NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Sample Answer for NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues Included After Question

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.

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 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.

A Sample Answer For the Assignment: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Title: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Becoming ethically aware is critical to nursing care in our complex healthcare environments. Each day in practice, nurses encounter various scenarios dealing with ethical dilemmas and the potential repercussions of their actions (Milliken, 2018). The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements guides the nursing profession’s principles and ethical standards. Milliken (2018) also suggests that nurse leaders can support ethical awareness and practice by focusing on unit-specific issues such as complex patient populations and staffing issues.

Nurses face challenges daily to provide quality care for complex patients with fewer resources. Kelly and Porr (2018) describe how nurses experience displacement of their professional nursing judgment and knowledge when standardized, efficient, and cost-effective care practices are utilized instead of the professional and ethical RN mandate to provide individualized, patient-centered care. Organizations are not necessarily designed to support the Code of Ethics and often desire ways to accommodate and advance savings, accept the organizations’ norms, and maintain the status quo (Kelly & Porr, 2018).

When it comes to the growing provider shortage and its bottleneck effect on emergency departments, one example of competing needs that comes to mind is the lack of incentives or bonus plans for retaining or recruiting staff for shifts. We are often understaffed and experiencing an influx of patients presenting to our emergency department, resulting in increased nurse-to-patient ratios. We are ultimately sacrificing optimal patient care delivery, charting, and follow-throughs due to the highly demanding census, which often feels like a “disaster status” and results in poor work morale and job satisfaction. ANA Provision 6 (2015) emphasizes the importance of a “morally good working environment to ensure ongoing safe, quality patient care and professional satisfaction for nurses and to minimize and address moral distress, strain, and dissonance.”

References

American Nurses Association [ANA]. (2015). Provision 6. In Code of ethics for nurses with interpretive statements (pp. 23–26) [PDF]. Silver Spring. https://www.nursingworld.org/coe-view-onlyLinks to an external site.

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. The Online Journal of Issues in Nursing23(1). https://doi.org/10.3912/ojin.vol23no01man06Links to an external site.

Milliken, A. (2018). Ethical awareness: What it is and why it matters. The Online Journal of Issues in Nursing23(1). https://doi.org/10.3912/ojin.vol23no01man01Links to an external site.

NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

A Sample Answer 2 For the Assignment: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Title: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

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.

Physician supply has been impacted due to the long training times, the capacity of
medical schools, and the lack of residency positions (Auerback et. al., 2018).  Due to the reduced
number of physicians treating patients, we have seen an increase in the number of advanced
practice registered nurses (APRN), especially NPs and physician assistants (PAs) that have
overlapped with the care that physicians provide. Although this has helped address the shortage
of primary care providers and specialists, the restrictions put on NPs in certain states has become
a barrier for them to practice fully and fill the need for more care providers. For instance, in New
York, there are written practice agreements between NPs and physicians (Poghosyan et. al.,
2018). In 2015, New York adopted the Nurse Practitioner Modernization Act that would remove
these practice agreements for NPs that had at least 3,600 practice hours, however sadly it has not
been fully adopted and NPs are still limited in their scope of practice. Texas is another state that
limits NPs practice by requiring that they practice under the supervision of a physician within a

NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues
NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

75-mile radius (Wofford, 2019).  These regulations affect patient’s access to care and do not
assist in achieving the nation’s goal of efficient and cost-effective care for all when limiting the
skill set of less costly providers (Poghosyan et. al,. 2018).
In order to provide better access to care and more cost-effective care, we must adopt the
same full practice authority for NPs in all U.S. states and territories. Giving NPs the right to
practice their skills fully would alleviate the shortage of not only primary care provides but also
specialists, where the access to care is often long.

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A Sample Answer 3 For the Assignment: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Title: NURS 6053 DQ 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.

A Sample Answer 4 For the Assignment: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Title: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

The healthcare systems have to provide the best quality of care to meet the rising demand for such services. The population growth, increasing percentage of the geriatric populations, and the emergence of many chronic illnesses contribute to the high demand for healthcare services. On the other hand, the rising costs of living make life unbearable for many and influence the many cases of mental health issues among the populations. The impact of the high cost of living is also evident in healthcare institutions. The U.S government introduced the Medicare and Medicaid program to increase access to healthcare services by people from low-income families. Such an initiative would increase their access to healthcare services. Besides, government policies on the Medicaid and Medicare programs require healthcare institutions to minimize unnecessary interventions and offer quality healthcare services to their patients. Healthcare institutions are always caught in the competing need to offer high-quality care which may require additional resources and reducing the cost of medication.  

