Discussion – Week 3
Organizational Policies & Practices to Support Healthcare Issues
The competing needs of the healthcare sector may impact the development of policies in several ways. Such as nursing bodies creating policies to facilitate the shortage of nursing staff which is currently worsening and heightened by the COVID 19 pandemic. As the healthcare sector demands plateaued over the past 2 years so was the demand for nurses. In 2018 the NCL (nursing compact licence) was replaced by the eNCL (enhanced nursing compact licence). As of august 2020, delegates of the national council of state boards of nursing annual meeting voted to approve a licensure compact for APRNs (Advanced Practitioner Registered Nurse). 7 states will be required to obliged to this request. Once such take place then only these 7 states that pass this regulation will benefit from a compact licence for APRN, KBN Connection, 2020. The act of attempting to implement this licence is to appease the demands for staffing shortages and attempting to meet the demands of an aging population which as increases significantly over the past decade.
Competing needs that has a significant impact on the national health crisis of nursing shortages is the advent of contract (travel) nurses who can travel from one state to another in search of the highest bidder and wage offer for their service. An ageing population also places a strain on the availability of nursing staff to equip health organisation to meet the needs of patients. As demands have increased over the years with factors such as technology improving health care services along with continuous research on care that is provided, which improves quality of care.
As contract nurses become a staple of the nursing staff the need for permanent staff along with part time nursing staff is necessary and plays a vital role in the day-to-day operations of the healthcare sector. Ferguson, A., et al., (2020) conducted a cross-sectional study which concluded that the use of contract (travel) nurses, reflected an increase in hospital acquired pressure injury (HAPI) along with incidence. Resulting recommendations that hospitals should use less or limit the number of contract nurses they have on staff at a given time or extensive training extend to contract workers, as necessary. Ferguson, A., et al., continue to point out that in California along with other states. Policies and regulations are in place to ensure a certain number of staff to patient ratio on a given basis. However, specificity regarding nursing staff status regarding nurse being permanent, part time or a traveller is not outlined or made mandatory. Hence health organisations are expected to use their judgement and expectations on how they go about with their style & level of staffing to attain patient care.
As the population ages, the implementation of compact licence would aid with improving the elderly accessibility to healthcare through APRNs. As one of the main aims and focus of APRNs was initially, to serve the vulnerable population and targeting remote areas. Despite policies and regulations being in place to accommodate APRNs providing care to an ageing population. The shortage of nursing staff is still evident which often time is dictated by policy on a state-by-state level. Feyereison, S., & Goodrick, E. (2021), pointed out that for APRN given the autonomy they possess. For APRNs to be able to act in their full capability and capacity. The board of medicine, nurses and policy makers will need to cooperate in allowing APRNs to function as trained and expected. Especially in areas where it is evident and agreed by all alliances that APRNs are needed to reduce the demands of patient care and needs.
Conclusion
As the nursing shortage persist over the years and heightened during the pandemic. Measures to alleviate such shortages continue to be geared towards increasing the number of nurses made available to the US market. As organisations such as the American nurse association (ANA), continues to lobby with policy makers of the dyeing need for a robust and swift actions to address the unsustainable nursing shortage facing our country, ANA, 2021.
References
ANA’s Proposed policy solutions to address the nursing staffing shortage crisis. (2021)
South Carolina Nurse, 28(4), 10-11. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=153915666&site=ehost-live&scope=site&custid=s6527200
Ferguson, A., Bradywood, A., Williams, B., & Blackmore, C. C. (2020). Association of Use of Contract Nurses with Hospitalized Patient Pressure Injuries and Falls. Journal of Nursing Scholarship, 52(5), 527–535. https://doi.org/10.1111/jnu.12572m
Feyereisen, S., & Goodrick, E. (2021). Examining variable nurse practitioner independence across jurisdictions: A case study of the United States. International Journal of Nursing Studies, 118, N.PAG. https://doi.org/10.1016/j.ijnurstu.2020.103633
LPNs & RNs: Answers to the Most Commonly Asked Questions Concerning Your Compact License. (2020). KBN Connection, 65, 30–31.
KBN Connection (KBN CONNECT), Fall2020; (65): 30-31. (2p
10.1097/01.NPR.0000790520.41080.5a
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent Norda! Thank you for sharing a discussion of policies/practices which support the health care issue you identified! As your research may have discussed, the nursing shortage was predicted during the latter part of the last decade. IT was during this time that key nursing education groups American Nursing Association, National League of Nursing), the Robert Wood Foundation, The Institute of Medicine’s Future of Nursing held conference calls (of which I participated) to discuss and plan to meet the patient care needs. It was during these meetings that the new role, Doctor of Nursing Practice was proposed to meet the faculty needs as we planned to increase enrollment in nursing schools.
However, what was not planned was a pandemic! As a result, any efforts to improve the numbers was significantly eroded. As we continue to seek efforts to improve staffing, such as compact licenses, what action steps would be recommended in order to increase the number of enrollments in nursing programs, which is paramount to reducing nursing shortages, in addition to other variables? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Hannah Dounis
Hannah Dounis Response to Norda Hemmings
Norda,
I agree that the COVID-19 pandemic has only worsened the nursing shortage and that policies should reflect the new strain on the healthcare system. Unfortunately, the compact license did not help with the nursing shortage as much as intended. Currently, only 30 states participate because the other states are apprehensive about disciplinary jurisdiction, licensure requirements, and the influence of unions (Villalba, 2020). With the pandemic, states were issuing emergency powers allowing more relaxed licensing requirements so nurses could practice in other states. However, to ensure patient safety and decrease the shortage, the compact license is a great way to do that as it allows for standardized requirements from qualified nurses.
As you also mentioned, contract or travel nursing is a good and bad idea to help with the nursing shortage. With the pandemic, many hospitals were utilizing traveling nurses, but those nurses were getting little training and were placed on units that they knew nothing about. Also, many nurses left their hospital jobs to pursue travel nursing due to the pay increase. Unfortunately, with the high pay that the nurses receive in their contract jobs, hospitals cannot compete. When the nurses decided to return to their original hospital, they asked for two to four times their previous pay rate, as some were making upwards of $150 per hour on their contract (Boyle, 2021). Both strategies were good ideas to help combat the nursing shortage, but it will take policymakers sitting down with healthcare facilities and workers to work the kinks out and make these strategies beneficial for the staff and the patients.
References
Boyle, P. (2021, September 7). Hospitals innovate amid dire nursing shortages. Retrieved from https://www.aamc.org/news-insights/hospitals-innovate-amid-dire-nursing-shortages
Villalba, C.C. (2020, October 15). Compact licensure is a critical response to the pandemic crisis. Retrieved from https://www.myamericannurse.com/compact-licensure-is-a-critical-response-to-the-pandemic-crisis/
6 months ago
Kailynn Jeffords
RE: Discussion – Week 3
North,
Hindering APRN’s from full practice authority contributes to the issues with greater access to care. Barriers to full practice authority lie at the state and national level but mostly it’s the states that regulate NP practice. Currently only 44% of states allow APRNs to practice independently. As stated in your post, if APRNs were more independent, the elderly would have more convenient access. This also applies to rural areas. I am currently in Florida where there is still restricted practice authority. Policies allowing independence would reform healthcare and expand primary provider coverage, especially with the shortage of primary physicians. After the Affordable Care Act was put into motion, it allowed for medicaid expansion and a faster way to implement full practice authority. Nursing associations and healthcare organizations should keep fighting for full practice authority to help close the gap of provider shortages and reduce the demands like you previously stated.
References
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023
Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.
6 months ago
Kailynn Jeffords
RE: Discussion – Week 3
Norda**
Sorry, autocorrect!
6 months ago
Sheri Mead
Sheri Mead – Response 2 to Norda Hemmings
Norda, thank you for your post exploring policy changes that include advocating for policies to allow APRNs full practice authority to help fill coverage gaps in care. The competing need here appears to be state rights to make their own healthcare policies versus the healthcare needs of their populations. Decision-makers involved in policy-making do not always have the input of medical personnel who are knowledgeable about the issues. APRNs’ varied state licensing and scope of practice require incredible investigation and vigilance, making fulfilling their original goal of providing easier access to care for the elderly and rural areas very challenging. The Consensus Model for APRN Regulation guides states in establishing consistency in APRN regulation with the goal to make it easier for APRNs to work between states to increase the number of practicing providers (National Council of State Boards of Nursing, 2022). However, until all states modify their requirements to comply with the Consensus Model, it will be difficult to have them join a compact agreement. The current revision of the APRN Compact is strongly opposed by the American Association of Nurse Practitioners (AANP) because it requires 2,080 practice hours after graduation, which is a costly and unnecessary barrier (American Association of Nurse Practitioners, 2020). As states continue to make their own decisions about healthcare policies, it likely will take several years for standard APRN regulations to be implemented.
Another way to help promote equity in APRN regulation and hasten compact approval is to educate and promote the role of the APRN. There are still many people who are unaware of the role of the nurse practitioner as a provider, who insist that a physician is the only qualified individual who can provide care. Some states regulate nurses through boards of medicine that are staffed with physicians, and they tend to be more restrictive with APRN scope of practice (Feyereisen & Goodrick, 2021). For example, an NP providing home-based primary care might be restricted from signing a DNR order or prescribing controlled substances for pain in some states (Osakwe et al., 2021). These types of limitations are baseless, unnecessary, and inconsistent. Countless studies support the quality-of-care NPs give in primary care compared to physicians, in addition to lower costs and higher patient satisfaction (Feyereisen & Goodrick, 2021). Changing state policies to include nurses as board members for nursing regulation would be helpful in progressing with consistent regulations to move forward with filling staffing shortages.
References
American Association of Nurse Practitioners. (2020). APRN compact licensure. https://www.aanp.org/advocacy/advocacy-resource/position-statements/aprn-compact-licensure
Feyereisen, S., & Goodrick, E. (2021). Examining variable nurse practitioner independence across jurisdictions: A case study of the United States. International Journal of Nursing Studies, 118, 103633. https://doi.org/10.1016/j.ijnurstu.2020.103633
National Council of State Boards of Nursing. (2022). APRN consensus model. https://www.ncsbn.org/aprn-consensus.htm
Osakwe, Z. T., Kim, R. S., Obioha, C. U., Osborne, J. C., Harun, N., & Saint Fleur-Calixte, R. (2021). Impact of state scope-of-practice laws on nurse practitioner-provided home visits. Geriatric Nursing, 42(3), 674–680. https://doi.org/10.1016/j.gerinurse.2021.03.002
6 months ago
Sydney Flick
Main Post
Introduction
Healthcare professionals are under constant stress each and every day. Between the pressures of healthcare practice in general, managing patients and families, and providing quality and safe care, healthcare professionals have a lot on their plate each and every shift. These healthcare challenges become even more stressful when compounded with competing needs, such as limited resources, short-staffing, and patient health needs. Competing needs in healthcare drive policy development in an effort to improve access to resources, but these competing needs also fuel the fires of burnout rates as well because healthcare professionals feel unsupported, unheard, and worn out.
Competing Needs in Healthcare and Policy Development
To first understand competing needs and their impact on policy development, it is important to know what competing needs are. According to Gaim et. al., competing needs “occur when management, depending on the use of limited resources or attention, requires more to be done than available resources suggest it is possible to do” (2018). In healthcare, competing demands include resources (i.e. medications, supplies, etc.), patient needs and diagnoses, staffing ratios, and even available space. In healthcare, competing demands include resources (i.e. medications, supplies, etc.), patient needs and diagnoses, staffing ratios, and even available space. All of these competing needs and more are seen in the correctional healthcare setting, though in some cases, correctional healthcare sees even more dire examples of limited resources and astronomical staffing ratios.
Despite the fact that competing needs can spell disaster for healthcare professionals, their existence is fuel for policy proposals. Many healthcare policies arise as a way to combat limited resources by offering training, grant funding, and resources to promote an increase in hiring and program development. Competing needs also put emphasis on quality care, which promotes policy changes to improve care and safety. “Through policy work, nurses can and should influence practice standards and processes to assure quality of care” (Burke, 2016).
Competing Needs and Their Impact on Burnout
Despite the fact that competing needs can most certainly drive policy reform and improvements, competing needs also fuel the fires of the healthcare burnout crisis as well. Many nurses tend to keep the stresses of work to themselves, but the silence can eventually lead “many to experience tension and frustration, which can trigger displaced aggression harmful to themselves and the profession as a whole” (Kelly & Porr, 2018). Factors contributing the burnout in healthcare include “excessive documentation, a lack of resources that compromised patient care, and lack of administrative action,” which are all competing needs seen within the healthcare system today (Epstein et. al., 2019). When resources are limited and staffing is critical, nurses begin to feel the pressure mounting. Competing needs may be essential for policy reform, but they are also critical when it comes to burnout as well.
References
Burke, S. (2016). Influence through policy: Nurses have a unique role. Retrieved June 14, 2022, from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019). Enhancing understanding of moral distress: The measure of moral distress for health care professionals. AJOB empirical bioethics. Retrieved June 14, 2022, from https://pubmed.ncbi.nlm.nih.gov/31002584/
Gaim, M., Wahlin, N., Pina e Cunha, M., & Clegg, S. (2018, April 5). Analyzing competing demands in organizations: A systematic comparison – Journal of Organization Design. SpringerLink. Retrieved June 14, 2022, from https://link.springer.com/article/10.1186/s41469-018-0030-9
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment. Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi: 10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
6 months ago
Ginger Spencer
RE: Main Post
Hi Sydney,
I agree with your point of view regarding healthcare professionals and burnout. It is safe to say that life is challenging enough without working in a profession where someone else’s life is basically in your hands. It is essential that
nurses and other healthcare professionals practice self-care and are aware of their mental health, so we can provide optimal care when taking care of our patients (Jacobs et al., 2018). The old saying goes, “you cannot pour from an
empty cup.” I have worked in the pandemic like most of us have, and I think we all have felt we have a duty to fulfill to our patients in a time of need, making it harder to think of ourselves in times like these.
It is crucial that the institutions we work for help to retain employees and provide resources for their employees’ physical and mental well-being. Doing this will improve job satisfaction and help to provide positive patient outcomes.
Nurses who are stressed and showing signs of burnout will likely make more errors when caring for their patients (Park et al., 2018). It is essential that nurses feel valued and maintain a healthy work-life balance. I think that
companies do need to strive to make their employees feel like they are valued and help with the burnout situation going on. I live and work in a very rural area and it’s evident that there is a nursing shortage because we have
travelers in our small hospital. We have never had to recruit travelers in the past. I am afraid it is just the beginning.
Ginger
References
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being. Nursing Administration Quarterly, 42(3), 231–245. https://doi.org/10.1097/naq.0000000000000303
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving united states payment models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine, 31(4), 588–604. https://doi.org/10.3122/jabfm.2018.04.170388
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Main Post
Excellent Sydney! Thank you for sharing a discussion of policies/practices which support addressng the current health care issue identified! If you served in a leadership/executive role in the organization, what action steps will be recommended in order to reduce burnout in the nursing staff? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Sydney Flick
RE: Main Post
Thank you Dr. Haggins!
If I served in a leadership/executive role, I think the first step for me would be to know what type of work my employees are doing each and every day. One of our biggest complaints as nurses at the prison is that management expects us to have everything completed and done each and every shift, but they don’t actually know what kind of work is being done each and every shift. For example, IPC (the clinic I work in at the prison) has a total of 66 patients currently, and the 66 patients are split into two sides. Of the 66 patients, approximately 25 are total care patients that require assistance with feeding, changing, etc. Add in the triaging of emergency situations (we’ve had as many as 15 in one night) and it can get hectic, especially when staffing for the entire prison complex is 2 RN’s, 1 LPN, and 1 CNA. If management actually understood how much work needs to be done on night shift, I think they could begin to appropriately staff shifts and brainstorm ways to minimize work load.
I think staff appreciation goes a long way too. We are constantly getting emails about how we aren’t getting work done correctly or filling documents out correctly, but we don’t every really get anything about things we’ve done right. Staff appreciation emails, employee of the month, and other staff recongition programs would go a long way in promoting satisfaction in our work and limit reasons to burn out as well. Obviously improving staffing ratios would also be phenomenal in promoting a decrease in burnout as well.
Thank you!
Sydney Flick
6 months ago
Esther Saint-Cyr
RE: Main Post
Hi Syndey,
I enjoyed reading your post. It was an informative post regarding the lack of resources in correctional healthcare. People in correctional facilities are entitled to medical care, including mental health care (Appelbaum, 2020). Unfortunately, there are some challenges to delivering health care services in corrections, such as overcrowding and security requirements. According to Montoya-Barthelemy (2020), almost 2.3 million people are incarcerated in state and federal prisons, local jails, immigration detention centers, juvenile correctional facilities, military prisons, and state hospitals in the United States is more than 0.7% of its total population.
Some inmates have a history of trauma or abuse, mental health conditions, or substance use. They require treatment during incarceration, and the correctional facilities can address these needs. Incarcerated people also have barriers to accessing health care and have unmet health needs before they were incarcerated (Mcleod & Martin, 2018). Because of this, correctional healthcare requires adequate resources to help meet the demand for all inmates’ care. Due to decreased substance use, increased access to health care, and fewer competing priorities, healthcare in corrections provides a better opportunity for people to address health needs. With adequate resources, it can decrease health care costs, decrease rates of reincarceration and improve public health.
References
Appelbaum, P. S. (2020). Discharge Planning in Correctional Facilities: A Constitutional Right? Psychiatric Services, 71(4), 409–411. https://doi.org/10.1176/appi.ps.202000084
McLeod, K. E., & Martin, R. E. (2018). Health in correctional facilities is health in our communities. Canadian Medical Association Journal, 190(10), E274–E275. https://doi.org/10.1503/cmaj.171357
Montoya-Barthelemy, A. G., Lee, C. D., Cundiff, D. R., & Smith, E. B. (2020). COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine, 58(6), 888–891. https://doi.org/10.1016/j.amepre.2020.04.001
6 months ago
Ana Freed
RE: Main Post
Response 2 Sydney
Sydney,
Excellent point on burnout being an important healthcare issue. Burnout has been linked to an increase in adverse events in patient care, such as medication errors or an increase in falls (Garcia et al., 2019). Add to this the stressors of a global pandemic and conflict over receiving a COVID vaccine, and it’s no wonder burnout is on the rise. Research has begun to explore what creates resilience to burnout and ways to mitigate burnout. One identified area is the use of mindfulness-based interventions, such as deep breathing or yoga (Hilcove et al., 2020).
References
Garcia, C., Abreu, L., Ramos, J., Castro, C., Smiderle, F., Santos, J., & Bezerra, I. (2019). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, 55(9), 553. https://doi.org/10.3390/medicina55090553
Hilcove, K., Marceau, C., Thekdi, P., Larkey, L., Brewer, M. A., & Jones, K. (2020). Holistic nursing in practice: Mindfulness-based yoga as an intervention to manage stress and burnout. Journal of Holistic Nursing, 39(1), 29–42. https://doi.org/10.1177/0898010120921587
6 months ago
Ifeanacho Orajaka
RE: Main Discussion Post – Week 3
There are many reasons why it is difficult to improve health literacy in both the primary and acute care setting. First, there is a shortage of primary care providers (Rosenberg, 2018). Nurse practitioners have started to fill the need for primary care as the rate of physicians retiring exceeds that of physicians entering the primary care workforce (Rosenberg, 2018). The physician shortage is leading to decreased health care Access, with an increasing number of people getting health coverage, especially with expanding Medicaid (Rosenberg, 2018). As a result, many primary care offices set appointments in 15-minute increments to see as many patients as possible.
Furthermore, the fee-for-service method has encouraged this problem by incentivizing a high volume of treatment over high quality (Park, Gold, Bazemore, & Liaw, 2018). How much can be accomplished in a 15-minute session with a doctor? It is tough to access a patient, carry out some basic labs like urine analysis and HbA1c, and educate the patient on the importance of adhering to medication regiment, ordering tests, and ordering or refilling medication all in such period. Using the doctor’s office visit as a case study, it is essential to note that the workforce would need more staff, more time, and an efficient model for organized patient care. They should also provide more educational resources and give more time to review them with the patients. Current policies on this topic do not support the needs of the workforce, resources, or patients by utilizing the fee-for-service model. In addition, many healthcare organizations are run with a business model that emphasizes cost outcomes instead of patient outcomes (Kelly & Porr, 2018). As a result results in policies that do not consider the needs of the workforce or patients. Multiple competing conditions affect the healthcare issue of low health literacy. First, there is a lack of primary care providers. There is also a lack of access to primary care services. When the Affordable Care Act (ACA) was passed, 29 states adopted the Medicaid expansion and saw a reduction of 38.3% in the number of uninsured individuals (Broome & Marshall, 2021). While an increase in people seeing primary care doctors went up, some diseases, such as hypertension and diabetes, have not improved their management (Broome & Marshall, 2021). Additionally, the use of the emergency room for non-emergent services has not improved either (Broome & Marshall, 2021). This emphasizes the lack of understanding by patients on managing their health effectively, even while seeing a primary care doctor more frequently.
The government could pass policies allowing more independent practice of nurse practitioners. This would help solve the first issue by providing more primary care providers to see patients for this type of care. Next, all primary care providers need to take a course on education that includes identifying barriers that affect compliance with medical advice. For example, education is ineffective if a patient is told to eat more vegetables and cook with less salt, but the patient eats canned vegetables to save money. The third policy that would help make primary care more effective would be having a minimum appointment time slot. The ACA encouraged quality care by paying based on how patients rated their visits to their doctor’s office (Broome & Marshall, 2021). This is ineffective for many reasons, mainly because a doctor might not deliver the best news to someone, and then they rate their experience as poor when the doctor was doing their job. I think having a minimum amount of time a doctor spends with a patient each visit would allow more time for education, questions, and careful explanation. It would also enable the doctor to stay on schedule throughout the day and likely improve their job satisfaction.
It could be concluded that health literacy is an issue affected by many factors. Finding a way to reach more people with effective primary care would be a considerable first step in improving health literacy. Moving away from a healthcare business model and transitioning to a model that focuses on patient outcomes would result in policies focusing on workers, resources, and patients.
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From clinician
to the influential leader (3rd ed.). New York, NY: Springer.
Kelly, P., Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to
enhance RN practice. The Online Journal of Issues in Nursing 23(1), Manuscript 6.
Doi:10.3912/OJIN.Vol12No01Man06
Park, B., Gold, S. B., Bazemore, A., Liaw, W. (2018). How evolving United States payment
models influence primary care and its impact on the quadruple aim. Journal of the American Board of Family Medicine, 31(4), 588-604. Doi: https://doi.org/10.3122/jabfm.2018.04.170388
Rosenburg, J. (2018). Nurse practitioners play an increasing role in primary care. Retrieved
from https://www.ajmc.com/view/nurse-practitioners-play-an-increasing-role-in-primary[1]care
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Main Discussion Post – Week 3
Excellent Ifeanacho! Excellent! Thank you for sharing a discussion of policies/practices which may suuport the improvements when addressing a current health care issue! As health care leader, what recommendations would be forthcoming in order to increase health literacy in our health care system? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Ifeanacho Orajaka
RE: Main Discussion Post – Week 3
Thank you so much, Dr. Haggins, for your feedback. To increase health literacy in the healthcare system, it is essential to:
- Develop and disseminate health and safety information that is accurate, accessible, and actionable.
- Increase the dissemination and use of evidence-based health literacy practices and interventions.
- Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services.
- Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.
Reference
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
(2010). National Action Plan to Improve Health Literacy. Washington, DC: Author.
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Main Discussion Post – Week 3
Excellent response Ifeanacho! Thank you for providing an evidence-based response!
Dr. Haggins
6 months ago
Petergay Sterling
RE: Main Discussion Post – Week 3
Hello Ifeanacho,
Although I realized that there was a nursing shortage, I did not realize that there was also a physician shortage! It makes sense that nurse practitioners would fill that role as they are able to perform many roles that were historically filled solely by a medical physician. I was aware that most primary care settings see patients for less than 15-minute segments based on work experience. A study showed that physicians spend approximately 13-24 minutes with each patient (Franklin, 2021). I too have wondered if providers are able to proficiently treat patients in such a short time. I wonder if this is rooted in evidence or if it just common practice and to help me understand further, I sought out data about average physician visit times to help. A survey showed that in 1990 the average time spent with patients was 17 minutes on average (Franklin, 2021). This data means that doctor patient time hasn’t changed too much since the nineties. Simultaneously, I know that just because the provider is not with the patient doesn’t mean that their work has ended. One study showed that on average physicians spend 16 minutes and 14 second per patient reviewing each patient’s electronic health records (EHR). The time spent on the EHR was dedicated to conducting chart reviews, documentations, and ordering medication and reviewing lab results (Finnegan, 2020). I think that the time within the EHR and the time spent with the patient is proficient to gather all of the information needed to treat the patient.
References:
Finnegan, J. (2020, January 14). For each patient visit, physicians spend about 16 minutes on EHRs, study finds. Retrieved from Fierce Healthcare: https://www.fiercehealthcare.com/practices/for-each-patient-visit-physicians-spend-about-16-minutes-ehrs-study-finds
Franklin, R. (2021, October 9). Are doctors spending less time with patients? Retrieved from Mobius MD: https://mobius.md/2021/10/09/how-much-time-do-physicians-spend-with-patients/
6 months ago
Richard Jeon
response #1
Hi Ifeanacho, thanks for your detail insight on health literacy. According to the Journal of Nursing Education (2022), approximately 36% of the U.S. adult population is below basic health literacy skills, with their caregivers also having difficulty understanding basic health information. As a bedside nurse, my personal belief is that education is one of the biggest role of nurses. If a patient came into the hospital for a stroke and we discharge them without adequate or proper education (such as signs and symptoms of stroke), and the patient gets readmitted for a stroke, I feel like health providers failed that patient. We are so involved in treating the patient in the hospital but overlook the fact that in the end, the patient has to have the will to take care of their own body. Kelly and Poor (2018) states that patient care is often compromised with premature discharges and hurried circumstances to teach patients about self-care and medication admin/side effects.
Unfortunately, as you’ve stated, there are shortage of doctors, NP, and nurses which make this situation worse as we are over-assigned patients and short of time just to do interventions such as passing medications. If there were adequate staffing, there would be more time to actually provide quality education. I believe every hospital should at least have a dedicated stroke and diabetic educator who can follow up during the patient’s hospital course and provide education to patient and families. This would decrease hospital readmissions and overall improve patient outcome. Primary prevention is the key to lessen the stress and burden of healthcare in the United States.
References
Kelly, P., Porr, C., (January 31, 2018) “Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice” OJIN: The Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi: 10.3912/OJIN.Vol23No01Man06. Retrieved from
https://doi.org/10.3912/OJIN.Vol23No01Man06
Using Health Literacy Tools to Develop and Evaluate Patient Education Material. (2022). Journal of Nursing Education, 61(5), 283. https://doi.org/10.3928/01484834-20220303-11
6 months ago
Norda Hemmings
RE: Main Discussion Post – Week 3
Response to Ifeanacho Orajaka,
Thank you for your insight on healthcare crisis and how policy affects such, Ifeanacho.
As I do agree with you the need for healthcare services needs to be tailored to primary care more versus healthcare being established as a business model type of approach. Moon,J.R., & Falick A. A. (2021), pointed out that despite the highest expense for health services per capita. The United States of America (USA) health system is considered the worst healthcare system among developed countries. As the US health system is inaccessible, lack equity and affordability especially to the most vulnerable group within the population.
I do agree with you that greater outcome could be achieved by us nationally, a preventative-care culture versus a sick-care culture. As health care literacy plays an active role in achieving primary health care services and goals being paramount and not comprehensive health services. Pawlack, R., 2005 pointed out that healthcare literacy is a major problem in the USA. As individuals with low health literacy understanding is at greater possibility of being hospitalized. However, primary care settings would aid with reducing such occurrence.
