NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Walden University NURS 6053 Organizational Policies and Practices to Support Healthcare Issues– Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  NURS 6053 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 Organizational Policies and Practices to Support Healthcare Issues  

 

Whether one passes or fails an academic assignment such as the Walden University  NURS 6053 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 Organizational Policies and Practices to Support Healthcare Issues   

 

The introduction for the Walden University  NURS 6053 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.

 

How to Write the Body for  NURS 6053 Organizational Policies and Practices to Support Healthcare Issues   

 

After the introduction, move into the main part of the  NURS 6053 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 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 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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Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

The COVID-19 pandemic has initiated an upheaval in society and has significantly  cause  considerable stress during this pandemic. Healthcare professionals have been on the front line during this health crisis, particularly hospital nurses in all specialty. The focus of this study was to assess the high level of stress of healthcare workers during the first wave of the pandemic.

Findings show that religious engagement among students declines during college, but their spirituality shows substantial growth. “Students become more caring, more tolerant, more connected with others, and more actively engaged in a spiritual quest.” (“Cultivating the Spirit – Spirituality in Higher Education”) The authors also found that spiritual growth enhances other outcomes, such as academic performance, psychological well-being, leadership development, and satisfaction with college. The study also identified a number of college activities that contribute to students’ spiritual growth. Some of these–study abroad, interdisciplinary studies, and service learning–appear to be effective because they expose students to new and diverse people, cultures, and ideas. Spiritual development is also enhanced if students engage in “inner work” through activities such as meditation or self-reflection, or if their professors actively encourage them to explore questions of meaning and purpose. (“Cultivating the Spirit – Spirituality in Higher (Alexander W, 2010)”). By raising public awareness of the key role that spirituality plays in student learning and development, by alerting academic administrators, faculty, and curriculum committees to the importance of spiritual development, and by identifying strategies for enhancing that development, this work encourages institutions to give greater priority to these spiritual aspects of students’ educational and professional development.

The COVID-19 pandemic by an international study is questionnaires disseminated from collecting online demographic and stress-related data over the globe, during the pandemic. Stress levels were evaluated using non-calibrated visual analog scale, from 0 (no stress) to 100 (maximal stress).

The main outcome was work-related stress, measured with the use of a visual analog scale i.e. a non-calibrated horizontal line ranging from minimum (0) to maximum (100). Visual analog scale of stress is a validated tool commonly used in daily practice. With this type of tool, participants can self-assess in a simple way the range of their possible feelings. Secondary outcomes were sociodemographic (age, sex), occupations (non-healthcare workers, medical doctors, paramedical staff), and working conditions (working in usual conditions, working in unusual conditions, interruption of work). This was a computerized questionnaire hosted on the secure REDCAP platform. It consisted of about 100 questions. The study presented here reports on the answers related to work-related stress. Depending on the answers given, individuals had access to all or part of the questionnaire.

Women Healthcare workers more affected:

In our study, whatever their profession, women had the highest levels of work-related stress during the first global lockdown. Our results concord with the literature revealing that women are more prone to stress, and may also suffer more from the negative psychological impact of the COVID-19 outbreak. Women often have a double life combining work and family life. This is even less reconcilable when both professional and family constraints increase. Indeed, families had to adapt to the closure of schools. Even in couples that shared the involvement in the education and care of children, women are still mostly implicated. Given these elements and the predominance of women in healthcare professionals, the WHO advised to study gender-specific consequences of the pandemic. Even if women have less severe forms of COVID, they were frightened of contracting COVID-19. They may also have been more impacted by the higher number of deaths and difficulties during the crisis. Women show greater psychophysiological concordance and consistency than men, and may therefore present more psychological vulnerability. Improving Work -Life  Integration (WLI) is likely to improve healthcare worker’s quality of life, organizational outcomes and, ultimately, quality of care for patients (Schwartz et al., 2018).,

Healthcare System Taking action on burnout

According to  National  Libraryy of Medicine During COVID-19, employers were noticing the need for intervention. Through employee assistance programs (EAPs) or health care insurance, mental health programs were offered. Some programs offered by mental health staff are stress reduction, cognitive restructuring and reframing, and grief counseling. Mental health can also help a nurse to recognize and admit to symptoms of burnout. COVID-19 was an introduction of EAPs and mental health checks that should occur routinely. Nurses will not always admit or even recognize that they need mental health support. However, if one knows the signs of burnout, they can see it in nurses.

The national collaborative, which rolled out in 2017, has three main goals: better understanding the challenges to clinician well-being, raising the visibility of clinician stress and burnout, and elevating evidence-based solutions. To date, the collaborative has received commitments from more than 150 organizations, including health systems, hospitals, medical schools and state medical boards, to improve clinician well-being and curb burnout.

Jonathan Ripp, MD, MPH, chief wellness officer at Mount Sinai Health System in New York City also co-chairs the national Collaborative for Healing and Renewal in Medicine, which this March co-published a first-of-its-kind charter in the Journal of the American Medical Association that outlines fundamental principles for supporting provider well-being. The charter has been endorsed by more than a dozen organizations, including the American Medical Association and Association of American Medical Colleges.

Preventing, promoting appropriate support for healthcare workers may significantly reduce the effects contibutind to burnouts in organization;

1. Strong Interpersonal Relationships outside of work
2. Work-Life Balance
3. Healthy Lifestyle
4. Decrease Stress
5. Mindfulness
6. Education
7. Recognize Achievements
8. Healthy work Enviroment
9. Recommendtions
10. Therapy

Conclusion

The COVID-19 pandemic has and will have consequences for every population. Nevertheless, healthcare professionals were more impacted than other workers by work-related stress. Paramedical staff were more impacted on than physicians. Across all occupational categories, age appears to mitigate work-related stress, and maybe due to the effects of experience. We were able to identify risk factors for high levels of work-related stress such as youth, female gender, paramedical professions and having maintained one’s professional activity. The impact of such a surge in work-related stress may inflict a second blow to already fragile healthcare systems. Adequately monitoring work-related stress and its effects on healthcare workers may be crucial to plan for post-pandemic adjustments. The finding that burnout and poor wellbeing are both associated with poorer patient safety has significant implications for policymakers and management teams within healthcare settings (Hall et al., 2016).

Reference

Bangasser DA, Eck SR, Ordoñes Sanchez E. Sex differences in stress reactivity in arousal and attention systems. Neuropsychopharmacology. 2019;44: 129–139. pmid:30022063

Broche-Pérez Y, Fernández-Fleites Z, Jiménez-Puig E, Fernández-Castillo E, Rodríguez-Martin BC. Gender and Fear of COVID-19 in a Cuban Population Sample. Int J Ment Health Addict. 2020; 1–9. pmid:32837428

Dutheil F, Duclos M, Naughton G, Dewavrin S, Cornet T, Huguet P, et al. WittyFit—Live Your Work Differently: Study Protocol for a Workplace-Delivered Health Promotion. JMIR Res Protoc. 2017;6: e58. pmid:28408363

Dutheil F, Pereira B, Moustafa F, Naughton G, Lesage F-X, Lambert C. At-risk and intervention thresholds of occupational stress using a visual analogue scale. PLoS One. 2017;12: e0178948. pmid:28586383

Lesage F-X, Berjot S, Deschamps F. Clinical stress assessment using a visual analogue scale. Occup Med. 2012;62: 600–605. pmid:22965867

Lesage FX, Berjot S. Validity of occupational stress assessment using a visual analogue scale. Occup Med Oxf Engl. 2011;61: 434–436. pmid:21505089

National Library of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882221/

Notman MT, Nadelson CC. Medicine: A Career Conflict for Women. Am J Psychiatry. 1973;130: 1123–1127. pmid:472890

Rossi R, Socci V, Talevi D, Mensi S, Niolu C, Pacitti F, et al. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. An N = 18147 web-based survey. Psychiatry and Clinical Psychology; 2020 Apr.

Sandanger I, Nygård JF, Sørensen T, Moum T. Is women’s mental health more susceptible than men’s to the influence of surrounding stress? Soc Psychiatry Psychiatr Epidemiol. 2004;39: 177–184. pmid:14999449

Schwartz, S. P., Adair, K. C., Bae, J., Rehder, K.J., Shanafelt, T.D., Profit, J., & Sexton, J.B 2018. Work-Life balance behaviors cluster in work settings and relate to burnout and safety culture: Across-sectional survey analysis BMJ Quality & Safety, 28 (2), 142-150. Doing: 10.1136/bmjqs 2018-007933

The National’s Health https://www.thenationshealth.org/content/48/8/1.3

Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17: 1729. pmid:32155789

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.
By Day 3 of Week 3
Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
By Day 6 of Week 3
Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

Sample Answer 2 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

The healthcare environment is significantly growing and improving the quality of clinical services is essential. Healthcare policies and practices provide regulation in daily operation and ensure uniformity for all employees so that there are no discrepancies (Rosa et al., 2020). For a policy to be developed in nursing, the competing needs must align with the agenda the strategy is advocating for. Competing needs arise when the healthcare workers want to meet the set goals and objectives. For example, the workforce needs may be adequately addressed but the resources required are not sufficient enough to facilitate policy development (Anderson et al., 2020).
The competing needs that may impact the national healthcare issue/stressor under study in this discussion is the multi-morbidity. Multi-morbidity is steadily increasing across the world and poses a major challenge to healthcare systems around the world (Franklin et al., 2017). According to the healthcare providers, the reasons for the rise in multi-morbidity is lifestyle choices in which most Americans live a sedentary life, leading to obesity, cardiovascular disease, and diabetes. In Medicare population, 65% of patients have two or more chronic illnesses, therefore, Multi-morbidity is related to ageing and it is also socially patterned being common and occurring at an early age in areas of high socio-economic deficiency (Sacha et al., 2020).
To address the competing needs, the healthcare organization has to implement major changes in the workforce issue, managing patients, and distribution of resources (Figueroa et al., 2019). Managing chronic illnesses reduces the cost of healthcare because the rate of chronic diseases is higher especially in the US compared to other nations. The population affected by chronic illnesses requires special attention, therefore, the government should get sufficient nurses to help the people. Through the process of expansion of the affordable treatment programs, discouraging sedentary lifestyle, improving the medication adherence, and providing grants and funds to support healthcare, the health organization in America can play its role in the reduction health care cost (Crowley et al., 2020).
In conclusion, managing chronic illnesses, increasing resources, and advising people to live a healthy lifestyle leads to achieving the set goals in healthcare. Reduction in workforce can be achieved through gathering enough resources. Managing the competing needs have impacted before setting organizations policies and practices.

References

Anderson, J. E., Ross, A. J., Macrae, C., & Wiig, S. (2020). Defining adaptive capacity in healthcare: a new framework for researching resilient performance. Applied ergonomics, 87, 103111. https://doi.org/10.1016/j.apergo.2020.103111
Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a better US health care system for all: coverage and cost of care. Annals of Internal Medicine, 172(2_Supplement), S7-S32. https://doi.org/10.7326/M19-2415
Franklin, P. (2017). Sustainable Development Goal on Health (SDG3): The opportunity to make EU health a priority. EPC Discussion Paper, 18 May 2017. https://doi.org/10.1371/journal.pone.0238912
Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC health services research, 19(1), 239. https://doi.org/10.1186/s12913-019-4080-7
Rosa, W. E., Gray, T. F., Chow, K., Davidson, P. M., Dionne-Odom, J. N., Karanja, V., … & Mazanec, P. (2020). Recommendations to leverage the palliative nursing role during COVID-19 and future public health crises. Journal of Hospice & Palliative Nursing, 22(4), 260-269. https://doi.org/10.1097/NJH.0000000000000665
Sacha, J., Sacha, M., Soboń, J., Borysiuk, Z., & Feusette, P. (2017). Is it time to begin a public campaign concerning frailty and pre-frailty? A review article. Frontiers in physiology, 8, 484.

Sample Answer 3 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thanks Rosemary and good job for your thoughts for this week discussion post. We are discussing healthcare stressors and their influence on nursing practice. It will require nurses to design specific strategies to influence nursing practice. Some organizations are not nurse friendly so keep those critical thinking tools ready.

