UNDERSTAFFING OF NURSES AND PATIENT SAFETY

IN OBSTETRICS WARD OF CARAGA REGIONAL HOSPITAL

Submitted by:

DIGOL, ABIGAIL
PATES, IRISH
ERNO, ROSEANN
OCENAR, ANNE CORINNE
BATAAN, NEYZA P.
CHAPTER 1
INTRODUCTION
Patient safety and the occurrence of adverse events in hospitals is a topic which
has been widely addressed over the last decades. In that respect, there has been an
increasing interest in the effect of working conditions on patient safety, and whether
understaffing and adverse events are correlated.

This paper therefore reports results from a study of under- staffing of nurses
understood as a lack of nurses available to conduct the tasks required of them. This
implies that nurses are forced to ignore or postpone important tasks, thereby
compromising patient safety.

Poor staffing specifically in Ob Ward increases the risk of mortality, and adverse
conditions such as ward deliveries, fetal death and hospital-related infections. These
implications pertain to the lack of time that nurses could give each patient, limitations
in the quality of nursing, and challenges in safe medication administration.

DEFINING THE CENTRAL PROBLEM

The lack of human resources basically affects the delivery of quality healthcare to
patients. According to the Philippines Department of Health, the ideal nurse to patient ratio is
1:12, but this is hardly true in many hospitals, such example is in Caraga Regional Hospital
specifically the Obstetrics Ward.
Presently the average Census is as follows:
1Nurse: 50 Post Partum Patients
1Nurse: 30 Room In Babies
1 Nurse: 10 Waiting Cases (Pre Partum)
In reality, an ideal care scenario isn’t exactly applicable in most cases, not because of
the lack of equipment and facilities, but due to the lack of nurses.
Many nurses fail not because our nurses are incompetent, but because the environment
that our healthcare system has laid out isn’t exactly ideal for patient care.
CHAPTER 2
Internal Environment: Strength and Weaknesses
Caraga Regional Hospital, a government Tertiary- Care hospital with Level 2
License to operate and a PHIC accredited Healthcare Institution with an
authorized bed capacity of one hundred fifty (150) but is currently implementing
a 300-bed capacity. It is fully equipped with modern facilities and offers the
following services:

1. OUT PATIENT SERVICES

2. 2 IN-PATIENT SERVICES
a. Internal Medicine
b. Obstetrics & Gynecology
c. Pediatric Medicine
d. General Surgery
e. Orthopaedic Surgery
f. Family Medicine

3. SPECIAL AREAS
a. Emergency Room
b. Delivery Room
c. 10 bed ICU
d. 5 bed PICU
e. Operating Room
f. NICU
4. RADIOLOGY AND IMAGING

CORE VALUES

Competence Humane Responsible

Integrity Service- Oriented Teamwork

VISION

A premier government hospital trusted by the community in providing expert and

compassionate healthcare services

MISSION

1. To enhance the competence of healthcare workers in order to provide

quality and compassionate healthcare.
2. To provide reliable and modern facilities for effective customer service.
3. To allocate resources for the delivery and continuity of equitable services to
the community.

QUALITY POLICY
 Caraga Regional Hospital commits to deliver effective and efficient
healthcare services to all stakeholders by satisfying customer and other applicable
requirements through continual improvement of the management system.

ORGANIZATIONAL STRUCTURE

SERVICES OFFERED
The Caraga Regional Hospital Obstetric Ward offers obstetric services to all
mothers both public and private. The area follows a standardize guidelines for health
care practitioners to ensure efficiency and effectiveness while securing safety in the
care delivered. Maternal and newborn programs such as family planning and newborn
screening are also offered.
EXTERNAL ENVIRONMENT: THREATS AND OPPORTUNITIES

Location:

Address:
Rizal Street, Brgy. Washington Roxas Street, Surigao City, Surigao del Norte
 OBSTETRIC WARD MAP

CATCHMENT AREAS

FUTURE PERSPECTIVE

WEIGHING THE OPTIONS/ ALTERNATIVES

 STAFF ABSENCES

Short staffing refers to a unit being staffed with fewer than the routinely or 'ideally' assigned
nursing staff: a condition that occurred in many nursing facilities on a regular basis. Short staffing
disproportionally affected the evening and the weekend shifts. Short staffing was often related to 'call-
ins': a staff member calling in to cancel for a scheduled shift. Call-ins occurred just a short time before
the beginning of a scheduled shift. The direct care nursing staff on the units where short staffing
occurred were faced with the same number of residents, who required the same amount of assistance
and supervision. To perform the same tasks/responsibilities during the same allotted time, the direct
care worker in many instances worked harder, longer hours and/or skipped their breaks. Still, not all the
tasks could be done as expected.
  FAST TURNOVER OF NURSES

Nurse turnover is an undesirable trend for healthcare employers. Turnover rates are
highest when jobs are plentiful and nurses who are unhappy with their positions have many
other options and also includes the reason why nurses turnover is low salary, nurse:patient
ration and even long hours of work.

