NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
Walden University NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
Whether one passes or fails an academic assignment such as the Walden University NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
The introduction for the Walden University NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
After the introduction, move into the main part of the NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
The COVID-19 pandemic has revealed many critical issues in the national healthcare system in the United States. The nursing shortage is among the top priorities because the whole system relies on nursing practitioners as the backbone. The statistics emphasize the urgent measures taken at each level of the government. As of March 2022, almost every state had taken executive actions to address the shortage, such as issuing temporary licenses to put nursing students to work (Zhavoronkova et al., 2022). The problem is significant enough to disregard the impact of competing needs in healthcare delivery.
Nursing shortage results from the impact of various external forces on the healthcare system. These include but are not limited to the aging population, aging workforce, nurse burnout, and population growth (Haddad et al., 2022). Therefore, the demand for registered nurses will be the highest among all professions. The reported growth will be at a faster rate (9%) than all other occupations, with more than 275,000 additional nurses being needed until 2030 (Haddad et al., 2022). The government actively invests in the development of nursing education and encourages more people to enter the profession and address the shortage. Nevertheless, the impact of competing needs in healthcare delivery persists. The available nurse workforce does not have sufficient resources to address all primary care needs. Alternative approaches such as preventative and chronic disease interventions and outpatient care models help close the gap, but they do not suffice (Korownyk et al., 2017). The nursing shortage is inextricably linked to diversity, aging, and education accessibility. For instance, the number of nurses has not kept up with the aging US population (Zhavoronkova et al., 2022). It implies that the new policies need to be comprehensive, addressing the factors and aspects of the healthcare issue.
In conclusion, the nursing shortage remains a central healthcare problem in the United States. It has many aspects and is related to other issues. Ignoring those related problems may not result in effective outcomes and a considerable increase in the nursing workforce. A more comprehensive approach is necessary for the government to ensure a long-term solution.
References:
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing.
Korownyk, C., McCormack, J., Kolber, M. R., Garrison, S., & Allan, G. M. (2017). Competing demands and opportunities in primary care. Canadian Family Physician, 63(9), 664-668.
Zhavoronkova, M., Custer, B. D., Neal, A., & Schweitzer, J. (2022, May 23). How To Ease the Nursing Shortage in America. Center for American Progress. Retrieved September 13, 2022, from https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/
Healthcare systems, networks, and providers focus on offering quality care using innovative
delivery models that reduces the overall cost while increasing accessibility. Imperatively, they develop sound and targeted policies to attain these goals but face competing needs like the needs of the healthcare workforce, patients, and limited resources (Griffiths et al., 2020). For example, healthcare organizations can address the workforce needs and those of patients using policies aimed at having optimal nurse staffing levels to reduce nurse shortage, improve quality, and prevent burnout syndrome that leads to nurse turnover. However, these competing needs may mean that the organization increases its costs and reduce their profit margins. The use of sufficient workforce in healthcare organizations ensures that the facility offers quality care to diverse patient population. The increasing demand for care emanating from an aging population and reforms in healthcare that lead to increased access mean that organizations should employ more nurses to bridge the gap.
Specific Competing Needs that Impacts Nurse Shortage
Nurse shortage is a significant problem that requires organizations to develop effective policies because of their competing needs. Nurse shortage leads to high turnover rates and is associated with quality care outcomes. Nurse shortage leads to increased workload and burnout syndrome which implies that organizations should develop policies to ensure that they have optimal nurse levels or staffing levels to address the issue (Kelly & Porr, 2018). As a national health stressor, nursing shortage emanates from the competing needs between patients’ need for quality care and organization’s focus on becoming sustainability while navigating the delicate obligation to have sufficient workforce in their operations.