I found your post interesting because I feel like there is a lack of policy to address this issue and the fact that our nation
is suffering from sedentary life-style compared to others. I further researched this topic and this is my findings.
Policy to improve care for patients with comorbidities
For patients with multi-morbidities, it is important to collaborate with the patient in planning goals for their care. Recent
health policy promoting integrated care emphasized that healthcare delivery is more meaningful for patients with muli-
morbidities when healthcare professional involved the patient in planning and creating goals for their health (Oksavik, et al.,
2020). However, promoting integrated care poses challenges in many healthcare delivery systems. Integrated care is
understood as an “effort to improve the quality of care for individual patients, service users and caregivers by ensuring that
services are well coordinated around their needs across different care environments”, (Gordon, et al., 2020). Five key
components of integrated care are a single point of entry, holistic care assessments, comprehensive care planning, care co-
ordination and a well-connected provider network (Gordon, et al., 2020). Competing resources continues to pose challenges in
some areas that prevents success of integrative care for patients. For implementation of a well-connected provider network
this could require an organization to implement policy for change in the delivery of health records. Further policy
development to address components of integrative care is needed to support patients with multi-morbidities.

References

Gordon, D., McKay, S., Marchildon, G., Bhatia, R. S., & Shaw, J. (2020). Collaborative Governance for Integrated Care: Insights
from a Policy Stakeholder Dialogue. International Journal of Integrated Care (IJIC), 20(1), 1–11. https://doi-
org.ezp.waldenulibrary.org/10.5334/ijic.4684
Oksavik, J. D., Kirchhoff, R., Sogstad, M. K. R., & Solbjør, M. (2020). Sharing responsibility: municipal health professionals’
approaches to goal setting with older patients with multi-morbidity – a grounded theory study. BMC Health Services
Research, 20(1), 141. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-020-4983-3

Sample Answer 4 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

The healthcare environment is significantly growing and improving the quality of clinical services is essential. Every healthcare policy at Local, State or Federal level must be tailored towards the interest of the patient and health workers safety. The policy must be prepared to promptly meet any arising competing need especially during pandemics, epidemics, natural disasters, wars, conflicts, and other crises. The occupational hazards of health workers (HWs) in standard work environments have been well defined in both the developed and developing world during routine working conditions. Any policy must be futuristic in order to meet any arising crisis. For instance, the ongoing ravaging pandemic Covid-19, when its first came in most healthcare facility experienced, supply deficiencies, infectious disease transmission, long working hours, staff shortages, financial reimbursements, mental fatigue and physical exhaustion. Crisis Health Workers suffer from injuries and illnesses that range from immediate, debilitating injuries to chronic, unforeseen effects like mental fatigue, physical exhaustion, anxiety, burnout, and even post-traumatic stress syndrome (Harrell et al., 2020). Patient safety is positively influenced by widespread seasonal influenza vaccination of healthcare workers, but yearly vaccination rates have been unacceptably low. As a result, mandatory vaccination programs have been widely discussed as a means of increasing vaccination rates. This program included human resources policies, various patient safety strategies, and a vaccination policy featuring the choice of free seasonal influenza vaccination or wearing a mask (Perlin et al.,2013). Continuous Health workers training to promote patient safety must be considered during policy formation. Patient safety education and training as well as utilization of Team Strategies and Tools to Enhance Performance and Patient Safety and root cause analysis are useful for improving patient safety culture (Hayashi et al.,2020).

Reference

Harrell, M., Selvaraj, S. A., & Edgar, M. (2020). DANGER! Crisis Health Workers at Risk. International Journal of Environmental Research and Public Health, 17(15).https://doiorg.ezp.waldenulibrary.org/10.3390/ijerph17155270

Hayashi, R., Fujita, S., Iida, S., Nagai, Y., Shimamori, Y., & Hasegawa, T. (2020). Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study. BMC Health Services Research, 20(1), 310. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-020-05114-8

Perlin, J. B., Septimus, E. J., Cormier, S. B., Moody, J. A., Hickok, J. D., & Bracken, R. M. (2013). Developing a program to increase seasonal influenza vaccination of healthcare workers: lessons from a system of community hospitals. Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality, 35(6), 5–15. https://doi-org.ezp.waldenulibrary.org/10.1111/jhq.12005

Sample Answer 5 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for the research that you have done on multimorbidity. Multimorbidity is commonly defined as the presence of two or more chronic medical conditions in an individual, and it can present several challenges in care, particularly with higher numbers of coexisting conditions and related to polypharmacy (“Managing patients with multimorbidity in primary care,” 2015). I agree that “the healthcare organization has to implement major changes in the workforce issue, managing patients, and distribution of resources”. Most health-related research is focused on the prevention and management of single medical conditions in isolation, which makes it difficult to develop the evidence-based strategies that patients and healthcare systems crucially need to understand the extent of this burden, and to treat disease clusters and interactions most effectively (“Multimorbidity,” 2020).

References

Managing patients with multimorbidity in primary care. (2015, January 20). The BMJ. https://www.bmj.com/content/350/bmj.h176
Multimorbidity. (2020, 2). The George Institute for Global Health. https://www.georgeinstitute.org/units/multimorbidity

Sample Answer 6 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

In correctional mental health care, the competing needs of mental health care workers, custody staff, governmental bodies, and the seriously mentally ill (SMI) inmate patients and their families, conflict in America today. Significant research exists to support the inverse relationship between deinstitutionalization of mental health care in America and other democratic countries, and the rate of incarceration (Hudson, 2016). For example, the rate of population growth in American prisons between 1980 and 2010 was 11 times greater than the growth rate of the general population during the same period of time (Rich, 2014). Nearly half of all incarcerated individuals in America experience some form of mental illness, a stark contrast to just 11% of the general population (Hoke, 2015). The deinstitutionalization of mental health care in America has shifted the burden of caring for seriously mentally ill individuals to their families, and in many cases, to the jails and prisons. In addition, when America declared a “war on drugs” in the 1980s, this led to a significant increase of incarcerations for drug-related crimes, disproportionately affecting individuals with psychotic disorders and substance abuse problems (Baillargeon, Binswanger, Penn, Williams & Murray, 2009, as cited in Hoke, 2015).
America is home to the largest prison system in the world (Hoke, 2015). This provides evidence that America is a punitive society, and this cultural view has created policies and practices that have led to mass incarceration (Rich, 2014). In the context of this national sentiment, it becomes increasingly difficult to deliver an appropriate level of care to inmates, much less a level of care that is equivalent to care received in the community (Rich, 2014). Jails and prisons frequently do not provide levels of mental health care in line with national standards (Hoke, 2015). Many barriers exist in providing an adequate level of mental health care to the SMI inmate population in America. Among the barriers to providing adequate mental health care to the SMI inmate population are lack of financial resources, lack of qualified provider resources, safety concerns, the nature of incarceration, and lack of policies to shift care of SMI inmates to more appropriate facilities designed to provide an acceptable level of mental health care. One example which is representative of this larger phenomenon is the management of those on suicide watch.
When an inmate expresses suicidal ideation or engages in self-harm behavior, they are moved to a holding area of the jail designed to prevent self-injury. This is referred to as suicide watch. These suicide watch holding areas are even less comfortable than regular jail housing. For example, inmates are provided only one stiff, tear proof blanket for warmth, and a single garment which affixes at the shoulders and side with large Velcro fasteners. Jails and prisons are almost always very cold environments due to the lack of soft surfaces. The suicide watch garment is only knee length and is sleeveless. The inmates are not allowed to have any undergarments due to the concern for ligature risk. They are not allowed plastic utensils to eat with due to the concern for possible self-harm. Suicide watch cells are placed in high traffic areas of intake or SMI housing units under constant supervision by custody staff removing what little privacy inmates ever experience. These areas tend to be too noisy for adequate sleep. Thus, in the name of safety, individuals who are struggling with emotional pain are stripped of basic comforts, their dignity, and privacy. This should not be acceptable, especially because in America, there is no other option for these individuals to be safely held in a more therapeutic environment.
State and federal policies to create long-term care facilities for the seriously mentally ill are needed. Funding for these facilities should be prioritized. Much of this funding can be diverted from the jails and prisons. Ironically, this would move America back toward institutionalization for the seriously mentally ill, reversing policies and practices instituted as far back as 1960. However, I believe this has become inevitable. Rates of death by suicide in jails and prisons are high, and account for over 30% of all incarceration deaths (Bureau of Justice Statistics, 2020).
In my experience as both a board certified psychiatric mental health nurse, and as the nursing supervisor in one of the largest county jails in America, the deinstitutionalization of long-term mental health treatment facilities in our country has proven to be both ineffective and costly. Recidivism rates remain high, in large part because community supports for treatment which would address the underlying issues that lead to incarceration are absent. Without changes in policy to devote appropriate resources for treating the seriously mentally ill, this troubling cycle will continue. Due to these many factors, I experience burnout, frustration, and a feeling of powerlessness to improve the care of the SMI inmates in my jail. As Kelly and Porr state in an article for the American Nurses Association, nurses feel this way today because of practicing in health care environments with limited resources which place limits on our ability to provide appropriate patient care (2018).

References

Bailargeon, J., Binswanger, I. A., Penn, J. V., Williams, B. A., & Murray, O. J. (2009). Psychiatric disorder and repeat incarcerations: The revolving prison door. American Journal of Psychiatry, 166(1), 103-109.
Bureau of Justice Statistics. (2020). Mortality in local jails, 2000-2016 – Statistical tables (NCJ 251921). U.S. Department of Justice, Office of Justice Programs. https://www.bjs.gov/content/pub/pdf/mlj0016st.pdf
Hoke, S. (2015). Mental Illness and Prisoners: Concerns for Communities and Healthcare Providers. Online Journal of Issues in Nursing, 20(1), 1. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol20No01Man03
Hudson, C. G. (2016). A Model of Deinstitutionalization of Psychiatric Care across 161 Nations: 2001–2014. International Journal of Mental Health, 45(2), 135–153. https://doi-org.ezp.waldenulibrary.org/10.1080/00207411.2016.1167489

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. http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Rich, B. A. (2014). Observations on the nature and extent of injustice in the American prison system. The American Journal of Bioethics: AJOB, 14(7), 1–3. https://doi-org.ezp.waldenulibrary.org/10.1080/15265161.2014.918211

Sample Answer 7 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thanks Darcy, I really enjoyed reading about deinstitutionalization of mental health care in America. As you stated, this shift places the burden of caring for seriously mentally ill individuals to their families, and in many cases, to the jails and prisons. Do you know if the mental I’ll inmates are getting state of the art mental health treatment?

