Assignment: Developing Organizational Policies and Practices Paper

Assignment: Developing Organizational Policies and Practices Paper

Assignment: Developing Organizational Policies and Practices Paper

Competing needs in healthcare organizations affect their abilities to deal with national health issues or stressors that compromise the quality of care delivery. Employees and leaders compete in healthcare settings based on the need to attain better quality provision and ensure that patients get value for their money, particularly through implementing evidence-based models like value-based care. Nurse burnout is a national health issue because of the adverse effects on nurses, patients, and the entire health care system (Chen et al., 2021). As such, healthcare organizations should evaluate their policies and practices to address nurse burnout while maintaining quality care and ethical standards. The purpose of this assignment is to discuss nurse burnout as a national health issue and the competing needs that hinder organizations from overcoming it. The paper critiques organizational policies on tackling the issue and recommends strategies to balance the competing needs while addressing ethical weaknesses of the current policy.

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Competing Needs Leading to Nurse Burnout

Nurses encounter demanding workloads because of low nurse-to-patient ratios, high patient acuity, limited resources and time that reduces charting shorts or breaks, and increased patient needs and assignments. The two critical competing needs identified in this situation include the attainment of proper or appropriate staffing ratios and the need to offer quality care (Chen et al., 2021). Staffing ratios allow organizations to increase their bottom line since private health facilities focus on profit maximization. However, meeting these needs is a challenge for the health care organization that I work for because of the existing nursing shortage. Nurse turnover contributes to a substantial shortage, with figures showing that it will reach close to 400,000 by 2025 (Brown, 2018). Due to the shortage, burnout is bound to surge, exacerbated by the increasing demand for care and the emergence of infectious diseases like the current COVID-19 pandemic. As such, the organization’s leadership needs to develop interventions to address and manage these competing needs of adequate staffing ratio and patient quality care.

Policies/ Practices to Impact Nurse Burnout

The organization has not instituted sufficient policies to address the current issue. However, practices like innovative approaches through staff scheduling exist, but these are standard interventions that do not substantially affect the issue. Having sufficient staffing numbers can reduce stress among employees, lower the prevalence of burnout associated with overburdened working, and create a better work-life balance for nurses. In their study, Kelly and Poor (2018) observed that enhancing employee well-being and ensuring improved patient care requires organizations to have an effective work-life balance. Through this approach, nurses become more engaged, compassionate, healthier, and well-positioned to offer quality care since they are well-rested.

Lowering the nurse-to-patient ratios is one of the most effective ways to address the problem of nurse burnout. The approach allows nurses to have more time for patients and provide holistic care. The organization also implements hourly rounding, enhancing the patient perception of nurses’ responsiveness in units where such may be a challenge. Hourly rounding also reduces patient falls, uses call lights, and enhances patient satisfaction levels and scores (Garcia; Brosinski & Riddell, 2020). Implementing an hourly rounding program is essential for identifying the “most cost-effectiv eapproach.” The implication is that if a facility integrates these strategies and enhances the quality of care without necessarily raising the cost of care or doing budget cuts, it can address the issue of nurse burnout.

Policy Critique

Ethical considerations are essential for effective care delivery, especially in healthcare organizations when dealing with employee issues like nurse burnout. Leaders in organizations need to balance profits and welfare of healthcare workers to alleviate other issues like nursing shortage which increases the susceptibility to adverse conditions like medication errors (Melnyk & Fineout-Overholt, 2018). Ethical awareness implores organizational leaders to consider the overall good of these practices to nurses and their welfare against profits (Milliken, 2018). Purposeful and systematic hourly rounding offers several benefits that include improved patient satisfaction, patient safety, and quality of care. Nurses can recognize any adverse patient event fast and employ corrective interventions (Hutchinson et al., 2018). Patient safety is a core aspect of human dignity, and providers should take all measures to protect patients. Implementation of hourly rounding is based on ethical principles related to the professional code of conduct as advanced by the American Nurses Association (ANA). Ethical considerations implore nurses and the facility administration to embed hourly rounding to enhance patient dignity through harm reduction and attending to all their needs timely.

Recommendation

The need to address nurse burnout and the competing aspects of quality and appropriate nursing ratios implores the organization to adopt evidence-based practice policies. Among these is the Quadruple Aim framework. The model focuses on enhancing patient experience, lowering the cost of care, improving the health of populations, and enhancing the welfare of healthcare workers, especially nurses. The framework allows organizations to focus on patients, nurses, and even the management (Jacobs et al., 2018). Therefore, implementing this approach would offer a host of benefits to tackling the issue of nurse burnout in the facility by addressing nursing ratios and quality of care.

The facility can implement the model through a systematic approach by focusing on current operations and processes to ascertain that they lead to enhanced efficiency. The approach entails evaluating areas where the organization is not performing well (Melnyk & Fineout-Overholt, 2018). The facility can use change models like Lewin’s change process to identify salient aspects to transform in the current practice of hourly rounding. The facility should integrate these components by identifying and using employees as change agents to make the case of enhanced effectiveness. The Quadruple Aim will help the organization enhance quality, address nurse burnout and improve nurses’ welfare.

Conclusion

Competing needs impact the ability of organizations to deliver quality care. Needs like the quality of care and attainment of appropriate patient ratios compete. They require healthcare facilities and their leadership to use effective interventions that result in quality care provision. The use of hourly rounding has ethical considerations based on its benefits and rationale. Implementing the Quadruple Aim framework will enable the facility to address the issue of nurse burnout while tackling the two competing needs of nurse staffing ratios and quality of care.

References

Brown, S. (2018). The Impact of Resiliency on Nurse Burnout: An Integrative Literature

Review. MEDSURG Nursing, 27(6), 349–378.doi:10.1097/JTN.000000

Brosinski, C., & Riddell, A. (2020). Incorporating hourly rounding to increase emergency

department patient satisfaction: A quality improvement approach. Journal of emergency nursing, 46(4), 511-517.DOI: 10.1016/j.jen.2019.08.004.

Chen, R., Sun, C., Chen, J. J., Jen, H. J., Kang, X. L., Kao, C. C., & Chou, K. R. (2021). A

large‐scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID‐19 pandemic. International Journal of Mental Health Nursing, 30(1), 102-116.DOI: 10.1111/inm.12796.

Garcia, M. G., Dutton, H., Samuel, K., & Marusich, J. (2021). Purposeful hourly rounding to

decrease peripheral intravenous infiltrations and extravasations in pediatrics. Journal of Pediatric Nursing, 61, 59-66.DOI: 10.1016/j.pedn.2021.03.009.

Hutchinson, M., Jackson, D., & Wilson, S. (2018). Technical rationality and the decentering of

patients and care delivery: A critique of ‘unavoidable’ in the context of patient harm. Nursing Inquiry, 25(2), e12225.DOI: 10.1111/nin.12225.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging Employees in Well-

Being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly,(3), 231.DOI: 10.1097/NAQ.0000000000000303.

Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical

and legal aspects of patient’s safety: a clinical case report. Journal of Medical Ethics & Historyof Medicine, 10(15), 1–5.

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.Vol23No01-Man06

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing &healthcare:

A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry”(pp. 7–32).

Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of

Issues in Nursing, 23(1), Manuscript 1. doi: 10.3912/OJIN.Vol23No01Man0

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Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (3-4 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.