DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Sample Answer for DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053 Included After Question
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
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 (1-2 pages):
Developing Organizational Policies and Practices
Add a section to the 2-3 page paper you submitted in Module 1. The new section should address the following in 1-2 pages:
- 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.
- Due to the nature of this assignment, your instructor may require more than 7days to provide you with quality feedback.
BY DAY 7 OF WEEK 3
Submit your revised paper.
SUBMISSION INFORMATION
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- To submit your completed assignment, save your Assignment as WK3Assgn_LastName_Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
A Sample Answer For the Assignment: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Title: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Healthcare Issue
As nurses we’re faced with ethical dilemmas daily. We must not confuse ethics and the actual laws surrounding this profession. Although ethics and the law are very similar and paths overlap, they are not the same. Ethical dilemmas occur quite frequently in the healthcare field, which makes healthcare professionals more aware of how to respond to such events. Ethical issues put all healthcare professionals in the mindset of doing what is best for the patient. A national healthcare issue that is currently on a higher trend seems to be the nursing shortage in the work field. Overwhelming patient assignments ultimately lead to disgruntled staff affecting the overall working environment. The shortage in nursing many organizations are facing seem to have multiple effects on quality improvement or indicators such as customer service scores, increased amount of workloads and a decrease in the quality of care rendered (Buerhaus, Skinner, Auerbach, & Staiger, 2017). As safety is the number one goal inpatient care, polices over time have been revamped to ensure safer working environments for the shortage of nurses ultimately reducing medication errors as well as nurse burnout. Moreover, whereas patient needs dictate that hospitals should hire more nurses, the financial performances of these hospitals is also a factor. Thus, nursing shorateg is being affected by the need to provide quality health care services vis-à-vis the need to maintain heallty financial performances by health care facilities. Evidence suggests that hospitals have chosen the latter need hence the existence of nursing shortage.
Policies and Practices to Address Nursing Shortage
At a leadership level, leaders must find the common balance to retain nurses by any means necessary while also understanding the demands placed on staff with unbearable patient acuities. Finding such balances demand strict policies to be put in place even if they are state-regulated. Within my organizations, we have strict policies for the different levels of care to determine the patient/nurse ratio (Abhicharttibutra et al., 2017). With the higher demands of needs for the care the patient may require they are put on different units, which also sets the bar for the nurse-patient ratio. A patient at a medical-surgical level of care does not and may not require the same care as a patient at an intensive care unit. For each level, there are guidelines our hospital follows, which will tell providers, managers, and patient flow coordinators the needs of the patient and the appropriate floors. This is done to ensure the acuity levels are not too intense for that unit, especially for the nurse-patient ratio on that unit. Along with setting limits regarding the units and patient level of care, there are also patient acuity tools utilized. Patient acuity tools have been proven useful with the formulation of proper nurse to patient ratios as well dispersing workloads. The purposes for nursing
tools as such “increase nurse satisfaction with their patient assignment.”
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Composing policies is done at many organizations and is forever changing. With established policies, the healthcare field is able to have standards in place to protect staff. Furrther, by enforcing these policies, nurses are protected from things such as assuming care of patients in what may be unsafe working environments. The American Nurses Association (ANA) is the safeguard for nurses and guides the policymakers within organizations for safe conditions. According to the ANA, federal regulations have been in placed to support nursing staff for safer working environments implying that facilities have an adequate amount of staff for patient care. The goal of policies and laws as such are necessary for the ensuring safety of the patient as well as safe workloads (Ferrer et al., 2014). Currently, there are a few states with staffing laws which is remarkable because by law that nurse is protected. The main strengths of staffing laws are that they help in enhancing the number of nurses employed annually in the healthcare sector, hence reducing patient-nurse ration in addition to protecting the rights of nurses for better healthcare (Yang, Hung, & Chen, 2015). However, the main obstacle towards this policy is that some states have failed to implement staffing laws, which makes it very hard to track down the hiring frequency and the total number of nurses in that state. As a result, the quality of healthcare tends to be affected negatively. Within such states, items such as patient acuity tools are used to help with facilitating fair-shared assignments amongst staff.
Ethical Considerations
One ethical issue when dealing with policies aimed at solving nursing shortage the laws on aging nurses and retirement. Healthcare facilities are faced with the hard decision of how to reduce the nursing shortage when the majority of nurses will be retiring in a few years. Many healthcare organizations have come up with strategies to work with nursing schools in the country where students will get absorbed after studying. It is however difficult for health institutions as they want to retain experienced nurses (Ferrer et al., 2014). Some of the policies that should address the nursing shortage should look at how the nurses are hired and the intervals of hiring to prevent the massive exit of nurses due to retirement such as the staffing laws. Aging nurses have the experience and expertise to provide quality health services. Experience in nursing will help in observing the principle of doing no harm. Experienced nurses will do little or no harm to patients. It is therefore important to consider the nursing principle of nonmaleficence when addressing the issue of nursing shortage in the country. Additionally, offering subsidized funds for students and nursing faculties will also help in solving the nursing shortage (Abhicharttibutra et al., 2017). This will help in increasing the enrollment of more students into nursing. Loan programs with no interest will also be initiated in nursing schools for registered nurses who want to enroll in advanced nursing courses. Consequently, increasing using wages will also attract more students to nursing school, which will, in turn, increase the number of nurses in the entire state
Recommendations
Given the community gap in understanding the nursing profession, improving the image of nursing in the country, by encouraging
nurses to frequently communicate with the press on positive nursing aspects will help to attract more students to take up nursing courses hence curbing the nursing shortage. Consequently, nurses should be encouraged to mentor students and lure the younger generation into taking up nurses courses. It is also necessary to launch nursing professionals’ advertising campaigns through social media platform, which will support the profession. It is also important for the supervisors in health care facilities to be encouraged to offer physical and psychological support to the workers. The supervisors should also be trained frequently to improve their supervisory skills. The knowledge imparted to them during the training will include treatment of the staff favorably, being friendly to the staff and encouraging team building (Nantsupawat et al., 2017). Positive impacts of nurses will be acknowledged through recognition. A chance for the nurses to voice their view and take part in policy-making activity will be in cooperated in all healthcare facilities. As such, the nursing working environment will be friendly hence retaining most nurses in their jobs and attracting young students towards joining the profession in future. A good example is a work that has been accomplished by the America Nursing Association in protecting the rights of nurses and enhancing ethical observation in the nursing profession which has greatly led to an increase in the number of nurses in the country (Abhicharttibutra et al., 2017). The organization has also initiated several training programs and scholarships which has attracted more young generation to study nursing which will completely abolish the issue of nursing shortage in future.
References
Abhicharttibutra, K., Kunaviktikul, W., Turale, S., Wichaikhum, O.-A., & Srisuphan, W. (2017). Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review, 64(1), 22-32.
Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four Challenges Facing the Nursing Workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.
Ferrer, J., Boelle, P. Y., Salomon, J., Miliani, K., L’Hériteau, F., Astagneau, P., & Temime, L. (2014). Management of nurse shortage and its impact on pathogen dissemination in the intensive care unit. Epidemics, 9, 62-9.
Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O.-A., Thienthong, H., & Poghosyan, L. (2017). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review, 64(1), 91-98.
Yang, P.-H., Hung, C.-H., & Chen, Y.-C. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing.
A Sample Answer 2 For the Assignment: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Title: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Burnout among nurses compromises the quality of health-care services patients receive. The evidence-based practices require that nurses engage with their patients and create a friendly environment to identify their needs and develop better treatment measures. Besides, they have to take an adequate history of the patients and make accurate diagnoses. On the other hand, nurses experiencing burnout will not have the urgency to interact with the patients because they feel undervalued and insignificance. Various factors contribute to the burnout experiences among the nurses. Some of the factors include a poor working environment and relationship with the leaders. Alternatively, the increasing number of patients with chronic illnesses increases the demand for nursing services. Also, patients with terminal illnesses require palliative care which is dependent on the holistic care approach. Such environments cannot be achieved with the high incidence of burnouts among the nurses. Therefore, addressing the health issue will be important progress to improving the quality of life of the nurses and the quality of healthcare services patients receive.
Two Competing Needs Impacting Your Selected Healthcare Issue/Stressor
The previous analysis focused on improving the healthcare worker’s work-life in the University Of Florida Shands Hospital. The competing needs that could impact the burnout issues in the hospital include the need to improve leadership and management in the organization, the need to develop a collaborative culture that allows healthcare providers to share ideas widely and improve the patients’ management. Also, there is a need to promote nursing informatics in the institution, which will significantly improve the quality of healthcare services the patients receive. The healthcare system is dynamic and this means that the needs will also change from time to time. However, the ability of the healthcare institution to handle the needs as they arise depends on the leadership practices.
Furthermore, poor leadership contributes to a poor working environment, which ultimately contributes to high burnout among the nurses. As a result, there is an urgent need to embrace transformational leadership and a culture of collaboration in the institution. The leadership and cultural system will create a sense of belonging and so reduce the turnout rate as well as burnout incidences among the nurses. Furthermore, nursing informatics needs to aim at linking the patients to the healthcare providers and utilizing the available data to improve the quality of healthcare services the patients receive. It may appear futile to increase the number of nurses or even offer counsel when their working environment is unconducive. Integration of an automated data management system will allow the nurses to access the patients’ data and link with other departments easily and so minimize the time taken to attend to a patient.
Relevant Policy or Practice in Your Organization That May Influence Your Selected Healthcare Issue/Stressor
The policies for addressing the healthcare issue in the organization include the increased use of an outside agency to supply the nurses, offering of counseling programs, shifting the 12 hours of work to 8 hours in a day, and offering preceptors for each new employee during the training. The policies aim to improve the nursing experiences and making them more productive in the duties. The policy on increasing the nurse supply and reducing the ratio of patients to nurses will prevent overload and so allow the nurses to spend adequate time with their patients (Boamah et al., 2016). Inadequate supply of the nurses results in overload and prolonged working hours because of the ever ballooning number of patients.
On the other hand, the counseling programs seek to deal with the psychological concerns of the patients. Burnout is characterized by emotional and psychological exhaustion with the victims having low energies to deliver in their areas of responsibilities. Therefore, offering counseling services will help in identifying other factors likely to be contributing to burnout and how to address them. Furthermore, reducing the working hours from 12 to 8 hours means that the nurses will have time to rest and engage in social activities. Also, their levels of fatigue will reduce significantly (Liu et al., 2019).
Critique The Policy for Ethical Considerations
The policies and practices support the ethical principles guiding the healthcare practice. The goal of healthcare delivery is to promote healthy living and reduce suffering among patients. On the other hand, it may be impossible to reduce suffering among patients when the healthcare providers are suffering. Therefore, the practices aimed at improving the quality of life for the nurses and giving them the freshness to handle patients’ needs accordingly. Also, the policies support the ethics of justice. On the other hand, some of the policies regarding the promotion of ethics include discrimination in recruitment by external agencies. Furthermore, the counsellors could provide bias information or rather use the nurses’ data against them. The effectiveness of the counselling sessions depends on the transparency and openness between the nurses and their counsellors. There are cases where nurses may outline specific relating to the organization’s management. Lack of confidentiality from the counsellor could lead to exposing the nurses and affecting their working relationships further.
Policy or Practice Changes Designed To Balance The Competing Needs Of Resources, Workers, And Patients
The organization should embrace open forums where both the leaders and nurses can share their ideas and opinions on the work process. The policy will help in balancing the need to address nurse burnout and the leadership approaches in the organization. The forums will promote the transformational relationship between the nurses and the leaders and so facilitate quality healthcare delivery. Recruiting transformation leaders or rather offering training may require additional resources. Similarly, adding the number of nurses in the organization will require more financial input. However, creating open forums and regular meetings will help in devising collaborative methods to address the nurses working conditions and improve leadership experiences. Burnout is not always about inadequate staffing; however, employees’ experiences and interactions with the organization plays an important role.
According to Asif et al. (2019), transformational leaders seek to understand the experiences of the nurses and work with them to overcome the challenges. The regular interaction between the leaders and the nurses allows frequent communication and sharing of ideas that alleviate the burnout experiences among the nurses (Wu et al., 2020).
Conclusion
Finally, burnout is a serious concern in healthcare delivery. Proper policies should be developed to improve the working experiences of the nurses and allow them to offer quality healthcare services to the patients. There is a need to increasing the nursing staff, reduce the working hours and offer counselling services; however, the hallmark approach to burnout incidences is improving the leadership practice and working environment which stimulates passion for work among the nurses.
References
Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito, N. (2019). Linking transformational leadership with nurse-assessed adverse patient outcomes and the quality of care: Assessing the role of job satisfaction and structural empowerment. International Journal of Environmental Research and Public Health, 16(13), 2381. https://doi.org/10.3390/ijerph16132381
Boamah, S. A., Read, E. A., & Spence Laschinger, H. K. (2016). Factors influencing new graduate nurse burnout development, job satisfaction, and patient care quality: A time-lagged study. Journal of Advanced Nursing, 73(5), 1182-1195. https://doi.org/10.1111/jan.13215
Liu, C., Liu, S., Yang, S., & Wu, H. (2019). Association between transformational leadership and occupational burnout and the mediating effects of psychological empowerment in this relationship among CDC employees: A cross-sectional study. Psychology Research and Behavior Management, 12, 437-446. https://doi.org/10.2147/prbm.s206636
Wu, X., Hayter, M., Lee, A. J., Yuan, Y., Li, S., Bi, Y., Zhang, L., Cao, C., Gong, W., & Zhang, Y. (2020). A positive spiritual climate supports transformational leadership as means to reduce nursing burnout and intent to leave. Journal of Nursing Management, 28(4), 804-813. https://doi.org/10.1111/jonm.12994
A Sample Answer 3 For the Assignment: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Title: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Healthcare organizations focused on delivering high-quality patient care usually have various ongoing activities at any occasion of different project lengths that require different investments of human and financial resources. The activities often conflict, potentially hindering the organization’s success due to competing needs. However, health organizations can balance the competing needs by planning strategically, setting goals, constant communication, and utilizing supportive tools (Gaim et al., 2018). Nursing shortage is the identified national healthcare stressor. The purpose of this paper is to explore the competing needs that impact nursing shortage, discuss practice in the organization that impacts nursing shortage, and recommend a practice change that can balance the competing needs.
Competing Needs Impacting Nursing Shortage
Nursing shortage is measured in connection with a healthcare organization’s staffing levels, available resources, and approximates of health care demand. The gap between the currently available workforce and the target for a higher level of workforce provision is defined as a shortage (Marć et al., 2018). The competing needs affecting the nursing shortage in the organization include patients’ healthcare needs and financial needs for the organization’s projects. There is an increasing need for high-quality healthcare among patients, which creates a high workload for nurses. With the increased aging population characterized by a high prevalence of chronic illnesses, patients need nurses to provide high-quality care (Marć et al., 2018). The patients’ healthcare demands have significantly created the nursing shortage in healthcare organizations. Furthermore, the increasing healthcare needs cause fatigue and burnout among the current workforce resulting in high turnover, which results in further nursing shortage.
The financial needs for an organization’s ongoing projects are another competing need impacting nursing shortage in organizations. Limited financial resources significantly contribute to the nursing shortage since healthcare leaders are required to allocate resources based on priority needs (Marć et al., 2018). Competing needs occur when leaders are forced to choose if to prioritize financial resources to hire more nurses or to use the resources for projects such as infrastructure and purchasing medical commodities. Besides, competing needs arise when leaders have to choose whether to use the limited financial resources as financial incentives for nurses or utilize the resources in other projects (Marć et al., 2018). Choosing the latter option results in inadequate motivation from the organization causing low job satisfaction, high turnover, and eventually nursing shortage.
A Practice in My Organization That May Influence Nursing Shortage
Mandatory overtime is a practice in my organization that may influence nursing shortages. The organization has seen a dramatic increase in leaders using mandatory overtime as a staffing tool. Mandatory overtime is an unsafe staffing practice that is commonly used to address the nursing shortage. Nurses are forced to work extra shifts because of inadequate staffing resulting in high burnout levels and job turnover, further worsening the shortage issue (Son et al., 2019). Besides, mandatory overtime negatively affects patient care since it is attributed to increased cases of medical errors and missed nursing care, resulting in poor patient outcomes and high healthcare costs. Nurses are involved in numerous activities during a single shift, including admitting patients, administering medication, conducting patient assessments, implementing nursing care interventions, and discharges. The duties cause physical and psychological fatigue such as muscle, joint, and back pains, high anxiety levels, depression, and sleep disturbances (Santana et al., 2020). The fatigue and negative health effects of long working hours from mandatory overtime shifts have been associated with a high nursing turnover rate secondary to low job morale. Furthermore, the negative effect on nurses’ health has caused a high rate of sick offs, which further causes a nursing shortage.
Ethical Considerations of the Practice
Mandatory overtime practice aims to meet the nursing staffing needs necessary to meet patient healthcare needs, thus promoting the best health outcomes. Mandatory overtime ensures that adequate nurses attend to patients at every shift, which ensures all interventions are implemented and promotes patient satisfaction. Therefore, the strength of the practice in promoting ethics is seen in ensuring patients receive the needed nursing care to promote better health outcomes (Son et al., 2019). The practice upholds beneficence by ensuring that there are enough nurses to meet patients’ needs at any shift and thus promote the best patient outcomes.
Nevertheless, the mandatory overtime practice is faced with ethical challenges since it puts patients’ and nurses’ health at risk, thus failing to uphold nonmaleficence. Extended shifts have been linked with increased risks for injury, such as musculoskeletal injuries, cardiovascular symptoms, development of high blood pressure, and high-stress levels due to fatigue and inadequate rest (Santana et al., 2020). The practice makes nurses work extended hours without having sufficient sleep, which is detrimental to their mental health. Inadequate rest and sleep and the ensuing fatigue affect a nurse’s ability to provide optimal patient care, thus affecting the quality and safety of patient care. Therefore, the practice puts patients’ safety at risk and increases the risk of hospital-acquired complications from poor or missed nursing care (Son et al., 2019). Furthermore, mandatory overtime violates the nurses’ right to make independent decisions on when to work overtime. Although some nurses do not mind working overtime, mandatory overtime is often an intrusion into nurses’ free time. It takes away their opportunity to engage in social life and have a healthy work-life balance (Santana et al., 2020). Besides, nurses hardly ever assess their fatigue levels correctly until they are at a point of being impaired.
Policy or Practice Changes Designed To Balance the Competing Needs
Task shifting is a practice change tailored to balance the competing needs in relation to the nursing shortage. Task shifting refers to a practice in which trained cadres without competencies for specific tasks implement the tasks, thus increasing levels of health care access (Afolabi et al., 2019). Task shifting seeks to offer cost-effective healthcare services by a new cadre of workers when a nursing shortage puts irrational demands on the existing nurses who cannot meet patients’ health needs. For instance, some trained nurses from other countries may not have the credentials to work as registered nurses in the US due to training differences. Task shifting can be applied by employing these nurses as health care technicians or nurses’ aides. It shifts their roles and responsibilities to diverse practices, especially in areas of long-term care (Leong et al., 2021). Besides, the registered nurses can delegate simple tasks to the nurses, thus reducing the workload.
Conclusion
Nursing shortage is a persistent health issue that affects nurses’ ability to provide high-quality care to patients, thus, compromising the safety of care and patient outcomes. It is not only an organizational challenge but also a healthcare challenge since it adversely affects healthcare outcomes. The competing needs affecting the nursing shortage in the organization are patients’ healthcare needs and financial needs for the organization’s projects. Mandatory overtime shifts have adverse health effects on nurses and patients. Task shifting can be introduced in the organization to lower nurses’ workload, thus reducing the associated nursing shortage.
References
Afolabi, O., Abboah-Offei, M., Nkhoma, K., & Evans, C. (2019). Task-shifting must recognize the professional role of nurses. The Lancet Global Health, 7(10), e1328-e1329. https://doi.org/10.1016/S2214-109X(19)30358-4
Gaim, M., Wåhlin, N., e Cunha, M. P., & Clegg, S. (2018). Analyzing competing demands in organizations: a systematic comparison. Journal of Organization Design, 7(1), 1-16. https://doi.org/10.1186/s41469-018-0030-9
Leong, S. L., Teoh, S. L., Fun, W. H., & Lee, S. W. H. (2021). Task shifting in primary care to tackle healthcare worker shortages: An umbrella review. European Journal of General Practice, 27(1), 198-210. https://doi.org/10.1080/13814788.2021.1954616
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2018). A nursing shortage – a prospect of global and local policies. International Nursing Review. https://doi.org/10.1111/inr.12473
Santana, I. R., Montes, M. A., Chalkley, M., Jacobs, R., Kowalski, T., & Suter, J. (2020). The impact of extending nurse working hours on staff sickness absence: Evidence from a large mental health hospital in England. International journal of nursing studies, 112, 103611. https://doi.org/10.1016/j.ijnurstu.2020.103611
Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. International journal of environmental research and public health, 16(21), 4083. https://doi.org/10.3390/ijerph16214083
A Sample Answer 4 For the Assignment: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Title: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Cost of medication determines whether the patients will be willing to seek healthcare services from an institution or not. The goal of the quadruple Aim is to reduce the cost of education and increase the access to healthcare services by the population. The cost of medication depends on various factors including the changing economic times and the need to increase the number of healthcare providers in an organization. From the business perspective, institutions operate with the aim of making profits. Therefore, in the call for improving the quality of the healthcare services the patients receive, the healthcare institutions may require to increase their staffs and other equipment necessary for efficient operations. Addition of the resources result in the increased cost which must be transferred to the patients who are the consumers. Therefore, the current study explores the conflicting perspective of the mandatory overtime as a way of meeting the needs of the patients without increasing the cost of medication.
Competing Needs
The increasing number of patients in the healthcare institution requires an additional human resource. However, conventionally, the ratio of healthcare providers to the patients have remained low because of the limited resources. Healthcare providers are forced to attend to many patients beyond the standard requirements. Alternatively, the healthcare institution may opt to recruit more staff and this will result in additional costs which may be transferred to what patients pay. Some leaders may opt make full of their current staffing in responding to the rising costs and change in the payment policies by the federal government.
The introduction of the pay-for-value compensation method meant that healthcare institution would improve the quality of healthcare services to the patients (Kominski et al., 2017). Besides, the policy aimed at eliminating all the unnecessary health interventions that could otherwise increase the cost of medication. Furthermore, the hospital institutions are forced to utilize their existing staff accordingly to improve both the quality of care and minimize the treatment costs. Nurses and other healthcare providers may be forced to work for long hours since they have to spend lots of time understanding the need of their patients to meet the quality threshold (Bernstrøm et al., 2019). On the other hand, the increasing number of patients also force them to work overtime. Therefore, the need to lower the cost of medication and at the same time maintain the quality.
Relevant Policy Practice
The healthcare organization introduced the mandatory overtime as a way of dealing with increasing demand for the quality healthcare services as well as maintain the cost low. Eliminating the mandatory overtime means that the institution may have to employ more staff and this will result in additional cost of medication. The nursing staffs are expected to work for about 2 hours extra per day to meet the demand for healthcare delivery. The policy was introduced after recognizing that the nurses and clinicians spent little time with the patients and so did not identify all their needs. As a result, the healthcare providers were required to spend enough time and so they would have to work overtime depending on the patients’ flow. Therefore, all the employees recruited in the organization were made aware of the mandatory overtime requirement whenever requested.
Critique of the Policy
The policy was developed to respond to the need to improve the quality of healthcare services to the patients. The introduction of the pay-for-performance means that the healthcare institutions would be compensated based on the patients outcome and not the services offered. As a result, the institution had to develop an approach of responding to the need without increasing the costs of medication to the patients. Nurses and clinicians would spend more time with their patients and understand all understand the underlying factors that could impact their treatment outcomes and this would lead to better outcomes.
However, exposing the healthcare providers to long-working hours could leads to injuries and emotional exhaustion. Studies have indicated that burnout among the employees in healthcare sector is attributed to the long working hours (Kowalczuk et al., 2020). It is ethically wrong to expose the healthcare providers to health risks with the intention of reducing the medication costs (Moon et al., 2020). The quadruple Aim advocate for both the better outcomes for the patients and improved quality of life for the healthcare providers. Mandatory overtime for the healthcare providers does not improve their quality of life but instead increases their risk of developing burnout.
Furthermore, studies show that fatigued employees are prone of making errors and this means that the patients could suffer more from the medication errors (Salen & Norman, 2018). The policy in the institution is only suitable for short-term goal but destructive in the long-run. All healthcare providers must be treated with dignity and be given enough time for rest. Therefore, while the goal of the policy was to address the issue of rising costs, it could increase the costs because of the frequent recruitment requirement due to high employees’ turnover in the organization. High turnover rates could compromise the quality of the healthcare delivery to the patients farther.
Recommendation
The healthcare organization can use other policies to improve the quality of healthcare services in the organization other than the mandatory overtime. The healthcare institution can introduce the electronic health system that will allow the healthcare providers to interact with their patients virtually and so reduce their need to go to the hospitals. The electronic health system will increase interaction between the healthcare providers and their patients as well as improve the level of patients’ commitment in managing their health (Sprivulis, 2020). Eventually, the pressure to attend to many patients in the hospital will reduce as the quality of treatment improves. In addition, the cost of medication ill improve significantly (Sanyal et al., 2018).
The healthcare providers will work with the community health volunteers in offering the healthcare services to the patients at home. The policy will promote better treatment outcomes which will improve the quality of life for the healthcare providers. Furthermore, the healthcare providers will be motivated to offer their best in interacting with the patients.
Conclusion
The rising cost of medication following the Medicaid and Medicare programs present a significant challenge to the healthcare delivery process. The introduction of pay-for-value compensation aimed at making the medication costs affordable. However, the increase in the number of patients seeking healthcare services exerts a significant pressure on the limited number of healthcare staff. The introduction of the mandatory overtime is one of the ways of ensuring the healthcare providers offer quality services to all patients. However, the policy presents more harm to the healthcare providers’ health. The electronic health systems can be deployed by healthcare institutions to minimize the need for the patients to visit the hospital and improve the treatment outcomes.
References
Bernstrøm, V. H., Alves, D. E., Ellingsen, D., & Ingelsrud, M. H. (2019). Healthy working time arrangements for healthcare personnel and patients: A systematic literature review. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-3993-5
Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38(1), 489-505. https://doi.org/10.1146/annurev-publhealth-031816-044555
Kowalczuk, K., Krajewska-Kułak, E., & Sobolewski, M. (2020). Working excessively and burnout among nurses in the context of sick leaves. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.00285
Moon, S., Mariat, S., Kamae, I., & Pedersen, H. B. (2020). Defining the concept of fair pricing for medicines. BMJ, l4726. https://doi.org/10.1136/bmj.l4726
Salen, P., & Norman, K. (2018). The impact of fatigue on medical error and clinician wellness: A vignette-based discussion. Vignettes in Patient Safety – Volume 2. https://doi.org/10.5772/intechopen.70712
Sanyal, C., Stolee, P., Juzwishin, D., & Husereau, D. (2018). Economic evaluations of eHealth technologies: A systematic review. PLOS ONE, 13(6), e0198112. https://doi.org/10.1371/journal.pone.0198112
Sprivulis, P. (2020). Connecting health care through information technology. Patient Safety First, 299-317. https://doi.org/10.4324/9781003116677-14
A Sample Answer 5 For the Assignment: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
Title: DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES NURS 6053
The competing needs of the workforce, resources, and patients must be considered in healthcare policy and development. The workforce is a critical component of healthcare delivery that may be impacted by policies related to compensation, working conditions, and scope of practice. For example, policies that do not adequately compensate nurses may decrease morale, burnout, and turnover (Duru & Hammoud, 2022). An unsafe working condition could be assigning too many patients to one nurse, resulting in missed care and ethical dilemmas if a nurse causes harm due to an inability to wholly provide care for an unreasonable number of patients (Milliken, 2018). To address the shortage of primary care providers, allowing Advanced Practice Registered Nurses full practice authority is one of the first steps in solving this crisis (Brom, et al., 2018). Full practice authority of Nurse Practitioners is the model recommended by the National Academy of Medicine (AANP, 2022). If a nurse is legally authorized to practice within the full scope of their education and experience, then the regulations limit the benefit APRNs can provide to patients. Nurse Practitioners have proven to provide safe and effective care with outcomes comparable to physicians (Neff et al.). Nurse Practitioners are limited by these regulations when they know they could provide good patient outcomes but are limited in what they can perform. This is why they are constantly advocating for full practice authority.