I also work mental health in Hospital in Texas. I understand that mental health can be challenging especially for the patients that need to stay hospitalized due to chronic mental illness. Placement is one of the most challenging problems we run across. Our patients stay is usually 3-7 days in the hospital. We currently have a patient that has been admitted for 90 days. This is the type of patient that needs long term inpatient care, and even for the rest of their lives. We have resources that we can send them too but the Doctors feels that certain patients with chronic mental health would get hurt in the streets due to people not understanding their illness. I agree that there is a gap and a loop hole in the policy of helping the chronically mental health patients get to a long term safe place facility. We have a local facility that houses mental health patients for up to 1 year. Most times families are burnt out and feel like they hit a wall. According to Esposito (2016), ” Thirty percent of people released from state psychiatric hospitals go to homeless shelters and “that’s just unacceptable.”
I’m sure you see so much more burnout with staff in the prisons due to feeling that the deinstitutionalization is not effective. I agree because I remember my grandparents telling me stories about how facilities used to house chronic mental health patients for long term and these facilities were big and beautiful. Today we don’t see that and it shows here in the hospital I currently work at since placement is always a problem. Since 1955, 93% of hospital beds have been lost in psychiatric hospitals (Mental Illness Police 2005).
Community Living Options for People With Serious Mental Illness. (n.d.). Retrieved December 16, 2020, from https://health.usnews.com/wellness/mind/articles/2016-10-26/community-living-options-for-people-with-serious-mental-illness
Patrick Moynihan: Deinstitutionalization Failed. (2019, January 23). Retrieved December 16, 2020, from https://mentalillnesspolicy.org/media/eft/deinstitutionalization-deadly-moynihan-torrey.html
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NURS 6053 Week 3 Assignment Developing Organizational Policies And Practices

NURS 6053- Week 4 Discussion Leadership Theories In Practice

NURS 6053- Week 5 Discussion Your Leadership Profile

NURS 6053 Assignment Personal Leadership Philosophies Essay

NURS 6053 Personal Leadership Philosophies Essay

NURS 6053 Week 7 Discussion Workplace Environment Assessment

NURS 6053 Week 11 Assignment Change Implementation and Management Plan

NURS 6053 Alterations in Cellular Processes

Assignment: NURS 6053 Planned Change in a Department or Unit

Assignment: NURS 6053 Systems Theory

NURS 6053 Review of current Healthcare Issues

NURS 6053 Module 5 Organizational Change Essay

NURS 6053 Module 3 Leadership Essay

NURS 6053 Discussion leadership theories and behaviors

NURS 6053 Reasons for Upholding a Standard of Conduct in the Profession of Nursing at Work and Personal Lives

NURS 6053 Reducing the demand on primary healthcare and the strain on the healthcare system

Sample Answer 8 for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

That’s a valid question Dr. Joubert, and I am not sure that I can provide a definitive answer. The jails are managed at the level of county governments, and prisons at the state or federal level. Different laws govern these facilities as a result. The very nature of incarceration interferes with the possibility for private interactions, and this lack of privacy inhibits inmates from sharing important information that is needed for mental health diagnosis and treatment. This is just one example of the multiple barriers to providing high quality mental health care in these facilities. Like all health care facilities, the jails and prisons are trying to do the right thing, but there are often cultural and organizational challenges. In my opinion, inmates do not received what you describe as “state of the art” mental health treatment. However, I feel that there are many organizations working hard to improve the mental health care that is delivered, care that is in line with established national standards. I think that great improvements have been made, but that more still needs to be done.
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I really enjoyed reading your post regarding mental health in prison systems. I too have provided care to this population in a psychiatric hospital setting. I agree that these individuals are often stripped of their dignity as a result of organizations’ measures to ensure safety. However, some things do not make sense to me. For example, you stated that patients in the prison system may not have plastic cutlery. In my healthcare facility patients can have plastic spoons and forks but not knives. This to me is mind-boggling. I have brought this up during a staff meeting challenging why it is ok to have the other plastic items and not knives when self-harm can still be done with spoons and knives. The Leadership/Management team was not successful in providing an alternative. How frustrating!
As the stressor of staffing is a dominant issue in our field of nursing healthcare staff are at higher risk for burnout. When our resources are low it also effects the quality of care being delivered to patients. Recently, The Joint Commission has stepped in after conducting a survey of 2,000 healthcare workers and found that “Only about 5% of respondents surveyed said their organization was highly effective at helping staff deal with feelings of burnout. Only about 39% said their organization was “slightly effective” at dealing with burnout, and 56% said their facility was either slightly or highly ineffective at it” (Palmer, 2020).
Tackling these challenges often depends on funding. In my experience as a nurse, my findings of a proactive environment were in non-profit facilities. I felt that my voice was heard, actions were taken, and patient/staff satisfaction was higher. Organizations that are non-profit have an abundant number of resources that can benefit both employees and the patients they serve. Brinkmann (2018) found that organizations who fund research can help inform the development of new policies by defining clinical priorities. “For-profit systems benefit from investors’ money and have more flexibility about which services they offer, often seeking more profitable ones” (Masterson, 2017).
Some healthcare organizations are implementing burnout interventions which include resilience training. These positive interventions may decrease employee turnover, improve problems in performance and delivery of care, and most importantly enhance patient satisfaction (Moore, 2020).

References

Brinkmann, J. T. (2018, January). Healthcare policy: Where it comes from and how to change it. The O&P EDGE Magazine – OPEDGE.COM. https://opedge.com/Articles/ViewArticle/2018-01-01/healthcare-policy-where-it-comes-from-and-how-to-change-it
Masterson, L. (2017, May 25). Nonprofit, for-profit hospitals play different roles but see similar financial struggles. Healthcare Dive. https://www.healthcaredive.com/news/nonprofit-for-profit-hospitals-play-different-roles-but-see-similar-financ/442425/
Moore, C. (2020, January 9). Resilience training: How to master mental toughness and thrive. PositivePsychology.com. https://positivepsychology.com/resilience-training/
Palmer, J. (2020, January 6). Joint Commission Portal addresses nurse burnout. Patient Safety & Quality Healthcare. https://www.psqh.com/analysis/joint-commission-portal-addresses-nurse-burnout/?webSyncID=2640b019-b609-27db-a623-44394d50370e&sessionGUID=d6ced981-6027-4277-e974-569973b17762

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for outlining the competing needs in correctional healthcare for mental health workers, custody staff, and mentally ill inmates and families. America is the largest home for prisoners; there is a need for proper care of inmates by reducing suicidal ideation and creating long term care for the sick. A study by Nieuwoudt and Bantjes (2019) showed that high levels of psychopathology, trauma, substance abuse, violence, inadequate mental health care resources, and problems relating to stigma increase the risk of suicidal behavior among criminals deter suicide prevention efforts. Adaptations for security staff of current empirically supported models of suicide risk training and intervention help reduce suicide attempts by inmates (Cramer et al., 2017). During the COVID-19 pandemic, the need for more nurses has risen. To provide quality care for the incarcerated, constitution, and ethical obligations must be adhered to, and all appropriate actions are taken to lessen the potential outbreak in correctional facilities (Williams et al., 2020).

References

Cramer, R. J., Wechsler, H. J., Miller, S. L., & Yenne, E. (2017). Suicide prevention in correctional settings: Current standards and recommendations for research, prevention, and training. Journal of Correctional Health Care, 23(3), 313-328. https://doi.org/10.1177/1078345817716162
Nieuwoudt, P., & Bantjes, J. (2019). Health professionals talk about the challenges of suicide prevention in two correctional centres in South Africa. South African Journal of Psychology, 49(1), 70-82. https://doi.org/10.1177/0081246318758803
Williams, B., Ahalt, C., Cloud, D., Augustine, D., Rorvig, L., Sears, D., & Walter, L. C. (2020). Correctional facilities in the shadow of COVID-19: Unique challenges and proposed solutions. Health Affairs, 10.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

How Competing Needs May Impact the Development of Policy related to Staffing Shortage.
Staffing shortage is a vital health policy issue on which there is a lot of agreement that nurses are a crucial part of the health care delivery system and that nurse staffing has impacts on safety. Adequate nurse staffing has been linked to measures of both patient and nurse satisfaction, and nature of care provided to patients (Kelly & Porr, 2018). Higher levels of adverse patient events including complications, mortality, and negative nurses’ job outcomes such as burnout and under poorer staffing conditions specifically, short staffing coverage or fewer nurses per unit of patient care (Austin, 2016). Adequate staffing directly affects healthcare providers particularly nurses’ ability to suitably monitor, assess, care for, and safely discharge patients. Outcomes are better for patients when staffing levels satisfy the patient’s needs. Strong health care teams decrease infection rates, set up checks in place to avoid mistakes, and guarantee strong lines of communication between staff, patients, and families.
Safe Staffing ratios are very important in light of the fact that patients are at a higher risk of infection, falls, medication errors, and even death. While hospitals and other healthcare facilities are intended to provide a safe place for patients to get treatment and fully recover, staffing deficiencies are undermining the very purpose behind the healthcare system. The appropriate staffing level diminishes the length of patient stay, death rates, and various preventable events such as infections and falls. While patient safety benefits, so too do nurses and other healthcare providers (Abelson, 2016). With an improved workload comes the opportunity for nurses to use their full expertise, without the pressure of fatigue or burnout, and good outcomes.
Competing Need that May Impact Staffing Shortage
Medical clinics, hospitals, and other healthcare organizations confronting healthcare rising costs and other financial uncertainty have tried to decrease nurse staffing as an approach to increase profitability. However, nurse staffing has been observed to be essential in terms of the quality of patient care and nursing-related outcomes. Nurse staffing can give an upper hand to hospitals and other health care facilities, and as a result better financial performance, especially in more competitive markets (Austin, 2016). In the course of recent decades, healthcare organizations have encountered financial uncertainty due to lower repayments from payers, higher acuity patients, and growing competition from rival organizations, and as such, healthcare organizations are ceaselessly looking for an approach to reduce cost. As more people endeavor to live longer, healthier, and more active lifestyles, healthcare concerns increase and so do the costs. Healthcare costs and spending is expected to increase in the future. The Society for Human Resource Management present that the Office of the Actuary at the Centers for Medicare and Medicaid Services estimates that aggregate health care spending in the United States will grow at an average annual rate of 5.8 percent from 2015 through 2025, or 1.3 percentage points higher than the expected annual increase in the gross domestic product (Centers for Medicare and Medicaid Services, 2016). This causes immense worry for leaders as they seek to provide coverage for their workers. Given the fact that registered nurse wages and benefits constitute a substantial portion of an overall hospital or other health care organization costs, as such, they have endeavored to reduce nurse staffing as a way to reduce or diminish costs and increase profitability.
How Might Policy Address Competing Needs
As staffing shortage puts patients care access in risk, healthcare organizations and industry leaders are exploring potential solutions. The issue of worker burnout is tangled up in the issues of staff shortages and turnover. In addition, burnout negatively affects both patient care and patient well-being, as mental, emotional, and physical exhaustion leaves healthcare providers particularly nurses incapable to perform their best. Workload additionally has a lot to do with burnout rates. There is currently a nationwide push for safe staffing legislation, which would mandate hospitals and other health care organizations to keep the nurse-to-patient ratios within safer limits (Abelson, 2016).
Within the nursing profession, many employees intend to further their careers by becoming nursing managers, nurse practitioners, or doctors, and increasingly more frequently they anticipate help along that adventure from their employers. Giving the sort of career development opportunities employees desire can be costly, but the costs of hiring and training replacements are far higher. Training employees is an investment and it pays profits on the opposite end, both in retained employees and in their increased capability (Kelly & Porr, 2018). Therefore, hospitals and other healthcare facilities must do their best to recruit and retain good nurses by creating a climate that appreciates or acknowledges nurses, offers advancement opportunities, and gives them a stronger or more grounded voice in the framework.

References

Abelson, R. (2016). Health Care Issues Loom in Politics, Payments, and Quality.
https://www.nytimes.com/2016/11/15/business/dealbook/health-care-issues-loom-in-
politics-payments-and-quality.html
Austin, W. (2016). Contemporary healthcare practice and the risk of moral distress. Healthcare
Management Forum, 1-3. doi:10.1177/0840470416637835
Contents/Vol-23-2018/N01-Jan-2018/Ethical-Nursing-Cost-Containment.html
Centers for Medicare and Medicaid Services. (2016, December 2). NHE fact sheet.
https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-
reports/nationalhealthexpenddata/nhe-fact-sheet.html
Kelly, P., & Porr, C. (2018). Ethical Nursing care versus cost containment: Considerations
to enhance RN Practice OJIN: The Online Journal of Issues in Nursing Vol. 23, No 1,
Manuscript 6, doi: 10.3912/OJIN. Vol23No01Man06. http//ojin.nursing
world.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tableof

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Kinner, great thoughts regarding safe staffing ratios are very important in light of the fact that patients are at a higher risk of infection, falls, medication errors, and even death. While hospitals and other healthcare facilities are intended to provide a safe place for patients to get treatment and fully recover, staffing deficiencies are undermining the very purpose behind the healthcare system. The appropriate staffing level diminishes the length of patient stay, death rates, and various preventable events such as infections and falls. While patient safety benefits, so too do nurses and other healthcare providers (Abelson, 2016). Class, safe staffing practices in addition to the nursing code of ethics can create drastic and influential changes in the health care and nursing industries. For example, some states have initiated “Safe Harbor,” please explain.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

It is so true that safe staffing in addition to the nursing code of ethics can create drastic and influential changes in the health care industry. Nurses are required to meet up with the needs of the patients while working short of staff which is very challenging to the nurses based on their ethical responsibilities to patients. As a result of this unsafe staffing, nurses are psychologically affected, helpless, inadequate, and unable to provide quality care to their patients. (American Nurses Association, 2015). This may end up leading the health care organization and even the Nurse into a lawsuit.
To help the nurses provide the care which patients deserve following their code of conduct or ethics, suggestions are made to create a credible venture that gives nurses the confidence in their job description, reanalyze the role of nursing, providing assistance to nursing staff and the nurse leader to advocate for their staff. A good example of the venture to ethically secure nurse’s confidence is the Safe Harbor for nurses Act. Where, a registered and licensed practical nurse may reject an assignment when he or she has a good faith belief that he or she “lacks the basic knowledge, skills or abilities necessary to deliver safe and effective nursing care to such an extent that accepting the assignment would expose one or more patients to an unjustifiable risk of harm. State of Taxes and New Mexico have already considered “The safe Harbor Nurse Act”. In New Mexico,” the legislature enacted legislation expanding employment protections for nurses. The Safe Harbor for Nurses Act allows registered and licensed practical nurses to refuse assignments under certain conditions without fear of retaliation or other adverse action by their employers “(New Mexico SB82 the Safe Harbor for Nurse Act,2019).