References
Moon, J. R., & Falick Ascher, A. (2021). Post–COVID-19 Health Care System: A Call for Community-Based, Person-Cantered, and Primary Care–Driven Care. American Journal of Public Health, 111(8), 1451–1455. https://doi.org/10.2105/ajph.2021.306160
Pawlak R. (2005). Economic considerations of health literacy. Nursing Economic$, 23(4), 173–180. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=106525141&site=ehost-live&scope=site&custid=s6527200
6 months ago
Berta Dantzler
RE: Main Discussion Post – Week 3
Ifeanacho,
I really enjoyed reading your post Ifeanacho, you really touched on some very key points that affected patient care and outcomes, such as access to providers, time spent with patients and health literacy. These are all very important to improve the populations’ health. As nurses continue to lobby and receive support from professional nursing organizations for example, the ANA, I am very optimistic that the solutions will be beneficial for patients, communities, healthcare workers and the healthcare systems.
6 months ago
Arielle Doering
RE: Main Discussion Post – Week 3
Ifeanacho,
You brought up a very critical point and I really enjoyed reading your opinions! There is a huge provider shortage and it only makes sense to utilize nurse practitioners to fill those gaps. I have been feeling lately that our hospitals have become more business minded, which sometimes takes away from actual care. Most patients report feeling like their doctors are always rushed and they have little time for questions (Brom, 2018). It makes sense why providers need small windows of time because they can see more patients. However, I feel nurse practitioners play a role in helping answer questions and provide education for patients. Do you have any opinions on how different states have various levels regarding scope of practice for nurse practitioners? It can be very limiting for some states, which only worsens the provider shortage.
Best,
Arielle
References
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023
Carranza, A. N., Munoz, P. J., & Nash, A. J. (2021). Comparing quality of care in medical specialties between nurse practitioners and physicians. Journal of the American Association of Nurse Practitioners, 33(3), 184-193. https://doi.org/10.1097/JXX.0000000000000394
6 months ago
Berta Dantzler
RE: Discussion – Week 3
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Berta Dantzler
Master of Science in Nursing Informatics, Walden University
NURS 6053C: Interprofessional Organizational and Systems Leadership
Dr. Rosemary Haggins
June 14, 2022
Discussion: Organizational Policies and Practices to Support Healthcare Issues
When trying to find ways to manage resources, workforce and patients, the organizations’ culture plays a big part in how the development of policy will be formed and implemented. According to Seixas and colleagues (2021) due to increasing healthcare cost demographic and advancement in technology, healthcare systems are under budgetary pressures. Assessing the work environment for what are the current and future needs to appropriately manage workforce resources is key. The policy would be formed on what areas need improvement and establishing standards and goals. The competing needs of the workforce may impact the development of new policy in order to keep patients safe and help the healthcare organization meet the Quadruple Aim. Also, as nurses “developing and fostering ethical awareness fundamentally requires recognition that ethics is in everything that we, as nurses, do” (Milliken, 2018) to keep patients safe even in a time when resources are scarce.
Next, the workforce shortage is a competing need that has impacted the healthcare systems on a national level. Healthcare workers burnout has reached a record high and healthcare organizations across the United States are feeling the impact of the nursing shortage due to burnout (New surgeon general advisory sounds alarm on health worker burnout and resignation, 2022). Due to the nursing shortage Pediatric clinics are also affected by the nursing shortage and in order to address the issue of childhood obesity and implement the strategies to improve childhood obesity, the nurse staffing issues need to be remedied. Nursing educators are needed to be able to promote wellness, educate and advocate to legislators for assistance and funding to help improve the populations’ health and outcomes.
Finally, policy can impact the competing needs by putting policies in place that support nurses in all areas of healthcare to be able to have and maintain appropriate nurse-to-patient ratios, to keep patients safe, assist nurses to advance their careers/practices and receive educational resources that can help improve patient care. Policies that support nurse retention can help improve patient outcomes, increase employee retention and reduce costs.
References
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/
ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
New surgeon general advisory sounds alarm on health worker burnout and resignation. (2022, May 23). HHS.gov. https://www.hhs.gov/about/news/2022/05/23/new-surgeon-general-advisory-sounds-alarm-on-health-worker-burnout-and-resignation.html
Seixas, B. V., Regier, D. A., Bryan, S., & Mitton, C. (2021). Describing practices of priority setting and resource allocation in publicly funded health care systems of high-income countries. BMC Health Services Research, 21(1), 90. https://doi.org/10.1186/s12913-021-06078-z
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent Berta! Thank you for sharing a discussion of policies/practices to address a current health care issue! You identify the need to address work force shortages! As nurse executive, what action steps/recommendations would be forthcoming in order to adequately address workforce shortages? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Berta Dantzler
RE: Discussion – Week 3
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Berta Dantzler
Master of Science in Nursing Informatics, Walden University
NURS 6053C: Interprofessional Organizational and Systems Leadership
Discussion Post Response #2 to: Dr. Rosemary Haggins
Dr. Rosemary Haggins
June 17, 2022
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Thank you for your response and feedback Dr. Haggins. As a transformational Nurse Executive Leader with the responsibility to improve quality and manage resources for patient safety and performance, healthcare administration and policy, and business management (Foxx & Garner 2021), I would address the workforce shortages, by developing a strategic plan to address the workforce issue by putting together a committee to include Stakeholders impacted by the nursing shortage. The committee planning would include an assessment of the needs, plans, implementation and evaluation of the outcomes, along with the dissemination of results. In having Stakeholders be a part the process of addressing staffing issues that affect not only the patients, but the health system as a whole, I would stimulate “others to use their creative minds and hearts to improve the practice environment and patient outcomes, which is a hallmark of transformational leadership” (Pearson, 2020), working together as a team to resolve issues that impacts everyone.
As a Nurse Executive Leader the priority would be open communication and feedback to address the current and future needs in order to ensure quality patient care, influence policy changes and address the challenges of the nursing shortage that requires the Nurse Executive to coordinate the allocation of resources in order to keep patients safe, include policy to maintain a safe nurse-to-patient ratio, and help the healthcare systems/organizations meet the goals of healthcare. This would include budget request to hire, train and deploy resources in critical shortage areas.
References
Foxx, M., & Garner, C. (2021). Qualifications of Executive Nurses for Service on Hospital Boards. The Journal of Nursing Administration, 51(12), 626–629. https://doi.org/10.1097/NNA.0000000000001085
Pearson, M. M. (2020). Transformational Leadership Principles and Tactics for the Nurse Executive to Shift Nursing Culture. JONA: The Journal of Nursing Administration, 50(3), 142–151. https://doi.org/10.1097/NNA.0000000000000858
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent Berta! Thank you for providing a peer-reviewed response to my question! Much appreciated!
Dr. Haggins
6 months ago
Rachel Donovan
Rachel Donovan Response to Berta Dantzler
Berta,
The current state of the healthcare workforce has been impacted by Covid-19, health worker burnout, and inevitable retirements. The healthcare workforce shortage is a national healthcare issue. I agree that internal policies must be in place to maintain appropriate nurse-to-patient ratios. Staffing ratios lead to a fair workload for nurses (Olley et al., 2019). Policies can help navigate the ethical dilemmas that could arise when faced with competing needs.
Patients need safe, affordable healthcare; hospitals need staff and revenue to continue operations; staff need compensation for their work and a guarantee of a safe working environment. While higher nurse-to-patient ratios may save hospitals on staff and increase their payment for services, it hurts patients’ and nurses’ safety. Decrease the ratio, and the patients and nurses are safe. Nevertheless, the hospital does not have extra money for advancing technology or hiring a much-needed evidence-based practice specialist.
Nurses need to speak up and change the silent culture that has been misunderstood as acceptance of the unethical situations many nurses face (Kelly & Porr, 2018). When nurses, leaders, and systems work with ethical awareness, it can help create policies to address competing needs in healthcare.
Resources
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288–293. https://doi.org/10.1071/AH16252
6 months ago
Berta Dantzler
RE: Rachel Donovan Response to Berta Dantzler
Rachel,
Thank you so much for your feedback Rachel. I agree with you patients need safe care and healthcare organizations need to put policies in place to support nurses. There is a lot of work that needs to be done to address the issues of the nursing shortage and burnout, but one thing about nurses, we are resilient, proud and love what we do! Thanks again.
6 months ago
Judeline Joseph
RE: Discussion – Week 3
Judeline Joseph, Main post, discussion week 3.
According to the American Nurses Association (ANA) code of ethics, nurses must provide compassionate and individually centered care to each patient, regardless of race, age, religion, social class, or illness (ANA, 2015). The ANA also stipulates that nurses should provide holistic care, promulgate public health through patient education, and be patient advocates (ANA, 2015). However, it is near impossible in this climate for nurses to adhere to the code of ethics while being proficient and getting everything done during their shift.
According to Aschmann et al., 2020, patient-centered care seeks to integrate both patient and family into the care planning, tremendously improving health outcomes and patient and caregiver satisfaction. Therefore, following ethical guidelines are beneficial to both the caregivers and the patient experience.
However, the prevalence of the nursing shortage has made it difficult for nurses to provide patient-centered care. Nurses feel the pain of failing in their ethical obligations to patients, which increases burnout, turnover rates, emotional exhaustion, the feeling of inadequacy, and decreased job satisfaction.
While the term has been widely used in healthcare and associated with reimbursement, it is rarely true on the floor. Patient centered-care is utterly impossible without adequate staffing and resources. Moreover, these two needs compete and may impact policy development.
Milliken, 2018, states that ethical actions consist of following the ANA guidelines in providing patient care. The authors laid out several examples where nurses’ actions were questionable and unethical due to time constraints, poor staffing, and inadequate resources, causing the patients unintended harm.
Organizations are often viewed as cutting corners, not staffing adequately, or providing appropriate resources to caregivers because of cost-related factors. Everhart, 2013 found that organizations have periodically sought to reduce staffing to increase profits. In a cross-sectional study, Lasater et al., 2021, found that mortality rates and other adverse outcomes were widely reduced by implementing one to four nurse-patient ratios in 87 acute care hospitals in Illinois.
The authors stated that the same study was conducted in New York, and a decrease in sepsis-related deaths was noted. Furthermore, they added that California is the only state with a mandated nurse-patient ratio, and the results are outstanding and widely known. The authors concluded that while legislators have tried to address and establish nurse-patient ratios in other states, such actions have failed due to the unjustified fiscal profitability of such ventures.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only
Aschmann, H. E., Boyd, C. M., Robbins, C. W., Chan, W. V., Mularski, R. A., Bennett, W. L., Sheehan, O. C., Wilson, R. F., Bayliss, E. A., Leff, B., Armacost, K., Glover, C., Maslow, K., Mintz, S., & Puhan, M. A. (2020). Informing Patient-Centered Care Through Stakeholder Engagement and Highly Stratified Quantitative Benefit–Harm Assessments. Value in Health, 23(5), 616–624. https://doi.org/10.1016/j.jval.2019.11.007
Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: Competitive versus less competitive markets. Health Care Management Review, 38(2), 146–155. https://doi.org/10.1097/HMR.0b013e318257292b
Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ Open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899
Milliken, A. (2018). Ethical Awareness: What It Is and Why It Matters. Online Journal of Issues in Nursing, 23(1), 2. https://doi.org/10.3912/OJIN.Vol23No01Man01
6 months ago
Joseph Lombardi
wk3 peer response 2
Judeline, excellent post regarding nurse burnout and their obligations to the patient. The organization too often puts an emphasis on cost savings measures and profit margins (Mudallal, et al., 2017). Nurses are being asked to do more than ever and since the pandemic started nurse burnout is being really highlighted as evidenced by the number of nurses retiring or leaving the field. One such way that hospital systems can address nurse burnout is through expanding mental health services for their employees such as EAP programs, employee wellness programs, and offering massages and other personal care time (Aryankhesal et al., 2019). By expanding services for nurses in need, the hospitals can help their nurses overcome burnout while also helping to ensure high patient satisfaction and level of care.
References
Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M.,
Sohrabi, R., & Farhadi, Z. (2019). Interventions on reducing burnout in physicians
and nurses: A systematic review. Medical journal of the Islamic Republic of Iran,
33, 77. https://doi.org/10.34171/mjiri.33.77
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The
Influence of Leader Empowering Behaviors, Work Conditions, and Demographic
Traits. Inquiry : a journal of medical care organization, provision and financing,
54, 46958017724944. https://doi.org/10.1177/0046958017724944
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent Judeline! Thank you for sahring discussion of policies/practices to support a health care issue! As you reflect on your research findings, what recomendations would be forthcoming to the organizational leaders in order to improve the nurses’ work environment in an effort to reduce turnover? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Judeline Joseph
RE: Discussion – Week 3
Thank you, Dr. Haggins, for the questions,
As I reflect on my research findings, I have found that several authors mentioned that active employee involvement in the workplace, new graduate nurse programs that support and empower those nurses to stay in the profession, and an increase in resources in the workplace are effective retention strategies to reduce burnout and high turnover rates in the industry (Foster, 2022).
References
Foster, S. (2022). Reflecting on retention: reasons why nurses choose to stay. British Journal of Nursing, 31(7), 405. https://doi.org/10.12968/bjon.2022.31.7.405
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent response Judeline! Thank you for providing a peer-reviewed response! Much appreciated!
Dr. Haggins
6 months ago
Norda Hemmings
RE: Discussion – Week 3
Response to Judeline, Discussion Post.
Thank you Judeline for such an awesome post and insight on nursing staff ratio and how policies do influence such practice. It was quiet enlightening to also learn that only the state of California has a policy related to the ratio and number of patient nursing staff members can be assigned to. Like you have pointed out, as nurses whose practice are guided by the nursing code of ethics. The lack of staff and increase expectations of health organizations have often time derailed our vision of practicing the expectations of our code of ethics. Which often time causes frustrations and a feeling of loss when we are unable to carry out our functions based on our nursing ethics, we have pledged to upon commencing and joining the Nursing profession. Erlen J. A., (2001). Highlighted in her published article that the shortages of nurse do affect the style and type of care patients receive along with influencing policies regarding patient care. Which may or may not affect the type of care patients receive or hurt a nurses practice and career.