High costs of healthcare emerge in different areas like cost of drugs, provider reimbursement and even running nursing home care facilities and high costs of better medical equipment that impact the ability of facilities to hire sufficient levels of staff. The employment of more nurses alongside these expenses with the aim of delivering quality care compete with the need to offer quality patient care (Lucchini et al., 2020). The implication is that such facilities should develop policies that will lead to better staff levels and ensure quality care in different areas of care delivery. Policies to emphasize innovative solutions are essential in this case to help the organization address the competing needs of ensuring a happy and satisfied workforce, management of scarce or limited resources that include financial resources, and offering quality care.
Impact of Policy on Competing Needs
The use of new staff scheduling systems by developing a staffing pool can help address the staffing needs. Healthcare providers can use their staff more efficiently in attempts to reduce the overall labor costs and deliver quality care (Kelly & Porr, 2018). For example, hospital organizations can reduce the need to use nurses in moving patients to and from emergency units and instead use other health providers like nurse assistants. Such policies can save the organizations from increased cost of paying the nurses hourly wages for the services which they can plough back and compensate the nursing staff through benefits.
Further, the organization will reduce nurse workload and employee turnover (Milliken, 2018). Training new nurses and employees in general is costly. Having competitive package and benefits and maintenance of the current staff as well as recognition of their efforts is essential to address nursing shortage and improving quality of care for patients in different areas of care provision. Policies are intended to improve the quality of care and reduce the competing needs in healthcare organizations. Nurses’ needs can compete with the need of offering quality care as it implies that organizations must have sufficient levels of staff while this requires additional resources.
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. DOI: 10.1016/j.ijnurstu.2019.103487.
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).
DOI: 10.3912/OJIN.Vol23No01Man06
Lucchini, A., Iozzo, P., & Bambi, S. (2020). Nursing workload in the COVID-19 era. Intensive
& critical care nursing, 61, 102929. DOI: 10.1016/j.iccn.2020.102929
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: The Online Journal
of Issues in Nursing, 23(1). DOI:10.3912/OJIN.Vol23No01Man01
REPLY QUOTE EMAIL AUTHOR
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.
To Prepare:
Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.
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4 Common Nursing Ethics Dilemmas
Working with patients, nurses will have many occasions when they need to call on nursing ethics to deal with difficult situations.
“Every day, nurses in all hospital departments face a variety of ethical issues and they need to reconcile their own values with their nursing professional obligation,” said Marian Altman, RN, MS, CNS-BC, CCRN-K, clinical practice specialist with the American Association of Critical-Care Nurses (AACN).
“There are a variety of reasons that nurses are not able to reconcile this conflict, such as lack of resources to do so and lack of time. Not addressing ethical issues is a problem. If the nurse ignores the issue, it may lead to burnout and they’re leaving the unit and/or the nursing profession.”
Nurses who do not heed the nursing code of ethics could also find themselves in legal trouble.
Not surprisingly, nursing professionals who don’t know the code of ethics may face a higher risk of being involved in situations that could lead to disciplinary charges or malpractice litigation, added David Griffiths, senior vice president, Nurses Service Organization, a professional liability insurance provider.
Every nurse should become familiar with the Code of Ethics for Nurses, developed and released by the American Nurses Association (ANA).
“It’s a framework for helping nurses with issues that might arise,” said Connie M. Ulrich, PhD, RN, professor of bioethics and nursing at the University of Pennsylvania School of Nursing and Medicine in Philadelphia and author of Nursing Ethics in Everyday Practice.
Additionally, Altman suggested contacting “the hospital’s ethics committee, the hospital code of conduct or a variety of educational resources. Some organizations have an ethics consultation service whose members round and proactively assist staff to discuss potential and/or real ethical issues.”
What are the Four Common Ethical Dilemmas in Nursing?
1. Informed consent
Concerns that patients and their families have not been fully informed about their treatments or clinical prognosis is a common ethical concern of nurses, Ulrich reported.
“It can create great concern for nurses,” Ulrich said. “Patients feel more comfortable asking the nurse to decipher what was said [by the doctor]. But it’s an ethical issue about how much they should convey.”
This is especially true about end-of-life decision making, she said. But nurses may not be prepared to have this discussion. She suggested building stronger interdisciplinary teams.