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
http://www.nursingworld.org/Coe-view only

New Mexico SB82 The Safe Harbor for Nurses Act,2019. https://trackbill.com/bill/new-mexico- senate-bill-82-safe-harbor-for-nurses-act/1612196/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Several changes in the healthcare industry have influenced the advocacy efforts of individual nurses and nursing organizations. The importance of nurse staffing to the delivery of high-quality patient care is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes. Nurse staffing is a crucial health policy issue on which there is a great deal of consensus that nurses are an important component of the health care delivery system and that nurse staffing has impacted safety. When nurses find themselves in compromising situations, there are ways to protect the nurse and their license. Nurses can invoke safe harbor, in good faith, to protect their licenses if they find themselves in compromised practice situations where it is not in the best interest of patients for them to accept an assignment, e.g. working mandatory overtime, accepting expanded patient assignments, etc(Safe Harbor /Resilience/texas nurses association. (n.d).

Reference

Safe Harbor /Resilience/texas nurses association. (n.d) TNA https://www.texasnurses.org/news/493894/Safe-Harbor-and-Resilience—What-Nurses-Need-to-Know-About-COVID-19.htm

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Most of the time, nurses are faced with risky and difficult situations. They should know the Board of Statutes and Rules, to see if they violate one, such as falsifying medical records, performing a procedure that could harm the patient, or even assisting in criminal activity. But what if a patient, a supervisor, or a doctor forced a nurse to do it? Then he/she is protected by a law, which is Nursing Safe Harbor. The nurses can use this to absolve themselves of liability when forced to commit a violation. It is hard for them to say no since they have higher ranks, so the nurse can file a safe harbor before committing to an act to protect themselves from termination of the license and being sued for putting the patient’s life in danger. They can invoke safe harbor anytime on their shift and notify the supervisor that they are invoking Safe Harbor. The safe-harbor request form consists of the following information: the name of the nurse and signature, time and date, location of where the conduct is to be completed, and a brief explanation of why the nurse is invoking safe harbor.
Explanation:
Nurses should be aware of this Nursing Safe Harbor law to protect themselves because, in a health care setting, we can’t control things, and it’s better to be equipped and prepared for possibilities. They should be aware of their rights, including their ability to refuse, especially when it is not legally right.

Reference:

S. Zach, 2018. What Nurses Should Do When Asked to Violate Board Statutes and Rules. Retrieved from: https://nursegrid.com/blog/what-nurses-should-do-when-asked-to-violate-board-statutes-and-rule/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

 

I agree that staff burn out is on the rise due to nursing shortage and the demand of patient care rising. In the hospital I currently work at, the staffing department goes by a grid. This grid does not always work. I work mental health and the acuity at times can be high, meaning we have patients that are chronically mentally ill needing more 1-1 attention. Even though acuity is high, management continues to use a grid to staff. We as nurses at times will have to call the staffing offices and ask for help due to certain circumstances and we hardly get any help. These are the days we feel over stretched and burnt out, second guessing our career. According to Chen et al, (2019), ” Burnout Recognized as a result of chronic workplace stress without successful management, burnout will be a medical diagnosis in the International Classification of Diseases 11th Revision (ICD-11) from 1 January 2022″.
Nursing burnout can change the way we give our patients the quality of care. For me, I notice that I need to take a break and leave the unit for a few minutes so I can reset. I try not to let the patient know I am having a bad day. We want our patients to trust us and have confidence in the treatment we are giving them. I believe that every hospital should have a nursing advocate for burnout and give nurses tips, resources and coping skills. This may help the nursing retention by just making this improvement. There has been several nurses that needed time off due to the well being of their mental health. Working 12 hour shifts and home life can be very stressful. Many healthcare workers who feel burn out due to short staffing and the struggle of all the demands of life usually keep it to themselves because of the stigma of mental health (Nursing Burnout Self Care, 2020).

Admin. (2020, August 06). Nursing Burnout: Self-care in Healthcare. Retrieved December 16, 2020, from https://nursinglicensemap.com/blog/nursing-burnout-tips/
Chen, Y., Guo, Y. L., Chin, W., Cheng, N., Ho, J., & Shiao, J. S. (2019, November 29). Patient-Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction. Retrieved December 16, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926757/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

 

Thank you for your post Kinner. I strongly agreed with you that outcomes are always better for patients when staffing levels satisfy the patient’s needs. One of the competing needs in health organization today is safe staffing ratios and this is very importance in light of the fact that patients are at a higher risk of infection, falls, medication errors, and even death. The evidence supporting inadequate nurse staffing and negative patient outcomes is well documented in the literature. Poor staffing levels lead to increased hospital acquired conditions, patient falls, readmissions, mortality rates, and missed nursing care. A nurse’s inability to deliver the required standard of care due to absence of resources then results in staff and patient injuries, nurse burnout, and increased turnover. This leads to increased use of healthcare dollars to take care of the injury or replace the employee (Comeaux and Bumpus,2019). Alarmingly, the study also shows that each year, roughly 250,000 patients are dying, not from diseases for which they are being treated, but from the care they received (Gingrich,2016). “It’s long overdue to press for widespread adoption of safe patient handling programs to protect health care workers and patients. Too many are suffering debilitating injuries that force them from the bedside. With demand for nursing services increasing, our nation cannot afford for the nursing shortage to worsen by losing nurses to avoidable injury.”

References

Comeaux, Y., & Bumpus, S. (2019). Safe Staffing: Optimal Nurse Staffing is More Than Just a Number. Med-Surg Matters, 28(5), 1–3.

Gingrich, M. (2016). Nurses Must Act for Passage of Safe Staffing Legislation. Pennsylvania Nurse, 71(2), 4–5.

Registered Nurse Safe Staffing Bill Introduced in Congress. (2013). Tennessee Nurse, 76(2), 13.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for the post. You clearly stated how competing needs impact the staffing shortage. To mitigate the problem, improved workload leads to an opportunity for nurses to use their full expertise without the pressure of fatigue or burnout, resulting in improved health outcomes. I agree with you that health care organizations aim to reduce rising costs and other financial uncertainty by decreasing nurse staffing to increase profitability. Reduced work hours for healthcare workers have positive effects for the nurses in both work and home life, leading to improved quality of care (Gyllensten et al.,2017). A study by Momennasab et al. (2017) on nursing workload and efficiency in trauma Intensive Care Unit (ICU) showed that heavy workload in the ICU is common in the morning and evening shifts, resulting in poor patient care quality. With respect to workload, staff allocation can enhance care quality and reduce medical costs (Momennasab et al., 2017). Lack of satisfaction, compassion fatigue, and burnout have adverse consequences on work performance and service quality (Cetrano et al., 2017). Arshakyan (2020) discovered that nursing homes’ profit orientation forces the management to sacrifice hiring more nurses, which leads to quality violations. Higher Medicaid funding increases the number of nurse staff, which leads to a higher quality of care in nursing homes (Arshakyan, 2020).

References

Arshakyan, L. (2020). Staffing and Quality of Care in Nursing Homes (Doctoral dissertation, California State University, Northridge). http://hdl.handle.net/10211.3/217371

Cetrano, G., Tedeschi, F., Rabbi, L., Gosetti, G., Lora, A., Lamonaca, D., … & Amaddeo, F. (2017). How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy. BMC Health Services Research, 17(1), 755. https://doi.org/10.1186/s12913-017-2726-x

Gyllensten, K., Andersson, G., & Muller, H. (2017). Experiences of reduced work hours for nurses and assistant nurses at a surgical department: a qualitative study. BMC Nursing, 16(1), 1-12. https://doi.org/10.1186/s12912-017-0210-x

Momennasab, M., Karimi, F., Dehghanrad, F., & Zarshenas, L. (2017). Evaluation of nursing workload and efficiency of staff allocation in a trauma Intensive Care Unit. Trauma Monthly, 23(1), e58161-e58161. https://doi.org/10.5812/traumamon.58161.

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Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

I enjoy reading your post about Policy related to Staffing shortage ,The workload and environment are factors responsible for the nurse shortage being experienced in health facilities. Safety issues that may include harassment and bullying are prevalent in the nursing environment, thus scaring people from pursuing nurses courses. Hence, the nursing industry is adversely affected (Ayudhya, 2017). Health centers have opted to reduce their operational cost by employing fewer registered nurses, who then compelled them to work overtime. When required during a high influx of patients into the health facilities. This increased workload without consent impairs the nurse morale to remain or join the nursing profession.
The shortage of nurses in health facilities is challenging since nurses are the caregivers to the hospitals’ patients. Their duties are to ensure that patients have been attended to by the doctor, taken drugs, and taken a bath, among other responsibilities. As a result, a shortage of nurses who are the backbone of health centers would mean the few who are there are overworked, and patients may not receive the maximum attention they deserve from nurses.
The appropriate staffing level diminishes the length of patient stay, death rates, and various preventable events such as infections and falls. While patient safety benefits, so too do nurses and other healthcare providers (Abelson, 2016). With an improved workload comes nurses’ opportunity to use their full expertise, without the pressure of fatigue or burnout, and good outcomes.

Reference

Ayudhya, B. I. N., & Kunishima, M. (2017). Risks of Abandonment in Residential Projects Caused by Subcontractors. Procedia Computer Science, 121, 232-237.
Abelson, R. (2016). Health Care Issues Loom in Politics, Payments, and Quality.https://www.nytimes.com/2016/11/15/business/dealbook/health-care-issues-loom-in-politics-payments-and-quality.html

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

I appreciate your stand on safe nursing levels, you mentioned that patients are at higher risk of infection, fall, complications resulting in prolonged stay and readmissions, lack of patient satisfaction, and minimal outcomes. Do you that as California braces for the influx of Covid-19 hospitalization, according to Rivera, Kurt (2020), Governor Newsome’s administration is allowing waivers for hospitals to increase the patient load in ICU units? Newsome said that staffing is the number one state challenge therefore issuing a temporary policy on increasing nurse staffing levels in ICU will help with Covid-19 admissions. California nurses are adamantly opposing this as it is a doorway to more infections and death. Statistics showed that 59000 nurses in California and 228 number of deaths.
In my work setting, the Covid-19 surge has flooded nurses with high acuity workloads especially in ICUs. My unit was one of the ICU converted to Covid unit, yesterday we had lots of admissions with no help. We managed to help ourselves and ended up coding two patients. Covid -19 surge influence on staffing has caused increased nursing burnouts leading to sick calls, injuries, and turnovers. According to Haddad and Toney-Butler (2020), Organizations must be creative in meeting the needs of nurses while providing the best and safest care to the patients. An environment that empowers and motivates nurses is necessary to rejuvenate and sustain the nursing workforce. Empowerment in autonomy in staffing ratio decisions considering high volume and acuity levels will lead to less burnout and a strong desire to leave the workforce.

Reference

Haddad, L., and Toney-Butler, T.(2020). Nursing Shortage. www.ncbi.nlm.nih.gov>books>NBK493175.
Rivera, Kurt. (2020). California Nurses push back against the new nurse to patient ratio during Covid-19.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy.

