PICOT Question Paper 500 words by 06/04/2021

Running head: PICOT QUESTION PAPER

PICOT QUESTION PAPER 3

PICOT Question Paper

Nancislyn Gonzalez

NRS-493

Barbara Pridgen

November 11th, 2020

PICOT Question Paper

Based on my practicum site which is a long-term care facility, the nursing facility is currently facing a major problem with nursing turnover and related nursing shortages. This being a long-term skilled care as any involved nurse; one requires caring for an increased number of patients than one would care while offering necessitated care at hospitals. Increased workload that requires extended time for the nurses in these facilities has contributed a lot in raising the rates of nursing turnover which in turn gives rise to nursing shortages (Gullatte, 2016). As outlined by Gullatte (2016), nursing shortage can affect the quality of health care delivered in all facilities and this can result to increased complications and at times deaths amongst the involved patients. Basically, high turnover rates in rehabilitation centers or long-term care facilities can affect the way organization functions where it is widely-known to cause ineffective functioning.

The augmented shortages of nurses due to increased nurse turnover have necessitated nurses to work for more and extended hours. The act of so doing makes such working conditions to be much stressful and give rise to job dissatisfaction, nurse burnout, and fatigue and at times cause some injury. Statistically, increased workloads amongst nurses continue to increase nurse burnout, re-admission rates, and risk of acquiring infections in patients and higher rates of mortality (American Association of Colleges of Nursing, 2017). Such mistakes or related outcomes are widely-known to make patients receive health care services of reduced quality and thus giving rise to various complications which could be prevented at the first place. Some medication errors resulting from fatigue is one illustration concerning how nurses that are having increased workload can increase the mortality rate.

The paper aims at addressing how providing necessitated resources like PPE, improving work environment and job satisfaction as compared to recruiting with sign-on bonus help in reducing the nursing turnover rates in long-term facilities to help in improving patient outcomes and safety.

PICOT question: Among nurses having chronic burnout, what would be the effect or impact of increasing the nurse enrolment compared to the issue of exploring retention strategies to resolve the nursing shortage that is currently affecting the United States healthcare over the next eight years? You still are comparing two interventions Nancislyn. You should compare a strategy to no strategy. For example, choose diligent retention strategies to no such strategies. For example: Nurses who are employed in a facility which employs concerted nursing retention strategies such as……contributes to less nurse burnout, more nurse satisfaction and better patient outcomes compared to the facility who does not utilize said strategies.

Population of Focus: Nurses working in long-term facilities. The population which is affected by this act is geriatric patients who are sixty-five years and above who are served by this category of nurses specifically in my site of practicum.

Problem

Nurse shortage surpasses to be the biggest problems which many healthcare organization faces. The rate at which nurses are coming into healthcare field and rapidly leaving their current workplaces due to various reasons even the nursing practice is alarming. Increased nursing turnover rates are a major concern to a large number of organizations simply because nursing turnover is much costly and non-beneficial to patient care. Poor job satisfaction and poor working environment are some of the major reasons why nurses leave their previous place of employment (Foster, 2015). As widely-researched, nurses leave their current place of work to go to look for green pastures to other healthcare facilities or leave nursing profession and change their profession or jobs as a result of poor quality leadership and increased workload.

Most nurses continue to report and have reported that workload is not only heavy but also stressful and they lacked interpersonal relationships or teamwork which made the working environment to be unfriendly and lacked the desired warmth. To add on this, nurses felt much stressed and burnout. In relation to this, the nurses could not perform at their level best to an extent of nursing practice. Typically, heavy workload can cause physical and mental hardships on nurses and thus making the nurses feel they are incapable of giving quality and desirable care to their patients. Studies which have been reviewed clearly show that high failure to rescue rates and high mortality rate were generally caused by having inadequate staffing to an extent of making the available nurses fatigued and stressed due to heavy workload. As a result, the nurses could not perform their assigned roles as preferred. Besides, nurses have reported as well that good management and leadership arise as a result of showing honesty, respect and recognition to the staff together with addressing their raised issues (Zinn, Guglielim, Davis & Moses, 2012).. A large number of nurses have reassigned their jobs and left their previous jobs simply because they felt they do not feel supported by the management towards addressing their concerns and lacked resources required to perform their assigned duties.