2. Disclosing medical conditions
Another example of an ethical dilemma is telling the truth to a patient vs. being deceptive, Altman said.
“Sometimes families request that patients not be told about their medical condition or diagnosis,” Altman added. “The nurse must consider the patient’s right to know. How does the nurse know what the family is saying is true?”
The nurse has an obligation to the patient and the ethical principles of nonmaleficence and fidelity—the obligation to prevent harm and the obligation to be faithful to your colleagues, Altman said, adding, “The nurse’s own value of truth-telling must also be considered.”
3. Incompetence among peers
“They may feel the behavior should be reported because of the threat to patient safety but hesitate to do so because it would worsen inadequate staffing,” Delgado said. “Some dilemmas can be framed as competing obligations, such as protecting the patient on one hand and protecting the staff on the other. The principles to consider are nonmaleficence and fidelity.
Resolving what appear to be competing obligations often requires thinking creatively, Delgado added.
“Solutions often become apparent when we stop and consider all the possible actions available to us,” she explained. “Beyond report or don’t report, there may be an option to talk to the individual in question, assess his or her awareness of the incompetence, and encourage further training, education or practice.”
4. Broader ethical issues
According to Felicia “Liz” Stokes, JD, RN, senior policy advisor at the ANA’s Center for Ethics and Human Rights, ANA considers the top three nursing ethics issues as:
- Creating and maintaining an ethical work environment
- Nursing’s role in social justice, such as opposing capital punishment
- Moral distress and moral resilience.
“The Code of Ethics for Nurses with Interpretive Statements is clear that nurses are bound in their duty to protect human health,” said Ruth McBain on behalf of ANA. “As the guiding voice for nursing ethics in the United States, the ANA feels that it is important to take a strong position on issues affecting human dignity and societal health.”
Cybersecurity and confidentiality of the patients’ data is the recent stressor in healthcare and requires adequate intervention measures to safeguard the privacy of the patients and protect healthcare organizations from law suits that maybe filed against them due to breach of confidentiality (Keshta & Odeh, 2020). Delivery of quality care requires a combination of competing needs such as adequate and skilled workforce, financial resources and infrastructural investment that will provide sufficient space to accommodate the patients and deliver the required healthcare needs. In the stressor of cybersecurity, the major competing wants is recruitment of qualified software professionals who will guarantee the security of patient’s confidential data.
As mentioned, security, privacy, and safety of the collected data is a major concern with big data. Big data depends on the use of personal and sensitive information (McGonigle & Mastrian, 2017). We as healthcare providers protect that information and ensure that it stays confidential. But what happens to that data once its online? What happens if there is breech in data? An example is the Ontario Nurses Association (ONA). ONA collects a large amount of personal data from its members including social insurance numbers, credit card numbers, addresses, and places of employment (ONA, n.d.). They were subject to “cyber-security” incident, compromising the personal information of almost 200,000 nurses in Ontario (Dubinski, 2020).
The website was infiltrated and ransom demands were placed on ONA to keep the data from being released. After this incident, ONA completed a forensic investigation and remediation to contain and uncover the issue (Soloman, 2020). ONA states their data is protected by extensive firewalls and password protection (ONA, n.d.). Firewalls are intended to prevent hacking, so having been breached, the forensic investigation is important for uncovering where and how the hackers were able to infiltrate it. Once that is uncovered, the firewall can be strengthened to prevent attacks in the future. This shows the importance of keeping data truly safe and how vulnerable data can be once online.
The impact of lack of confidentiality on the patient’s information can severely damage the reputation of the healthcare organization and turn out to be very costly. Recent research reveals that data breach cost has been on a rapid increase compared to any other time in history. The recent data breaches in healthcare have been financially motivated (Seh et al., 2020). The most targeted areas have been in the billing software that intents to manipulate the healthcare refunds on Medicaid program. This eventually results to loss of trust among the customers and the patient’s number is likely to decrease hence the annual financial turnover will be negatively affected.