Nursing stress related to nursing shortage has been a problem for many years. Nurses typically receive a 4-6 patients during a shift on our medical floors. On our Behavioral health floors, we can get up to 7 patients and even 8 when our census is very high. While I was in nursing school, I had no idea that I was about to get into a profession that tested my limits of patient care. Although staffing levels are set according to budgets, there is a bigger picture that should be addressed. Patient safety and quality care should be the focus of every nurse’s assignment. Even if we are given one extra staff, that would make a huge difference. There have been times we are short staff because of the acuity on the floor, and nurses have been put on call because administration goes by a grid and not acuity.

competing needs that may impact the national healthcare issue/stressor you selected

Patient safety shouldn’t start with the nurse, patient safety starts when the decision is made on how many patients a nurse will receive on her assignment. According to Murrells & Rafferty, 2014, “Nurses frequently reported leaving care undone, and missed nursing care episodes were strongly associated with higher numbers of patients per nurse and lower safety culture ratings”. There have been times that I leave work very stressed due to being short-staffed and remembered I forgot to mention something during report or even a task left undone. I then have to call the nurse and apologize and have then complete what was left undone due to having so much going on and not having enough help. There are so many responsibilities nurses have, including assessment, charting, comfort patients, watch for changes, update family, and educate patient and family. Nurses are expected to give quality of care, work 12-hour shifts, and work with the minimal amount of staff. According to a survey, nursing leaders are aware of the nursing shortage and agrees the quality of patient care is only going to get worse (American Association of Critical Care Nurses, 2018).

What are the impacts, and how might policy address these competing needs?

Since nurse staffing is usually determined by hospital cost, most times on our floor there will be about 4 staff placed on call just in one day. Most times we have to advocate for ourselves when acuity is high, and we are having several discharged and admissions. We will ask our manager to please call in a staff member to help. One thing we bring up is that we feel we are not giving quality of care to our patients due to the fact that we are being over stretched. Instead of calling in a staff, most times management will say they can help out for a couple of hours since our grid does not call for an extra staff. This is very frustrating; I don’t understand why every case or unit can’t be looked at individually and not just by numbers. According to a study by the University of Pennsylvania, hospitals that staff appropriately have positive outcomes and have a lower re admission rate (Healthcare News and Insight, 2018). Hospitals need to see that the cost of readmissions and patient falls outweigh the cost of having extra staff for patient safety. An example of this is when an elderly man was taken off a 1-1 prematurely because I believe they needed that staff member on another floor. This man fell and broke his nose. The hospital had to incur a lawsuit and all hospital resources by doing all sorts of tests.

References:

Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2014, February 01). ‘Care left undone’ during nursing shifts: Associations with workload and perceived quality of care. Retrieved December 14, 2020, from https://qualitysafety.bmj.com/content/23/2/116

JavaScript required. (n.d.). Retrieved December 14, 2020, from https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=7&sid=95812acb-2ecd-4b83-a34d-d47064be7f5d@pdc-v-sessmgr03

Low nurse staffing may cost your facility millions of dollars. (2020, November 18). Retrieved December 14, 2020, from http://www.healthcarebusinesstech.com/low-nurse-staffing-may-cost-your-facility-millions-of-dollars/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

I enjoyed reading your post about how organizations staff based on a budget grid instead of staffing by acuity. While the organization keeps costs down due to this model, it also faces other problems when staffing is not based on acuity. According to Stasik (2019), a staffing grid is used by managers to determine how many staff members are required for each shift. A staffing grid considers the complexity and acuity of a patient. Other organizations use budget-based staffing grids, and nurse to patient ratio grids. Staffing by acuity ensures that patients get the highest level of care (Nguyen, 2015). Acuity staffing improves patient outcomes and reduces the length of hospital stay thus reducing costs (Ingram & Powell, 2018).
Hospitals can use evidence-based practices to determine the best way to staff by acuity (Stasik, 2019). Patient acuity is determined by how stable the patient is and the unique needs of the patient. Staffing by patient acuity is paramount to patient safety (Nguyen, 2015). Some hospitals are concerned with keeping costs down since nursing labor constitutes 50% of their costs (Ingram & Powell, 2018). As a result, these hospitals focus on keeping costs down and employ a budget-based staffing grid. This often results in medication errors, patient falls, and reduced satisfaction among staff members (Stasik, 2019).
Regards,
Martha Chimhashu

References

Ingram, A., & Powell, J. (2018, April 11). Patient acuity tool on a medical-surgical unit. American Nurse. https://www.myamericannurse.com/patient-acuity-medical-surgical-unit/
Nguyen, A. (2015). Acuity-based staffing. Nursing Management (Springhouse), 46(1), 35–39. https://doi.org/10.1097/01.numa.0000459555.94452.e2
Stasik, S. (2019, January 31). Nurse Staffing Plans 101 | Berxi™. Berxi. https://www.berxi.com/resources/articles/everything-to-know-about-nurse-staffing-plans/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Hello Lorraine, I truly enjoyed reading your post. Unfortunately, almost every nurses’ story in this pandemic is that of helplessness, hopelessness, and dissatisfaction in the workplace. We feel like we are facing this battle alone with little or no help from the management. Your post was so vivid and insightful that I can’t help but ask who in a global pandemic will be utilizing a grid instead of patient’s acuity to determine unit staffing/assignment? I personally have not seen the utilization of grid and not acuity cited anywhere as an evidence-based practice in rationing assignments and staffing. That is an absolute administrative failure. Influential clinical and organizational leaders prioritize their employees’ and colleagues’ perceptions, attitudes, and feelings (Marshall & Brooke, 2017). Unfortunately, that is rarely the case as unit managers are more focused on saving money budgeted for the unit’s operational use to gain year-end bonuses for themselves. Your institution is lucky to have as many as four nurses willing to be placed on call yet not utilize it for better patient outcomes and staff satisfaction. For instance, in my hospital, we are so stretched that nurses are desperately begged by management to work as much overtime as they want, working in different specialty units and alternating shifts. I have colleagues who work two weeks straight with no off day. Nurses who are in OR, PACU, and Cath Lab. are being utilized to staff the hospital because of the low census in elective surgeries leading to staff being frustrated, burnt-out, and quitting the job abruptly. The American Nurses Association (ANA) opined that some of the strategies that may be utilized to minimize burnout are the availability of seamless workflow resources, the number of admissions and discharges, sensitivity to staffing ratio, and patient acuity. Not grid as being practiced by your management. That begs the question, at what point does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) intervene?

References

American Nurses Association (n.d.). Nurse Staffing. Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for your post, I agree with you that hospitals need to see that the cost of readmissions and patient falls outweigh the cost of having extra staff for patient safety. A study completed by Rosenburg (2016) directly related low nurse staffing to significantly higher readmission rates. Hospitals have been placing a stronger emphasis on ensuring the patient has adequate discharge planning during hospitalization, and close follow-up after discharge to reduce the risk of readmission. However, when staffing is low, this impacts the ability of the nurse to participate in discharge planning and provide the necessary education the patient needs. It seems that bedside nurses are increasingly asked to do more with fewer resources. Some nursing units have requirements in which they must assure the patient has a certain number of minutes of patient education prior to discharge (such as heart failure), but when they are responsible for six patients, it seems impossible to provide thorough education. Increased nurse staffing relates to a larger opportunity to provide adequate patient education and effectively participate in discharge planning (Giuliano et al., 2016). It is no question that if a patient is educated on their disease, signs, and symptoms to monitor for, how to maintain special dietary restrictions, and the importance of medication adherence, that it may help to prevent readmission. For example, a patient with newly diagnosed heart failure would need to be educated on the importance of daily weight monitoring, the importance of adhering to their medication regimen, dietary recommendations, and when to notify the doctor. If staffing is low and nursing is not able to provide this crucial teaching, the patient may not understand these components and will be at risk for readmission. However, even with the mandated nurse to patient ratios, it does not necessarily address patient acuity. A nurse who has five patients with low acuity is going to have a better day than a nurse responsible for five patients with very high acuity.

References

Giuliano, K. K., Danesh, V., & Funk, M. (2016). The Relationship Between Nurse Staffing and 30-Day Readmission for Adults With Heart Failure. The Journal of Nursing Administration, 46(1), 25–29. https://doi.org/10.1097/NNA.0000000000000289
Rosenburg, K. (2016). More Nurses Mean Fewer Readmissions for Patients with Heart Failure. The American Journal of Nursing, 116(4).

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for the informative post, you made excellent points on the negative effects of inadequate staffing. Inappropriate nurse-patient ratios can result in harm to patient as well as cost the organization. As if the nurse staffing problem was not already significant before, Covid-19 has amplified the situation. Nurses have had increased work loads due to nurses being out due to quarantine for risk of exposure testing positive for the virus (Sheraton, 2020). The Covid 19 pandemic has had significant impact on the well-being of health care workers causing increased incidence of psychological ailments which included anxiety, depression, occupational stress, PTSD and insomnia (Sheraton, 2020). The effects of the pandemic highlight an ongoing need not only for increased staff for mental health support for health care workers as well. A good mental health support system within an organization has afforded nurses a greater sense of control and has helped improved resilience during a pandemic (Sheraton, 2020). There are many lessons to be learned from Covid-19 pandemic and I hope that change can be initiated through new policy implementation to improve the work life of healthcare workers.

References

Sheraton, M., Deo, N., Dutt, T., Surani, S., Hall-Flavin, D., & Kashyap, R. (2020). Psychological effects of the COVID 19 pandemic on healthcare workers globally: A systematic review. Psychiatry Research, 292, 113360. https://doi-

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

I feel your frustration. We are in a profession where corners should not be cut, and unfortunately, it is not getting any better. As the baby-boom generation continues to age and overall population numbers increase, the demand for nurses continues to grow — especially in times of crisis like 2020’s COVID-19 outbreak. (“U.S. nursing shortage: A state-by-state breakdown,” 2020). This means that nurse burnout will continue as well as the likelihood of patient mortality. The RN workforce in the U.S. is estimated to grow by 28%, from approximately 2.8 million to 3.6 million in 2030, needing over 200,000 RNs annually to replace the retiring generation (“Nursing shortage by state: 2020 stats & solutions,” 2020).
You mentioned a patient who had a fall, and in the Massachusetts Department of Public Health (MDPH) unintentional fall-related injury report, it was reported that total charges for acute care hospital events associated with unintentional falls were over $471 million in the fiscal year 2006 (“Patient falls,” n..d.). It is hard to believe that there was something more important for that 1:1 person to be doing than supporting a potential fall risk.

References

Nursing shortage by state: 2020 stats & solutions. (2020, May 6). Nightingale College. https://nightingale.edu/blog/nursing-shortage-by-state/
Patient falls. (n.d.). PatientCareLink – A Quality & Safety Initiative for MA & RI. https://patientcarelink.org/improving-patient-care/patient-falls/
The U.S. nursing shortage: A state-by-state breakdown. (2020, December 1). NurseJournal. https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Lorraine, I found your post quite interesting and informative. Globally, the issue of nursing shortage has been a major challenge in the health care sector for quite sometime. This has unfortunately led to a multi-faced level of concern as it directly affects patient outcomes, safety and overall satisfaction which has now come to a warning threshold (Boamah & Laschinger, 2016). The nursing practice continues to struggle with the issue of staffing shortages because there is a significantly high level of turn over rate, lack of potential educators, and most importantly an inequitable and unbalanced distribution in the workforce. Clinical setting with increased patient-to-nurse ratios tend to experience burnouts and job dissatisfaction among nurses on the field.
Liu & Aungsuroch. 2018, suggest that legislative policies have been implemented by certain States nationally to limit patient-to-nurse ratios clinically, but amid this policies when there is a shortage in the number of nursing staff the ratios increase to fulfill the need irrespective of the acuity of the patient population. It is imperative that nurses that render direct patient care at the bedside should essentially decide the most appropriate nurse-patient ratios instead of those in the leadership and supervisory roles. When nurses become more involved in inter-professional researches, evidence-based practices, and quality improvement strategies, it helps raise more awareness, and increase professional empowerment. There will be less errors, higher morbidity, and mortality rates and more increased efforts made to foster the health and overall well-being of the global population. Stake holders and leaders in various health-care organizations have a very important role to play in the balance of the competing needs by developing strategies aimed at leveling the allocation of financial budgets (Lewis & Cunningham, 2016). There should also be the incorporation of policies that mandate an acceptable nurse to patient ration at the bedside to eliminate job dissatisfaction and the negative impact of burnout.

