NURS6053 Analysis of a Pertinent Healthcare Issue

Assignment: Analysis of a Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

  • Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
  • Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
  • Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

  • Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
  • Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
  • Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

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Solution

Analysis of a Pertinent Healthcare Issue

Introduction

Registered nurses are the largest group of the healthcare workforce in the United States.   Yet, there is a shortage of registered nurses, with most healthcare institutions having inadequate nursing staff.  The shortage of registered nurses is expected to intensify as the need for health care services turnover increases, and the existing registered nurse population age and retire.  The paper analyzes nursing shortage as a pertinent healthcare issue in the United States and strategies organizations use to address this issue.

Nursing shortage and its impact on my organization

There is nursing shortage both at state and national levels According to Zhang et al. (2019), registered nurses play a very important role in the delivery of health care. With the aging population, the demand for health care is increasing at an exceptional rate.  Since 1998, the country has experienced a rise in registered nurse shortage mainly due to the growing elderly population along with the aging and retirement of current nurses. Consequently, the demand for registered nurses continues to surpass the supply of registered nurses, causing an unprecedented deficit of registered nurses in the country.

Nursing shortage has greatly impacted my organization.   In the past year, there has been a 20 percent turnover rate of nursing staff with 15 percent of night shift nurses being temporary nurses.  During these periods of nursing shortage, my organization has difficulty recruiting and retaining nurses. As such, the hospital is using temporary nurses from temporary employment agencies to fill vacancies.  Filling vacancies with temporary nurses is improving the provision of health care services by permitting shorter wait times and ensuring that appropriate nurse-to-patient ratios are met.

A summary of articles on nursing shortage

Zhang and colleagues analyze the causes of registered nurse shortage.  According to Zhang et al.(2018), age is the most important factor in the shortage of nurses because more people are living for sixty-five years and more.  Demand for health care services increases as people age.  Aging of the registered nurse workforce is another important factor contributing to future nursing shortages across states.  With around 50 percent of registered within twenty years of retirement,   registered nurse populations will need higher inflows to maintain increases in the size of nurses in employment (Zhang et al., 2018).

Apart from the aging population and aging of the registered nurse workforce, the recent economic recession along with health care reform will have a great effect on the registered nurse workforce. As the economy of the United States recovers, health care organizations might be forced to reduce their registered nurse workforce by the economic pressure. This may in turn decrease the number of available jobs to registered nurse graduates and discourage prospective nursing students in the coming years.  In the meantime, the recent health care legislation has expanded coverage to more than 31 million individuals who were previously uninsured, increasing the demand for registered nurse jobs and health services. Nevertheless, these laws might also reimbursement to health providers and reduce registered nurse salaries, which might have a negative effect on the number of students wanting nursing as a career (Zhang et al., 2018).

The article by Chen and colleagues analyzes turnover as a contributing factor to the nursing shortage.  High According to Chen et al. (2018), the nursing shortage has become a global issue for numerous years. In the US, it is anticipated that there will be a shortage of 260,000 registered by 2025.  Nursing turnover might indirectly increase the burnout, stress, and workload of the remaining nurses, which prompts turnover intention and thus create a vicious cycle.  Increased turnover contributes to shortage of nurses.   Turnover intention is the behavioral and psychological tendency whereby workers intend to leave their present profession or organization.   Work-related factors linked to turnover intention include work environment, psychological capital, work experience, and family-work conflict (Chen et al., 2018).

Healthcare organizations are addressing nursing shortages by requiring part-time nurses to work full-time and varying working hours for permanently employed.   Also, organizations are employing high-cost temporary nurses to meet the increase in patient demand. Uncertainty on excess capacity, in combination with the need to reduce the cost of staffing, is inducing hospitals to substitute regular nurses for temporary nurses.