The need to develop proper measures and formulate policies to safeguard the patient’s data is a major competing want for all healthcare organizations across the country. The policy framework should include proper training of the employees on responsible use of the health systems database, develop a concrete internal control, enhance the use of multifactor authentication, promote responsibilities of the third-party security, creation of data back-ups, proper maintenance of the systems through keeping the systems updated and use of well updated anti-virus and firewall. A strategy that may effectively mitigate the challenge of using big data is for users to become hypervigilant in their part of data security. When the news of this data breach was released, all employees received notifications about not giving out information about passwords, and not to click on links in emails due to possible phishing. Until cybersecurity is 100% impenetrable, we must all do our part to help secure our patient’s data (McGonigle & Mastrian, 2017).
References
Keshta, I., & Odeh, A. (2020). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal. https://doi.org/10.1016/j.eij.2020.07.003
Seh, A. H., Zarour, M., Alenezi, M., Sarkar, A. K., Agrawal, A., Kumar, R., & Khan, R. A. (2020). Healthcare Data Breaches: Insights and Implications. Healthcare, 8(2), 133. https://doi.org/10.3390/healthcare8020133
Dubinski, K. (2020, September 17). Ontario nurses’ regulatory body investigating cybersecurity incident. https://www.cbc.ca/news/canada/london/college-of-nurses-ontario-cyber-security-incident-1.5727816
McGonigle, D. & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Ontario (n.d.). COVID-19 vaccines for Ontario. Retrieved on December 30, 2020. https://covid-19.ontario.ca/covid-19-vaccines-ontario?gclid=EAIaIQobChMI8ISnrr727QIVaE1yCh36gwrvEAAYASAAEgLqmPD_BwE#about-covid-19-vaccines
Ontario Nurses Association (n.d.). Privacy policy. Retrieved on December 30, 2020. https://www.ona.org/privacy-policy/
Soloman, H. (2020, September 18). Ontario nurses’ governing body hit by ransomware attack. https://www.itworldcanada.com/article/ontario-nurses-governing-body-hit-by-ransomware-attack/435884
The complex and evolving nature of the care environment places healthcare practitioners in a position to experience diverse practice issues. These issues/stressors can impact patient care and overall health outcomes locally, nationally, and globally. Policy formulation effectively addresses national healthcare issues since it helps outline actions and plans for practical solutions (Teitelbaum & Wilensky, 2019). However, competing needs affect policy development profoundly, and it is crucial for nurses to understand this influence.
Unequal access to care is among the national healthcare issue that significantly impacts people’s health. Its causes are diverse, but social determinants of health play a critical role in influencing access due to health disparities (Daniel et al., 2018; Islam, 2019). When developing policies to promote access to care, healthcare professionals must examine the influence of competing needs that should be balanced to prevent inadequacy in some areas while addressing others. When addressing access to care problems, healthcare professionals and leaders should balance the needs of the workforce, patients, and resources. Health resources are limited and should also be used efficiently (Kelly & Porr, 2018). Therefore, policy development should be based on the available resources and ensure patient and workforce needs are given the necessary priority.
Competing needs that may impact access to care problem include limited organizational resources, nurses’ needs, and patients’ increasing demand for quality care. For instance, a policy/practice intervention like community-based education and visits to promote healthy living and access to care in rural areas must not overuse the organization’s financial resources at the expense of nurses’ immediate needs. Such a policy should not also deny nurses the ample time required to attend to patients in regular care or increase their workload due to the possibility of job dissatisfaction. From these intersections, it is apparent that competing needs determine a policy’s design and who should be involved in its execution. The other observation is that a policy might address these competing needs by addressing the area where solutions might impact other areas positively.
References
Daniel, H., Bornstein, S. S., Kane, G. C., & Health and Public Policy Committee of the American College of Physicians*. (2018). Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Annals of Internal Medicine, 168(8), 577-578. https://doi.org/10.7326/M17-2441
Islam, M. M. (2019). Social determinants of health and related inequalities: Confusion and implications. Frontiers in Public Health, 7, 11. https://doi.org/10.3389/fpubh.2019.00011
Kelly, P., & Porr, C. (2018). Ethical Nursing Care Versus Cost Containment: Considerations to Enhance RN Practice. Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06
Teitelbaum, J. B., & Wilensky, S. E. (2019). Essentials of health policy and law. Jones & Bartlett Publishers.
Hi Precious,
I agree with your post. I have been researching the impact of the nursing staff shortage on patient care as well as hospital systems. Nurses are not able to care for their patients in an effective manner if they are burned out and overworked. Nursing staffing shortages are effecting all parts of the country. Inadequate staffing levels leads to poor patient care. ( Jarrar et al, 2018). Which leads to poor patient outcomes. Hospital systems must come up with a plan to assist nurses to not feel overwhelmed. Staffing ratios must be explored as well as ways to assist nurses to care for themselves as well. Employers must find ways to assist nurses with becoming satisfied with their jobs. Pay can be increased as well incorporating self care into everyday assignments. ( Girones et al, 2021). Thank you for this information in this post.
Llop-Gironés, A., Vračar, A., Llop-Gironés, G., Benach, J., Angeli-Silva, L., Jaimez, L., Thapa, P., Bhatta, R., Mahindrakar, S., Bontempo Scavo, S., Nar Devi, S., Barria, S., Marcos Alonso, S., & Julià, M. (2021). Employment and working conditions of nurses: Where and how health inequalities have increased during the covid-19 pandemic? Human Resources for Health, 19(1). https://doi.org/10.1186/s12960-021-00651-7
Jarrar, M., Al-Bsheish, M., Aldhmadi, B. K., Albaker, W., Meri, A., Dauwed, M., & Minai, M. (2021). Effect of practice environment on nurse reported quality and patient safety: The mediation role of person-centeredness. Healthcare, 9(11), 1578. https://doi.org/10.3390/healthcare9111578
A block of time for care coordination sounds like a great intervention for these complicated patients that get stuck in hospitals. This approach also assists with value-based healthcare (VBHC), since it could help with finding solutions and improving outcomes for these difficult patients (NEJM Catalyst, 2017). Unfortunately, my experience with VBHC is that since payers (Medicare in particular) reimburse based on outcomes, they are more focused on undesired outcomes than positive ones so they can avoid payments.
This has trickled down to organizations that base any new policies around the negative outcomes associated with not being paid back. Instead of focusing on positive outcomes with policies like increased time for collaborative care coordination, the old business model of healthcare is just manifesting itself in a new way (Kelly & Porr, 2018). Healthcare systems and payers using VBHC need to integrate inevitable negative outcomes in a way that is not punitive and find ways to reward desired outcomes.
For example, fall prevention is an even bigger priority in hospitals since the implementation of VBHC by Medicare means falls impact hospital reimbursement. This priority conflicts with the evidence-based health benefit of early mobilization of patients since nurses are trained to over-use bed alarms and patients end up feeling like they are bothersome when alarms are involved. This newer policy-based barrier to mobilizing patients combines with inappropriate activity orders, staff not having time, patients refusing, and patients only moving with physical and occupational services. (Young et al., 2022). Ironically, an attempt to improve outcomes through VBHC can do the exact opposite. Bed alarms are, of course, appropriate and preventative intervention for falls in many cases, but nurses being scared to move patients and patients being afraid to set off bed alarms leads to deconditioning, longer hospital stays, and other health complications. Financial prioritization by hospitals often leads to trading off patient-centered care like this example with fall prevention grossly outweighing mobility.
References
NEJM Catalyst (2017, January 1). What is Value Based Healthcare? https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558
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.
Young, D., Kudchadkar, S., Friedman, M., Lavezza, A., Kumble, S., Daley, K., … & Hoyer, E. (2022). Using systematic functional measurements in the acute hospital setting to combat the immobility harm. Archives of physical medicine and rehabilitation, 103(5), S162-S167.
Working in an underfunded setting can be quite frustrating, especially for those of us who are passionate about the profession. Maintaining ethical standards that are driven by evidence-based practice is not always a top priority for facility administrators considering the multitude of factors that goes into functional planning for an organization, at the top of which; profit.
Managing patients that potentially require the use of restraints is delicate and complicated. It is always best to employ other less restrictive measures with restraints being a last resort. However, when understaffed and working with a patient that has exhausted all other safety options, and continues to be a threat to their own safety or that of others, restraints must be employed. One must consider factors for restraint monitoring as reported in (Alcock, et al., 2021); physically restrained patients are more likely to sustain physical injuries such as: erythema, bruising, edema, pressure ulcers. It is reported that physical restraints increase the likelihood of post-traumatic stress disorder. These may also induce delirium through indirect stimulation of the adrenal access because of physiological and emotional stress. Restraints are a contributing factor to sleep disorders as the normal sleep wake cycle may become disrupted within this patient demographic (Alcock, et al., 2021). In theory, working short staffed should not be a component to the decision making for restraint initiation, in practice it is often a variable.
Filling the employee void of an understaffed hospital takes more than financial planning. It takes strategy, designed to obtain and more importantly, retain employees. Creating strategies that invest in the workforce for the creation of a supportive work environment improves employee retention. It is stated that an employer of choice is: “the one that supports employees at the workplace while offering relief from the stress of daily life” (Sampson, 2022). In a hospital setting these protections must also extend to organizational unity against healthcare worker abuse and incivility from patients and family members.
In my opinion, staffing is often a matter of ethics. Here are a few questions to consider; is an employer willing to hire more staff? Does the hiring of additional staff require a lowering of the pay rate in order to balance the budget? These are considerations that must be weighed pragmatically, without a viable profit margin, there simply may not be enough money to go around.
Sample Answer for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
Competing needs arise within any organization as healthcare workers seek to meet their targets and leaders seek to meet hospital goals. Either targets or goals require establishing priorities and allocating resources. For example, a policy addressing adequate nurse staffing is essential to meet the patient and workforce needs while minimizing hospital cost. However, utilizing in more nursing staff might result in economic inefficiencies along with misallocated resources.
The shortage of staff is connected with negative impacts; including lower quality and quantity of care because there are few resources to offer. Work overload to the existing nurses lead to burnout, and eventually compromising patient safety. Nursing shortage policies are constantly supported by current literature and they vary from country to country. However, there is continuous effort to modify certain aspect such as pay agreements, emergency hiring plans and RN residency programs to improve working environment for nurses (Park & Yu, 2019). Nurses should also voice their opinion on ways to resolve competing needs; the culture of silence creates a culture of acceptance and continues to suppress nursing professional knowledge (Kelly & Porr, 2018).
Competing needs that may impact nursing shortage is aging population in which baby boomer entering the age of increased need for health services. Which would require more students to enroll into the nursing program today and hire more educators to provide students with proper training. Another contributing factor is nurse burnout, statistics shows a national turnover rates is 8.8% to 37% (Lisa et al., 2020). Nurses are experiencing burnout daily and leaving the profession for better opportunities or advancing in their career. Ensure an optimal nurse to patient ratios to improve nurse staffing and improve quality of care delivered. Lastly, workload and work environment has forced hospitals to reduce staffing and implement mandatory overtime polices to ensure nurses would be available to work when the number of patients admitted increased unexpectedly. Furthermore, increase the workload to decrease on health care costs.
A policy might address these competing needs by ensuring an optimal nurse to patient ratio which can improve care outcomes for patients and ensure patient safety. Healthcare policymakers’ involvement in developing a staffing policy in every organization to improve working conditions (such as working hours, violence in workplace, managing workload) for the nurses staff to improve competencies and better job satisfaction. Ensure adequate government funding to allocate resources for training and clinical skills without causing strains on the government and organization budget. Also, devote resources toward increasing nurses wages; a token of appreciation for their dedicated and hard work.
