Week 6 leadership replies

OlgaBenitezLeadershipreply.docx

Olga Benitez

Nursing Leadership and Management

Dr. Lazo, Carmen

Florida National University

Oct 09, 2024

Discussion Points

The main discussion points include addressing the effects of patient acuity shifts due to the vascular surgeon's new admissions. Highlight the persistent budget issues, primarily caused by the current unit’s configuration not meeting higher acuity demands. Propose a shift towards a blended care model that divides the unit into medical-surgical and step-down categories.

Additional FTEs

Additional FTE caregivers are needed to handle increased patient acuity effectively (Vryonides et al., 2021). A realistic estimate would be to add at least 2-3 FTEs to align staffing with patient complexity, enhancing care quality without straining current resources.

OT Staffing

Identifying if OT has been regularly used to cover the staffing gap is crucial. Relying on OT suggests that the staffing guideline fails to meet the current patient demands, justifying the need for a more permanent staffing solution (Vryonides et al., 2021).

OT Expense

Financial data indicating a $125,000 OT expense over six months reflects a significant deviation from the budget. This expense highlights an inefficient use of resources, driven by a reliance on OT to meet the unit’s increased acuity needs (Griffiths et al., 2021).

Recommendations

A transition from OT usage to expanding the core staff is necessary. Hiring full-time RNs addresses understaffing, decreases OT dependence, and fosters a more sustainable, cost-effective staffing model (Griffiths et al., 2021). Additionally, this strategy enhances patient care by reducing nurse fatigue and increasing continuity of care.

Cost Comparison

The OT expense of $125,000 every six months equals about $250,000 annually. In contrast, hiring three full-time RNs would average $240,000 annually (assuming an annual salary of $80,000 each). Even though initial hiring and training costs are involved, this approach ultimately reduces costs compared to the escalating OT expenses while improving staff morale and patient care quality (Khademi et al., 2021).

Staffing Grid

· Medical–Surgical Unit (70%):

· Day Shift: 6 RNs, 4 CNAs

· Night Shift: 5 RNs, 3 CNAs

· Step-Down Unit (30%):

· Day Shift: 3 RNs, 2 CNAs

· Night Shift: 2 RNs, 1 CNA

This option employs a more robust staffing model, increasing the number of RNs and CNAs in both units. It prioritizes higher coverage to address increased patient acuity and reduce staff workload. This model enhances patient care, allowing for better handling of complex cases in the step-down unit. It is ideal for scenarios requiring intensive patient management and consistent support.

References

Griffiths, P., Saville, C., Ball, J. E., Jones, J., Monks, T., & Safer Nursing Care Tool study team (2021). Beyond ratios - flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation and economic modelling study. International journal of nursing studies, 117, 103901. https://doi.org/10.1016/j.ijnurstu.2021.103901

Khademi, M., Mohammadi, E., & Vanaki, Z. (2021). Resources-tasks imbalance: Experiences of nurses from factors influencing workload to increase. Iranian journal of nursing and midwifery research, 20(4), 476–483. https://doi.org/10.4103/1735-9066.160994

Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2021). The ethical dimension of nursing care rationing: A thematic synthesis of qualitative studies. Nursing ethics, 22(8), 881–900. https://doi.org/10.1177/0969733014551377

YudeisyGarciaLeadershipdiscussion.docx

Yudeisy Garcia

7 hours ago, at 1:45 PM

Top of Form

Week 6 Discussion

Yudeisy Garcia

Nursing Leadership and Management

Question 1

When planning to discuss the proposed configuration change to a blended model with an overall ADC of 20 and a blend of 70% medical-surgical (ADC) and 30% stepdown (6 ADC), there are several key discussion points to cover it is important to cover the need for Additional FTE Caregivers. Assessing whether the proposed configuration change and the increased acuity require additional full-time equivalent (FTE) caregivers. Considering factors such as patient volume, acuity levels, desired nurse-to-patient ratios, and workload expectations. Calculate the estimated number of FTEs required based on these factors and compare it to the available staffing resources (Erenstein & McCaffrey, 2020).