References

Boamah SA, Laschinger H. The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses. J Nurs Manag. 2016;24(2):E164–74.
Laschinger HK, Read EA. The effect of authentic leadership, person-job fit, and civility norms on new graduate nurses’ experiences of coworker incivility and burnout. J Nurs Adm. 2016;46(11):574–80.
Lewis HS, Cunningham CJ. Linking nurse leadership and work characteristics to nurse burnout and engagement. Nurs Res. 2016;65(1):13–23.
Liu Y, Aungsuroch Y. Factors influencing nurse-assessed quality nursing care: a cross-sectional study in hospitals. J Adv Nurs. 2018;74(4):935–45.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

A recent analysis by researchers from the University of Missouri and the Health Resources and Services Administration found that United States faces a primary care physician shortage that would exceed 40,000 by 2025. This shortage affects access to care, especially in rural or poor urban communities (Kuehn, B. M. 2008). The Nurse Practitioner (NP) has emerged as a profession capable of closing the gap in the primary care physician shortage. Studies have shown that NPs are equally as competent as physicians. They also cost less, spend more time with their patients, and get better satisfaction rates (Zand M. B. 2011). Studies have also shown that NPs provide the same or better quality of care. Using NPs to help fill the shortage increases access to care, as more NPs fill positions in rural and poor urban communities than physicians.
The values of the organization on access to care frequently affect resource allocation and policy decisions (Harrison & Taylor, 2016). Although NPs wages tend to be lower than that of physicians, they do not receive equivalent reimbursement as physicians (Naylor and Kurtzman, 2019). Some organizations may not hire NPs to act as primary care providers due to this. This competing need for primary care providers and the need to bring in revenue is a difficult one. The other competing need is that of keeping your primary care physicians happy when some physicians who have never worked with NPs have the perception that they deliver substandard care or working with them will get them sued (Sustaita et. al., 2013).
The primary care physician shortage hurts our access to care, not just in rural and poor urban communities; it also increases the time it takes to see a provider in most areas. Policy could address these competing needs by adopting a comanaging team of NPs and physicians, comanaging teams allow payments to be bundled or billed at physician rates (Hariharan S. 2015). This would negate the issue with lower reimbursement that NPs usually receive. The other way to combat the competing need of keeping physicians happy, is to pass a policy that gives all NPs full practice authority. Doing this, would eliminate the need for NPs to work under the supervision of a physician, thus alleviating the threat of being sued. The policy should include performance results of NPs be reported to the public to show the high quality of care they give (Naylor & Kurtzman, 2019). Workforce challenges are one of the most important challenges that healthcare leaders face (Parsons, J. 2019), however they must find ways of influencing or making policies that keep patient safety and resources in balance.

References

Hariharan, S. (2015). Using Advance Practice Registered Nurses and Physician Assistants to
Ease Physician Shortage. Physician Leadership Journal, 2(3), 46–51.
https://search-ebscohost- com.ezp.waldenulibrary.org/login.aspx? direct=true&db=mnh&AN=26214952&site=ehos t-live&scope=site
Harrison, K. L., & Taylor, H. A. (2016). Healthcare resource allocation decisions affecting
uninsured services. Journal of health organization and management, 30(8), 1162–1182.
https://doi.org/10.1108/JHOM-01-2016-0003
Kuehn, B. M. (2008). Reports Warn of Primary Care Shortages. JAMA: Journal of the American
Medical Association, 300(16), 1872.
https://search-ebscohost- com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edb&AN=34899887&site=eds- live&scope=site
Naylor, M & Kurtzman, E. (2019). Reinventing Primary Care. Health Affairs, 29(5).
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2010.0440?journalCode=hlthaff
Parsons, J. E. (2019). Addressing Workforce Challenges in Healthcare Calls for Proactive
Leadership. Frontiers of Health Services Management, 35(4), 11–17.
https://doi-org.ezp.waldenulibrary.org/10.1097/HAP.0000000000000058
Sustaita, A., Zeigler, V. L., & Brogan, M. M. (2013). Hiring a nurse practitioner: What’s in it for
the physician? The Nurse Practitioner, 38(11), 41–45.
https://doi-org.ezp.waldenulibrary.org/10.1097/01.NPR.0000435783.63014.1c
ZAND, M. B. (2011). Nursing the Primary Care Shortage Back to Health: How Expanding
Nurse Practitioner Autonomy Can Safely and Economically Meet the Growing Demand
for Basic Health Care. Journal of Law & Health, 24(2), 261–284.
https://search-ebscohost- com.ezp.waldenulibrary.org/login.aspx?direct=true&db=a9h&AN=67026493&site=eds- live&scope=site

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thanks Laura for your discussion posts. I would agree that Nurse Practitioner (NP) has emerged as a profession capable of closing the gap in the primary care physician shortage. Studies have shown that NPs are equally as competent as physicians. They also cost less, spend more time with their patients, and get better satisfaction rates (Zand M. B. 2011). Class, nurse shortage is continuing to be an issue in most healthcare organizations for several different reasons. Many states are looking at mandate staffing ratios, do you know how many states have this policy in place now?

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Currently 14 states have staffing ratios. CA is the only state that stipulates in regulations and law a
required nurse to patient ratio at all times (Nurse Staffing | Health Care Advocacy | American Nurses
Association, n.d.).
Reference
Nurse staffing | health care advocacy | american nurses association. (n.d.). ANA. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Currently, California is the only state to have mandated staffing ratios (ANA, 2019). In 2017, congress introduced bill H.R. 2392 that proposed to mandate staffing standards and allow hospitals to comply with the minimum nurse to patient ratio by unit (H.R. 2392, 2017). Sadly, the bill never passed. As a bedside nurse, I can attest that taking care of too many patients results in poor and unsafe care. A heavy patient load results in medication errors, falls, hospital-acquired infections, and prolonged hospital stay (Blitchock, 2019). In California, nurses report higher job satisfaction, less burnout, and low turnover rates. California has a nurse union called the Union of Health Care Professionals that represents and advocates for better working conditions for their members (Blitchock, 2019). Texas is one of the seven states that have nurse staffing committees comprising nurses who recommend the appropriate nurse to patient ratio (ANA, 2019). The other states are Connecticut, Illinois, Nevada, Ohio, Oregon, and Washington (ANA, 2019).

References

ANA. (2019, July). Nurse Staffing | Health Care Advocacy | American Nurses Association. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/
Blitchock, A. (2018, January 6). Proposed Federal RN Ratios – What You Can Do About It. Nurse.Org. https://nurse.org/articles/federal-staffing-ratios/
US Congress. (2017, May 4). H.R.2392 – 115th Congress (2017-2018): Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017. Congress.Gov | Library of Congress. https://www.congress.gov/bill/115th-congress/house-bill/2392?r=9

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

14 states currently addressed nurse staffing in hospitals in law/regulations which are: CA, CT, IL, MA, MN, NV, NJ, NY, OH, OR, RI, TX, VT, and WA.
7 states require hospitals to have staffing committees responsible for plans (nurse-driven ratios) and staffing policy – CT, IL, NV, OH, OR, TX, WA.
CA is the only state that stipulates in law and regulations a required minimum nurse to patient ratios to be maintained at all times by unit. MA passed a law specific to ICU requiring a 1:1 or 1:2 nurse to patient ratio depending on the stability of the patient.
MN requires a CNO or designee to develop a core staffing plan with input from others. The requirements are similar to Joint Commission standards.
5 states require some form of disclosure and/or public reporting – IL, NJ, NY, RI, VT

Reference

Nurse staffing | health care advocacy | American nurses association. (n.d.). ANA.https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/#:~:text=States%20with%20Staffing%20Laws,%2C%20OR%2C%20TX%2C%20WA.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Nice reading your post, I agree with you that the primary care physician shortage hurts our access to care, not just in rural and poor urban communities; it also increases the time it takes to see a provider in most areas. Some solutions to fix these problems are an effective use of technology, tax shifting, collection of more consistent data, and use of interprofessional care teams ( MacLean et al., 2014). Combining all these elements creates a foundation that can influence policy and build for a better work environment thus addressing the last leg of the quadruple aim model. Tax shifting is allowing healthcare providers to practice according to their training without restrictions or unnecessary oversight such as an NP needing a collaborative agreement with a physician to practice or prescribe medications. Interprofessional collaboration encompasses all healthcare divisions working together to deliver quality care thereby contributing significant benefits to their communities, health systems, and workers. Well-developed technology such as telemedicine has become a tool used to combat this issue where patients can be triage in the emergency department thus freeing up the nurse to perform other duties (McHugh et al., 2018). We can name study after study that demonstrates how staffing plays a vital role in positive health outcomes or the lack thereof. Nationwide staffing regulations and policies are the only way to safeguard patient wellness and nursing frustrations as we all strive for a better system.

References

MacLean, L., Hassmiller, S., Shaffer, F., Rohrbaugh, K., Collier, T., and Fairman, J. (2014). Scale, Causes, and Implications of the Primary Care Nursing Shortage. Annual Review of Public Health, 35, 443-457.
McHugh, C., Krinsky, R., and Sharma, R. (2018). Innovations in emergency nursing: Transforming emergency care through a novel nurse-driven ED Telehealth express care service. Journal of Emergency Medicine, 44 (5), 472-477.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Your post is informative and addresses an important healthcare issue. Shortage among physicians affects patient treatment leading to longer wait times, poor quality of care, and even assess to care. “As pressures on the healthcare system intensify, it is anticipated that APRNs will increasingly fill critical roles in providing outstanding patient-centered care” (Kraines, 2018, p. 23). Advanced Practice Registered Nurses (APRNs) have and will close the gap of physician shortages that you mentioned in your post. Nurse practitioners (NPs) provide patient-centered care because of their experience working one-on-one with patients at the bedside, which enables nurses to be good listeners and accurately provide detailed assessments in a timely manner. “NPs also typically outscore MDs when it comes to patient satisfaction” (Regis College, n.d.). When a compact license is implemented, this will allow NPs to practice across those states where the compact license legislation is enacted. The NP would be able to provide telehealth treatment across states or practice as a travel NP. Currently, NPs do not have a compact license. It will be implemented when seven states enact the legislation, which now is only pending in one state, Delaware (NCBSN, n.d.).

References

Kraines, K. L. (2018). Filling critical gaps in primary healthcare: Advanced practice registered nurses meeting the challenge. Yale Nursing Matters, 18(1), 20-23.
NCBSN. (n.d.). APRN compact. Retrieved from https://www.ncsbn.org/aprn-compact.htm
Regis College. (n.d.). How nurse practitioners can close the gap in healthcare. Retrieved from https://online.regiscollege.edu/blog/how-nurse-practitioners-can-close-the-gap-in-healthcare/

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

With the significant shortage of healthcare providers and issues with burnout take hold in healthcare, Nurse practitioners are prime to fill inpatient care gaps as you rightly mentioned. The role of the nurse practitioner is growing, with more clinicians choosing that career path than ever before. The absolute truth to the matter is that there is a doctor deficiency thus having enough physicians to provide essential care is a problem. Nurse practitioners are in a perfect position to provide primary care, so there is a clear path of more and more nurses taking that route to be a nurse practitioner.
Nurse Practitioners have not been universally tapped to fill care gaps in this crisis shortage of doctors ( Lowes et al,.2018). There is variability about the extent to which nurse practitioners are allowed to practice at the top of their licensure. Some states have more lenient autonomy policies, meaning nurse practitioners in those states are better positioned to fill the care gaps left by an increasing physician shortage (Norful et al,.2018). States that allow more nurse and nurse practitioner autonomy have better strategies for closing patient care access gaps brought about by physician shortage.