References
Haddad, L.M., Annamaraju, P., & Toney-Butler, T.J. (2020). Nursing Shortage. Retrieved June 15, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK493175/
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
Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. In Health Policy and Technology, 8(3), 296-303. https://doi.org/10.1016/j.hlpt.2019.08.003
Sample Response for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
This is insightful Youland. In every organization, there are always competing ought to be addressed to ensure efficiency in the operational processes. Specifically, in healthcare institutions that involve the development and implementation of different policies, there are always competing needs be fully addressed by the management or policymakers. Competing needs arise within any organization as healthcare workers seek to meet their targets and leaders seek to meet hospital goals (Minvielle, 2018). In every healthcare organization, leaders and workers often have their specific goals. The differences in their objectives or goals may lead to competing needs. As leaders and workers set their targets, there are always priorities; besides, there is always the need to consider the available resources that may facilitate processes and procedures towards meeting these goals. A policy addressing adequate nurse staffing is essential to meet the patient and workforce needs while minimizing hospital costs. However, utilization of more nursing staff might result in economic inefficiencies along with misallocated resources (Wicks & St Clair, 2017).
Before embarking on allocating resources, there is always the need for healthcare management to consider their priorities to address the competing needs. In most cases, healthcare institutions consider their priorities before distributing resources to different processes. To effectively formulate policies that would ensure incorporation of the best practices as well as the efficiency in the general operational processes, the management needs to involve nurses and other healthcare professional teams (Park & Yu, 2019). In other words, making a decision on where to allocate resources should involve the entire workforce. A policy might address these competing needs by ensuring an optimal nurse-to-patient ratio, improving care outcomes for patients, and ensuring patient safety. Besides, a policy may be formulated and enough resources allocated to ensure a significant reduction in the number of healthcare-acquired infections and the improvement in patient outcomes.
References
Minvielle, E. (2018). Toward Customized Care: Comment on”(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”. International journal of health policy and management, 7(3), 272. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890073/
Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. In Health Policy and Technology, 8(3), 296-303. https://doi.org/10.1016/j.hlpt.2019.08.003
Wicks, A. M., & St Clair, L. (2017). Competing values in healthcare: balancing the (un) balanced scorecard. Journal of Healthcare Management, 52(5). https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=10969012&AN=27028943&h=xt8qw%2fV9vHxEXGym8bL66d4PtA2v%2f%2bjudnSM4Nhe6H
Sample Answer for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
Policies are made to govern a certain practice and are necessary to hold persons accountable for their actions. Registered nurses (RNs) are constantly challenged to provide quality nursing care while resources are chipped away, sometimes along with their energy, pride, and ability to provide holistic patient care (Kelly & Porr, 2018), but are still expected to promote beneficence and avoid maleficence in all circumstances. Nurses and nurse leaders must establish policies that are ethical and just and not waver in the presence of competing needs. Policies and procedures provide a road map for day-to-day operations and are put in place to be followed for the betterment of the organization and improve practices. For example, a policy that focuses on staffing for nurses and nurse assistants is necessary to ensure that adequate staffing is available. The policy should provide parameters for nurse to patient ratio and a list of resources, steps, and protocols to assist where needed. The development of a policy in regards to the use of resources and being economical can also help to diffuse the fight between the need for staff versus the need for personal protective equipment (PPE).
