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Developing Organizational Policies and Practices

Developing Organizational Policies and Practices

            Healthcare organizations focused on delivering high-quality patient care usually have various ongoing activities at any occasion of different project lengths that require different investments of human and financial resources. The activities often conflict, potentially hindering the organization’s success due to competing needs. However, health organizations can balance the competing needs by planning strategically, setting goals, constant communication, and utilizing supportive tools (Gaim et al., 2018). Nursing shortage is the identified national healthcare stressor. The purpose of this paper is to explore the competing needs that impact nursing shortage, discuss practice in the organization that impacts nursing shortage, and recommend a practice change that can balance the competing needs.

Competing Needs Impacting Nursing Shortage

Nursing shortage is measured in connection with a healthcare organization’s staffing levels, available resources, and approximates of health care demand. The gap between the currently available workforce and the target for a higher level of workforce provision is defined as a shortage (Marć et al., 2018). The competing needs affecting the nursing shortage in the organization include patients’ healthcare needs and financial needs for the organization’s projects. There is an increasing need for high-quality healthcare among patients, which creates a high workload for nurses. With the increased aging population characterized by a high prevalence of chronic illnesses, patients need nurses to provide high-quality care (Marć et al., 2018). The patients’ healthcare demands have significantly created the nursing shortage in healthcare organizations. Furthermore, the increasing healthcare needs cause fatigue and burnout among the current workforce resulting in high turnover, which results in further nursing shortage.

The financial needs for an organization’s ongoing projects are another competing need impacting nursing shortage in organizations. Limited financial resources significantly contribute to the nursing shortage since healthcare leaders are required to allocate resources based on priority needs (Marć et al., 2018). Competing needs occur when leaders are forced to choose if to prioritize financial resources to hire more nurses or to use the resources for projects such as infrastructure and purchasing medical commodities. Besides, competing needs arise when leaders have to choose whether to use the limited financial resources as financial incentives for nurses or utilize the resources in other projects (Marć et al., 2018). Choosing the latter option results in inadequate motivation from the organization causing low job satisfaction, high turnover, and eventually nursing shortage.

A Practice in My Organization That May Influence Nursing Shortage

Mandatory overtime is a practice in my organization that may influence nursing shortages. The organization has seen a dramatic increase in leaders using mandatory overtime as a staffing tool. Mandatory overtime is an unsafe staffing practice that

 

is commonly used to address the nursing shortage. Nurses are forced to work extra shifts because of inadequate staffing resulting in high burnout levels and job turnover, further worsening the shortage issue (Son et al., 2019). Besides, mandatory overtime negatively affects patient care since it is attributed to increased cases of medical errors and missed nursing care, resulting in poor patient outcomes and high healthcare costs. Nurses are involved in numerous activities during a single shift, including admitting patients, administering medication, conducting patient assessments, implementing nursing care interventions,

Developing Organizational Policies and Practices
Developing Organizational Policies and Practices

and discharges. The duties cause physical and psychological fatigue such as muscle, joint, and back pains, high anxiety levels, depression, and sleep disturbances (Santana et al., 2020). The fatigue and negative health effects of long working hours from mandatory overtime shifts have been associated with a high nursing turnover rate secondary to low job morale. Furthermore, the negative effect on nurses’ health has caused a high rate of sick offs, which further causes a nursing shortage.

Ethical Considerations of the Practice

Mandatory overtime practice aims to meet the nursing staffing needs necessary to meet patient healthcare needs, thus promoting the best health outcomes. Mandatory overtime ensures that adequate nurses attend to patients at every shift, which ensures all interventions are implemented and promotes patient satisfaction. Therefore, the strength of the practice in promoting ethics is seen in ensuring patients receive the needed nursing care to promote better health outcomes (Son et al., 2019). The practice upholds beneficence by ensuring that there are enough nurses to meet patients’ needs at any shift and thus promote the best patient outcomes.