Lowe, G., Plummer, V., & Boyd, L. (2018). Nurse practitioner Integration: Qualitative
Experiences of the Change Management Process. Journal of Nursing Management, 26(8),
992–1001 https://doiorg.ezp.waldenulibrary.org/10.1111/jonm.12624
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain. Annals of Family Medicine, 16(3), 250–256. https://doi-org.ezp.waldenulibrary.org/10.1370/afm.2230

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

I enjoyed reading your post on the nationwide primary care provider (PCP) shortage and how nurse practitioners (NPs) may help address the shortage. Increasing autonomy of the nurse practitioner’s practice could help fill in the gap. Currently, there are 22 states with full practice authority (AANP, 2019). Full practice authority means that NPs can assess, diagnose, and prescribe medicine independently (AANP, 2019). The shortage of PCPs is projected to increase with the aging population. Primary care visits account for over 50% of all doctor visits (Xue et al., 2018, p. 263). Research shows that patients who have a PCP have 30% lower healthcare costs, and a reduced mortality rate (Xue et al., 2018, p. 264). By increasing the autonomy of NPs, we can increase the number of PCPs, especially in underserved and rural areas. Most physicians do not want to work in rural areas, opting to work in concentrated suburban areas. NPs can bridge the gap and work in underserved communities. This will result in better access to healthcare providers in that region and ultimately lead to a higher quality of care and reduced mortality.
Regards,
Martha Chimhashu

References

AANP. (2019, December 20). State Practice Environment. American Association of Nurse Practitioners. https://www.aanp.org/advocacy/state/state-practice-environment
Xue, Y., Greener, E., Kannan, V., Smith, J. A., Brewer, C., & Spetz, J. (2018). Federally qualified health centers reduce the primary care provider gap in health professional shortage counties. Nursing Outlook, 66(3), 263–272. https://doi.org/10.1016/j.outlook.2018.02.003

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Discussion – Week 3: Organizational Policies and Practices to Support Healthcare Issues
Specific needs of the unit or the facility can affect and impact the development of a new policy or an update to address those needs. Staffing shortages is a major healthcare issue that most facilities face that affects the performance of the unit. Staffing shortages lead to poor performance because it leads to staff burnouts, medical errors, medication errors, poor clinical decisions, and patient safety. It affects the staff member’s “ability to give quality patient care” and may allow the staff member to disconnect to their job due to emotional distress (Laureate Education, 2009, 3:24). The healthcare issue that has been most prominent on my unit, which is Chemical Dependency and dual diagnosis unit, is prescription drug overdose. When the unit runs with short staffing, many elemental situations get overlooked. For example, a new patient is admitted, and their belongings is not accurately searched. The counselor aide (CA) rushes and forgets to check the patient’s jacket pocket that has the patient’s prescription bottle of Seroquel 300 mg. After the patient is administered medication from the nurse, the patient goes to bed and takes the prescribed Seroquel 300 mg that she brought with her. The patient may take more doses depending on her intentions. Minor mistakes can cause a major incident such as a patient overdosing on the unit. This puts another stressor on the nurse who is already burned out.
According to the Joint Commission’s detox unit policy, the nurse-patient ratio should be 1:7. This ratio is only effective when we are fully staffed. Although our unit follows this policy, we do have incidences where we are forced to work short and one nurse must handle up to 21 detox patients. This has caused the detox nurse to be overwhelmed caring for patients constantly vomiting, complaining, cursing, and yelling. Burnout among staff can cause negative emotions to affect their job performance and produce a negative work environment (Kelly & Porr, 2018). Prior to Thanksgiving, my unit was affected due to Covid-19. A new admission, who was asymptomatic for Covid-19, was admitted and the virus spread throughout the unit like wildfire. Up to 14 staff members were affected and half of the patients had to be moved to the Covid-unit. This presented a larger issue since staffing was already low. Nursing managers should consider the staffing needs according to the workload of the unit to avoid burnout among their staff members. “Nurses in management and administration have a particular responsibility to provide a safe environment that supports and facilitates appropriate assignment and delegation” (American Nurses Association, 2015, p. 33). Better communication, productive teamwork, and work incentives are some examples of effective strategies that can make an impact on unit functions and performance.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only
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
Laureate Education (Producer). (2009b). Working with individuals [Video file]. Baltimore, MD: Author.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Nurse-patient ratios are a perpetual problem in nursing. Ratios are being further stretched during the pandemic. California Governor Gavin Newsome is proposing new ratios and many nurses are upset (ABC News, 2020). He wants emergency room (ER) nurses seven to one, telemetry/medical surgical seven to one, and intensive care units (ICU) three to one (ABC News, 2020). This is insanely unrealistic especially when the ERs are flooded with COVID patients that meet ICU criteria. The union representing Los Angeles (L.A.) County nurses is currently in meetings with L.A. Department of Public Health leadership stop this from happening (National Nurses United, 2020). Common sense would dictate that when a person is forced to take on more demands with less resources, failure is imminent. Keeping patients safe is part of our nursing licenses. If ratios are increased the Governor needs to put protections in place to protect nursing licenses. When someone decrees a new law of the land it has to be feasible. Right now, this is not the case. The hospital I am at struggles with retaining nurses they hired six months ago. Pretty sure this pandemic is going to expedite the departures to three months. Newsome needs to balance his increasing demands with protections for nurses or this will be a complete disaster.

ABC News Bakersfield. (2020, December 16). Nurses upset with governor Gavin Newsom over nurse-to-patient ratio. https://www.turnto23.com/news/coronavirus/nurses-upset-with-governor-gavin-newsom-over-nurse-to-patient-ratio-increase
National Nurses United. (2020, December 16). California nurses hold press conference to warn new rule to let hospitals violate safe staffing standards will lead to more death and suffering of both patients and health care workers. https://www.nationalnursesunited.org/press/california-nurses-hold-press-conference-warn-new-rule-let-hospitals-violate-safe-staffing

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

This is a very interesting post you have here. I agree with you that staffing shortage is a major healthcare issue that needs to be looked into and addressed diligently especially considering that it can cause staff burnout which can have a negative impact on the performance of nurses and ultimately patient care. Studies have shown that medical malpractices such as medication errors which lead to increased incidence of readmission is linked to nurse burnout. Nurse burnout is a phenomenon characterized by a reduction in nurses’ energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy (Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. 2017). Nurses experiencing burnout have been found to become detached from their jobs allowing errors due to absent mindedness to increase exponentially. Nursing shortages lead to errors, higher morbidity, and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout, dissatisfaction, and the patients experienced higher mortality and failure-to-rescue rates than facilities with lower patient-to-nurse ratios (Haddad L. M., Toney-Butler, T. J, 2020).
It is also very interesting that you mentioned your experience currently with the pandemic as my organization is also experiencing similar staff shortage due to infected nursing staff members that have to self-isolate. The management in my organization have continued to help alleviate the effect of the stress on us by recruiting new nurses via nursing agencies, ensuring that nurse managers take up clinical duties and introducing renumeration such as additional pay to nurses on duty. I hope to read more of your posts and wish you good luck.

References

Haddad L. M, Toney-Butler, T. J [2020]. Nursing Shortage. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Inquiry : a journal of medical care organization, provision and financing, 54, 46958017724944. https://doi.org/10.1177/0046958017724944

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Staffing shortages are a dominant stressor in our profession. With the COVID-19 pandemic, it has only led to more of a shortage and burnout for healthcare workers. The Joint Commission has stepped in with recommendations such as resilience training after conducting a survey of 2,000 healthcare workers and their responses to how their organizations are handling burnout. They found that “Only about 5% of respondents surveyed said their organization was highly effective at helping staff deal with feelings of burnout. Only about 39% said their organization was “slightly effective” at dealing with burnout, and 56% said their facility was either slightly or highly ineffective at it” (Palmer, 2020).
Our facility too has experienced situations where lack of staff resulted in contraband being missed while conducting the initial body search upon admission. In the event that these incidents are caught, another body and room search are performed. Then the doctor on call and supervisor are notified and an incident report is completed. This adds more work to an already frustrated nurse and team. Managers will meet with the staff responsible and re-educate them while providing training on how crucial the initial body search is. The good thing about the COVID-19 pandemic is that our facility does not allow visitors which was another opportunity for manipulative patients to sneak in contraband.
Tackling these challenges often depends on funding. In my experience as a nurse, my findings of a proactive environment were in non-profit facilities. I felt that my voice was heard, actions were taken, and patient/staff satisfaction was higher. Organizations that are non-profit have an abundant number of resources that can benefit both employees and the patients they serve. Brinkmann (2018) found that organizations who fund research can help inform the development of new policies by defining clinical priorities. “For-profit systems benefit from investors’ money and have more flexibility about which services they offer, often seeking more profitable ones” (Masterson, 2017).

References

Brinkmann, J. T. (2018, January). Healthcare policy: Where it comes from and how to change it. The O&P EDGE Magazine – OPEDGE.COM. https://opedge.com/Articles/ViewArticle/2018-01-01/healthcare-policy-where-it-comes-from-and-how-to-change-it
Masterson, L. (2017, May 25). Nonprofit, for-profit hospitals play different roles but see similar financial struggles. Healthcare Dive. https://www.healthcaredive.com/news/nonprofit-for-profit-hospitals-play-different-roles-but-see-similar-financ/442425/
Palmer, J. (2020, January 6). Joint Commission Portal addresses nurse burnout. Patient Safety & Quality Healthcare. https://www.psqh.com/analysis/joint-commission-portal-addresses-nurse-burnout/?webSyncID=2640b019-b609-27db-a623-44394d50370e&sessionGUID=d6ced981-6027-4277-e974-569973b17762

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thanks Soyoung for your thoughts regarding ethical leadership. Nurses who are ethical are like beacons in the night. For example, I have worked with a lot of nurses who did not honor the Code of Ethics. More specifically, nurses stealing patient medications. Class, describe how medication is administered on your unit.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

A work environment that is stressful and competitive and lacks supportive administration may result in increased occurrences of workplace violence (Kamari, et. al., 2020). Healthcare organizations are responsible for providing a safe environment for its employees and the public (Hemati-Esmaeili, et. al., 2018). Development of policy to address workplace violence must take in consideration the needs and available resources for the organization. Well known problems that contribute to workplace violence include hospital overcrowding, long wait times, shortage of nurses which causes misconception of nurses to be uncaring (Hemati-Esmaekili, 2018). Potential outcomes of workplace violence for healthcare organizations include compromised patient care, nurses’ physical and mental well-being, the resulting short- and long-term absences due to sickness, staff exiting the profession, and the increased organizational costs (Hoyle, Smith, Mahone & Kyle, 2018). These indicators call for need for policymakers to identify prevention strategies for both nurses and healthcare organizations which includes accurate reporting of workplace violence occurrences as well as support for nurses that have experienced violence and aggressive acts (Hoyle, Smith, Mahoney & Kyle, 2018).
Competing Needs that Impact Workplace Violence
Violence towards nurses globally has been referred to as the “the silent epidemic” that may cause serious psychological, physical, emotional, professional, functional, social, and financial consequences (Hoyle, Smith, Mahoney & Kyle, 2018). Competing needs such as adequate staffing may cause a barrier in the ability to diminish workplace violence. Inadequate staffing prevents the presence of the nurse at bedside and development of therapeutic relationships with patients which can result in workplace bullying (Wolfe, 2019). Policy changes that support adequate staffing allows for nurses to pay attention to their patient’s and ensures that the needs of the patient are being met. Supporting adequate staffing is just one example of how competing needs affects workplace violence. Implementing policy to address nursing shortage, long wait times and hospital over-crowding and workplace violence normalization may also have an effect on occurrence of workplace violence.