The Impact of Organizational budget on the Nursing Shortage
I am constantly reminded that healthcare is a business just like any other and organization leaders are always trying to find new ways and ideas to satisfy the consumer but save the company money. Unfortunately, Health care is not like other businesses because people’s lives are at stake and when healthcare is faced with competing needs, one is likely to surpass the other and the other just might be as valuable as someone’s life. The shortage of nurses has a tremendous impact of any healthcare organization and can directly attack healthcare budget in more ways than one. For example, the shortage of nurse’s force countless hours in overtime to ensure that shifts are adequately covered to ensure patients receive the treatment that they need, because after all, patient satisfaction, safety, and best outcomes are the goal. On the contrary, these nurses who overwork themselves are more likely to perform at a level that is below satisfactory eventually resulting in mediocre patient care, documentation errors, medication errors and many other patient delivery errors. Researchers has suggested that overworked health care providers have reported a decline in mental and physical state, demonstrated inadequate patient care and nurse leaving/shortage (Leineweber et al., 2014). A study conducted on Nurses’ practice in relation to burnout concludes that adequate staffing and leadership and support for nurses are crucial for nurses wellbeing and mental health. (Leineweber et al., 2014).
To paint a picture; at my organization, if a patient has a complaint or is not satisfied with the delivery of care they received, often times letters are written to the CEO or Hospital’s president and they are forced to discount patient’s hospital bills to regain consumer satisfaction and prevent any contamination to the reputation of the Organization. Organizational budgets can force decisions between paying nurses or providing necessities needed for adequate patient care delivery such as PPE’s that as necessary for minimizing the risk of health care providers contracting diseases. If nurses do not feel safe, they may opt to leave their jobs, creating a bigger deficit for the organization, therefore a balance must be found between competing needs.
References
Alyahya, M. S., Hijazi, H. H., Al Qudah, J., AlShyab, S., & AlKhalidi, W. (2018). Evaluation of
infection prevention and control policies, procedures, and practices: An ethnographic
study. AJIC: American Journal of Infection Control, 46(12), 1348–1355. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.023
Kelly, P., Porr, C. (2018) Ethical Nursing Care Versus Cost Containment: Considerations to
Enhance RN Practice http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Leineweber, C., Westerlund, H., Chungkham, H. S., Lindqvist, R., Runesdotter, S., &
Tishelman, C. (2014). Nurses’ practice environment and work-family conflict in relation to burn out: A multilevel modelling approach. PLoS ONE, 9(5). https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0096991
Sample Response for NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues
This is insightful Rashae; healthcare is a business just like any other and organization. As a result, healthcare leaders are always trying to find new ways and ideas to satisfy the consumer but save the company money. As a result, there are always planning processes meant to ensure effective utilization of resources and ensure effective patient outcomes. In the process of planning, there is always the need to consider priorities (Ansmann & Pfaff, 2018). For instance, a healthcare organization may be faced with different needs; however, through planning and setting priorities, they will be able to utilize their resources in a more profitable way.
Nurse shortage has been a critical issue in most healthcare institutions. Researchers have suggested that overworked health care providers have reported a decline in mental and physical state, demonstrated inadequate patient care, and nurse leaving/shortage. Therefore, allocating more resources towards employing more nurses is always a priority (Hovland & Moltu, 2019). However, other priorities such as the reduction of medication errors may set in. Medication errors have been considered one of the major factors that contribute to low patient satisfaction and negative patient outcome.
Therefore, healthcare management may weigh their priorities before engaging in allocating resources (Kelly, 2018). To effectively formulate policies that would ensure incorporation of the best practices as well as the efficiency in the general operational processes, the management needs to involve nurses and other healthcare professional teams. With proper planning and allocation of resources, healthcare institutions are able to generate more profits and enhance operational processes in addition to meeting the needs of patients. Setting priories may help in the budgeting processes for the entire institution.
References
Ansmann, L., & Pfaff, H. (2018). Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution: Comment on”(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”. International journal of health policy and management, 7(4), 349. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949226/
Hovland, R. T., & Moltu, C. (2019). Making way for a clinical feedback system in the narrow space between sessions: navigating competing demands in complex healthcare settings. International journal of mental health systems, 13(1), 1-11. https://ijmhs.biomedcentral.com/articles/10.1186/s13033-019-0324-5
Kelly, P., Porr, C. (2018). Ethical Nursing Care Versus Cost Containment: Considerations to
Enhance RN Practice. http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
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