It is important to discuss the financial implications of the proposed changes, including any potential budget adjustments that may be necessary to accommodate the blended model and the increased staffing needs. Consider the cost of hiring additional FTEs versus the potential impact on patient care and outcomes. Ensure open and transparent communication with key stakeholders, including the nurse manager, unit staff, finance department, and human resources. Collaborate on developing an action plan that addresses the staffing needs, financial considerations, and any necessary adjustments to ensure safe and quality care for patients.

Question 2

Calculate the Cost of OT: We have to determine the average monthly OT expense by dividing the total OT expense of $125,000 by 6 (months). This will provide an estimate of the monthly cost incurred due to OT (Erenstein & McCaffrey, 2020). Consider the number of FTEs required based on the proposed blended model with an overall ADC of 20 and a blend of 70% medical-surgical (ADC) and 30% stepdown (6 ADC). Calculate the estimated cost of hiring additional RNs by considering their salaries, benefits, and any associated recruitment or onboarding expenses. Compare the estimated monthly cost of hiring additional RNs with the average monthly OT expense. Evaluate which option is more cost-effective in the long run.

Ultimately, the recommendation should consider a balance between financial considerations, patient care needs, and the well-being of the nursing staff. It is essential to involve key stakeholders, such as the nurse manager, finance department, and human resources, in the decision-making process to ensure a comprehensive and informed approach.

Question 3

I am not sure what a grid on this would look like but I would imagine I can calculate staffing needs for stepdown (ADC). Multiply the ADC for the stepdown unit (30% of 20) by the determined nurse-to-patient ratio for that unit. This will provide the number of nurses required for the stepdown patients. I can consider any additional support staff required to assist with patient care, such as nursing assistants or unit secretaries and determine the appropriate staffing levels for support staff based on patient volume, acuity, and unit requirements. I can also consider the required coverage for different shifts (day, evening, night) and ensure appropriate staffing levels for each shift based on workload, patient needs, and unit policies (Swearingen, 2019).

References

Erenstein, C. F., & McCaffrey, R. (2020). How healthcare work environments influence nurse retention. Holistic Nursing Practice, 21(6), 303-307.

Swearingen, S. (2019). A journey to leadership: designing a nursing leadership development program. The Journal of Continuing Education in Nursing, 40(3), 107-112.

Bottom of Form

OlgaBenitezLeadershipreply.docx

Olga Benitez

Nursing Leadership and Management

Dr. Lazo, Carmen

Florida National University

Oct 09, 2024

Discussion Points

The main discussion points include addressing the effects of patient acuity shifts due to the vascular surgeon's new admissions. Highlight the persistent budget issues, primarily caused by the current unit’s configuration not meeting higher acuity demands. Propose a shift towards a blended care model that divides the unit into medical-surgical and step-down categories.

Additional FTEs

Additional FTE caregivers are needed to handle increased patient acuity effectively (Vryonides et al., 2021). A realistic estimate would be to add at least 2-3 FTEs to align staffing with patient complexity, enhancing care quality without straining current resources.

OT Staffing

Identifying if OT has been regularly used to cover the staffing gap is crucial. Relying on OT suggests that the staffing guideline fails to meet the current patient demands, justifying the need for a more permanent staffing solution (Vryonides et al., 2021).

OT Expense

Financial data indicating a $125,000 OT expense over six months reflects a significant deviation from the budget. This expense highlights an inefficient use of resources, driven by a reliance on OT to meet the unit’s increased acuity needs (Griffiths et al., 2021).

Recommendations

A transition from OT usage to expanding the core staff is necessary. Hiring full-time RNs addresses understaffing, decreases OT dependence, and fosters a more sustainable, cost-effective staffing model (Griffiths et al., 2021). Additionally, this strategy enhances patient care by reducing nurse fatigue and increasing continuity of care.

Cost Comparison

The OT expense of $125,000 every six months equals about $250,000 annually. In contrast, hiring three full-time RNs would average $240,000 annually (assuming an annual salary of $80,000 each). Even though initial hiring and training costs are involved, this approach ultimately reduces costs compared to the escalating OT expenses while improving staff morale and patient care quality (Khademi et al., 2021).