As ANA (American Nurses Association) also pointed out that nurses are expected to be advocates for their patients. Often the shortage of nurses along with an institution policy prevents nurses from advocating for their patients in compromised situations, ANA, 2021. As time progresses and the nursing shortage ensue more than ever before. One cannot help but ask is the code of ethics for nurses’ standard and practices are on the verge of becoming extinct or impractical to carry out on a day-to-day basis during patient care?
References
ANA, (2021). ANA’s Proposed policy solutions to address the nursing staffing shortage crisis. South Carolina Nurse, 28(4), 10-11. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=153915666&site=ehost-live&scope=site&custid=s6527200
Erlen, J.A., (2001). The nursing shortage, patient care and ethics.. Orthopaedic Nursing, 20(6), 61-65.https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=106818662&site=ehost-live&scope=site&custid=s6527200
6 months ago
Rose Victor
RE: Discussion – Week 3
6 months ago
Hannah Dounis
Main Post Discussion Week 3- Hannah Dounis
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Main Post Discussion Week 3- Hannah Dounis
Excellent Hannah! Thank you for sharing a discussion of policies/practices which support the health care issue described! Based on research findings, what recommendations would be forthcoming in order to adequately reduce the effects of the nursing shortage? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Hannah Dounis
RE: Main Post Discussion Week 3- Hannah Dounis
Dr. Haggins,
One main recommendation that kept coming up in my research on how to reduce the effects of the nursing shortage was to address the nurse educator shortage. This includes university faculty, clinical instructors, and preceptors. In 2021, 62% of nursing schools had at least one vacancy for a full-time faculty member (Zhavoronkova et al., 2022). With the limited faculty nursing school are having to limit how many students they can take on at one time, which during a nursing shortage only adds to the issue. Another recommendation that I kept running across was to prioritize nurse retention. To do this Jean (2022), recommends several strategies including rewarding tenured nurses with bonuses, increasing float pools, and expanding referral bonus programs. This will help with the shortage because if you invest in the staff that you already have, and they feel valued it helps to increase morale and retention.
References
Jean, J.Y. (2022). 6 proven strategies from nurse execs to combat the nursing shortage in 2022. Retrieved from https://nursejournal.org/articles/proven-strategies-to-survive-the-nursing-shortage-2022/
Zhavoronkova, M., Custer, B.D., Neal, A., Schweitzer, J., & Bombardieri. (2022). How to ease the nursing shortage in America. Retrieved from https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Main Post Discussion Week 3- Hannah Dounis
Excellent Hannah! Thank you for providing a peer-reviewed response to my question! Much appreciated!
Dr. Haggins
6 months ago
Richard Jeon
response #2
Hi Hannah, thanks for detailed insight on nursing shortage. I agree with you that more policies involving quality nursing education is needed to ensure there are adequate nurses down the road. I did not know that nursing faculty shortage attributed to nursing shortage; According to Regner et al. (2022), “approximately 69,000 qualified nursing applicants were denied entry into nursing programs in 2014”, which is probably worse now post COVID pandemic. On a national or even on a state level, there could be federal nursing grants and loan assistance program that target new college students to become interested in the profession of nursing. On a bachelor level, one thing I really liked about working for HCA is that they worked with Galen College of Nursing to allow their employees to further their career in Master’s nursing programs at almost no cost to the employees. This kind of programs are needed to push nurses to become NPs, leadership positions, and educators on a Master’s level. On my main post, I wrote about the federal bill ‘H.R.3165 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021’ was proposed in 2021 to implement a hospital staffing plan that submits to Department of Health and Human Services (HHS) that complies with specific nurse-to-patient ratio by each unit. The bill also provides additional resources such as nurse loan repayment program and scholarship/grant program that will promote more new graduate nurses to the workforce.
References
Congress.gov. (n.d.). H.R.3165 – Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021. Retrieved March 22, 2022, from https://www.congress.gov/bill/117th-congress/house-bill/3165?r=18&s=2
Regner, B., Haas, M., & Russek, M. (2022). Solutions to the Nursing Shortage.The North Dakota Nurse, 91(2), 9. https://www.proquest.com/trade-journals/solutions-nursing-shortage/docview/2657442546/se-2?accountid=14872
6 months ago
Ginger Spencer
RE: Discussion – Week 3
Organization Policies and Practices to Support Healthcare Issues
Competing Needs and their Impacts on Policy Development
American Nurses Association (2015) pointed out that policy formulation in healthcare systems states that the Policy must align with the various needs and agendas of the persons within the system and the multiple elements that function to develop policies. Milliken (2018) points out that nursing shortages hinder the provision of services within health facilities, thus the limitation on policy formulation geared towards better performance of nurses. As much as formulation of Policy is essential, it is good to note that where the nursing shortage is concerned, policies formulated may favor patients but harm nurses. Nurses suffer burnout due to decreased staff in facilities and the massive influx of patients streaming in and out of hospitals. This has been especially true during the recent pandemic. For this matter, all stakeholders need to be included in developing policies that favor all sides.
Competing Needs and their Impact
Nursing shortages and untrained nurses within institutions are competing needs that hinder the service delivery and quality in healthcare facilities. The low numbers of nurses within institutions relate to the increased workload and, consequently, nurses’ burnout. Whereas there is a constant low number of trained nurses servicing the large patient population, the quality of patient care is declining, and it is eminent that exhausted individuals can make medical errors and cause poor patient outcomes. Nursing shortages and untrained nurses in hospitals and other healthcare facilities is thus the leading reason why the constant burnout evidence of a reduction in quality service delivery by nurses leads to quality issues in patients.
How Policy addresses the Nurses’ Competing Needs
Nurses, when exhausted, end up providing poor services for patients leading to an undesirable reputation created within hospitals. One thing that has helped some in the hospital I work in has been to cross-train nurses to other departments so that untrained nurses are not getting pulled to help in areas where they are not adequately trained. Another policy initiated was keeping a nurse on call in each department in case of an influx of patients. The on-call nurse was called in once the census reached a certain level. Unfortunately, with Covid-19, all those efforts were exhausted, and still, there was a nursing shortage. There still needs to be policy reform in the event of another pandemic to help with the rise of nursing burnout. This will help reduce overworking nurses and thus achieve the best service quality in healthcare institutions. For policymakers and the management of hospitals to address the competing needs, Kelly and Porr (2018) explain that stakeholders, including the management and the patients themselves, must be engaged in the policy formulation where the creation of policies captures the needs of every individual.
References
American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements.
Silver Spring, MD Author https://www.nursingworld.org/coe-view-only/
Kelly, P., and Porr, C., (2018). Ethical Nursing Care Versus Cost Containment: Considerations
to Enhance RN Practice; OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 1, Manuscript 6. DOI: 10.3912/OJIN.Vol23No01Man06.
https://doi.org/10.3912/OJIN.Vol23No01Man06
Milliken, A., (2018). Ethical Awareness: What It Is and Why It Matters ; OJIN: The
Online Journal of Issues in Nursing Vol. 23, No. 1, Manuscript
1.DOI: 10.3912/OJIN.Vol23No01Man01
https://doi.org/10.3912/OJIN.Vol23No01Man01
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Excellent Ginger! Thank you for sharing a discussion of policies/practices which support the resolutions to the health care issue identified! As you reflect on your research findings, what action steps would be a priority to you as a nurse executive in order to address the issues surrounding burnout and stress in nursing? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Ginger Spencer
RE: Discussion – Week 3
Dr. Haggins,
Hello. As a nurse executive, I believe that leadership should make nurses feel valued by listening to their needs and addressing their concerns. Although leaders cannot please everyone, listening and communicating with the staff is one of the best ways to establish a relationship in which there is mutual respect. Once you have addressed the top concerns amongst nurses, you can begin to prioritize the needs and start to implement a plan to help with these issues. As I said in my post, having extra nurses that are cross-trained to help with the nurse-to-patient ratio or having an on-call nurse to come in when the census gets high are some of the ways to help decrease some of the stress. Every situation is different depending on what unit you are on so, I think having conversations with the nurses working on the front lines and getting input from them is the first step in addressing their needs.
Ginger
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 3
Great response Ginger! Thank you!
Dr. Haggins
6 months ago
Arielle Doering
RE: Discussion – Week 3-Response #1
Ginger,
I enjoyed reading your response and felt you did a great job answering this week’s prompt. I spoke also about staffing concerns but I thought you highlighted a great point about how poor staffing can ultimately hurt nurses. Cross-training nurses is a great idea by your hospital and one that other hospitals have utilized. It is important for nurses to be adaptable but definitely only works if nurses are trained. does your hospital use any incentive programs for nurses who help train other staff? It can be helpful if nurses are well compensated for their contribution.
Best,
Arielle
References
González‐Gancedo, J., Fernández‐Martínez, E., & Rodríguez‐Borrego, M. A. (2019). Relationships among general health, job satisfaction, work engagement and job features in nurses working in a public hospital: A cross‐sectional study. Journal of clinical nursing, 28(7-8), 1273-1288. https://doi.org/10.1111/jocn.14740
Reguindin, J., Capoccitti, K., & Serapion, V. (2022). Cross-Training Nurses to Support an Intensive Care Unit during a Pandemic: An Urban Community Hospital Experience. Healthcare Quarterly (Toronto, Ont.), 25(1), 64-69. https://doi.org/10.12927/hcq.2022.26804
6 months ago
Holly Murray
RE: Discussion – Week 3
Ginger,
Many nurses have left the hospital setting to work in primary care. Nursing is not safe at the moment. Nurses need to feel empowered and appreciated. (Hunter, 2021) The ask is that facilities budget to allow for more nursing positions so that work conditions are safe. (Bourgault, 2022) Staffing ratios are still a big concern. Nurses are not able to work their level of potential. As an ICU nurse, critical lifesaving decisions need to be made frequently. Those decisions are not able to be made in a timely manner when the nurse has an unsafe assignment.
Bourgault, A. (2022). The Nursing Shortage and Work Expectations Are in Critical Condition: Is Anyone Listening?. Crit Care Nurse 1 April 2022; 42 (2): 8–11. doi: https://doi.org/10.4037/ccn2022909
Hunter, C. (2021). Nursing Shortage: Why There’s a Continued Demand for Nurses. Retrieved from https://www.snhu.edu/about-us/newsroom/health/nursing-shortage
6 months ago
Harlette Numa-Duvil
Week 3-Discussion, Initial Post
Competing needs, including those of patients, the employees, and resources, may influence the creation of a policy since competing demands must fit with the policy’s objective. For example, to satisfy patient and worker demands while reducing financial costs, a policy addressing proper nurse staffing is essential. Lopes et al (2015, p. 12) state that optimal labor allocation and mobilization are critical for ensuring optimal delivery of health services in terms of cost, quality, and quantity. Inability to fully deploy and use the personnel might result in a clinical staff shortfall or surplus. Specific conflicting requirements that may affect workload as a universal healthcare issue include a good match between nursing personnel and patients’ requirements. Corporations are looking for ways to strike a healthy balance between nursing staff competence and size, as well as patient demands, to provide high-quality, safe care and excellent treatment services while keeping operating expenses low (Van den Oetelaar et al., 2016, p. e012148).
Fulfilling the needs of the nurses is a requirement for addressing the patient’s needs. De Simone et al. found that nurses who are happy with their jobs are more likely to be motivated, resulting in high-quality work (2018, p. 135). In this scenario, the policy should address the nurse’s concerns, such as reduced shift hours and workloads to avoid burnout. As a result, employee turnover will be reduced, and patient satisfaction will rise. A policy could solve these conflicting priorities by assuring an ideal caregiver-to-patient ratio, which would result in better nurse staffing in institutions and better patient care results. For example, in a medical/surgical department, the ratio may be 5: 1, implying that one caregiver will be allocated to no more than five patients. A hospital’s staffing policy, according to Livanos, can enhance the working circumstances for nursing staff including the quality of patient care (2018, p. 69).
References
De Simone, S., Planta, A., & Cicotto, G. (2018). The role of job satisfaction, work engagement, self-efficacy, and agentic capacities on nurses’ turnover intention and patient satisfaction. Applied Nursing Research, 39, 130-140. https://doi.org/10.1016/j.apnr.2017.11.004
Livanos, N. (2018). A broadening coalition: Patient safety enters the nurse-to-Patient ratio debate. Journal of Nursing Regulation, 9(1), 68-70. https://doi.org/10.1016/s2155-8256(18)30056-5
Lopes, M. A., Almeida, Á. S., & Almada-Lobo, B. (2015). Handling healthcare workforce planning with care: Where do we stand? Human Resources for Health, 13(1). https://doi.org/10.1186/s12960-015-0028-0
Van den Oetelaar, W. F., Van Stel, H. F., Van Rhenen, W., Stellato, R. K., & Grolman, W. (2016). Balancing nurses’ workload in hospital wards: Study protocol of developing a method to manage workload. BMJ Open, 6(11), e012148. https://doi.org/10.1136/bmjopen-2016-012148
6 months ago
Rosemary Mc Williams Haggins WALDEN INSTRUCTOR MANAGER
RE: Week 3-Discussion, Initial Post
Excellent Harlette! Thank you for sharing a discussion of policies/practices which support the improvements in a current health care issue! As you reflect on your research findings, what action steps would you recommend to nurse leaders in order to improve nurse satisfaction? Thank you again!