 LACK OF COMMITMENT

Lack of commitment is most related to conflict with personal needs. However, lack of
learning, lack of appreciation and fairness, inadequate monetary benefits, patient care
situations, poor relations with coworkers, career developmental stage, and lack of job security
are also discussed. Some nurses only aims for 2 years’ experience and after that will apply or
work abroad or will seek for greener Pasteur.

1) Patient harm

Understaffing increased the patient’s risk of contracting pneumonia, urinary tract infections or
other hospital-related infections. Quality care given to patients will be compromised since nurses will be
dealing with more number of patients / workloads.

Chapter 3

CONCLUSION

Understaffing of nurses can affect patient safety negatively in both direct—(pressure wounds,
infections, mortality) and indirect ways (poor documentation, failure to mobilize patients, lack of proper
surveillance). The type of ward, hospital, patient group, and country in the included studies vary, but all
studies show that too few nurses at the hospital wards give too little time to perform important nursing
tasks, which may have consequences of varying degrees of severity for the patient.

RECOMMENDATIONS
The biggest challenge that nurses face in our country’s health care set up is the high
nurse to patient ratio, especially in rural and public hospitals. Top this off with an extremely low
salary with minimal benefits that drive qualified candidates away. Hence, it is strongly
recommended that in order to have adequate staffing of nurses, salary increase is proposed to
solve this problem.
 CURRICULUM VITAE

IRISH PATES, RN
PERSONAL INFORMATION:
Age: 34 y/o
Civil Status: Married
Religion: Roman Catholic
Tel #: 09279452499
E-mail: irishpates@gmail.com
Address: Blk 13 Lot 22 Canlanipa Homes, Surigao City,
Surigao Del Norte, Philippines, 8400

EDUCATIONAL ATTAINMENT:

BS Nursing Graduate Pamantasan ng Lungsod ng Maynila

PROFESSIONAL LICENSE:

 State of licensure: USA Texas

o Status: Current- Valid until 09/30/2020

 Philippines Board of Nursing

o License Number: 0372098

o Valid Until: 09/25/2020

WORK HISTORY:

2017- Present Staff Nurse Caraga Regional Hospital

2012- 2014 Staff Nurse St. Luke’s Medical Center- BGC
2006- 2011 Cabin Crew Qatar Airways
2005-2006 Staff Nurse Las Pinas General Hospital and Satellite Trauma Center

AREAS OF EXPERTISE

Medical- Surgical (4 yrs.)

Obstetrics (1 yr.)
NEYZA PALO-BATAAN
10650 Sitio Looc, Brgy. Luna
Surigao City, Surigao del Norte
Mobile No.: +639479623559
E-mail address: neyzah15@yahoo.com

OBJECTIVE:

To work in an institution that would enhance my knowledge, skills, and attitude in rendering
services to people, to have continuous interest in seeking knowledge and information based on
what is good and right and to become indispensable instrument in the effective and responsive
delivery of quality care to all through this employment.

SKILLS:

Advocate for patient’s rights; work with dedication and commitment; patient centered,
hardworking and energetic; flexible; always ready to deal with different kinds of individual;
adapt easily to change of environment and work schedule; honest and trustworthy; maintain a
positive attitude; interface well with patients, families, and health care staff.