Staffing Grid

· Medical–Surgical Unit (70%):

· Day Shift: 6 RNs, 4 CNAs

· Night Shift: 5 RNs, 3 CNAs

· Step-Down Unit (30%):

· Day Shift: 3 RNs, 2 CNAs

· Night Shift: 2 RNs, 1 CNA

This option employs a more robust staffing model, increasing the number of RNs and CNAs in both units. It prioritizes higher coverage to address increased patient acuity and reduce staff workload. This model enhances patient care, allowing for better handling of complex cases in the step-down unit. It is ideal for scenarios requiring intensive patient management and consistent support.

References

Griffiths, P., Saville, C., Ball, J. E., Jones, J., Monks, T., & Safer Nursing Care Tool study team (2021). Beyond ratios - flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation and economic modelling study. International journal of nursing studies, 117, 103901. https://doi.org/10.1016/j.ijnurstu.2021.103901

Khademi, M., Mohammadi, E., & Vanaki, Z. (2021). Resources-tasks imbalance: Experiences of nurses from factors influencing workload to increase. Iranian journal of nursing and midwifery research, 20(4), 476–483. https://doi.org/10.4103/1735-9066.160994

Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2021). The ethical dimension of nursing care rationing: A thematic synthesis of qualitative studies. Nursing ethics, 22(8), 881–900. https://doi.org/10.1177/0969733014551377

YudeisyGarciaLeadershipdiscussion.docx

Yudeisy Garcia

7 hours ago, at 1:45 PM

Top of Form

Week 6 Discussion

Yudeisy Garcia

Nursing Leadership and Management

Question 1

When planning to discuss the proposed configuration change to a blended model with an overall ADC of 20 and a blend of 70% medical-surgical (ADC) and 30% stepdown (6 ADC), there are several key discussion points to cover it is important to cover the need for Additional FTE Caregivers. Assessing whether the proposed configuration change and the increased acuity require additional full-time equivalent (FTE) caregivers. Considering factors such as patient volume, acuity levels, desired nurse-to-patient ratios, and workload expectations. Calculate the estimated number of FTEs required based on these factors and compare it to the available staffing resources (Erenstein & McCaffrey, 2020).

It is important to discuss the financial implications of the proposed changes, including any potential budget adjustments that may be necessary to accommodate the blended model and the increased staffing needs. Consider the cost of hiring additional FTEs versus the potential impact on patient care and outcomes. Ensure open and transparent communication with key stakeholders, including the nurse manager, unit staff, finance department, and human resources. Collaborate on developing an action plan that addresses the staffing needs, financial considerations, and any necessary adjustments to ensure safe and quality care for patients.

Question 2

Calculate the Cost of OT: We have to determine the average monthly OT expense by dividing the total OT expense of $125,000 by 6 (months). This will provide an estimate of the monthly cost incurred due to OT (Erenstein & McCaffrey, 2020). Consider the number of FTEs required based on the proposed blended model with an overall ADC of 20 and a blend of 70% medical-surgical (ADC) and 30% stepdown (6 ADC). Calculate the estimated cost of hiring additional RNs by considering their salaries, benefits, and any associated recruitment or onboarding expenses. Compare the estimated monthly cost of hiring additional RNs with the average monthly OT expense. Evaluate which option is more cost-effective in the long run.

Ultimately, the recommendation should consider a balance between financial considerations, patient care needs, and the well-being of the nursing staff. It is essential to involve key stakeholders, such as the nurse manager, finance department, and human resources, in the decision-making process to ensure a comprehensive and informed approach.

Question 3

I am not sure what a grid on this would look like but I would imagine I can calculate staffing needs for stepdown (ADC). Multiply the ADC for the stepdown unit (30% of 20) by the determined nurse-to-patient ratio for that unit. This will provide the number of nurses required for the stepdown patients. I can consider any additional support staff required to assist with patient care, such as nursing assistants or unit secretaries and determine the appropriate staffing levels for support staff based on patient volume, acuity, and unit requirements. I can also consider the required coverage for different shifts (day, evening, night) and ensure appropriate staffing levels for each shift based on workload, patient needs, and unit policies (Swearingen, 2019).

