NRS 493 Topic 2 DQ 1
DQ: During your practicum, determine what clinical problem or issue the organization is facing
In the healthcare industry, there is a growing demand for providers and nurses. By 2033, the Association of American Medical Colleges estimates that the United States would be short between 54,100 and 139,000 primary care and specialized physicians (2020). Due to a shortage of physicians, patient care has been delayed due to a lack of available appointments. Patients can make appointments with any available provider at any of the clinics, although same-day appointments are not always available. When patients are unable to schedule appointments for urgent conditions, they are sent to the emergency department or urgent care centers.
During my practicum the clinical problem that my organization is facing is the overwhelming nurse shortage. This is one problem that I have personal experienced and has affected my overall mental and physical health. The reasons for this shortage include lack of educators, high turnover, and inequitable workforce distribution (Haddad et al, 2022). As time goes on, the population ages and increases as a whole which increases the need for health services which directly increases the need for personnel, especially nurses. Many of the disease and conditions that were previously incurable have now been able to be treated with new technology, medications, and clinical trials which calls for the need for an increased amount of personnel to look after the patients’ health. This causes hospitals to work overtime to try and combat the increase of both patients and diseases. It has become very apparent that there is a necessity of nurses after the COVID-19 pandemic which showed how severely unprepared the nation is in terms of healthcare when there was limited access to hospital beds, ventilators, protective gear, masks, hand sanitizer, other life saving machinery etc. The overall nurse shortage has become a phenomenon that has become increasingly prominent in society over time, and this is due to turnover and dissatisfaction. Nurse turnover is what occurs when a nurse leaves an organization either voluntarily or involuntarily for a variety of different reasons ranging from wanting to retire to finding better benefits at other facilities. Nurse turnover is one barrier because it disturbs the well-functioning systematic process of the hospital, and the major consequence is that there are more patients than personnel leading to burnout in nurses that remain who must take on double or more of the responsibilities which debilitates nurses from being able to carry out evidence-based practice due to lack of time and resources (Dewanto & Wardhani, 2018). This debilitates the overall patient care quality given in the organization. The shortage of nurses is ironically what causes even more shortage in nurses. The lack of staff causes nurses and other personnel to gain double and triple the amount of patients and work that they typically do which causes burnout, stress, and overall dissatisfaction of the job due to difficult working conditions. Furthermore, in many instances, long shift hours are extended due to a lack of personnel coming in to take the next shift which may be due to staff calling in sick due to emotional exhaustion and the overload of work which makes them not want to come in to work. This issue has personally impacted me because the overload of work leads to more chance of mistakes and complications like injury which overall decreases the quality of care given to the patient.
Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC nursing, 17(Suppl 2), 52. https://doi.org/10.1186/s12912-018-0317-8
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage . National Library of Medicine. Retrieved May 5,
2022, from https://www.ncbi.nlm.nih.gov/books/NBK493175/
I have noticed several issues happening with the clinic I am doing my practicum is facing. These issues include how their medications are stored and administered and the lack of handwashing stands available outside treatment rooms.
Effective handwashing practice has been seen to reduce hospital-acquired infections such as Clostridium difficile, Methicillin-resistant Staphylococcus aureus (MRSA), and Catheter-associated urinary tract infection (CAUTI), to mention a few (Jayasree and Afzal, 2019). The lack of handwashing stands outside of treatment rooms in the clinic will reduce the tendency for staff to wash their hands and lead to increased HAIs among nurses, other staff, and patients.
In addition, a medication error is one of the issues, especially with vaccination in the clinic. Medication error is a pertinent issue that needs to be addressed because of its implication for patient health and nurses’ legal matters. In the USA, the medication error-related deaths have been more than the deaths related to car accidents, breast cancer, and human immunodeficiency virus (Shahrokhi et al. 2013). It was observed that the storage of medication in the clinic, coupled with other working environments, can lead to a high incidence of medication errors. The oral medicines and other topical medications are stored on shelves and manually labeled under each medication. Vaccines are also stored in a cooler cabinet where nurses handpick them. The possibility of a medicine missing together is high and can lead to medication error which will cause harm to patients and legal issues for nurses.
REFERENCES
Jayasree, T., & Afzal, M. (2019). Implementation of Infection Control Practices to Manage Hospital Acquired Infections. Journal of Pure & Applied Microbiology, 13(1), 591–597. https://doi-org.lopes.idm.oclc.org/10.22207/JPAM.13.1.68
Shahrokhi, A., Ebrahimpour, F., & Ghodousi, A. (2013). Factors effective on medication errors: A nursing view. Journal of research in pharmacy practice, 2(1), 18–23. https://doi.org/10.4103/2279-042X.114084
The EBP project will focus on theoretically and clinically significant problems in nursing. This requires skill in knowledge development activities such as the translation of research into practice, application of new knowledge, the evaluation of practice, initiatives that improve the wide acceptability of health care practices and results, along with active involvement in collaborative research.
As per my opinion the following are two GCU Library scholarly databases that will help someone to find the best research articles providing the best support for EBP proposals:
- CINAHL
- PubMed
CINAHL (Cumulative Index to Nursing and Allied Health Literature) is an index of English-language and selected other-language journal articles about nursing, allied health, biomedicine and healthcare. CINAHL Database provides indexing of the top nursing and allied health literature available including nursing journals and publications from the National League for Nursing and the American Nurses Association. Literature covers a wide range of topics including nursing, biomedicine, health sciences librarianship, alternative/complementary medicine, consumer health and 17 allied health disciplines.
In addition, CINAHL Database provides access to health care books, nursing dissertations, selected conference proceedings, standards of practice, audiovisuals and book chapters. It includes full-text journals, legal cases, clinical innovations, critical paths, research instruments and clinical trials.
While PubMed, utilize search interfaces that offer a greater variety of advanced features. These additional features are powerful than the Google scholar. These two databases are better than general search and google scholar in the quality of search.
Research guides: Webinars & workshops: Webinar calendar. Webinar Calendar – Webinars & Workshops – Research Guides at Grand Canyon University. (n.d.). Retrieved January 31, 2023, from https://libguides.gcu.edu/webinars