PERSONAL INFORMATION:__________________________________________________-

Civil Status : Married

Date of Birth : November 02, 1990
Place of Birth : Hilongos, Leyte
Age : 26 yrs. old
Sex : Female
Religion : Roman Catholic
Nationality : Filipino
Spoken Languages : Cebuano, Tagalog & English
EDUCATIONAL BACKGROUND:_______________________________________________
College : University of Cebu – Banilad Campus
Bachelor of Science in Nursing
Banilad Cebu City
2009 – 2011
Saint Joseph College
Practical Nursing
Maasin Southern Leyte
2007 – 2009

Secondary : Hilongos National Vocational School

Hilongos, Leyte
2003 - 2007

Elementary : Hilongos South Central School

Hilongos, Leyte
1997 – 2003
Graduated with Honors

TRAININGS/ SEMINARS ATTENDED:_________________________________________

 National Certificate II in Health Care Services June 15, 2008-2013

 Intravenous Therapy Training Sept. 28- Oct. 1, 2012
 CPR Pro for the Professional Rescuer October 16, 2012
 Basic Life Support (BLS) Course October 16, 2012
 Advanced Cardiac Life Support (ACLS) Course October 18, 2012
 EKG Reading, Pharmacology & Basic Capnography October 18, 2012
Endotracheal Intubation Course
 Orientation On Hospital TB DOTS Referral System April 04, 2013
 HIV-AIDS Awareness and Health Information Updates July 11-12, 2013
 Basic Life Support Training – Healthcare Providers August 15-16, 2013
 NLPGNI’s Y2014 Annie Sand Lecture Series November 27, 2014
 The Need For Quality and A Call for Excellence November 27, 2014
 Standards of Professional Care in Intravenous Therapy July 12, 2015
 Renal Replacement Therapy June 4, 2016
 Neonatal Intravenous Therapy June 5, 2016
 Throwback Thursday: Revisiting Common Medical Emergencies March 2, 2017

WORKING EXPERIENCE _____________________________________________ ______

 Caraga Regional Hospital - Staff Nurse Jan. 2013 to Feb. 2015

 Rural Health Unit Sison – Nurse July 2015 – Present
 Anne Corinne N. Ocenar
11172 Brgy. Rizal , Surigao City
Ceeceeoh18@gmail.com
09194237495 / 09063675263

PERSONAL INFORMATION
Civil Status : Single
Date of Birth : November 24, 1990
Place of Birth : Surigao City, Surigao del Norte
Age : 28 yrs. old
Sex : Female
Religion : Roman Catholic
Nationality : Filipino
Spoken Languages : Cebuano, Tagalog & English

EDUCATION
2012 Southwestern University

2010 COLLEGE: Velez College

2007 HIGH SCHOOL : Saint Paul University Surigao

2003 ELEMENTARY: Surigao Education Center

PROFESSIONAL EXPERIENCE
2010 – 2012 Clinical Practicum,
Cebu Community Medical Center
Sacred Heart Hospital
Talisay District Hospital
Medical Surgical Unit
Vicente Sotto Memorial Medical Center
Opon Periculture Center & Maternal House Inc.

Functioned in the role of a RN under supervision of a RN preceptor providing comprehensive care

to adults and children with their families experiencing acute medical surgical health alterations.
Provided basic care, including vital signs,hygienic and nutritional care to patients experiencing a
variety of health alterations. Interacted with children and their families providing physical and
emotional support

2014 – March 2015 CONVERGYS

Customer Service Associate
8th,9th,10th Flr.
TGU Tower,
J.Del mar Avenue Corner Salinas Dr.
 Cebu IT Park , Apas
Cebu City 6000
Philippines

April 2015 – May 2017 JP MORGAN CHASE & CO.

Retail Customer Service
7th Floor , Ebloc Tower
Jose Maria del Mar St, Asiatown IT Park,
Cebu City 6000, Philippines
August 2017 –
February 2018 St. Vincent General Hospital
Staff Nurse
210- D Jones Avenue
Cebu City 6000 Philippines

March 2018-
Present Caraga Regional Hospital
Staff Nurse
Surigao City, Surigao del Norte

Professional Organizations

2013 Philippines Nursing Association

Trainings and Certificates

March 6-8, 2018 Standard First Aid and Basic Life Support Training (March 6-8 2018 )
Red Cross – Cebu Chapter

March 27-29, 2018 Fundamentals in Intravenous Therapy c/o Gesundheits Synergy and
Professional Advancement Institute
August 2018 Research and Management
c/o Caraga Regional Hospital
July 18-20, 2018 Advance Cardiac Life Support, ECG Reading and Interpretation ,
Stroke Management c/o Gesundheits Synergy and Professional
Advancement Institute
July 28 2018 Continuing Professional Development Seminar on: The Role of
Governance and the Profession of Management