References

Hemati-Esmaeili, M., Heshmati-Nabavi, F., Pouresmail, Z., Mazlom, S., & Reihani, H. (2018). Educational and Managerial Policy Making to Reduce Workplace Violence Against Nurses: An Action Research Study. Iranian Journal of Nursing and Midwifery Research, 23(6), 478–485. https://doi-org.ezp.waldenulibrary.org/10.4103/ijnmr.IJNMR_77_17
Hoyle, L. P., Smith, E., Mahoney, C., & Kyle, R. G. (2018). Media Depictions of “Unacceptable” Workplace Violence Toward Nurses. Policy, Politics & Nursing Practice, 19(3/4), 57–71. https://doi-org.ezp.waldenulibrary.org/10.1177/1527154418802488
Kumari, A., Kaur, T., Ranjan, P., Chopra, S., Sarkar, S., & Baitha, U. (2020). Workplace violence against doctors: Characteristics, risk factors, and mitigation strategies. Journal of Postgraduate Medicine, 66(3), 149–154. https://doi-org.ezp.waldenulibrary.org/10.4103/jpgm.JPGM_96_20
Wolf, L. (2020). How safe staffing can improve emergency nursing: time to cut the Gordian knot. The Journal of the RCN Accident and Emergency Nursing Association, 28(1), 28–32. https://doi-org.ezp.waldenulibrary.org/10.7748/en.2019.e1928

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Hi Holly! I found your discussion on workplace violence very interesting and sad. There is a report from Australia that found 65% of nurses experience workplace violence (Pariona et. al., 2020). It also found that 60 – 90% of nurses can expect to be a victim to some sort of physical or verbal abuse in the workplace. In most healthcare organizations it is the Human Resources Department (HR) that overseas the compliance and policies related to workplace violence and it has been found that they do not do enough, which effects the mental health of it’s nurses. More resources must be utilized in order to decrease this global healthcare issue. Workplace violence is responsible for staffing shortages, due to employees who must stay out of work due to injuries or do to leaving their job because of the violence (Blando et. al., 2020). It also contributes, as you mentioned, to increased stress levels, along with lower productivity, patient satisfaction, and patient outcomes. One major competing need is money and profit driven management models. In order to provide a safer work environment, it has been shown that money must be spent on things such as qualtily security programs, designing the workspace to reduce risk, installing panic buttons, and increasing lighting. Policies must be put in place that provide a safe work environemnt for healthcare workers. At the federal level, there is bill that was referred by the Senate to the Committee on Health, Education, Labor, and Pensions on November 21, 2019 titled H.R. 1309, Workplace Violence Prevention for Health Care and Social Service Workers Act (H.r.1309 – 116th Congress (2019-2020): Workplace Violence Prevention for Health Care and Social Service Workers Act, n.d.). The main responsibility of this act is require the Department of Labor to address workplace violence; to develop a comprehensive plan to protect healthcare workers. More must be done, individual organizations must implement policies to address this issue and leadership must be willing to budget for the expense it takes to protect their workers.

References

Blando, J. D., Lou Ridenour, M., & Hartley, D. (2020). Surveys of workplace violence
perceptions, prevention strategies, and prevalence of weapons in healthcare
facilities. Journal of Healthcare Protection Management, 36(2), 76–87.
https://search-ebscohost- com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=145969768&site=ehos t-live&scope=site
H.r.1309 – 116th congress (2019-2020): Workplace violence prevention for health care and social service workers act. (n.d.). https://www.congress.gov/bill/116th-congress/house-bill/1309
Pariona, C. P., Cavanagh, J., & Bartram, T. (2020). Workplace violence against nurses in health
care and the role of human resource management: A systematic review of the
literature. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 76(7), 1581–1593.
https://doi-org.ezp.waldenulibrary.org/10.1111/jan.14352

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thank you for your response to my post! It is very sad that workplace violence is such an issue. A few years ago, we actually lost a nurse at my organization due to workplace violence. I truly believe that every nurse has or will experience workplace violence in some form. I have only been in nursing for 6 years and can think of several instances where I have experienced workplace violence and even recall feeling very fearful from the expereinces.

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Your post is very interesting; it makes me think now what employers can do to protect their workers from becoming victims of an employee to employee violence. I haven’t experienced this yet, but knowing our working environment is very stressful, and we sometimes tend to lose our temper, and it could happen to anyone of us.
One of the competing needs that I want to talk about is the negligence in hiring or retaining workers when the employer knew or should have known the potential for violence. Performing background screens upon hire in addition to responding immediately and appropriately to risks of violence in the workplace can reduce this liability.
Training should also be provided at all organization levels upon hire and a minimum of annually after that. Recommended topics consist of an overview of the work environment violence prevention plan, consist of recognized risks and control steps; risk elements for specific professions; ways to prevent or diffuse unpredictable scenarios; the place and use of safety devices such as alarm and panic buttons; and other subjects recognized by the employer as appropriate to the particular office (SHRM, 2020).
Another defense companies can use their workers is to develop a zero-tolerance policy toward work environment violence. This policy should cover all employees, clients, visitors, specialists, and anybody else who might contact company personnel (OSHA, n.d.).

References

Occupational Safety and Health Administration. (n.d.). Workplace violence. https://www.osha.gov/workplace-violence
Society for Human Resource Management. (2020). Understanding workplace violence prevention and response. https://www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/workplace-violence-prevention-and-response.aspx

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Hi, Holly:
Workplace violence is a particularly important factor that contributes to nurse burnout, emotional stress, and negatively impacts workforce performance. When a staff member feels unsafe, they are unlikely to perform or may be hesitant to come to work. Those that have experienced workplace violence can suffer from post-traumatic stress disorder (PTSD). Gillespie et al. (2010, p. 182) states that “when initial signs of violence are identified, interventions should be implemented immediately, especially de-escalation techniques” and suggests that workplace violence-prevention training should be implemented annually and semiannually. At my facility, we have a handle-with-care program that educates staff on de-escalation and physical techniques. I believe the de-escalation classes are helpful, but physical skills are not effective. To build physical skills, it takes more than one-hour training for an individual to act upon it in an actual situation unless they have previous martial arts or self-defense training. Another study shows that, “assault management training was associated with less severe injuries” (McPhaul & Lipscomb, 2004, p. 6). Such training may be more effective if it was offered more consistently. It may also be helpful if staff were not working in isolation and had more support at work. Staff needs to look out for each other and notice if a coworker is stressed out. This staff members may need to tap out for a couple minutes away from the situation or unit. This may prevent workplace violence or another situation from developing.

References

Gillespie, G. L., Gates, D. M., Miller, M., & Howard, P. K. (2010). Workplace violence in healthcare settings: Risk factors and protective strategies. Rehabilitation Nursing, 35(5), 177-184. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.942.4217&rep=rep1&type=pdf
McPhaul, K. M., & Lipscomb, J. A. (2004). Workplace violence in health care: Recognized but not regulated. Online Journal of Issues in Nursing, 9(3), 1-14. http://ldihealtheconomist.com/media/nv09.pdf

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Your post is very informative and interesting. Workplace violence has been increasing, especially in the healthcare arena. I was a victim of workplace violence, and it was very frightening. After the incidents, I recall calling out sick because of injury or just not feeling safe to work with the same patient or family. As a health care provider, no one should have to question whether they feel safe at work. Violence, assault, or threats are not acceptable at no cost, especially in an environment where empathy and compassionate care is being administered.
I believe that workers should be able to provide care in a safe and violence-free environment. According to Congess.gov, the purpose of the workplace violence prevention in health care and social service act is to ensure organizations implement and adopt techniques that would prepare healthcare workers to respond appropriately in a violent event (para. 3). I agree that companies should develop a plan to protect healthcare workers by providing employees with proper training and should be renewed annually. Also, I agree that employees should be protected from discrimination and retaliation when reporting violence, threats, or concerns.
“75 percent of 25,000 workplace assaults occur annually in healthcare settings, only 30 percent of nurses and 26 percent of physicians have reported incidents of violence” (Stephens, 2019, para 1). Based on the information gathered, I too believe there is enough evidence to support this bill.

References

Congress.gov. (n.d.) 2019, from https://www.congress.gov/bill/116th-congress/house-bill/1309?q=%7B%22search%22%3A%5B%22h.r.+1309%22%5D%7D&s=1&r=1
OSHA.gov. (n.d.). Workplace violence prevention – Health care and social service workers. https://www.osha.gov/dte/library/wp-violence/healthcare/index.html
Stephens, W. 2019 Violence against healthcare workers: A rising epidemic. https://www.ajmc.com/focus-of-the-week/violence-against-healthcare-workers-a-rising-epidemic

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Thanks Holly and Class, have you ever worked with a nurse who was liked by the staff but she undermined the nurse manager’s authority? For example, the nursing leader wanted feedback about a new schedule reflecting12 hour shifts. One charge nurse spoke highly about the potential change to me but was overheard talking negatively to the staff. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

Finding balance can be a difficult task as nurse leader. Maybe allowing nurses to submit there thoughts anonymously would be the best way to get honest feedback.
Reply Quote Email Author
Hi Holly, great post. I agree that staff is more at risk for workplace violence in a stressful environment. Therefore, it is imperative that healthcare organizations and leaders have policies in place that help against workplace violence. Improving lighting, shortening work shifts, and providing staff with alarms and phones can help decrease workplace violence (Arnetz et al., 2018, p. 2). In order to prevent workplace violence, it is important that staff has the appropriate resources available. I currently work on a mental health unit, and patients tend to be more aggressive when they see inadequate staffing. Which shows that staffing can play a major role in workplace violence.
Workplace violence can lead to decrease in job satisfaction. According to Li et al. (2020), workplace violence can lead to decrease productivity at work and can negatively impact the care that patients receive (p. 1). So, implementing policies that can prevent workplace violence are imperative to have a successful healthcare organization.

References

Arnetz, J., Hamblin, L. E., Sudan, S., & Arnetz, B. (2018). Organizational Determinants of Workplace Violence Against Hospital Workers. Journal of occupational and environmental medicine, 60(8), 693–699. https://doi.org/10.1097/JOM.0000000000001345
Li, Y. L., Li, R. Q., Qiu, D., & Xiao, S. Y. (2020). Prevalence of Workplace Physical Violence against Health Care Professionals by Patients and Visitors: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(1), 299. https://doi.org/10.3390/ijerph17010299

Sample Answer for NURS 6053 Organizational Policies and Practices to Support Healthcare Issues

How Competing Needs Impact the Development Policy?
Competing needs appear within an organization during the attempts of an employee to achieve goals and targets. Management of these needs requires careful planning of resources allocation, hiring of the workforce, and providing quality services to patients. These competing needs impact policy development so that these needs should align with the organization’s policy and advocacy. For example: to provide quality and top of the line service to patients, hospital resources must be abundant; if resources are scarce and limited, then the goals and target might not be met. Sometimes, if the policy is not aligned with the competing needs, plans would be difficult to achieve. Thus, it is important that hospitals must make sure to assign resources to the competing needs in the order of importance during the creation of policies, which in turn will assist the company in meeting its goals.

Competing Needs that may Impact Opioid Overdose Management
Public stigma is driven by stereotypes about individuals with opioid use disorders, such as their viewed dangerousness or viewed ethical failings, which equate to negative attitudes toward individuals with opioid usage disorders (Tsai et al., 2019). Many words related to substance use disorder stigmatize and use those words to avoid people who need treatment from seeking assistance. When they establish social connections, people with substance abuse conditions and individuals in recovery are more most likely to seek substance abuse treatment and preserve sobriety. Isolation, prejudice, and discrimination are obstacles to social addition (Michigan.gov, 2020). When people with opioid usage disorders internalize or prepare for the general public stigma connected to their illness, disengagement from care leads to poorer health results.

How might Policy Address the Competing Needs?
Provided the complexity of modern health care environments, nurses must be able to recognize and resolve ethical problems as they occur. Ethical awareness includes identifying all nursing actions’ ethical implications and is the initial step in moral action. This means that nurses should first acknowledge the possible consequences of their actions to solve problems and address client requirements efficiently (Milliken, 2018). Increase staff responsiveness to help-seeking through organizational commitment, awareness-raising, and skills development. This includes methods to reward and develop staff abilities, understanding and motivation; countering stigmatization; addressing personnel self-confidence, and guaranteeing all patients are evaluated for drug disorders. Strategies are drawn from the management literature and involve building an organizational culture that incorporates responsiveness to drug concerns as part of the core company and organizational identity (Australian Family Physician, 2013). Health system policies must also ensure that all personnel preserves patients’ dignity with substance use disorder, beginning with communication standards that avoid stigmatizing language.

References

Australian Family Physician. (2013). Obstacles to alcohol and drug care. Royal Australian College of General Practitioners, 42 (5). https://www.racgp.org.au/afp/2013/may/obstacles-to-alcohol-and-drug-care/
Michigan.gov. (2020). End the stigma. https://www.michigan.gov/opioids/0,9238,7-377-88148-512727–,00.html
Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: The Online Journal of Issues in Nursing, 23 (1), Manuscript 1. DOI: 10.3912/OJIN.Vol23No01Man01
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
Tsai, A. C., Kiang, M. V., Barnett, M. L., Beletsky, L., Keyes, K. M., McGinty, E. E., Smith, L. R., Strathdee, S. A., Wakeman, S. E., & Venkataramani, A. S. (2019). Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS medicine, 16(11), e1002969. https://doi.org/10.1371/journal.pmed.1002969
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Sample Answer for NURS 6053 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