Facing understaffing in nursing, how can you maintain patient safety as your top priority?

Understaffing in nursing is a significant challenge that can compromise patient safety. Maintaining a high standard of care during such times is crucial. You must prioritize tasks, delegate effectively, and communicate efficiently. It's about working smarter, not harder, and ensuring the safety and well-being of your patients remain at the forefront of everything you do. With a strategic approach and a focus on critical care needs, you can navigate through these tough times while providing the best possible care.

1 Prioritize Care

When understaffed, prioritizing patient care becomes essential. You must assess which patients require immediate attention and which can wait. Triage skills are invaluable in these situations, allowing you to quickly determine the severity of each patient's condition. Focus on critical tasks that ensure patient stability, such as medication administration, vital signs monitoring, and attending to those with life-threatening conditions. By concentrating on the essentials, you can maintain patient safety even with limited resources.

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Joseph de Veyra, DNP, RN, PCCN, MPH, MBA

MIT MBA l Harvard MPH l CNO at NPHub, I help NP programs optimize student clinical placements I 40 under 40 Honoree-Seattle l Inc. 5000 Exec
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Nurses, when understaffed, maintaining patient safety is crucial. Here are three best practices to prioritize care: 1️⃣ **Use ABCD Method:** Prioritize tasks using the ABCD approach—Airway, Breathing, Circulation, and Disability. Focus on critical needs first. 2️⃣ **Apply the Nursing Process:** Assess, diagnose, plan, implement, and evaluate. This structured approach helps identify and address the most urgent patient needs effectively. 3️⃣ **Limit Admin Work:** Minimize non-essential administrative tasks. Delegate or defer them when possible to concentrate on direct patient care. By focusing on these strategies, we can ensure patient safety even in challenging staffing situations.

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Sally Kuykendall

Author, researcher, and program evaluator
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In my experience, chronic understaffing is an intentional decision by healthcare administration to cut costs, typically failure to hire and retain qualified staff by offering competitive salaries. The best way to address understaffing is to educate the decision-makers on the problem. 1) Immediately notify the supervisor at the beginning of the shift that staffing is less than recommended and patient safety is in jeopardy. 2) Fill out an incident report on every minor error, including near misses. Be sure to note the patient census and staffing numbers on the incident report.

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Renato Gonzalez Pereira

BSN, RN | Nursing Faculty
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By prioritizing care, communicating effectively, and working collaboratively as a team, nursing professionals can overcome the challenges of staffing shortages and keep patient safety as the top priority, even in resource-limited situations. However, for a very limited time. Fatigue is the main factor in errors.

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2 Delegate Wisely

Effective delegation is a lifeline in times of staffing shortages. Understand the competencies of each team member and assign tasks accordingly. Utilize support staff for non-clinical tasks to free up nursing time for direct patient care. It's important to ensure that delegated tasks are within the scope of practice of the person you're assigning them to and that they are comfortable with their responsibilities. Clear communication about expectations and the importance of each role in maintaining patient safety is key.

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Sally Kuykendall

Author, researcher, and program evaluator
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Be sure to gain input from the staff when delegating assignments. Staff who routinely work with a patient can anticipate needs or change in physical or mental status more easily ensuring better patient care. Also involve family in simple caregiving, such as feeding or range of motion.

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Renato Gonzalez Pereira

BSN, RN | Nursing Faculty
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Delegating tasks is essential for the dilution of work with the team. I consider the training stage crucial. Without training, it is not possible to feel comfortable and prepared for professional practice, along with the delegated responsibilities.

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3 Efficient Rounds

Making efficient rounds is a strategy that can help manage workload and maintain patient safety. Group tasks geographically or by acuity to minimize time spent walking between patients. Use technology, like electronic health records (EHRs), to document on the go and stay organized. This approach allows you to spend more time at the bedside, providing care and monitoring patients closely for any changes in their condition.

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Renato Gonzalez Pereira

BSN, RN | Nursing Faculty
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Rondas eficientes são essenciais para gerenciar a carga de trabalho e garantir a segurança do paciente quando a enfermagem não tem pessoal suficiente. As tarefas podem ser organizadas por localização ou acuidade, o que reduz o tempo de deslocamento. Pronto-socorro eletrônico facilita a organização e a documentação. Essa abordagem garante a segurança e o bem-estar do paciente, permitindo tempo para o cuidado direto e monitoramento e intervenção oportunos.

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4 Communication is Key

Communication is critical in ensuring patient safety, especially when understaffed. Keep lines of communication open with your colleagues to facilitate a team-based approach to care. This includes briefings at the start of the shift, handovers that are thorough yet concise, and ongoing dialogue about patient status. Clear communication can prevent errors and ensure that everyone is aware of their responsibilities and the needs of the patients.

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5 Support and Self-Care

In an understaffed environment, supporting one another and practicing self-care are vital. Recognize the signs of burnout and stress in yourself and your colleagues. Encourage breaks and provide emotional support. Remember that taking care of yourself is not selfish; it's necessary to maintain the stamina and mental clarity required to ensure patient safety. A well-rested and supported nursing staff is better equipped to provide high-quality care.

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6 Continuous Learning

Staying educated on best practices in patient safety is crucial, especially when resources are limited. Engage in continuous learning to refine your skills in triage, emergency response, and efficient care delivery. Familiarize yourself with new technologies and procedures that can streamline workflows and reduce the burden on the nursing staff. Ongoing education helps you stay prepared to provide the best care possible, even in challenging circumstances.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Facing understaffing in nursing, how can you maintain patient safety as your top priority?

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1 Prioritize Care

2 Delegate Wisely

3 Efficient Rounds

4 Communication is Key

5 Support and Self-Care

6 Continuous Learning

7 Here’s what else to consider

Nursing

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