Monday, 31 October 2016

Comment on: Duffield et al. (2016) A protocol to assess the impact of adding nursing support workers to ward staffing

Comment on: Duffield C., Roche M., Twigg D., Williams A. & Clarke S. (2016) A protocol to assess the impact of adding nursing support workers to ward staffing. Journal of Advanced Nursing 72(9), 2218–2225


Annette Ayers, RN, BSN, MHA
University of Texas at Arlington

I recently read the article “A protocol to assess the impact of addition nursing support workers to ward staffing” in the September 2016 issue of JAN. With a potential nursing shortage, which is being caused by multiple factors, healthcare facilities are going to have to look at new ways to provide care. As a nursing executive, I believe the addition of non-licensed staff or the LVN, to provide some aspects of patient care, is a way to accomplish this goal (Lafer & Moss, 2007).

I do feel that there is one additional limitation that should be addressed in the study. As required by the Board of Nursing, the delegation of tasks by the Registered Nurse can only be done for those with stable and predictable health conditions (Texas Board of Nursing, 2016). As patients in the hospital are becoming more critical, the addition of non-licensed staff may become less beneficial because many tasks will still be required to be accomplished by the licensed staff member.

One recommendation for the study would be to include types of units when the pairing of units to be studied is completed. Pairing of units based on nursing hours per day, is just one factor to be considered. For example a medical-surgical unit that cares for orthopedic patients may have the same nursing hours per day as the medical-surgical unit with dialysis patients, but these units are very different. For example, orthopedic patients require much more time for education related to physical limitations, whereas dialysis patients typically require many more interventions and medications. Pairing of units based on similar patients, with similar nursing tasks that can or cannot be delegated, could be beneficial to the study.
References

Duffield, C., Roche, M., Twigg, D., Williams, A., & Clarke, S. (2016). A protocol to assess the impact of adding nursing support workers to ward staffing. Journal of Advanced Nursing, 72, 2218-2225.

Lafer, G., & Moss, H. (2007). The LPN: A practical way to alleviate the nursing shortage. Retrieved from www.afscme.org/news/publications/health-care/the-lpn-a-practical-way-to-alleviate-the-nursing-shortage

Board of Nurse Examiners (2016). Nursing practice act. Retrieved from http://www.bon.texas.gov/pdfs/delegation_pdfs/Delegation-Rule225.pdf


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