Dr. Rosemary Haggins
Part-time Faculty
Walden University
College of Health Sciences
MSN, Leadership and Management
155 Fifth Avenue South, Suite 100
Minneapolis, Minnesota 55401
310-569-0429 (Cell)
6 months ago
Harlette Numa-Duvil
RE: Week 3-Discussion, Initial Post
Dr. Haggins,
As a nurse leader, I would find duties to unload from nurses so they would have enough time to speak with their patients and give them the care they require in order to increase nurse satisfaction. Additionally, the nursing shortage that leads to burnout among us has catastrophic effects on both the profession and the patients. Given that we are all dealing with this overwhelming situation, it is crucial for our nurse leader to begin with peer-to-peer coaching sessions at any departmental level, where faculty, residents, and trainers can express their thoughts and receive guidance from peers and mental health professionals about preventing burnout and promoting wellness. Additionally, the most crucial factor in determining job happiness is compensation. On the one hand, we have traveling nurses who are getting paid more, which is great, but their positions are insecure and they do not receive benefits. In contrast, full-time nurses who receive all the perks continue to grumble about their pay as compared to that of travelers. The gap is so wide that it causes turbulence in the second group. In conclusion, while hiring nurses, firms must provide fair-market salaries.
6 months ago
Courtney Whitaker
Initial Discussion Post- Week 3
Nursing shortages have been a topic of discussion since I entered the healthcare field over 20 years ago. There is not a lack of nursing positions. According to the American Association of Colleges of Nursing (2022), over 200,000 new nursing positions have been created annually since 2016. Several competing needs negatively impact the nursing shortage. The growing population of aging adults that require nursing care due to chronic illnesses is one competing need (Centers for Disease Control and Prevention, 2022a). The Affordable Care Act has increased those with healthcare coverage, impacting the need for additional nurses and furthering the nursing shortage. Experienced nurses are retiring, and nurses leaving the profession due to burnout has contributed to the nursing shortage (Goodare, 2017). As the most prominent healthcare professionals, the noted lack of nurses can negatively impact patient outcomes.
Competing needs for nursing have sparked strategies to mitigate the issue. The recent pandemic caused the implementation of new policies and recommendations to help reduce the nursing shortages in healthcare facilities. The Centers for Disease Control and Prevention recommended that facilities allow confirmed or suspected exposed staff to COVID-19 to return to work within five days if they are asymptomatic (Center for Disease Control and Prevention, 2022b). This recommendation and policy change for a mandatory ten-day stay at home to returning to work within five days if there were no symptoms was implemented at my current facility secondary to a shortage of nurses. The policy changes negatively impacted the morale of the nursing staff. Some nurses felt the facility did not care about its employees’ well-being. Some nurses followed the policy guidelines and returned to work. Although this policy was implemented to mitigate the nursing staff shortage, it only amplified the need for nursing staff. There was a way for nurses that were out sick and unable to work. My facility offered bonus incentives, critical pay, and internal contracts to address the shortage of nursing staff available to work. The impact of this strategy was only a temporary fix and led to additional fatigue and burnout.
I recently read an article about the untapped supply of licensed nursing professionals. Pradeep & Davis (2022) speaks to the use of foreign-trained nurses to address the nurse shortage. Although these nurses have met their countries’ nursing standards to obtain a nursing license, they are currently working as healthcare technicians instead of practicing as nurses. I believe this warrants a need for further thought and could be a great source of nurses that can help reduce the nursing shortage in the states. Perhaps the development of policies that address the use of foreign-trained nurses in the U.S. can be a way to tap into a supply that answers the need of nurses here in the states.
References
American Association of Colleges of Nursing. (2022). Nursing facts sheet. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet#:~:text=Nursing%20Fact%20Sheet%201%20Nursing%20is%20the%20nation%27s,segments%20of%20the%20U.S.%20…%20More%20items…%20
Centers for Disease Control and Prevention. (6 June 2022a). Promoting health for older adults. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/promoting-health-for-older-adults.htm
Centers for Disease Control and Prevention. (21 January 2022b). Strategies to mitigate healthcare personnel staffing shortage. https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html
Goodare, P. (2017). Literature review: Why do we continue to lose our nurses? Australian Journal of Advanced Nursing, 34(4), 50–56.
Pradeep, A., & Davis, D. (2022). A solution to nurse shortages. British Journal of Nursing, 31(2), 64. https://doi.org/10.12968/bjon.2022.31.2.64
6 months ago
Stacy Hinson
RE: Discussion – Week 3 Main Post
Policies are solutions that are created to address the needs of an organization. As Pesut explained,” problem-oriented change looks at what is wrong or why and how are we limited by the problem” (Marshall & Broome, 2021. Pg. 41). The need for policies is developed out of problems that arise from things such as workforce issues like violence in the workplace or resources as is seen with staffing shortages and a decrease in the quality of care. These issues arise to the extent that the government or organization must step in and form a solution for the good of the community that is then enforced by laws and government.
The competing needs that may impact the staffing issue within healthcare are the disproportion between providers and patients with baby boomers being a large population in need of healthcare. The increase in people’s awareness and usage of medical care has never been as far-reaching as it is today with the assistance of the internet (Ahmed & Carmody, 2020). There is also the shift in work value and ethics that have shifted to more providers seeking out specialties where they see fewer patients for more money and not being willing to work the long hours as was done in the past covering twice as many shifts as is done today.
Policies can address these discrepancies and uniform training for nurse practitioners increases the number of available providers. Policies addressing the number of patients that can be treated by individual providers at one time is another way of ensuring competent care is provided for all patients (AHA, 2021).
Reference:
AHA. (2021, November). Fact sheet: Strengthening the health care workforce: AHA. American Hospital Association. Retrieved June 15, 2022, from https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce
Ahmed, H., & Carmody, J. B. (2020, July 15). On the looming physician shortage and strategic expansion of Graduate Medical Education. Cureus. Retrieved June 15, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430533/
Marshall, E. S., & Broome, M. (2021). Transformational leadership in nursing from expert clinician to influential leader. Amazon. Retrieved June 15, 2022, from https://www.amazon.com/Transformational-Leadership-Nursing-Clinician-Influential/dp/0826135048
6 months ago
Harlette Numa-Duvil
Week 3-Peer Response #2
Hi Stacy,
I concur with what you said. The world has altered since the Covid-19 Pandemic. The foundation of the American health care system is a staff that is talented, qualified, committed, and diverse. In any case, there is a severe and growing personnel deficit in hospitals and health systems today. According to AHA 2022, these workforce shortages are expected to persist, with the words of an analysis data showing there will be a shortage of up to 3.2 million health care workers by 2026. The bipartisan Healthcare Workforce Resilience Act would protect U.S. healthcare workers-trained, international physicians who are crucial to patient care in their communities and speed up the employment process for highly trained nurses who could support institutions facing staffing shortages.
Reference
American Hospital Association Strengthening the Health Care Workforce| November 2021|
www.aha.org AHA. (2021, November). Fact sheet: Strengthening the health care
workforce.
6 months ago
Rose Victor
RE: Discussion – Week 3
Mandatory Overtime as a Healthcare Issue
Nursing is an essential component of the medical and health industry. Nurses play a significant role in ensuring the wellness of patients under their care. Health institutions and hospitals work to meet their goals and objectives to ensure that the population’s health demands are met. The objectives are set even though the nursing population in the country is significantly low compared to the patients they ought to serve. The health departments across different states set mandatory overtime to achieve the optimal practitioner staffing levels in the hospital institutions to achieve the desired goals. However, mandatory overtime is not enacted across all the states, although nurses are still forced to work beyond their contract hours (Son et al., 2019).
The country faces a significant issue of nurses’ shortage that affects the relay of healthcare services in the United States. Many hospitals that have high patient populations request their practitioners to work for longer hours to meet the demands of their patients despite the shortage. However, mandatory overtime for nurses can negatively affect them, nurses. Nursing professionals risk suffering from burnout and exhaustion when they work for more than their contract hours. Burnout and stress from overtime can lead to medical errors that reduce the quality of services offered to the patients (Shah et al., 2021).
Low staffing levels remain a significant issue in the health industry, and mandatory overtime should not be used as a permanent solution to the problem. Hospital committees and managements should scrap the mandatory overtime strategy despite their desire to meet the staffing shortages problem and meet the patients’ demands. The committees should focus on developing policies to employ more nursing professionals to meet the minimum staffing ratios in the medical industry. However, mandatory overtime appears like an easy fix for the medical institutions; hence they may ignore the more significant issue, which is low nursing staffing levels. Federal legislation must be placed to protect the nurses from mandatory nursing to compel clinic committees to employ more staff in the healthcare field.
References
Shah MK, Gandrakota N, Cimiotti JP, Ghose N, Moore M, Ali MK.( 2021). Prevalence of and
Factors Associated With Nurse Burnout in the US. JAMA Netw Open. ;4(2):e2036469. doi:10.1001/jamanetworkopen.2020.36469
Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of Working Hours and Patient Safety
Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. International journal of environmental research and public health, 16(21), 4083. doi: 10.3390/ijerph16214083
6 months ago
Ginger Spencer
RE: Discussion – Week 3
Rose,
The nursing and provider shortage is being felt in my area, which I never thought I would see. I live in a very rural area and usually, the small hospital in my community and surrounding communities never have travelers, but now they are staffed with just as many as larger cities. Since the pandemic, nursing burnout has become even more significant than before. It is something you see on the news, on social media, in the community, and in our workplace.
Nurse leaders and executives need to take the initiative to create a better work environment so that employee retention is not a problem. Oftentimes, facilities are stuck on patient satisfaction scores and investing their money in medical treatments instead of prevention and workplace contentment (de Oliveria et al., 2019). If staff were happier, they would stay longer, which would show in the care they provide. Sometimes patient satisfaction standards are set so high, but nurse-to-patio ratios and acuity levels are unmatched. The standard of care set for these patients seems unachievable, leading to nursing burnout, job dissatisfaction, and employee turnover (Duffield, 2011).
It is sad to see so many local nurses leaving our hospital to travel or even leave the field. My hope is that something will be done to address the nursing shortage and burnout.
Ginger
References
de Oliveira, S., de Alcantara Sousa, L., Vieira Gadelha, M., & do Nascimento, V. (2019). Prevention actions of burnout syndrome in nurses: An integrating literature review. Clinical Practice & Epidemiology in Mental Health, 15(1), 64–73. https://doi.org/10.2174/1745017901915010064
Duffield, C., Diers, D., O’Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24(4), 244–255. https://doi.org/10.1016/j.apnr.2009.12.004
6 months ago
Janelle McEwen
RE: Discussion – Week 3
Rose, thank you for the insightful post. I was reading the H.R. 3165 bill which was reintroduced to parliament in 2021. The bill requires hospitals to implement and submit to the Department of Health and Human Services (HHS) a staffing plan that complies with specified minimum nurse-to-patient ratios by unit (The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act ( S . 1357 ), 2022). Hospitals must post a notice regarding nurse-to-patient ratios in each unit and maintain records of actual ratios for each shift in each unit. The above bill is currently not fully observed in our hospital (McHugh et al., 2021). Our chief nurse argues that mandated legislative proposals to nurse staffing limit innovations in team-based care models and increase stress on a health care system already facing an escalating shortage of educated nurses. What is your view to the above position of our chief nurse?
References
The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act ( S . 1357 ), (2022) (testimony of 117th Congress). https://www.congress.gov/bill/117th-congress/house-bill/3165
McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6
6 months ago
Sophronia Flowers
RE: Discussion – Week 3- Initial Post
Competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Often nurses face the difficult task of providing care when resources are limited. Those in the policy-making work push for quality of care but nurses are working more than 12-hour shifts, working short-staffed, and with inexperienced staff. Unfortunately, healthcare is a business, and some health systems are run with a business model in mind. “ RNS working within this business model of healthcare must learn to adapt and practice under the auspices of a care delivery model that is antithetical and philosophical principles learned in nursing school, including patient-centeredness and holism” (Kelly & Porr, 2018). A policy cannot come to full fruition if the competing needs are not addressed.
The national issue I selected is healthcare payment reform. Healthcare payment reform moves payment from fee for service to value-based care. Simply quality over quantity. The competing need that impacts my issues of choice is access to care. This payment reform does not address this need. “Research-informed approaches for reducing health care disparities that are feasible and capable of sustained implementation are needed to inform policymakers. More important, for health equity to be achieved, it is essential to create a health care system that provides access, removes barriers to care, and provides equally effective treatment to all persons living in the United States” (Wasserman et al, 2019). The Affordable Care Act (ACA) was believed to eliminate these disparities and it provides the first steps in ensuring access, if it remains unchanged there is a need for more data to evaluate its long-term effectiveness. Using payment reform as a tool to achieve equity has not been well researched. Systemic reviews of pay-for-performance incentives have failed to reduce disparities. Through payment reform, the Medicare Accountable Care Organization (ACO) was bred. Although ACOs encourage quality improvement, they have yet to fully address access to care.
To address access to care, policy needs to address this need. There should be a policy in place to discuss access or barriers to care and other social determinants of health. Implementation of a screening tool is not associated with exposure to value-based payment for practices (Brewster at el, 2020). There also needs to be multilevel interventions in place to address the access need of the patient. There should also be some sort of national transportation in place to assist those in need.
Brewster, A.L, Fraze, T.K., Gottlieb, L.M., Frehn, J., Murray, G.F., & Lewis, V.A. (2020). The role of value-based payment in promoting innovation to address social risk: A cross-sectional study of social risk screening by us physicians. The Milbank Quarterly: A Multidisciplinary Journal of Population and Health Policy, 98(4), 1114-1133. Retrieved June 15, 2022, from https://doi.org/10.1111/1468-0009.12480
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Consideration to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi: 10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Wasserman, J., Palmer, R.C., Gomez, M.M., Berzon, R., IbrahIm, S.A., & Ayanian, J.Z. (2019). Advancing health services research to eliminate health care disparities. American Journal of Public Health. Retrieved June 15, 2022, from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304922
6 months ago
Carol Mathis
RE: Discussion – Week 3
6 months ago
Esther Saint-Cyr
RE: Discussion – Week 3
6 months ago
June James
RE: Discussion – Week 3
Healthcare Policies, Organizational Resources, and Medical Errors
According to Madrazo-Pérez et al. (2019), resources are crucial for the overall well-being of a community. The article states that socio-economic resources such as poverty, unemployment rates, access and distribution of health resources, socio-economic disparities, and marginalization are essential for individual and community well-being. Hence, these factors are critical in determining the path that healthcare organizations undertake. Hence, socio-economic resources and factors are crucial in determining the framework and guidelines adopted by healthcare organizations. In addition, healthcare organizations are business enterprises. Thus, they need to create policies that generate economic benefits while addressing social issues.