Nevertheless, the mandatory overtime practice is faced with ethical challenges since it puts patients’ and nurses’ health at risk, thus failing to uphold nonmaleficence. Extended shifts have been linked with increased risks for injury, such as musculoskeletal injuries, cardiovascular symptoms, development of high blood pressure, and high-stress levels due to fatigue and inadequate rest (Santana et al., 2020). The practice makes nurses work extended hours without having sufficient sleep, which is detrimental to their mental health. Inadequate rest and sleep and the ensuing fatigue affect a nurse’s ability to provide optimal patient care, thus affecting the quality and safety of patient care. Therefore, the practice puts patients’ safety at risk and increases the risk of hospital-acquired complications from poor or missed nursing care (Son et al., 2019). Furthermore, mandatory overtime violates the nurses’ right to make independent decisions on when to work overtime. Although some nurses do not mind working overtime, mandatory overtime is often an intrusion into nurses’ free time. It takes away their opportunity to engage in social life and have a healthy work-life balance (Santana et al., 2020). Besides, nurses hardly ever assess their fatigue levels correctly until they are at a point of being impaired.

Policy or Practice Changes Designed To Balance the Competing Needs

Task shifting is a practice change tailored to balance the competing needs in relation to the nursing shortage. Task shifting refers to a practice in which trained cadres without competencies for specific tasks implement the tasks, thus increasing levels of health care access (Afolabi et al., 2019). Task shifting seeks to offer cost-effective healthcare services by a new cadre of workers when a nursing shortage puts irrational demands on the existing nurses who cannot meet patients’ health needs. For instance, some trained nurses from other countries may not have the credentials to work as registered nurses in the US due to training differences. Task shifting can be applied by employing these nurses as health care technicians or nurses’ aides. It shifts their roles and responsibilities to diverse practices, especially in areas of long-term care (Leong et al., 2021). Besides, the registered nurses can delegate simple tasks to the nurses, thus reducing the workload.

Conclusion

Nursing shortage is a persistent health issue that affects nurses’ ability to provide high-quality care to patients, thus, compromising the safety of care and patient outcomes. It is not only an organizational challenge but also a healthcare challenge since it adversely affects healthcare outcomes. The competing needs affecting the nursing shortage in the organization are patients’ healthcare needs and financial needs for the organization’s projects. Mandatory overtime shifts have adverse health effects on nurses and patients. Task shifting can be introduced in the organization to lower nurses’ workload, thus reducing the associated nursing shortage.

 References

Afolabi, O., Abboah-Offei, M., Nkhoma, K., & Evans, C. (2019). Task-shifting must recognize the professional role of nurses. The Lancet Global Health7(10), e1328-e1329. https://doi.org/10.1016/S2214-109X(19)30358-4

Gaim, M., Wåhlin, N., e Cunha, M. P., & Clegg, S. (2018). Analyzing competing demands in organizations: a systematic comparison. Journal of Organization Design7(1), 1-16. https://doi.org/10.1186/s41469-018-0030-9

Leong, S. L., Teoh, S. L., Fun, W. H., & Lee, S. W. H. (2021). Task shifting in primary care to tackle healthcare worker shortages: An umbrella review. European Journal of General Practice27(1), 198-210. https://doi.org/10.1080/13814788.2021.1954616

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2018). A nursing shortage – a prospect of global and local policies. International Nursing Review. https://doi.org/10.1111/inr.12473

Santana, I. R., Montes, M. A., Chalkley, M., Jacobs, R., Kowalski, T., & Suter, J. (2020). The impact of extending nurse working hours on staff sickness absence: Evidence from a large mental health hospital in England. International journal of nursing studies112, 103611. https://doi.org/10.1016/j.ijnurstu.2020.103611

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 health16(21), 4083. https://doi.org/10.3390/ijerph16214083

  Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

 

Supported by at least three current, credible sources.

 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

 

At least 75% of post has exceptional depth and breadth.

 

Supported by at least three credible sources.

 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

 

One or two criteria are not addressed or are superficially addressed.

 

Is somewhat lacking reflection and critical analysis and synthesis.

 

Somewhat represents knowledge gained from the course readings for the module.

 

Post is cited with two credible sources.

 

Written somewhat concisely; may contain more than two spelling or grammatical errors.

 

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

 

Lacks depth or superficially addresses criteria.

 

Lacks reflection and critical analysis and synthesis.

 

Does not represent knowledge gained from the course readings for the module.

 

Contains only one or no credible sources.

 

Not written clearly or concisely.

 

Contains more than two spelling or grammatical errors.

 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness 10 (10%) – 10 (10%)

Posts main post by day 3.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not post by day 3.

First Response 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Second Response 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Participation 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

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For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource