NRSG 310 Unit 4 Individual Project

The Healthcare sector and patient care settings have the sole purpose of improving patient outcomes. As such, the stakeholders are usually actively looking into strategies that can be used to improve patient outcomes. While some of these strategies revolve around patient care and management practices, some concern staffing issues such as nursing staff turnover, motivation, and the state of the working conditions (Wan et al., 2018). The implication is that change initiatives are usually necessary to enable the implementation of various interventions that can help in solving various clinical problems that negatively impact patient care. The organization’s leaders should, therefore, always be alert to accurately identify what changes are appropriate so that they can formulate effective strategies to help solve the identified clinical issues (Moussa et al., 2019). Therefore, the purpose of this assignment is to identify the needed change in the workplace. Various aspects will be explored, including; the change description, change implications for nursing, the change impacts on the quality of care and safety concerns for the patients, and the implementation of the change.

Change Descriptions

As earlier pointed out, change is necessary for healthcare organizations to help improve patient outcomes. Therefore, the considered change at the facility is to implement new programs to help improve patient outcomes. It has been noted that there have been increasing rates of nurse turnover at the facility. Such high rates of nurse turnover have seriously impacted patient outcomes (Antwi & Bowblis, 2018). High rates of nurse turnover are a healthcare phenomenon where nurses leave the work positions to go to other apparently better facilities in search of greener pastures, change careers to go for other careers that they consider less stressful, or just quit working in the facility for the sole reason of being overwhelmed.

High rates of nurse turnover are connected to various negative impacts. The phenomenon impacts the healthcare facility, the nurses,

and the patients. When there are high rates of turnover, the hospital has to spend more money on having higher staff. The implication is that the facility has to frequently spend on training the new staff for them to perform at their best in the new environment. In the end, the facility overspends on hiring staff (Antwi & Bowblis, 2018). The other problem is the nurses left working in the facility are likely to experience burnout which further compounds the problem. When there is burnout, there is an increased possibility of medical errors, which result in patient harm hence compromising their safety. Nursing staff turnover also compromises the care services offered to patients as the resulting shortage of staff leads to some patients not being given enough time and attention. Such an occurrence can easily lead to the patient’s condition deteriorating.

The nursing issue needs a nursing intervention that is likely to solve the issue and ensure the nurse turnover rates are lowered. Several reasons can lead to high nurse turnover, chief among them is working conditions (Dewanto & Wardhani, 2018). Therefore, it is important to start with an evaluation and find the cause of the increasing trend of high cases of nurse turnover. The evaluation is key in determining the most appropriate intervention to use. As such, the targeted intervention is the use of motivation and empowerment programs. Motivation and empowerment programs have been shown to improve nurse retention rates. Therefore, the nature of change will entail changing the organization’s current operations where there is a lack of effective programs to promote nurse retention and reduce nurse turnover rates.

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Change Implications for Nursing

The targeted change has various implications for nursing. For example, the implementation of the motivation and empowerment programs will mean that the nurses will have to participate in the initiated programs to help fight the current problem. It is also expected that nurses will have a chance to air their grievances which could lead to incidences such as work dissatisfaction and the urge to quit the organization. The proposed change is also expected to impact nursing since the nurse leaders and executives will need to support the motivation and empowerment programs for the programs to succeed (Smith, 2018). The implication is that the organization may have to set up a committee to come up with the most appropriate motivation and empowerment programs applicable to the setting. There is also a possibility of outsourcing expertise to bring in individuals who can best handle the motivation and empowerment programs to make the program a success. As such, the organization may have to spend more if that is the case.

Change Impact on Quality of Care and Safety Concerns for Patients

The proposed change is also expected to impact the quality of care and safety concerns for patients. As earlier indicated, high rates of nurse turnover may lead to deteriorating patient care services as the less number of nurses left to attend to the patient could face burnout, hence poor patient services. Poor patient treatment and management practices mean that there are higher chances of increased medical and medication errors, possible patient falls, and enhanced rates of hospital-acquired infections and other possible problems (Kurniawaty et al., 2019). However, with the change implementation, it is expected that there will be reduced rates of medical errors since there will be enough nurses to control burnout and manage the patients better. Improved patient services will also mean that the patients will be more confident with the facility and be calm, knowing that they will not have to be impacted by possible medical errors and other negative impacts brought about by the high rates of staff turnover.

Implementation Plan for The Change

Implementation is one of the most important phases of change implementation. During this phase, the actual intervention is put into practice to help bring the expected or the desired change. Therefore, it is important to formulate an implementation plan(Melnyk & Fineout-Overholt, 2019). The setting for this project is our healthcare facility. The facility has nurses in every department. However, the proposed change is to be implemented among the nurses working in the surgical wards. This is one of the departments where the rates of nurse turnover have been considerably high. Therefore, every nurse in this department will form part of the project.

The proposed change should be guided by a timeline. Therefore, the proposed timeline for implementing this project change is six months. The proposed time will be sufficient to enable a systematic implementation of the project. The project may also have financial implications (Melnyk & Fineout-Overholt, 2019). For example, as part of motivation, some money may need to be given to the nurses upon performing some duties at a specific level. In addition, the facility may need to outsource experts in the motivation and empowerment of staff. As such, all these have to be included as part of the overall budget.

There are also possibilities of facing challenges and barriers during the implementation process. As such, plans should be put in place to overcome such. One possible barrier is the lack of support from the organizational leaders by failing to offer the needed support for the project (Melnyk & Fineout-Overholt, 2019). This barrier can be solved by aligning the project goals with the mission and vision of the facility. Possible resistance to change may also be a barrier. When there is resistance, then there are high chances of the project failing. This may be solved by creating awareness among the individuals to reduce the chances of change resistance.

Conclusion

Change is a common phenomenon in organizations, especially in healthcare organizations where there is always a need to improve patient outcomes. Therefore, it is important to formulate an appropriate change initiative to help improve patient outcomes. This write-up has explored a potential change project to help reduce nurse turnover rates.

NRSG 310 Unit 4 Individual Project References

Antwi, Y. A., & Bowblis, J. R. (2018). The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2), 131-163. https://www.journals.uchicago.edu/doi/abs/10.1162/ajhe_a_00096.

Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC nursing, 17(2), 1-7. https://doi.org/10.1186/s12912-018-0317-8.

Kurniawaty, K., Ramly, M., & Ramlawati, R. (2019). The effect of work environment, stress, and job satisfaction on employee turnover intention. Management science letters, 9(6), 877-886. http://dx.doi.org/10.5267/j.msl.2019.3.001.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.

Moussa, L., Garcia-Cardenas, V., & Benrimoj, S. I. (2019). Change facilitation strategies used in the implementation of innovations in healthcare practice: a systematic review. Journal of Change Management, 19(4), 283-301. https://doi.org/10.1080/14697017.2019.1602552.

Smith, J. G. (2018). The nurse work environment: Current and future challenges. Journal of Applied Biobehavioral Research, 23(1), e12126. https://doi.org/10.1111/jabr.12126

Wan, Q., Li, Z., Zhou, W., & Shang, S. (2018). Effects of work environment and job characteristics on the turnover intention of experienced nurses: The mediating role of work engagement. Journal of Advanced Nursing, 74(6), 1332-1341. https://doi.org/10.1111/jan.13528