Key to the creation and implementation of healthcare policies is the human resource. Madrazo-Pérez et al. (2019) state that human resources are crucial in determining healthcare policies, their successful implementation, and creating the organizational culture. According to Madrazo-Pérez et al. (2019), the corporate culture is the good views, behaviors, actions, and expectations. These items are officially integrated into the organization through policies. Thus, healthcare organizations must find a balance between hiring qualified personnel to successfully implement and adopt their strategic goals while minimizing healthcare expenses. However, this is a challenge as hiring more competent personnel means incurring hire ages. Human resources in the healthcare sector, such as nurses, depend on healthcare policies in influencing their manner of caring for, application of healthcare-related interventions, their integration into healthcare teams, autonomy, and implementation of their roles in healthcare provision. However, conflicts and dilemmas arise when their role in healthcare provision conflicts with the resources available to them to achieve their objectives. These resources include; the availability of enough staffing, financial resources, the functioning of healthcare systems, and the availability of adequate healthcare equipment and other resources. This is a conflict as the organizational policy dictates what should be done, but the lack of resources might impede achieving what needs to be done.
According to Nkurunziza et al. (2019), one of the leading causes of medical errors is the incompetency of healthcare professionals. This relates to the skills, education, experience, and knowledge of healthcare professionals, which the article deems lacking. However, enhancing this requires healthcare resources such as financial resources to aid in improving the technical know-how of healthcare professionals. This also involves healthcare policies initiated and implemented by competent personnel. Healthcare policies should therefore support continuous education, personal growth, and professional growth in order o reduce medical errors. The same sentiments have been shared by Wondmieneh et al. (2020), who recognized lack of training, work experience, and incompetent management as the contributing factors to medical errors. Another factor Wondmieneh et al. (2020) noted that contributes to medical errors is the failure of electronic healthcare systems. This refers to the software programs, hardware, and electronic systems utilized in healthcare provision. An ideal healthcare system requires appropriate resources and policies that enhance the competency needs of the personnel, training requirement, appraisals, and mechanisms for taking appropriate measures. Wondmieneh et al. (2020) also identify the high turnover rate among healthcare providers as contributing to medical errors. The article thus identifies increasing the wages of healthcare professionals and adopting policies that address the welfare of healthcare professionals as strategies for addressing the menace of medical errors. The article also states a need to allocate resources that will aid in creating policies that encourage safety, access, and quality in healthcare provision. Rasool et al. (2020) also state that the lack of adequate healthcare personnel contributes to the risk of medical errors. The article thus recommends that healthcare organizations and policymakers initiate policies that ensure sufficient resources are located to provide a balanced patient-to-caregivers ratio. All these policy and resource allocation measures will aid in improving the lack of quality, safety, patient satisfaction, and access to care which the adverse effects of medical errors are. The steps will also aid in achieving the desired clinical outcomes and the reduction of medical costs and expenses during healthcare provision (Rasool et al., 2020).
References
Madrazo-Pérez, M., Parás-Bravo, P., Rayón-Valpuesta, E., Blanco-Fraile, C., & Palacios Ceña, D. (2019). The impact of health human resources policies in primary care nursing: a qualitative study. International journal of environmental research and public health, 16(19), 3653.
Nkurunziza, A., Chironda, G., Mukeshimana, M., Uwamahoro, M. C., Umwangange, M. L., & Ngendahayo, F. (2019). A review of the literature reviews factors contributing to medication administration errors and barriers to self-reporting among nurses. Rwanda Journal of Medicine and Health Sciences, 2(3), 294-303.
Rasool, M. F., Rehman, A. U., Imran, I., Abbas, S., Shah, S., Abbas, G., … & Hayat, K. (2020). Risk factors associated with medication errors among patients suffering from chronic disorders. Frontiers in public health, 8, 531038.
Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC nursing, 19(1), 1-9.
6 months ago
Stacy Hinson
RE: Discussion – Week 3
June,
Great informative post. I agree that hiring nurses with more experience provides a better workforce. I feel that one of the problems with the younger nurses is the bullying and the lack of the more experienced nurses to take them under their wing. I feel if improved implementation of mentor programs gives the novice nurse the support and encouragement that is needed in this field then hiring the new nurse would be advantageous to the organizations for their loyalty would be set with a place that values them enough to provide the skills that are needed and nurture them in their careers (Hoover et al., 2020).
Reference:
Homayuni, A., Hosseini, Z., Aghamolaei, T., & Shahini, S. (2021, April 9). Which nurses are victims of bullying: The role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff – BMC nursing. BioMed Central. Retrieved June 17, 2022, from https://doi.org/10.1186/s12912-021-00578-3
Hoover, J., Rao, K., Rosser, E., & Koon, A. (2020, July 29). Mentoring the working nurse: A scoping review. Human resources for health. Retrieved June 17, 2022, from https://pubmed.ncbi.nlm.nih.gov/32727573/
6 months ago
Rachel Donovan
Main Post Discussion 2 – Rachel Donovan
Organizational Policies and Practices to Support Healthcare Issues
Effective nurse leaders use ethical awareness to balance the organization’s and patients’ needs. The nurse leader can recognize ethical issues and respond by acting with a moral agency (Milliken, 2018). Further, all nurses need ethical awareness and the confidence and support to act on it.
Nurses are constantly told to do more with less. They are also not often the ones to speak up for many reasons. However, the “culture of silence has unknowingly created a culture of acceptance, and continues to suppress nursing professional knowledge” (Kelly & Porr, 2019, p.5). This perceived uninterest impacts policy.
Policy to relieve health worker burnout stacks the workforce’s needs in competition with the organization’s goals and patient satisfaction and safety. Burnout affects everyone differently and can be reversed, but avoiding burnout calls for more resources and support from the systems level and health worker education, recognition, and self-care practices (Crabtree et al., 2022). The nurse leader can lead by example in self-care practice and as a moral compass when navigating the competing needs in healthcare delivery and informing policy.
References
Crabtree, N. S., DeYoung, P. M., Vincent, N. J., Myers, T. P., & Czerwinskyj, J. (2022). Compassion fatigue, compassion satisfaction, and burnout: A study of nurses in a large Texas healthcare system. Journal of Nursing Scholarship, 1. https://doi.org/10.1111/jnu.12780
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
6 months ago
Ana Freed
RE: Discussion – Week 3
6053 Initial Post Discussion Week 3 Ana Freed
One issue where the competing needs in healthcare are driving policy is that of limiting the scope of practice of ARNPs. With many physicians leaving primary care or retiring, it seems foolish and shortsighted to limit the ability of the ARNP to function autonomously (Xue et al., 2018). Forcing ARNPs to enter collaborative practice agreements limits the ARNP’s ability to practice with available physicians. If that physician retires or quits the practice, the ARNP is no longer able to work until a new physician is located (Martin & Alexander, 2019). Limiting the full scope of practice to primary care also does little to alleviate the mental health crisis America is experiencing (Chapman et al., 2019) (Delaney & Vanderhoef, 2019).
References
Chapman, S. A., Toretsky, C., & Phoenix, B. J. (2019). Enhancing psychiatric mental health nurse practitioner practice: Impact of state scope of practice regulations. Journal of Nursing Regulation, 10(1), 35–43. https://doi.org/10.1016/s2155-8256(19)30081-x
Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future. Journal of the American Psychiatric Nurses Association, 25(1), 11–18. https://doi.org/10.1177/1078390318806571
Martin, B., & Alexander, M. (2019). The economic burden and practice restrictions associated with collaborative practice agreements: A national survey of advanced practice registered nurses. Journal of Nursing Regulation, 9(4), 22–30. https://doi.org/10.1016/s2155-8256(19)30012-2
Xue, Y., Kannan, V., Greener, E., Smith, J. A., Brasch, J., Johnson, B. A., & Spetz, J. (2018). Full scope-of-practice regulation is associated with higher supply of nurse practitioners in rural and primary care health professional shortage counties. Journal of Nursing Regulation, 8(4), 5–13. https://doi.org/10.1016/s2155-8256(17)30176-x
6 months ago
Rachel Donovan
Rachel Donovan Response to Ana Freed
Ana,
I appreciate your perspective on the competing needs of healthcare in regards to APRN full practice authority. The United States is in the midst of a mental health crisis. The provider workforce is already spread thin and at risk of shrinking due to increasing burnout and inevitable retirement. APRNs, specifically PMHNPs, have trained to provide care for the mental health population, but depending on their practice state, they might still need to collaborate with a physician. In states with a more restrictive practice, there is a smaller APRN workforce, decreased patient access, and increased cost of care (Martin et al., 2020). I support legislation and state policy changes to grant full practice authority to APRNs. Further, systemwide policies must align with APRNs’ full practice authority for care to be optimal (Schirle et al., 2020). I recommend looking at the advocacy tab on the American Association of Nurse Practitioners (AANP) website. The AANP works on APRN policy priorities and advocates for the future of healthcare.
References
Martin, B., Phoenix, B. J., & Chapman, S. A. (2020). How collaborative practice agreements impede the provision of vital behavioral health services. Nursing Outlook, 68(5), 581–590. https://doi.org/10.1016/j.outlook.2020.04.002
Schirle, L., Norful, A. A., Rudner, N., & Poghosyan, L. (2020). Organizational facilitators and barriers to optimal APRN practice: An integrative review. Health Care Management Review, 45(4), 311–320. https://doi.org/10.1097/HMR.0000000000000229
6 months ago
Arielle Doering
RE: Discussion – Week 3
In all professions, those in leadership or management roles often have the most difficult jobs. In healthcare, there are individuals from each discipline that have significant responsibility. For example, nurse leaders play a critical role in ethical decision-making to ensure balance between the needs of the hospital and the best patient outcomes. One of the biggest concerns that nurse leaders have is ensuring that staffing needs are met. Currently, there is a huge shortage of healthcare staff, which has only gotten worse since the pandemic.
Competing needs, such as the needs of patients impact the development of policy. For example, patients need staff to provide care for them. It can be difficult for patients to receive care if there are not enough staff members (Griffiths, 2020). This is when policies are implemented to protect the needs of patients. Some policies made to protect patients are mandating patient to nurse ratios and requiring a certain amount of staff for each shift. However, the needs of the organizations can often be in competition with the needs of patients. Organizations are financially concerned that they won’t be able to afford more staff (Griffiths, 2020). So organizations can often struggle trying to adhere to these policies, especially if it will be costly.
One of the most difficult concepts is the financial aspect of maintaining appropriate staff. The pandemic has driven most nurses out of the profession, which has increased the need for travel nurses and contract staff. It can be extremely expensive to pay for travel or contract staff. Some organizations have offered retention bonuses or other incentives to keep permanent staff and promote job satisfaction. Overall, policies aimed to combat staffing concerns will provide the best outcomes for patients and staff (Griffiths, 2020). However, organizations might need to find ways to financially afford to maintain more staff and adhere to staffing policies.
References
Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group. (2020). Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. International Journal of Nursing Studies, 103, 103487. https://doi.org/10.1016/j.ijnurstu.2019.103487
Saville, C. E., Griffiths, P., Ball, J. E., & Monks, T. (2019). How many nurses do we need? A review and discussion of operational research techniques applied to nurse staffing. International Journal of Nursing Studies, 97, 7-13. https://doi.org/10.1016/j.ijnurstu.2019.04.015
Walden University, LLC. (Producer). (2009b). Working with Individuals [Video file]. Baltimore, MD: Author.
Walden University, LLC. (Producer). (2018). Moral Leadership [Video file]. Baltimore, MD: Author.
6 months ago
Kailynn Jeffords
RE: Discussion – Week 3
There are many factors that national healthcare spending affects. The United States already spends more than two times per capita of other well-developed countries. The nurse burnout has made hospital employment decrease, requiring organizations to hire contract workers. Travel nurses help the hospitals demand for care, but with a high cost. There has been a recent surge of contract workers due to the covid-19 pandemic and the pay discrepancy. The covid-19 pandemic does not bode well for the already high spending related to healthcare. The cost of labor for hospital employees is more than 50% of spending for each facility. The pandemic forced the US, who normally relies on global supply chains, to pay higher rates to local and national supply chains to provide enough PPE and other supplies to hospitals. Supplies and resources used in patient care account for approximately 20% of expenses for each facility (Cost of Caring, 2022).
The healthcare system in America depends on competition between insurance markets and providers to improve quality while lowering costs. The Affordable Care Act was implemented to increase coverage and lower premiums. Increased health insurers could result in lower costs for facilities and patients (consumers) by creating a better healthcare economy and more room to negotiate prices with hospitals/doctors that try to overcharge above the level of competition. When a hospital buys out a physician practice, procedures cost more than when the practice was previously physician owned. Physicians and private insurers depend on Medicare prices to decide their rates of reimbursement.
Healthcare spending is more a state-by-state problem, than a federal issue. States have a budget allowing expenses for healthcare, transportation, education, etc. Patients and consumers are affected by having higher premiums and out of pocket expenses when the budget for healthcare spending is exceeded. Health policy commissions can help at the state level spending by relying on state commissions to reach their policy goals. Improving competition by being transparent about pricing at the insurance and hospital level will help consumer shopping.
References
Agirdas, C., Krebs, R. J., & Yano, M. (2019). The effects of competition on premiums: using United Healthcare’s 2015 entry into Affordable Care Act’s marketplaces as an instrumental variable. Health Economics, Policy, and Law, 14(3), 374–399. https://doi.org/10.1017/S1744133117000263
Capps, C., Dranove, D., & Ody, C. (2018). The effect of hospital acquisitions of physician practices on prices and spending. Journal of Health Economics, 59, 139–152. https://doi.org/10.1016/j.jhealeco.2018.04.001
Chernew, M., Cutler, D., & Shah, S. (2021). Reducing Health Care Spending: What Tools Can States Leverage? The Commonwealth Fund.
Costs of caring: AHA. American Hospital Association. (2022). Retrieved June 15, 2022, from https://www.aha.org/costsofcaring
Fulton, B. D. (2017). Health Care Market Concentration Trends in the United States: Evidence and policy responses. Health Affairs, 36(9), 1530–1538. https://doi.org/10.1377/hlthaff.2017.0556
6 months ago
Hannah Dounis
Hannah Dounis Response to Kailynn Jeffords
Kailynn,
I agree with your post that healthcare spending affects many factors. Also, healthcare spending has increased since the pandemic for various reasons. According to Centers for Medicare and Medicaid (2021), healthcare spending grew by 9.7% in 2020, which equals $12,530 per person. As you mentioned, COVID-19 put a strain on the healthcare system, and the cost of newly needed supplies and increased healthcare stays did not help the already high healthcare spending. The average length of a hospital stays increased by 9.9% at the end of 2021, and hospital expenses were up 11% (American Hospital Association, 2022). This with the rising costs of labor and the increased need for supplies, hospitals were spending more money than ever, and as you mentioned, these costs were getting passed on to the insurance companies, which in turn passed them on to the patients. The best thing that can be done to help offset the rising costs is by having policymakers work to standardize prices for health insurance and services to help reduce the risk of price gouging.
References
American Hospital Association. (2022). Massive growth in expenses and rising inflation fuel continued financial challenges for America’s hospitals and health systems. Retrieved from https://www.aha.org/costsofcaring
Centers for Medicare and Medicaid Services. (2021). Historical. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical
6 months ago
Sheri Mead
Main Post: Discussion – Week 3, Sheri Mead
Competing Needs: Impact on Policy
No matter what the topic is, when resources are inadequate to serve all the needs, someone must have the authority and responsibility to prioritize the needs and allocate the resources. Often, it may be difficult to determine which need is more worthy than the other, and there is sway and influence toward the decision then judgment after it has been made. The people affected by the decision probably do not have all the “big picture” information about the options and may have strong feelings about the morality of the decision. Nurses are especially aware of whether the workplace feels like a “morally good environment,” as they are duty-bound by nursing ethics to monitor and address concerns that impact nursing care (American Nurses Association, 2015, p. 23-24). In healthcare, there is a continuous struggle with competing needs that requires fluidity in leadership to place the priority where it needs to be for the current circumstances. The final decision cannot meet all demands to be the most moral, most affordable, safest, fastest, AND easy, so there will always be a level of compromise and an unsatisfied party.
Competing Needs: Impact on Health Literacy
Health literacy is impacted by the current competing needs of the healthcare workforce shortage because not only are there fewer workers but the remaining workers are left to prioritize care to essential tasks and patient safety. Tasks like showers, ambulation, and patient teaching are often sacrificed in favor of assessments, medications, wound care, bed changes, and repositioning. With the current state of staffing, health literacy is not really being addressed because it is not realistic to ask for the workers to stretch any further in their duties than they already are. A study by Cho et al. (2019) found that “missed care” by nurses is very detrimental to their mental health and job satisfaction. The study continued to detail the significance of more missed care classified as emotional or psychological rather than physiological and the trust barrier that formed in the relationship between the patient and nurse (Cho et al., 2019).
For policymakers, it is more immediately profitable to increase hospital throughput by giving nurses maximum workloads and discharging patients when they are medically stable. Time spent on patient education and health literacy may be ethical, but it does not generate additional revenue. For example, minimal discharge instructions should include a thorough review with teach-back of the patient’s diagnosis and medications with instructions on where to get them, how to take them, what signs and symptoms to watch for, and when to seek help. With a full emergency department waiting for beds on the floor, the nurse may already be getting calls for report for the next patient before the first one leaves, causing stress and a hasty discharge that leaves the departing patient inadequately prepared. Problems that brought them to the hospital to begin with may occur if the original issue was not resolved. For example, a patient with fluid overload who could not get to the pharmacy or could not afford their diuretic will likely be a readmission if there was no advice on what to do to solve that problem.
Addressing the Impact
Healthcare administrators can help to increase health literacy by placing nurses and nurse practitioners in positions that allow them to practice to the full scope of their licenses. By supplementing areas experiencing provider shortages with more affordable nurse practitioners, the provider cost is lessened while the collaborative approach of the nurse practitioner provides a more holistic experience for the patient and may add a provider where one was not previously viable (Ferguson, Arnold, Morris, Rademaker,& Davis, 2021). Advanced practice nurses as providers offer unique strategies in their holistic approach and emphasis on health promotion (Fichadiya, Then, & Rankin, 2021). Both professions embrace patient autonomy, work well collaboratively with other disciplines, and share the philosophy of the nurse educator to help the patient to learn about themselves and be involved in making informed health choices. This solution is intertwined with improved staffing ratios for hospital care. As nurses are relieved of the burden of continuously taking maximum patient loads, they will be able to focus more on the total patient experience, which includes the patient teaching and wellness items that have gone by the wayside as nurses have struggled to keep patient safety the focus with the little time allowed.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only
Cho, S. H., Lee, J. Y., You, S. J., Song, K. J., & Hong, K. J. (2019). Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes. International Journal of Nursing Practice, 26(1). https://doi.org/10.1111/ijn.12803
Ferguson, L., Arnold, C., Morris, J., Rademaker, A. & Davis, T. (2021). The nurse practitioner as a bridge to interprofessional research team collaboration in rural community clinics. Journal of the American Association of Nurse Practitioners, 33 (5), 409-413. doi: 10.1097/JXX.0000000000000387.
Fichadiya, P., Then, K. L., & Rankin, J. A. (2021). The impact of nurse practitioners on health outcomes in outpatient heart failure management: A systematic review. Canadian Journal of Cardiovascular Nursing, 31(2), 13–17.
6 months ago
Stacy Hinson
RE: Main Post: Discussion – Week 3 Reply #2
6 months ago
Sophronia Flowers
RE: Main Post: Discussion – Week 3, Sheri Mead
Sheri,
I really enjoyed your post on health literacy and its competing needs. At the end of the day, you are correct; the patient is the one who suffers. Sufficient health literacy may increase a person’s willingness to take responsibility for their health and their family’s health (healthypeopole.gov, 2020). Is that the goal we all have for our patients? We know that our other responsibilities while providing care often takes the place of assessing our patient’s education levels or the best way they learn so that we can adequately educate them. There was a study that took place to look at existing policies surrounding health literacy and to offer suggestions to improve health literacy and health outcomes. The US was part of this study. The result is not surprising. “We observed a number of common features that provide helpful signposting of future policy development in other countries. All represent a response to perceived deficiencies in the quality of patient communication and patient engagement. Most present health literacy as a universal challenge…” (Trezona et al, 2018). The bottom line is that staffing ratios must improve for health literacy to be adequately addressed. I really enjoyed your post.
Healthy People 2020. (2020). Health Literacy. Retrieved June 18, 2022, from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy
Trezona, A., Rowlands, G., Nutbeam, D. (2018). Progess in implementing national policies and strategies for health literacy- what have we learned so far? International Journal of Environmental Research and Public Health, 15(7). https://doi.org/10.3390/ijerph15071554
6 months ago
Blessing Nnakwu
RE: Main Post: Discussion – Week 3, Sheri Mead
6 months ago
Blessing Nnakwu
RE: Discussion – Week 3
Health care systems in the world face a significant challenge of how to deliver wide access to health services while enhancing the quality of care and controlling costs. The health care providers are highly determined to offer quality care (Kelly & Porr, 2018). However, the health care needs are growing with the increase of the aging population hence the need for more technology to enhance better treatment. Adequate nursing staff is needed to maintain the work force and also to maintain the quality of effective utilization of work in any organization. The health care providers are not enough to fulfill these needs which cause work overload or staff shortage, hence medical errors and burnout which affect the quality of healthcare. The competing needs can trigger the development of policies that will standardize the running of the healthcare system. For example, the Affordable Care Act was introduced to take care of the increasing health care costs so that patients can get quality care even if they are from middle-income homes.
Some areas in which costs are being increased are included in the cost of drugs, in nursing home hospitality, and in the cost of medical equipment. These inflations then tend to trigger a rise in costs required by patients. Nurse shortage is one of the problems leading to overload which comprises the quality of care. Therefore one of the solutions is to employ more nurses. Other solutions would include developing an efficient scheduling network to supplement the staffing needs (Straw, 2018).
In hopes of reducing labor costs and delivering quality care, there are several ways an institution can use their staff more efficiently. For instance, In Freeman White’s blog post, Kristyna Culp estimated that the use of nurses to move the sick to and from the emergency unit as compared to utilizing transport employees would increase hospital costs by $111690 annually. The estimation claims that an approximate pay rate of $19.50 in a transport staff hourly and $45 per hourly are spent by the nurses and an encircling expedition transport time of 30 minutes for every sick person. Apart from donating competitive pay, and packages of benefit, some ways of maintaining the current staff are streaming processes to simplify staff workload, rewarding and recognizing the staff as well as treating the employees with respect and promoting them (Burak, 2022).
One way that an organization could improve their quality of care and reduce healthcare costs is by creating policies that take into consideration the number of hours that any healthcare provider should work. Policies can be intended to improve the quality of care and reduce health care costs at the same time. The organization should come up with policies that set the number of hours that any health care provider can work in order to prevent employers from overscheduling a nurse or forcing nurses to stay longer than necessary. In that policy, they can design ways the institution will do to achieve quality care at low costs. The Affordable Care Act, for instance, designed some tools to reduce health care costs. For instance, it created The Center for Medicare and Medicaid innovation or CMMI used for testing delivery methods to lower costs and improve the health care quality of the individuals who benefited from federal health insurance programs (Kaiser Family Foundation, 2018). This is one way of improving the healthcare quality but it is not related to health caregivers. Generally, it impacts the entire health care system.
References
Burak, Andrew. (2022). How to reduce labor costs without cutting headcount. https://relevant.software/blog/how-to-reduce-labor-costs/
Kelly, P., & Porr, C. (2018). Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice. OJIN: The Online Journal of Issues in Nursing, 23(1).
Kaiser Family Foundation. (2018 Feb 27). What is CMMI? And 11 other FAQs about the CMS Innovation Center. https://www.kff.org/medicare/fact-sheet/what-is-cmmi-and-11-other-faqs-about-the-cms-innovation-center/#:~:text=The%20Center%20for%20Medicare%20and%20Medicaid%20Innovation%20(CMMI)%2C%20also,of%20care%2C%20and%20inefficient%20spending.
Straw, Christen N. DNP(c), MSN, RN, CNL, OCN Engagement and retention in float pools, Nursing Management (Springhouse): October 2018 – Volume 49 – Issue 10 – p 30-36
doi: 10.1097/01.NUMA.0000546201.01962.0d
6 months ago
Kailynn Jeffords
RE: Discussion – Week 3
Blessing,
Controlling costs in healthcare is very important for high-income countries like the United States. However, politicians have not been active and their measures to solve the problem have become useless. One reason is for high costs is unnecessary procedures that do not better the health of the patient. One hospital system that does achive great patient outcomes that other organizations should strive to be like is the Mayo Clinic. The Mayo Clinic strives to put patients first and physicians are hired on a fixed salary based on their specialty. Patients are triaged and treated no matter their ability to pay. The Mayo is regarded as one of the best healthcare systems for achieving quality outcomes at lower costs.
I think physician burnout is also contributing to costs. Rates of burnout have exceeded 50% in residents and physicians. Burnout can lead to negative consequences on patients which can lead to increased costs. I agree with your stance in your post that organizations should hae a policy limiting hours that can be worked to prevent these consequences. I believe this will help contribute to higher quality care given and happier employees.
References
Sturmberg, J. P., & Bircher, J. (2019). Better and fulfilling healthcare at lower costs: The need to manage health systems as complex adaptive systems. F1000Research, 8, 789. https://doi.org/10.12688/f1000research.19414.1
West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: Contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529. https://doi.org/10.1111/joim.12752
6 months ago
Nicolette Dabish
RE: Discussion – Week 3
The healthcare industry is a field that has many needs, including workers and resources. The nursing portion of the healthcare industry is in very high demand, an estimated 200,000 nursing jobs have been created every year since 2016 (American Association of Colleges of Nursing, 2022). More recently, since the COVID-19 pandemic, it seems that there have been increased needs within the healthcare field. There are competing needs in the healthcare field, such as workforces, resources and patients, which all affect policy development in healthcare. When there are competing needs, one issue needs to take precedence over another because there are not enough resources to cover all these competing needs (Gaim et al., 2018).
Competing needs extend into staffing, especially when it comes to nursing staff. Nurses are always under a lot of pressure to provide the best possible care for their patients, however there are many things that can get in the way of providing the most optimum patient care. Accoring to the American Nurses Associatiion, 54% of nurses reported that they do not spend enough time providing care for each of their patients, with 43% of those nurses reporting to have worked longer hours in attempt to compensate (The Nursing Licensure Organization, n.d.). Much of this lack of time with patients is due to the nurse-patients ratios, which are unsafe. The nursing shortage differs state by state, as do the regulations on patient care and what is considered safe (Feyereison & Goodrick, 2021). In Michigan, there is no law regulating the number of hours worked or patients a nurse can recieve. My hospital does have a policy in place that nurses and nursing aids cannot exceed a 16 hour shift, there is no regulation on the number or type of patients recieevd. There is constant back and forth between nurses and management and the hospital organization on what is considered to be a safe nurse to patient ratio, however voices are left unheard, mostly due to the lack of staff.
Nursing is a career that requires physical strength, mental strenght, intuition, strong emotional intelligece among so many other things. Nurses often are under so much pressure to perform under all the stressors listen above, with a lack of help, which can contribute to nurse burn out (Kelly & Porr, 2018). Unfortunately nurse burn out is a real thing that occurs due to nurse to patient ratios and nurses ability to perform all the needed tasks.