References

Erenstein, C. F., & McCaffrey, R. (2020). How healthcare work environments influence nurse retention. Holistic Nursing Practice, 21(6), 303-307.

Swearingen, S. (2019). A journey to leadership: designing a nursing leadership development program. The Journal of Continuing Education in Nursing, 40(3), 107-112.

Bottom of Form

OlgaBenitezLeadershipreply.docx

Olga Benitez

Nursing Leadership and Management

Dr. Lazo, Carmen

Florida National University

Oct 09, 2024

Discussion Points

The main discussion points include addressing the effects of patient acuity shifts due to the vascular surgeon's new admissions. Highlight the persistent budget issues, primarily caused by the current unit’s configuration not meeting higher acuity demands. Propose a shift towards a blended care model that divides the unit into medical-surgical and step-down categories.

Additional FTEs

Additional FTE caregivers are needed to handle increased patient acuity effectively (Vryonides et al., 2021). A realistic estimate would be to add at least 2-3 FTEs to align staffing with patient complexity, enhancing care quality without straining current resources.

OT Staffing

Identifying if OT has been regularly used to cover the staffing gap is crucial. Relying on OT suggests that the staffing guideline fails to meet the current patient demands, justifying the need for a more permanent staffing solution (Vryonides et al., 2021).

OT Expense

Financial data indicating a $125,000 OT expense over six months reflects a significant deviation from the budget. This expense highlights an inefficient use of resources, driven by a reliance on OT to meet the unit’s increased acuity needs (Griffiths et al., 2021).

Recommendations

A transition from OT usage to expanding the core staff is necessary. Hiring full-time RNs addresses understaffing, decreases OT dependence, and fosters a more sustainable, cost-effective staffing model (Griffiths et al., 2021). Additionally, this strategy enhances patient care by reducing nurse fatigue and increasing continuity of care.

Cost Comparison

The OT expense of $125,000 every six months equals about $250,000 annually. In contrast, hiring three full-time RNs would average $240,000 annually (assuming an annual salary of $80,000 each). Even though initial hiring and training costs are involved, this approach ultimately reduces costs compared to the escalating OT expenses while improving staff morale and patient care quality (Khademi et al., 2021).

Staffing Grid

· Medical–Surgical Unit (70%):

· Day Shift: 6 RNs, 4 CNAs

· Night Shift: 5 RNs, 3 CNAs

· Step-Down Unit (30%):

· Day Shift: 3 RNs, 2 CNAs

· Night Shift: 2 RNs, 1 CNA

This option employs a more robust staffing model, increasing the number of RNs and CNAs in both units. It prioritizes higher coverage to address increased patient acuity and reduce staff workload. This model enhances patient care, allowing for better handling of complex cases in the step-down unit. It is ideal for scenarios requiring intensive patient management and consistent support.

References

Griffiths, P., Saville, C., Ball, J. E., Jones, J., Monks, T., & Safer Nursing Care Tool study team (2021). Beyond ratios - flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation and economic modelling study. International journal of nursing studies, 117, 103901. https://doi.org/10.1016/j.ijnurstu.2021.103901

Khademi, M., Mohammadi, E., & Vanaki, Z. (2021). Resources-tasks imbalance: Experiences of nurses from factors influencing workload to increase. Iranian journal of nursing and midwifery research, 20(4), 476–483. https://doi.org/10.4103/1735-9066.160994

Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2021). The ethical dimension of nursing care rationing: A thematic synthesis of qualitative studies. Nursing ethics, 22(8), 881–900. https://doi.org/10.1177/0969733014551377

YudeisyGarciaLeadershipdiscussion.docx

OlgaBenitezLeadershipreply.docx

YudeisyGarciaLeadershipdiscussion.docx

OlgaBenitezLeadershipreply.docx

YudeisyGarciaLeadershipdiscussion.docx