Hospital administration is considering a fundamental reorganization of the way that nursing care is provided in the medical–surgical units

Question

The administration would like to provide more people to care for the clients' every need. To do this, the administration plans to decrease registered nurses (RN) and replace them with more unlicensed assistive personnel (UAPs) and fewer licensed practical nurses (LPN). Which is the most important consideration to base a decision regarding reorganization for nursing care delivery?
A) Cost analysis supports the change, providing more profit for the hospital, a decrease in costs to clients and insurers, and a potential for increased market because of an increase in client satisfaction.
B) Previous research studies support that a decrease in licensed professional nurses at the bedside increases rates of mortality, increases hospital-acquired infections and complications, and increases the rate of medication and procedural errors.
C) A consumer poll of clients and families supports providing more persons at the bedside to care for them when they are hospitalized; clients and families expressed that they would feel safer when more people cared for their every need.
D) A risk-to-benefit analysis supports a trial of the reorganization based upon the gain of profits versus the potential loss in any potential for lawsuits or mishaps of not identifying an unstable client in time and transferring the client to a critical care unit.

Answer 1

Ans: B
Feedback:
The most important consideration should be client safety, which research suggests that a decrease in licensed professional nurses at the bedside results in an unsafe client environment. UAPs receive minimal training and need close supervision by licensed nurses. Costs analysis examines profits, and human lives should always be placed above money. A consumer poll may have asked biased questions that did not explain the motives for the consumer research, and the desires of consumers should not outweigh a potential for unsafe practice. The risk–benefit analysis examines financial losses and profit benefits. In its consideration of causes for potential losses were safety-related issues, which should be a red flag for the stakeholders, considering adopting such a nursing delivery system.