Resources, including funding and infrastructure, are essential considerations in healthcare policy development. Using cost-effective care often takes precedence over patient-centered care, prioritizing resources towards saving money rather than individualizing care (Kelly & Porr, 2018). Policies that do not provide adequate resources may result in poor access to healthcare services, decreased quality of care, and increased costs. For example, Sentara Healthcare’s mobile care units aid those who do not have transportation to medical appointments, and care centers provide care in low-income areas (HealthLeaders & Cheney, 2022). This funding of infrastructure and transportation resources has increased access to care by individualizing support to those who need it.
Patients are the ultimate beneficiaries of healthcare policies, and policies must consider their needs and preferences. Patients may be impacted by policies related to insurance coverage, access to care, and quality of care. For example, the Affordable Care Act (ACA) Medicaid expansions improved cardiovascular risk factors in low-income populations (Gotanda et al., 2021). It allowed 50 million people to obtain health insurance (Zambrano, 2022). Patients are also affected when nurses and providers do not have enough support to adequately meet individual patient needs, a problem often encountered when the primary focus is on the “business model of healthcare” (Kelly & Porr, 2018).
Overuse of emergency departments can lead to overcrowding, longer wait times, and increased healthcare costs. Overcrowding in the ED increases the risk of death by 34% (Savioli et al., 2022). This can also contribute to burnout in healthcare providers and decreased quality of care. Primary care improves patient outcomes, increases access to healthcare, lowers healthcare costs, and combats disparities (Park et al., 2018).
In conclusion, competing needs such as the workforce, resources, and patients are essential considerations in healthcare policy development. The lack of access to primary care is a significant issue that can contribute to the overuse of emergency departments. Policies that address these competing needs can help to alleviate this issue and improve access to primary care services.
Competing needs like need for sufficient workforce levels to offer quality care services to patients against limited resources can impact healthcare organizations. The competing needs may impact policy development since the agenda advocated by the said policy should align with these aspects. For instance, a policy addressing sufficient levels of workforce and patient safety may require organizations to allocate additional resources to the course to help improve outcomes (Haryanto, 2019). Effective use of available workforce leads to the provision of quality, and cost-effective services to patients to meet their care needs. However, getting sufficient workforce may be difficult due to the resources required leading to a shortage of providers.
Specific Competing Needs and Impact on Nurse Shortage
Nursing shortage is a critical healthcare issue that is affected by an effective fit between an organization’s operating cost and patients’ needs based on the quality and safety of care. As such, organizations are seeking ways to attain a balance between nurse staffing and patient needs. Through this approach, they can sustain operational costs while providing safe and quality care (Livanos, 2018). Organizations should align nursing capacity with the patients’ needs to attain better outcomes. They can attain this by having effective distribution of resources and nurses in all departments thus ensure that the workload is equal among practitioners.
Impact and How Policy can address competing Needs
The amount of workload for each nurse impacts patients’ and staff’s needs. Increased workload also affects working and efficiency of an organization and nurses. These include high vulnerability to adverse events like medication errors due to fatigue and burnout. Nurses may also feel dissatisfied by their jobs leading to high turnover. Organizational policies like hiring of temporary nurses can help address these competing needs (Manz et al., 2021). Such a policy improves nurse staffing levels and ratios to patients leading to optimal care delivery and better patient outcomes.
Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |