Peer responses week 3 class 6053

WEEK 3 PEER RESPONSE NURS-6053

1 day ago

Vanessa Hagan-Osei

RE: Discussion - Week 3

COLLAPSE

Organizational Policies and Practices to Support Healthcare Issues

The development of a healthcare policy impacts the needs of patients, workforce availability, and resources available. Thus, developing an approach that balances competing needs to achieve high patient satisfaction and patient outcomes is essential. Healthcare organizations that fail to balance competing needs are more likely to achieve negative results (Hsin, 2017). Some competing demands affected by the lack of nurses in specialty units resulting from requiring at least a bachelor's degree in nursing are nurse burnout, coupled with fewer patient cases per day, and resource availability. This week we discuss how the needs mediate policy development.

The moral, legal, ethical implications of practices back the value of providing the best patient care for the community and individual patients (Laureate Education, 2012). My department sees many patients in need of various cardiac procedures such as cardiac catheterizations, pacemaker implants, cardioversions, and transesophageal echocardiograms every week. The majority of these patients require a high level of care post-procedure and nurses with sedation experience during their procedure. Management typically wants to hire nurses with a BSN in addition to two years of experience in critical care. Given this, it is crucial to have qualified nurses and an adequate number of nurses to care for this patient population. Therefore, these two mediators should serve as critical indicators for the hospital policy development and monitor and track nurses' ability to effectively deliver care within their work environments (MacPhee, Dahinten, and Havaei, 2017).

After accounting for nurse staffing needs and patient acuity, nurses' perceptions of frequent heavy workload, frequent interruptions, and stretching of resources lead to emotional exhaustion. Recognizing the importance of resources is the first step of excellent patient care or possible barrier to delivering care. For the Cath lab, room availability is our most significant resource. Room availability is factored into policymaking to determine the number of cases scheduled per day. According to Kelly and Porr (2018), working within the business model of healthcare silences and prevents nurses from voicing the best way to care for patients. Nurses unconsciously then support a culture of acceptance and suppress nursing knowledge about how important is it to get patients to the lab.

In conclusion, compromised nursing standards mediates the relationship between heavy workloads and nurse outcomes (MacPhee, Dahinten, and Havaei, 2017). Nurses should raise awareness of the needs as it influences policies, and also, it is an ethical obligation to the profession and patients.

References

Hsin, Y. L., Ching, T. Y., Yu, N. W., Wen, C. H., Tzu, H. H., Yueh, E. L., Chin, Y. L., & Yea, I. L. . S. (2017). Balancing competing needs mediates the association of caregiving demand with caregiver role strain and depressive symptoms of dementia caregivers: A cross‐sectional study. Journal of Advanced Nursing, 73(12), 2962–2972. https://doi-org.ezp.waldenulibrary.org/10.1111/jan.13379

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

Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file]. Baltimore, MD: Author.

MacPhee, M., Dahinten, S., & Havaei, F. (2017). The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes. Administrative Sciences, 7(1), 7. https://doi-org.ezp.waldenulibrary.org/10.3390/admsci7010007

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18 hours ago

Muktar Trawalley

RE: Discussion - Week 3

COLLAPSE

Competing needs in health care not only affect patient care, but decreases patient and nurse satisfaction; furthermore, it contributes to the effect of nurse burnout. In the article “The effects of nurse staffing on hospital performance: competitive versus less competitive markets” the author Everhart, Neff, Al-Amin, Nogle, and Weech-Maldonado reported that when hospitals who are facing financial uncertainty and choose to reduce their nurse staffing in attempts to increase profitability. This strategy has been found to compromise the quality of patient care and nurse related outcomes. In the article “Nurse staffing and nurse outcomes: A systematic review and meta-analysis” the author Shin, Park, and Bae reported they found a relationship between nurse staffing and nurse outcomes. The nurse outcomes that they reviewed were nurse burnout, job dissatisfaction, intent to leave, and needle stick injuries and patient outcomes such as mortality rate, hospital-acquired pneumonia, unplanned extubation, and cardiac arrest in intensive care units. Through their systematic review, they found that the majority of studies determined a distinct correlation between lower staffing ratios and negative nurse outcomes as well as negative patient outcomes. They determined that through their analysis that human resources can use this as an advocate for justifying better nurse staffing and can help set a nurse staffing policy for better outcomes.

I experienced this in person this year. We had JACHO come to our hospital and put a conditional hold on our accreditation to bring several things up to JACHO standards and through all of the transitions and new policies many nurses choose to change jobs and quit that left our hospital in a serious nursing shortage. The scary part is all of a sudden on the psych acute unit we would 2 nurses for 16 patients. As you can see with only 2nurses on shift this means every nurse is tripled with some patients being severely critically ill. This makes for very unsafe working conditions for the nurses and patients as some shifts you would not take a break for the full 12 hours. Nurse burnout became evident and just like the story in the article by Hartrick Doane and Varcoe (2015), they discuss a nurse who during shift change became enraged about her coffee cup getting chipped and for her after a long and difficult shift had found that to be the last straw and it caused her emotions to boil over. Hospitals need to find ways to help keep educated nursing staff and increase job satisfaction. According to May, Bazzoli, and Gerland (2006), they stated that policy-makers can help to guide the ways hospitals respond to nursing shortages by aiming to shape recruitment and retention strategies with quality improvement such as the Magnet Recognition Program.

According to Platts (2018), the American Nurses Credentialing Center developed a program called the Magnet Recognition program that identifies excellence in nursing and acknowledges health care organizations who focus on three goals of promoting a supportive environment for quality nursing practice, excellence in nursing care of patients, and the use of best practices by staff. Magnet status is recognized not only by consumers, but health care staff as a high distinction that recognizes high quality of nursing care of patients and high nurse job satisfaction. It’s very extremely difficult to obtain but once achieved it is well worth all the effort.

Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital performance: competitive versus less competitive markets. Health Care Management Review, 38(2), 146-155. doi:10.1097/HMR.0b013e318257292b

Hartrick Doane, G., & Varcoe, C. (2015). How to nurse: Relational inquiry with individuals and families in changing health and health care contexts. Philadelphia, PA: Wolters Kluwer. As quoted in 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/TableofContents/Vol-23-2018/No1-Jan-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html.

May, J., Bazzoli, G., & Gerland, A. (2006). Hospitals' responses to nurse staffing shortages. doi.org/10.1377/hlthaff.25.w316. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.w316

Platts, B. A. (2018). Magnet Excellence—One Hospital’s Experience. Journal of Hospital Librarianship, 18(2), 136–144. https://doi-org.ezp.waldenulibrary.org/10.1080/15323269.2018.1437504

Shin, S., Park, J.-H., & Bae, S.-H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273–282. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2017.12.0