Description of the Competing Needs 

The healthcare institution where I work is committed to offering the best healthcare services to patients. The institution services many people with more of them being from poor backgrounds. The access to healthcare services to the poor families increased courtesy of the Medicaid program. The increasing number of patients visiting the hospital meant that the institution had to recruit more staff. The healthcare institution adopted the patient-centered care delivery approach and this means that they would give adequate time to the patients’ interactions to obtain relevant data for better patient management. Spending more time on a patient was necessary for offering the best quality of care, making the right diagnoses, and minimizing undesirable outcomes in their patients. On the other hand, the approach would require that the hospital recruits more healthcare staff to meet the demand for healthcare services. Therefore, the need to have more staff to offer high-quality services and the need to reduce the cost of the medication will be competing.  

Relevant Policy or Practice 

In responding to the competing need, the healthcare institution developed a policy that would require the healthcare providers to have mandatory overtime. Though the policy would increase the cost of a treatment since the nurses for the overtime; the cost incurred will be less compared to that needed for recruiting other full-time staff. The nurses and healthcare providers are required to attend to all the booked patients in a day. The number of extra hours spent on the work will depend on the patients in the queue. The healthcare providers are compensated based on the number of extra hours worked. The healthcare institution developed the policy as the cheap available alternative for addressing the need to meet the growing number of patients. The policy means that the healthcare institution will still be able to attend to their patients without any going unattended. Besides, the healthcare providers will commit themselves to offer a patient-centered care approach.  

Critique of the Policy 

The mandatory overtime policy in the healthcare institution aims at benefiting the patients and ensuring their needs are addressed accordingly. The patients will benefit because they will have adequate time to interact with the healthcare providers. Furthermore, the healthcare providers will have additional money from the overtime compensation and this may motivate some of them. Employees derive motivation from different things with some having more value on the monetary rewards and this constitutes a major strength to the policy.  

The Healthcare system is highly sensitive because a slight error can even lead to a patient’s death. According to Zaree et al. (2018), the psychological well-being of the healthcare providers influences the quality of the care they deliver to the patients. Healthcare providers experiencing burnout are less likely to offer the best care to their patients. Furthermore, they will lack the moral to interact with their patients in a friendly manner. The healthcare organization must aim at creating a suitable environment that will promote high productivity among the patients. Both patients and healthcare providers are important stakeholders that influence the sustainability of the health organization’s operation. There must be a proper balance between the protection for the patients and the protection for the healthcare providers. The best way for the healthcare institution to promote the healthcare providers’ wellbeing is by ensuring they have a good working environment with all the resources and have adequate time for rest.  

On the other hand, there are significant concerns related to the policy, especially on the healthcare providers’ part. The first concern is that employees should not be forced to work beyond the set working hours. Employees should be allowed to participate in the overtime program voluntarily because some value their families while others require personal time. Forcing all the healthcare providers into the mandatory overtime program means that some will be emotionally and psychologically drained. The emotional and psychological draining reduces the effectiveness of the healthcare providers in their duty delivery. Besides, there could be many cases of burnout and absenteeism arising from the employees who feel fatigued and exploited in their professional practice.  

Furthermore, working for long hours could expose healthcare providers to physical injuries and other healthcare issues. According to Son et al. (2019), overtime is associated with inadequate sleep and fatigue. Also, some of the nurses are likely to have lower back pain because they have overworked. Fatigued nurses or other healthcare providers are prone to medical errors and this could cause more harm to the patients and this is ethically wrong (Milliken, 2018). Therefore, the major ethical concern in the policy is whether it is justifiable to expose the healthcare providers to health risks in the process of promoting the patient’s experiences. The harm presented to the healthcare providers is greater than the benefits emerging from the policy and thus making it unethical (Kelly & Porr, 2018).  

Best Practices 

The need to offer the best healthcare services at an affordable cost cannot be overlooked. The quadruple aim address four issues including promoting the quality of healthcare delivered to the patients, better population health, reduced cost of medication, and better quality of life for the healthcare providers. The increasing number of patients seeking medical services presents a major challenge to achieving the quadruple aim without straining the available resources in the healthcare institutions. However, the use of telehealth can significantly address the challenges because it will reduce the number of patients visiting the healthcare facility. According to Monaghesh & Hajizadeh (2020), the use of telehealth has been effective in managing patients during the Covid-19 pandemic. Adopting the policy will help the healthcare institution serve many patients at a reduced cost.  

The policy will require the healthcare providers to intensify the patient education provided to the patients and equipping them with self-care skills. Patient’s education allows them to take control over their lives and so reduce their dependence on the healthcare providers (Tuckson et al., 2017). Furthermore, the patients will be committed to healthy behavioral practices and so there will be reduced cases of adverse treatment outcomes. Healthcare providers derive happiness when they realize that their patients have recovered and have better health status. On the other hand, high incidences of mortality and poor treatment outcomes affect the healthcare providers’ emotions negatively. The telehealth system will be the best solution to addressing the competing needs in the healthcare institution (Salles et al., 2021). There will be no need for mandatory over time and so the healthcare providers will have adequate time for personal life.  

Conclusion 

Competing needs in healthcare systems are common; therefore, healthcare providers must constantly develop measures to improve the quality of care delivered to the patients and maintain low operational costs. The healthcare institution developed a mandatory overtime policy which is not efficient because of the many adverse outcomes to the healthcare providers. Instead, adopting the telehealth system would be the best policy for addressing the need to reduce costs and improve the quality of care concurrently. The policy will reduce the number of patients visiting the healthcare institutions and so reduce congestion and the pressure exerted on the limited number of healthcare providers. Providing patients’ education will promote independence and this is needed for quality health outcomes.  

References 

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), 6. doi:10.3912/OJIN.Vol23No01Man06.  

Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), 1. doi:10.3912/OJIN.Vol23No01Man01. 

Monaghesh, E., & Hajizadeh, A. (2020). The role of Telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health, 20, 1193 https://doi.org/10.21203/rs.3.rs-23906/v3 

Salles, N., Saillour-Glénisson, F., Sibe, M., Langlois, E., Kret, M., Durrieu, J., Arditi, N., Abraham, M., & Perry, F. (2021). Effectiveness and organizational conditions of effectiveness of telemedicine in nursing homes. A study protocol of a comparative prospective cohort (EFFORT study). DIGITAL HEALTH, 7, 205520762098242. https://doi.org/10.1177/2055207620982422 

Son, Y., 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 

Tuckson, R. V., Edmunds, M., & Hodgkins, M. L. (2017). Telehealth. New England Journal of Medicine, 377(16), 1585-1592. https://doi.org/10.1056/nejmsr1503323 

Zaree, T. Y., Nazari, J., Asghary Jafarabadi, M., & Alinia, T. (2018). Impact of psychosocial factors on the occurrence of medication errors among Tehran public hospitals nurses by evaluating the balance between effort and reward. Safety and Health at Work, 9(4), 447-453. https://doi.org/10.1016/j.shaw.2017.12.005 

A Sample Answer 5 For the Assignment: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

Title: NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

The healthcare systems have to provide the best quality of care to meet the rising demand for such services. The population growth, increasing percentage of the geriatric populations, and the emergence of many chronic illnesses contribute to the high demand for healthcare services. On the other hand, the rising costs of living make life unbearable for many and influence the many cases of mental health issues among the populations. The impact of the high cost of living is also evident in healthcare institutions. The U.S government introduced the Medicare and Medicaid program to increase access to healthcare services by people from low-income families. Such an initiative would increase their access to healthcare services. Besides, government policies on the Medicaid and Medicare programs require healthcare institutions to minimize unnecessary interventions and offer quality healthcare services to their patients. Healthcare institutions are always caught in the competing need to offer high-quality care which may require additional resources and reducing the cost of medication.  

Description of the Competing Needs 

The healthcare institution where I work is committed to offering the best healthcare services to patients. The institution services many people with more of them being from poor backgrounds. The access to healthcare services to the poor families increased courtesy of the Medicaid program. The increasing number of patients visiting the hospital meant that the institution had to recruit more staff. The healthcare institution adopted the patient-centered care delivery approach and this means that they would give adequate time to the patients’ interactions to obtain relevant data for better patient management. Spending more time on a patient was necessary for offering the best quality of care, making the right diagnoses, and minimizing undesirable outcomes in their patients. On the other hand, the approach would require that the hospital recruits more healthcare staff to meet the demand for healthcare services. Therefore, the need to have more staff to offer high-quality services and the need to reduce the cost of the medication will be competing.  

Relevant Policy or Practice 

In responding to the competing need, the healthcare institution developed a policy that would require the healthcare providers to have mandatory overtime. Though the policy would increase the cost of a treatment since the nurses for the overtime; the cost incurred will be less compared to that needed for recruiting other full-time staff. The nurses and healthcare providers are required to attend to all the booked patients in a day. The number of extra hours spent on the work will depend on the patients in the queue. The healthcare providers are compensated based on the number of extra hours worked. The healthcare institution developed the policy as the cheap available alternative for addressing the need to meet the growing number of patients. The policy means that the healthcare institution will still be able to attend to their patients without any going unattended. Besides, the healthcare providers will commit themselves to offer a patient-centered care approach.  

Critique of the Policy 

The mandatory overtime policy in the healthcare institution aims at benefiting the patients and ensuring their needs are addressed accordingly. The patients will benefit because they will have adequate time to interact with the healthcare providers. Furthermore, the healthcare providers will have additional money from the overtime compensation and this may motivate some of them. Employees derive motivation from different things with some having more value on the monetary rewards and this constitutes a major strength to the policy.  

The Healthcare system is highly sensitive because a slight error can even lead to a patient’s death. According to Zaree et al. (2018), the psychological well-being of the healthcare providers influences the quality of the care they deliver to the patients. Healthcare providers experiencing burnout are less likely to offer the best care to their patients. Furthermore, they will lack the moral to interact with their patients in a friendly manner. The healthcare organization must aim at creating a suitable environment that will promote high productivity among the patients. Both patients and healthcare providers are important stakeholders that influence the sustainability of the health organization’s operation. There must be a proper balance between the protection for the patients and the protection for the healthcare providers. The best way for the healthcare institution to promote the healthcare providers’ wellbeing is by ensuring they have a good working environment with all the resources and have adequate time for rest.  

On the other hand, there are significant concerns related to the policy, especially on the healthcare providers’ part. The first concern is that employees should not be forced to work beyond the set working hours. Employees should be allowed to participate in the overtime program voluntarily because some value their families while others require personal time. Forcing all the healthcare providers into the mandatory overtime program means that some will be emotionally and psychologically drained. The emotional and psychological draining reduces the effectiveness of the healthcare providers in their duty delivery. Besides, there could be many cases of burnout and absenteeism arising from the employees who feel fatigued and exploited in their professional practice.  

Furthermore, working for long hours could expose healthcare providers to physical injuries and other healthcare issues. According to Son et al. (2019), overtime is associated with inadequate sleep and fatigue. Also, some of the nurses are likely to have lower back pain because they have overworked. Fatigued nurses or other healthcare providers are prone to medical errors and this could cause more harm to the patients and this is ethically wrong (Milliken, 2018). Therefore, the major ethical concern in the policy is whether it is justifiable to expose the healthcare providers to health risks in the process of promoting the patient’s experiences. The harm presented to the healthcare providers is greater than the benefits emerging from the policy and thus making it unethical (Kelly & Porr, 2018).  

Best Practices 

The need to offer the best healthcare services at an affordable cost cannot be overlooked. The quadruple aim address four issues including promoting the quality of healthcare delivered to the patients, better population health, reduced cost of medication, and better quality of life for the healthcare providers. The increasing number of patients seeking medical services presents a major challenge to achieving the quadruple aim without straining the available resources in the healthcare institutions. However, the use of telehealth can significantly address the challenges because it will reduce the number of patients visiting the healthcare facility. According to Monaghesh & Hajizadeh (2020), the use of telehealth has been effective in managing patients during the Covid-19 pandemic. Adopting the policy will help the healthcare institution serve many patients at a reduced cost.  

The policy will require the healthcare providers to intensify the patient education provided to the patients and equipping them with self-care skills. Patient’s education allows them to take control over their lives and so reduce their dependence on the healthcare providers (Tuckson et al., 2017). Furthermore, the patients will be committed to healthy behavioral practices and so there will be reduced cases of adverse treatment outcomes. Healthcare providers derive happiness when they realize that their patients have recovered and have better health status. On the other hand, high incidences of mortality and poor treatment outcomes affect the healthcare providers’ emotions negatively. The telehealth system will be the best solution to addressing the competing needs in the healthcare institution (Salles et al., 2021). There will be no need for mandatory over time and so the healthcare providers will have adequate time for personal life.  

Conclusion 

Competing needs in healthcare systems are common; therefore, healthcare providers must constantly develop measures to improve the quality of care delivered to the patients and maintain low operational costs. The healthcare institution developed a mandatory overtime policy which is not efficient because of the many adverse outcomes to the healthcare providers. Instead, adopting the telehealth system would be the best policy for addressing the need to reduce costs and improve the quality of care concurrently. The policy will reduce the number of patients visiting the healthcare institutions and so reduce congestion and the pressure exerted on the limited number of healthcare providers. Providing patients’ education will promote independence and this is needed for quality health outcomes.  

References 

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), 6. doi:10.3912/OJIN.Vol23No01Man06.  

Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), 1. doi:10.3912/OJIN.Vol23No01Man01. 

Monaghesh, E., & Hajizadeh, A. (2020). The role of Telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health, 20, 1193 https://doi.org/10.21203/rs.3.rs-23906/v3 

Salles, N., Saillour-Glénisson, F., Sibe, M., Langlois, E., Kret, M., Durrieu, J., Arditi, N., Abraham, M., & Perry, F. (2021). Effectiveness and organizational conditions of effectiveness of telemedicine in nursing homes. A study protocol of a comparative prospective cohort (EFFORT study). DIGITAL HEALTH, 7, 205520762098242. https://doi.org/10.1177/2055207620982422 

Son, Y., 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 

Tuckson, R. V., Edmunds, M., & Hodgkins, M. L. (2017). Telehealth. New England Journal of Medicine, 377(16), 1585-1592. https://doi.org/10.1056/nejmsr1503323 

Zaree, T. Y., Nazari, J., Asghary Jafarabadi, M., & Alinia, T. (2018). Impact of psychosocial factors on the occurrence of medication errors among Tehran public hospitals nurses by evaluating the balance between effort and reward. Safety and Health at Work, 9(4), 447-453. https://doi.org/10.1016/j.shaw.2017.12.005 

Christi, I enjoyed reading your post. Resistance to change can be a powerful barrier to policy adoption. In my work setting, we have

experienced multiple policy or procedural changes that staff is resistant to accept. Within a few months, most staff reverts to the original way of

doing things. One of the most significant barriers an organization faces when initiating change is resistance from staff, and how behavior toward

change is approached will determine long-term success (Redman et al., 2021). Competing needs add another layer of complexity to the problem.

Self-awareness and high emotional intelligence are essential characteristics to cultivate to be a positive change agent. The purpose of this post is

to take a deeper look at resistance to change in efforts to support policy change leading to positive patient outcomes.

Although resistance is identified as a barrier, resistance should not be viewed as unfavorable. When nurse leaders understand resistance as

fear of the unknown and a sense of loss from the change, leaders can be more equipped to successfully navigate their team through the change

process (Dubose & Mayo, 2020). Although this response to change is considered normal and pliable, a more rigid reaction to change can be

explored through early childhood trauma. Through an attachment lens, individuals who establish a secure attachment with a parental figure in

early childhood are less resistant to change in adulthood. Those who developed an insecure attachment during childhood with a parental figure

are more resistant to change in adulthood (Forsell & Åström, 2012).

When nurse leaders understand, acknowledge, and communicate with their staff why resistance is present during policymaking, leaders can

be more successful at creating long-term change. Self-awareness and emotional intelligence skills enhance when individuals become aware of

and can differentiate between average levels of resistance and an altered reaction to change due to their personal history. Working together as a

team creates an environment capable of effective policymaking for competing needs.

Grading Rubric Guidelines DQ

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.