Intervention

Hiring and retaining competent nurses through provision of required resources, suitable working conditions that leads to job satisfaction is a key element in addressing the issue of nurse turnover as proposed in the paper. A large number of researchers have outlined the way many government officials, experts and organization members are much aware of multifactorial nursing shortage due to increased nursing turnover and thus the urge of finding the desirable fixes which are multi-studied. Suggestions have been focused on reducing the workload, and improving nurse and patient outcome and safety. Any organization can work to improve leadership and evidence-based practice management involved processes since reduced and poor job satisfaction is widely-known to arise from management’s poor quality (Sookyung, Bakken, Douglas & Stone, 2008). As a result, it is much imperative for leaders and managers in healthcare facilities receive adequate training and education concerning how they can retain nurses using the most suitable strategies to reduce the associated adverse effects.

Comparison

In the past, the healthcare facilities preferred to offer the sign-on bonuses to increase the nurse enrolment to the new employees but failed to change the way their existing environments appear to retain these staff. The past strategies that were being used and are currently being used by some facilities to increase the nurse staffing was based on offering incentive to recruit the nurses through the act of attracting the potential and competent nurses with sign-on bonuses. Even though sign-on bonus was helpful in bringing in the required nurses, this did not certainly make the recruited nurses to be much committed to the healthcare facility or organization the sign to. As compared to the issue, of providing the necessitated resources followed by making the nurses to be satisfied with their jobs while at the same time provide better working conditions and favorable working environments, the second strategy is widely-known to give rise to increased nursing retentions as compared to the issue of attracting nurses through sign-on bonuses (Black, 2015). Consequently, some studies have shown the way managers who engaged in leadership and management skills training to lead staff and better support the existing staff offered sufficient nurse to patient ratio to reduce the nurse workload has helped in improving the retention rates for a large number of organizations (Black, 2015).

Outcome

The issue of retaining existing nurses who are more experienced, knowledgeable of established policies and organization, and high-trained will save and is widely-know to save organization financial resources and give rise to increase patient outcomes and necessitated safety. Typically, hiring and retaining nursing staff to offer and provide better quality healthcare services and minimizing the mortality rates.

Time

The nursing retention rates and suitable strategies have continued to be examined simply because; at times there appear to be no clear reason regarding why the nursing turnover rates surpass to be high while given that, the nurses’ age can play a critical role in nurse shortage (Adams, 2016). In order to address the issue of nurse turnover in long-term facilities, providing necessitated resources like PPE in this Coronavirus era, improving the working conditions of nurses together with finding ways through which nurses can be satisfied with their current jobs require to evaluated how it will help in reducing the rates of nurse turnover for the next eight years basically while using my site. The future researchers requires to conduct both quantitative and qualitative research to establish the direct relationship which exist between organizational performance or management’s role and nurse turnover and the way these factors impact both patient outcomes and safety.

References

Adams, Susan Louisa. (2016). "Influences of Turnover, Retention, and Job Embeddedness in Nursing Workforce Literature." Online Journal Of Rural Nursing & Health Care 16, no. 2: 168-195. CINAHL Complete, EBSCOhost (accessed July 30, 2018).

American Association of Colleges of Nursing. (2017). Nursing Shortage Fact Sheet. Retrieved from https://www.aacnnursing.org/News-information/Fact-Sheets/Nursing-Shortage.

Black, P. (2015). Developing an Enhanced Perspective of Turnover and Retention of Nurses and Health Care Aides in Long-Term Care Homes. Perspectives: The Journal of the Gerontological Nursing Association, 38(2), 25-30.

Foster, S. (2015). Setting our sights on a Pathway to practice improvement. British Journal Of Nursing, 24(20), 1043. doi:10.12968/bjon.2015.24.20.1043

Gullatte, M. (2016). Nursing Workforce Shortage. Georgia Nursing, 76(3), 10.

Nelson, I. E. (2017). Nurse Manager Perceptions of Work Overload and Strategies to Address It. Nurse Leader, 15406-408. doi:10.1016/j.mnl.2017.09.009

Sookyung, H., Bakken, S., Douglas, K., & Stone, P. W. (2008). Evidence-Based Staffing: Potential Roles for Informatics. Nursing Economic$, 26(3), 151-173.

Zinn, J.L., Guglielim, C.L., Davis, P.P., & Moses, C. (2012). Addressing the nursing shortage: the need for nurse residency programs. AORN Journal, 96(6), 652-657. Doi:10.1016/j.aorn.2012.09.011.