Role, Responsibility, Accountability and Regulation Pediatric Nurse



Role, Responsibility, Accountability and Regulation Pediatric Nurse

Essay 1

Overview / Plan

This essay highlights key issues related to Role, Responsibility, Accountability and Regulation Pediatric Nurse. Increasing attention is being focused on the impact of adequate nurse staffing on patient outcomes and the multiple factors that can affect safe staffing. At the same time that mounting research is supporting the vital role that nurses play in patient outcomes, the national nursing shortage is negatively affecting the number of nurses available (American Nurses Association, 2000; Buerhaus, Staiger, & Auerbach, 2000).

The Institute of Medicine's report of September 1999 first called the public's attention to the problem of increased patient morbidity and mortality related to errors occurring within healthcare delivery systems (Institute of Medicine, 1999). Since this time there has been a growing emphasis on patient safety, process improvement, and the potential effects of adequate staffing. In 2002, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) supported this patient safety initiative by introducing a standard requiring hospitals to measure performance indicators of staffing effectiveness linked to patient outcomes (JCAHO, 2002). Studies by Aiken and colleagues demonstrated an increase of 30% in mortality risk for patients being cared for by nurses with average workloads of eight or more patients compared with those patients being cared for by nurses with a workload of four or fewer patients (2002, 2003).

While these studies focused on adult patients, the same concerns exist regarding the relationships between adequate staffing and outcomes in pediatric patients. The Society of Pediatric Nurses (SPN) believes the following additional factors are of critical importance regarding safe staffing for pediatric patients: ? The acuity and intensity of nursing resources required to care for children have been growing steadily over the last decade (National Association of Children's Hospitals and Related Institutions [NACHRI], 2003). ? The number of children living below the poverty level is higher now than 25-30 years ago and contributes to deficits in primary and preventive health care and results in increased healthcare issues and higher acuity for these children (Children's Defense Fund, 2002). ? The multitude of settings providing pediatric care and the wide range of resources available in each setting greatly affect the type and number of nursing staff required to care for any given patient population.

Position Statement/Recommendations SPN believes that all children and their families should receive high quality family-centered care. As an advocate for patients, families, and the pediatric nursing profession, SPN endorses the following recommendations: 1. No single published ratio for nurse staffing is automatically applicable in all settings where children receive care. Published recommendations for staffing ratios must be carefully evaluated for the particular pediatric setting since these ratios may inadvertently minimize the complexity and multitude of issues that must be considered in the care of pediatric patients and their families.

2. The professional registered nurse must be considered an essential member of the team providing care for children and their families; staffing plans must reflect this vital role (American ...