In conclusion, competing needs affect healthcare policy, which can lead to better outcomes, however this can only occur if the needed resources are available. It is up to nurses to advocate for themselves and safe patient rations, because the silence is dangerous (Kelly & Porr, 2018). There is also only so much hospital systems can do, as staff needs to apply and there needs to be nurses that are available to perform the tasks needed.
References:
American Association of Colleges of Nursing. (2022). Nursing facts sheet. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet#:~:text=Nursing%20Fact%20Sheet%201%20Nursing%20is%20the%20nation%27s,segments%20of%20the%20U.S.%20…%20More%20items…%20
Feyereisen, S., & Goodrick, E. (2021). Examining variable nurse practitioner independence across jurisdictions: A case study of the United States. International Journal of Nursing Studies, 118, N.PAG. https://doi.org/10.1016/j.ijnurstu.2020.103633
Gaim, M., Wahlin, N., Pina e Cunha, M., & Clegg, S. (2018). Analyzing competing demands in organizations: A systematic comparison. Journal of Organization Design, 7(6). https://doi.org/10.1186/s41469-018-0030-9
Kelly, P., Porr, C., (January 31, 2018) “Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice” OJIN: The Online Journal of Issues in Nursing, 23(1), Manuscript 6. https://doi.org/10.3912/OJIN.Vol23No01Man06
NursingLicensure.org. (n.d.). Health experts debate the merits of nurse-staffing ratio law. Retrieved June 11, 2022, from https://www.nursinglicensure.org/articles/nurse-staffing-ratios/
6 months ago
Janelle McEwen
RE: Discussion – Week 3
As an RN, our vigilance at the bedside is critical to our ability to ensure patient safety; thus, it is rational that assigning increasing numbers of patients eventually compromises a nurse’s ability to provide safe care. In our hospital, several factors influence nurse staffing, including patient acuity, admissions numbers, transfers, discharges, and staff skill mix and expertise (Needleman et al., 2018). Studies examining the association between nurse staffing ratios and patient safety report a positive report elevated risk of patient safety events, morbidity, and even mortality as the number of patients per nurse increases (Haegdorens et al., 2019; Griffiths et al., 2018). The above competing needs have substantially influenced policy development with at least 14 states passing nurse-staffing legislations stating minimum staffing ratios as of March 2021 (Needleman et al., 2018).
In week 2, I identified the Great Resignation as the national stressor affecting healthcare delivery in the U.S. Nurse staffing and patient safety competing needs played out explicitly at the height of the pandemic, particularly due to the Great Resignation. When my colleagues aged >50 years chose to resign to safeguard their health from the SARS-CoV-2 infections, those left had a challenge balancing the needs of the non-COVID-19 patients with COVID-19-positive patients, with the organizational focus being curbing the spread of the virus. Besides, it was difficult to take an off due to the longer shifts and burnout, since doing so; it would have further exacerbated the already dire situation of unbalanced nurse-patient ratio.
In line with the American Nurses Association (2021) recommendation, addressing the nursing staffing challenge calls for advocacy for safe staffing. Staffing levels in a value-based health care system should not be fixed because day-to-day hospital requirements are constantly in flux. Instead, nurses should be sanctioned to create flexible staffing plans for their unit in line with mandated nurse –patient ratios or standards (American Nurses Association, 2021). Staffing levels would improve, and nurses would be able to support each other when most needed.
References
American Nurses Association. (2021). Advocating for safe staffing. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/
Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., & Ball, J. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474–1487. https://doi.org/10.1111/jan.13564
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: An observational multicentre study. BMC Health Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4688-7
Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2018). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 364(11), 1037–1045. https://doi.org/10.1056/NEJMSA1001025
6 months ago
Sophronia Flowers
RE: Discussion – Week 3- Response #1
Hello Janelle,
I found your post both interesting and informative. The Greater Resignation as a national stressor is something I have not recently considered as I am no longer at the bedside. I found this interesting study that took place in Taiwan. The study’s intent was to look at the relationship between nursing professionals’ quality of life, personal quality of life, and intention to stay and resign. The study was comprised of 553 participants from three different hospitals in which a questionnaire was completed and followed up in three months. The results were not surprising. It showed that compassion and satisfaction increased the effects related to intent to stay and resignation (Chen et al, 2021). Although these factors should be considered, staffing ratios must be addressed as you mentioned. “The question for healthcare executives is whether factors promoting massive resignation in other industries have any bearing on efforts to retain the healthcare workforce, particularly in nursing, and what nursing leaders can do to address this trend” (Boston-Fleischhauer, 2022). Has your particular work area done anything to address this from a healthcare system or unit standpoint?
Boston-Fleischhauer, C. (2022). Reversing the great resignation of nursing. JONA: The Journal of Nursing Administration, 52(6), 324-326. doi: 10.1097/NNA.0000000000001155. Retrieved June 17, 2022, from https://journals.lww.com/jonajournal/Abstract/2022/06000/Reversing_the_Great_Resignation_in_Nursing__More.3.aspx?context=LatestArticles
Chen, Y.C., Li, T.C., Chang, Y.W., Liao, H.C., Huang, H.M., & Huang, L.C. (2021). Exploring the relationships among professional quality of life, personal quality of life and resignation in the nursing profession. Journal of Advanced Nursing, 77(6), 2689-2699. https://doi.org/10.1111/jan.14770
6 months ago
Janelle McEwen
RE: Discussion – Week 3- Response #1
Hello Sophronia, thank you for the in-depth response! Available evidence suggest that healthcare institutions have traced the potential causes of the Great resignation to similar issues, including the desire for better work environments (De Smet et al., 2021). Our hospital has taken measures to reverse the impacts of the Great Resignation on nursing shortage, including amplifying continuing-education programs, roles, and resources, that support novice clinicians and “in need” skill sets and doubling down on environmental factors, for example, team dynamics, purpose or meaning of work, feeling valued by organization, flexibility, and professional development opportunities. Similarly, the hospital sought to ensure total rewards offering is aligned with organizational strategy and meets a holistic set of needs, for example, dependent care and mental-health services (Berlin et al., 2022).
References
Berlin, G., Lapointe, M., & Murphy, M. (2022). Surveyed nurses consider leaving direct patient care at elevated rates. McKinsey & Company, February, 1–12. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/surveyed-nurses-consider-leaving-direct-patient-care-at-elevated-rates
De Smet, A., Dowling, B., Mugayar-Baldocchi, M., & Schaninger, B. (2021). “Great attraction” or “great attrition”? The choice is yours. McKinsey Quarterly, September, 1–8. https://www.mckinsey.com/business-functions/people-and-organizational-performance/our-insights/great-attrition-or-great-attraction-the-choice-is-yours
6 months ago
Carol Mathis
RE: Discussion – Week 3
Post #2
Jannell and colleagues and Dr. Rose:
Jannelle, you mentioned your colleagues aged >50 years old had resigned due to fear of COVID-19, I am >50 and I was the second nurse out of 30 nurses to start the vaccination series. The total number of nurses in my office was 3, including me. I hung out, worked, and had COVID-positive hospice patients and made it through. I did have nurses leave who were fearful and most went to Remote work from home jobs. Some of our nurses left to do travel nursing and according to Farmer, B., (2021), traveling ICU nurses pull in as much as $10.000 a week. The nurses who left our company like traveling and the work they say is different and much less work and mostly traveling while working in hospice. An article I read by Morris, G., (2022), states what is causing the nursing shortage is: an aging population, an aging workforce, nurse burnout, family obligations, and facility shortages of nurse educators. The current states with nursing shortages reported were Alaska, California, South Carolina, New Jersey, and Texas.
References:
Farmer, B., (2021), Worn Out Nurses Hit The Need For Better Pay Stressing Hospital Budgets And Morale. Retrieved from https://www.npr.org on 06/18/2022
Morris, G., (2022), Post-Pandemic Nursing Shortage: What it means for aspiring nurses. Retreived from https://nursing journal.org/articles/post-pandemic-nursing-shortage/ on 06/18/2022
6 months ago
Nicolette Dabish
RE: Discussion – Week 3
Hi Janelle,
I agree one of the most important parts of our jobs as RNs is patient safety! Your post was very informative, particularly the piece where you included the information on how nurse to patient ratios affect patient safety. Unfortunately, there is a correlation between poor nurse/ patient ratios and increased morbidity and failure of patient safety (Haegdorens et al., 2019). The importance of proper staffing is actually so important that many states have begun to pass legislation regulating nurse and patient ratios (Needleman et al., 2018). The need for nurses is high, especially with these new legislations regulating ratios. There are an estimated 200,00 plus nursing jobs created every year, however there are not enough nurses to fill these positions (American Association of Colleges of Nursing, 2022). It is a nurse’s job to advocate for themselves and safe staffing ratios, because if a nurse does not then there will be no resolutions.
References:
American Association of Colleges of Nursing. (2022). Nursing facts sheet. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet#:~:text=Nursing%20Fact%20Sheet%201%20Nursing%20is%20the%20nation%27s,segments%20of%20the%20U.S.%20…%20More%20items…%20
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: An observational multicentre study. BMC Health Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4688-7
Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2018). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 364(11), 1037–1045. https://doi.org/10.1056/NEJMSA1001025
6 months ago
Holly Murray
RE: Discussion – Week 3
There are a number of reasons for the nursing shortage that causes unsafe nurse to patient ratios. Baby boomers, whose generation make up the majority of nurses are retiring. The average age of a nurse in practice is age 50. (Hunter, 2021) Computer technology and high acuity patients have forced some of those into early retirement. Hospitals are losing their most seasoned nurses who bring a great deal of knowledge to the table. Modern medicine has advanced allowing people to live longer than ever before. (Hunter, 2021) This causes more patients to need care at one time and there are not enough nurses to meet that demand. Nursing school is the foundation for all nurses. Schools must have an appropriate number of educators to complete each school. This is another area that is also lacking. Nurses are burned out. It was an issue prior to COVID, but got worse after the pandemic. The cause of the nursing shortage is multi factorial and one area cannot improve without improvement in the other areas.
Putting a policy in place to mandate nurse to patient ratios does not necessarily mean hiring more nurses. Hiring more nurses would cost money and does not guarantee the experience that is needed. (Kelly, 2018) California is the only state in the United States that has mandated nurse to patient ratios. A policy of this nature would increase patient wait times in the emergency room. (DCHA, n.d.) Hospitals would have to block beds and divert patients to other hospitals. (DCHA, n.d.) For example, the hospital I work for is trauma and stroke certified and if a patient were to be diverted, the next closest facility to send them to is 2.5 hours away; this could be detrimental. There may also be reduction in budgeting and non-nursing resources.
DCHA. (n.d.). Studies Show that Mandatory Nurse Ratios Are Not the Answer. Retrieved from https://www.mnhospitals.org/Portals/0/Documents/policy-advocacy/nursestaffing/130219%20DCHA_FactSheets.pdf
Hunter, C. (2021). Nursing Shortage: Why There’s a Continued Demand for Nurses. Retrieved from https://www.snhu.edu/about-us/newsroom/health/nursing-shortage
Kelly, P., Porr, C., (January 31, 2018) “Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 1, Manuscript 6.
6 months ago
Sydney Flick
Response #2
Hi Holly,
Great job on your post! I never considered how many different factors are actually making an impact when it comes to the nursing shortage, but everything you said was so true! I never really thought about it before, but in the group of nurses that oriented with me at my job, there was only one other nurse as young as me in the group. According to Smiley et. al., “the median age of RNs was 52 years, up from 51 years in 2017. Nurses aged 65 years or older account for 19.0% of the RN workforce, up from 14.6% in 2017 and 4.4% in 2013. They also comprise the largest age category. The median age of LPNs/LVNs was 53 years, up from 52 years in 2017” (2021). With this age group quickly approaching the age of retirement, it’s only a matter of time until we see a dramatic fall in the number of nurses.
Policies to address ratios is a great way to mitigate burnout and outrageous ratios, but some studies suggest that safe staffing ratios aren’t always the answer, which I really find interesting. When looking at California, research has found that ” mandated nursing ratios has resulted in many unintended and negative consequences for patients, nurses, and other employees,” including poor flexibility with patient needs, poor patient care, lack of quality nurses, increasing safety concerns, and low work satisfaction (DCHA, n.d.). This is surprising news to me, especially considering how overwhelming ratios can be when it comes to quality care and safety.
Great job!
Sydney Flick
References
DCHA. (n.d.). Studies show that mandatory nurse ratios are not the answer. Retrieved June 17, 2022, from https://www.mnhospitals.org/Portals/0/Documents/policy-advocacy/nursestaffing/130219%20DCHA_FactSheets.pdf
Smiley, R. A., Ruttinger, C., Oliveira, C. M., Hudson, L. R., Allgeyer, R., Reneau, K. A., Silvestre, J. H., & Alexander, M. (2021). The 2020 National Nursing Workforce Survey. Journal of Nursing Regulation, 12(1). https://doi.org/10.1016/s2155-8256(21)00027-2
6 months ago
Esther Saint-Cyr
RE: Discussion – Week 3
Hi Holly,
There are some benefits to state-mandated nurse-patient ratios. Inquiries and reports have implicated low nurse staffing levels in hospital failures, which concluded that high-mortality hospitals have serious staffing problems (Saville et al., 2019). This can cause nurse burnout. According to Bakhamis et al. (2019), studies have linked RN burnout to lower patient satisfaction, more medical errors, higher infection rates, and higher mortality rates. Burnout can harm patient outcomes and safety due to staffing shortages. This is a negative consequence of nurses being unable to face the demands of the job from being overwhelmed due to nurse shortage.
References:
Bakhamis, L., Paul, D. P., Smith, H., & Coustasse, A. (2019). Still an Epidemic. The Health Care Manager, 38(1), 3–10. https://doi.org/10.1097/hcm.0000000000000243
Saville, C. E., Griffiths, P., Ball, J. E., & Monks, T. (2019). How many nurses do we need? A review and discussion of operational research techniques applied to nurse staffing. International Journal of Nursing Studies, 97, 7–13. https://doi.org/10.1016/j.ijnurstu.2019.04.015