across the ward, displaying vitals and notifying staff when a patient’s vitals fall outside of doctor-defined parameters.
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References
1. U.S. Bureau of Labor Statistics.
2. American Nurses Association.
3. Association of American Medical Colleges.
6. Needleman, J. et al. (2006) Health Aff. 25, 204.
7. Aiken, L.H. et al. (2002) JAMA 288, 1987.
8. Lake, E.T. et al. (2016) BMJ Qual. Saf. 25, 535.
9. Dall’Ora, C. et al. (2021) Int. J. Nurs. Stud. 118, 103921.
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