The strategies used to address the organizational impact of nursing shortage

Shortage of nursing staff causes inadequate staffing in hospitals.   Low nurse-to-patient ratio makes nurses ration time for care, a practice that is associated with adverse events such as medication errors, healthcare-associated infections, patient falls, and mortality. AS indicated by Griffiths et al. (2018), low registered nurse staffing is linked to the omission of necessary care.  Missed nursing care is any aspect of care that is delayed or omitted in whole or in part.   Enquiries into possibly preventable deaths in hospitals show how omissions by nurses can result in serious adverse events. For instance,  failure to identify early signs of deterioration, measure the vital signs of patients,  provide a sufficient response, and communicate abnormal observation are regularly associated with preventable deaths.

The use of temporary nurses and nurse floating are strategies that health care organizations are using to ensure there are adequate nursing and the right number of available nurses to provide patient care. Floating is moving a nurse from his or her permanently assigned / home unit to another unit due to staffing needs. According to O’Connor and Dugan (2017), floating is a form of resource sharing that healthcare institutions use to resolve nurse staffing shortages.  it is a cost-effective scheme of dealing with changing patient acuities and census. Health care institutions use floating instead of requiring nurses to work on an overtime rate or using agency staffing/ temporary nurses.

Floating may impact my organization positively because it will ensure each unit has adequate qualified nursing staff to work each shift daily. Short staffing leads to care not being provided causing patients and their families to feel dissatisfied and unsafe with the staff.  However, floating can put patients at risk. As indicated by O’Connor and Dugan, (2017) floating nurses to units that they are not familiar with can put healthcare organizations and patients at risk. For nurses, being floated to other units where the needs of patients are dissimilar from those usually encountered in their home unit can evoke frustration, anxiety, and stress and ultimately threaten the safety of patients.

Temporary / travel nurses account for around 30 percent of the nursing workforce in the US.  According to Faller et al.(2017),  travel nurses are employed on a short-term contract period, usually, 2 twenty-six, thirteen or four weeks, and they complete multiple nursing tasks in different regions of the United States.  .  When travel nurses receive their unit assignments and orientation, their role is to assume direct patient duties right away.

The use of temporary nurses may impact my organization positively because temporary nurses may be integral in addressing immediate nursing staff shortages, cost pressures, and changes in patient demand, However, the use of temporary nurses may be a costly solution for my organization, due to substantial changes and increased rates of pay incurred when employing travel nursing staff. Additionally, there are safety concerns connected with the utilization of temporary nursing staff, including potential for less familiarity with the practice of nursing units and disruptions in team communication and continuity of care (Dall’Ora, et al., 2019).

 

References

Chen, H., Li, G., Li, M., Lyu, L., & Zhang, T. (2018). A cross-sectional study on nurse turnover intention and influencing factors in Jiangsu Province, China.  International Journal of Nursing Sciences, 5(4), 396-402. https://doi.org/10.1016/j.ijnss.2018.09.012

Dall’Ora, C., Maruotti, A., & Griffiths, P. (2020). Temporary Staffing and Patient Deaths in Acute Care Hospitals: A retrospective Longitudinal Study. Journal of Nursing Scholarship, 52(2), 210-216. https://doi.org/10.1111/jnu.12537

Faller, M., Dent, B., & Gogek, J. (2017). A Single-Hospital Study of Travel Nurses and Quality: What Is Their Impact on the Patient Experience? Nurse Leader, 15(4), 271-275. https://doi.org/10.1016/j.mnl.2017.03.016

Griffiths, P., Racio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., & Ball, J. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487. doi: 10.1111/jan.13564

O’Connor, K., & Dugan, J. (2017). Addressing Floating and Patient Safety. Nursing, 47(2), 57-58. doi: 10.1097/01.NURSE.0000511820.95903.78

Zhang, X., Tai, D., Pforsich, H., & Lin, V. W. (2018). United States Registered Nurse Workforce Report Card and Shortage Forecast: A revisit.   American Journal of Medical Quality, 33(3), 229-236. doi: 10.1177/1062860617738328.