IndexBackgroundContextImpact on NursingConclusionLow-patient nursing staffing practices impact health care in many ways. Studies have revealed a direct relationship between low nurse staffing and the outcomes of both nurses working in this field and the patients they serve. Harrington et al. explore the high costs related to low nurse staffing in nursing homes in the United States, focusing on the need to improve staffing ratios and the barriers that prevent their implementation and enforcement. High patient-to-nurse ratios in long-term care facilities lead to poor patient outcomes and cost Medicare and Medicaid billions of dollars each year. The implementation and enforcement of safe patient ratios based on the acuity of residents served is necessary to provide safe and effective holistic care in nursing homes across the United States. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay ContextFor many years evidence has shown that nursing homes in the United States are in desperate need of making improvements. In 1987, the U.S. Congress passed the Nursing Home Reform Act in an effort to address poor outcomes in long-term care facilities by including a “sufficient staffing” requirement. Since then, many other initiatives aimed at improving care have been developed, including the Patient Protection and Affordable Care Act of 2010. According to Harrington et al., “These efforts have included reviews of policies and investigation procedures, public reporting of quality nursing homes and other efforts that have led to some positive changes in nursing home care, such as reducing the use of physical restraints.” However, despite these changes, studies continue to show serious deficits in nursing home care that lead to poor patient outcomes and increased healthcare costs. The results of a recent study conducted by the U.S. Office of the Inspector General “found that 33% of Medicare nursing home residents experienced adverse events, resulting in harm or death during the first 35 days of a skilled nursing stay. post-acute". Trained healthcare providers could have prevented more than half of these adverse events with proper monitoring and treatment, and could have saved Medicare $2.8 billion. states have since increased their staffing needs above those set by the federal government. Despite these changes, staff standards continue to be poor. With the continuous advancement of medicine, the life expectancy and severity of patients increase, leading to a greater need for more qualified nursing personnel to monitor and care for those in need. Therefore, the implementation and enforcement of safe staffing ratios must also take patient acuity into consideration. Impact on Nursing Having an adequate number of trained nurses working in the field, monitoring patients, and supervising the care provided improves health outcomes in many ways. In addition to poor patient outcomes and higher costs, understaffing can impact morale, lead to job dissatisfaction and high turnover rates. Harrington et al. state: “It is likely that adequate staffing levels will need to be addressed before improvements can be made in other factors such as turnover, management andcompetence". The issue of staffing adequacy is central to improving health and nursing care, so much so that staffing levels can be used as a predictor of nursing home shortages and hospitalization rates. Despite this knowledge, when the Centers for Medicaid and Medicare Services created a model to determine minimum staffing levels taking into account resident acuity and compared that number to actual staffing practices, it found that nearly 60 percent of facilities did not meet the total minimum staffing. standards, nearly 80% did not meet minimum RN standards and 54% did not meet minimum standards for nursing assistants. With all this evidence supporting higher nurse-to-patient ratios, you might think the solution is simple. Yet the problem remains. Studies have shown that the best way to improve staffing ratios is through federal and state enforcement. According to Harrington et al., “higher state minimum RN and total nurse staffing has been shown to have a stronger effect on nursing home staffing levels than higher Medicaid payment rates.” This is likely because there is no regulation of how nursing homes spend their profits and that staffing ratios do not influence payments made by Medicare and Medicaid, both of which focus on controlling costs rather than quality of care. results. According to Harrington et al., for-profit nursing homes make up approximately 70% of all facilities operating in the United States and, with the goal of maximizing profits, often operate with fewer staff than nonprofit facilities. As you might imagine, these for-profit facilities also see more violations and worse patient outcomes. Market-based strategies aimed at increasing public disclosure and reporting have been implemented in an attempt to combat this problem, but have had little success, demonstrating once again that regulatory requirements may be the most effective way to improve staffing ratios and quality results. CMS, the agency responsible for federal regulation and setting standards, works with other state agencies to ensure facilities comply. Investigations of surveys completed by these agencies have revealed that violations are often underidentified and/or underreported, and fines are minimized or not issued at all. Additionally, Medicare and Medicaid rarely deny facilities access to their program based on violations, leaving little to no incentive for facilities to remain compliant. Even if the regulations were enforced appropriately, CMS has no guidelines regarding penalties for low or inadequate staffing. Other factors influencing this issue include the gap between liberal political leadership, which is tied to stronger regulation, and conservative political leadership which favors less government intervention. Additionally, nursing home associations and industries have donated money to political campaigns that further their interests. One such example is Kentucky's nursing home industry which has donated a significant amount of money to politicians "lobbying against laws requiring them to hire more employees, increasing fines for violations, and prosecuting elder abuse ”. Another factor is that the government tends to hire industry managers who may have more conservative views that tend to favor less regulation. The solutions to this problem are quite complicated and are influenced by many factors. Second.