Sample Answer for NURS 6053 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 Organizational Policies and Practices to Support Healthcare Issues
Title: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
Healthcare organizations develop policies to guide the daily activities and meet their expected treatment outcomes and standards. The operation of a healthcare institution depends on both internal and external structures. The internal components include the staffing, the working hours, and schedule policies, and collaboration structures (Laureate Education (Producer), 2018). On the other hand, the external factors include the government policies such as the Medicaid and Medicare programs and the 30 days-readmission policy among others. Therefore, healthcare institutions have to work to meet both external and internal needs. Though, in most cases, the competing needs presented by the policies could affect operational efficiency. The current discussion focuses on the rising cost of the medication issue and the need to improve the patients’ experiences.
The patient’s experience depends on various factors including their interactions with the healthcare providers and the quality of medications they receive. Healthcare institutions may be required to recruit enough healthcare staff to meet the desired healthcare provider patients ratio. Also, the institution may have to stock high-quality drugs to achieve the best therapeutic outcomes in the patients as per the bioethical requirements (Milliken, 2018). The fact is that improved patient experiences result in a lower cost of medication because the patients will have few cases of complications and the number of days they spent in hospitals (Kelly & Porr, 2018). However, the healthcare personnel may be required to engage intensive care approach including taking more time to understand the patients’ needs and developing the right diagnosis. Furthermore, they will have to explore other socio-cultural issues that could be affecting the treatment outcomes for the patients. In such as case, the healthcare institution will have to invest heavily in the resources needed for proper diagnosis and ensure that healthcare staff adequately meet the patients’ needs.
The illustration indicates that the healthcare institutions will struggle between meeting the patients’ needs and keeping the medication costs low (Hardin et al., 2017). Investing in the resources needed to offer the best care will mean that the costs for the healthcare services will increase. Healthcare institutions operate to make a profit and so must balance between their expenses and income. It will be unrealistic to have high-standard healthcare services at a low cost (Paterick et al., 2017).
Policies such as mandatory patient education and promoting self-care practices can help address the issue. Educating the patients means that they will have the required knowledge to promote healthy behavioural practices. Adopting the policy will reduce the risk of poor treatment outcomes and complications likely to emerge due to the patient’s non-adherence and unhealthy behaviours (Toukhsati et al., 2019). In addition, the patients will understand what they have to do to better their quality of life and so reduce their level of dependence on the healthcare providers (Figueroa et al., 2019). The number of patients seeking healthcare services continues to rise; therefore, adopting the policy will ensure that the healthcare institution serves a large population without straining the resources and this will reduce the cost of treatment.
Finally, competing needs are common in healthcare systems. However, healthcare providers must always develop new measures and policies for addressing health issues. Adopting the policy on patient education on self-care skills will reduce the burden presented on the healthcare institutions by the increasing number of patients and the rising cost of medication. Furthermore, the healthcare institution will be able to manage their staff without exposing them to any health harm and so achieve the quadruple aim.
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References
Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: A rapid review. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4080-7
Hardin, L., Kilian, A., & Spykerman, K. (2017). Competing health care systems and complex patients: An inter-professional collaboration to improve outcomes and reduce health care costs. Journal of Interprofessional Education & Practice, 7, 5-10. https://doi.org/10.1016/j.xjep.2017.01.002
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06.
Laureate Education (Producer). (2018). Moral Leadership [Video file]. Baltimore, MD: Author.
Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01.
Paterick, T. E., Patel, N., Tajik, A. J., & Chandrasekaran, K. (2017). Improving health outcomes through patient education and partnerships with patients. Baylor University Medical Center Proceedings, 30(1), 112-113. https://doi.org/10.1080/08998280.2017.11929552
Toukhsati, S., Jaarsma, T., Babu, A., Driscoll, A., & Hare, D. (2019). Self-care interventions that reduce hospital readmissions in patients with heart failure; Towards the identification of change agents. Clinical Medicine Insights: Cardiology, 13, 117954681985685. https://doi.org/10.1177/1179546819856855
A Sample Answer 2 For the Assignment: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
Title: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
Competing needs arise within any organization as healthcare workers seek to meet their targets and leaders seek to meet hospital goals. Either targets or goals require establishing priorities and allocating resources. For example, a policy addressing adequate nurse staffing is essential to meet the patient and workforce needs while minimizing hospital cost. However, utilizing in more nursing staff might result in economic inefficiencies along with misallocated resources.
The shortage of staff is connected with negative impacts; including lower quality and quantity of care because there are few resources to offer. Work overload to the existing nurses lead to burnout, and eventually compromising patient safety. Nursing shortage policies are constantly supported by current literature and they vary from country to country. However, there is continuous effort to modify certain aspect such as pay agreements, emergency hiring plans and RN residency programs to improve working environment for nurses (Park & Yu, 2019). Nurses should also voice their opinion on ways to resolve competing needs; the culture of silence creates a culture of acceptance and continues to suppress nursing professional knowledge (Kelly & Porr, 2018).
Competing needs that may impact nursing shortage is aging population in which baby boomer entering the age of increased need for health services. Which would require more students to enroll into the nursing program today and hire more educators to provide students with proper training. Another contributing factor is nurse burnout, statistics shows a national turnover rates is 8.8% to 37% (Lisa et al., 2020). Nurses are experiencing burnout daily and leaving the profession for better opportunities or advancing in their career. Ensure an optimal nurse to patient ratios to improve nurse staffing and improve quality of care delivered. Lastly, workload and work environment has forced hospitals to reduce staffing and implement mandatory overtime polices to ensure nurses would be available to work when the number of patients admitted increased unexpectedly. Furthermore, increase the workload to decrease on health care costs.
A policy might address these competing needs by ensuring an optimal nurse to patient ratio which can improve care outcomes for patients and ensure patient safety. Healthcare policymakers’ involvement in developing a staffing policy in every organization to improve working conditions (such as working hours, violence in workplace, managing workload) for the nurses staff to improve competencies and better job satisfaction. Ensure adequate government funding to allocate resources for training and clinical skills without causing strains on the government and organization budget. Also, devote resources toward increasing nurses wages; a token of appreciation for their dedicated and hard work.
References
Haddad, L.M., Annamaraju, P., & Toney-Butler, T.J. (2020). Nursing Shortage. Retrieved June 15, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK493175/
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi: 10.3912/OJIN. Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html
Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. In Health Policy and Technology, 8(3), 296-303. https://doi.org/10.1016/j.hlpt.2019.08.003
A Sample Answer 3 For the Assignment: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
Title: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
I agree with your post and find it sad that nurses have such limited time to spend with their patients and family members. The nursing practice is based on giving our patients the best care possible (Walden University, LLC, 2012). When we spend more time charting than with the patients it can feel as though we aren’t giving our patients most of our attention, and this can be frustrating. In the ICU we typically have more quality time with our patients. About a year ago my facility-initiated charting by exception to relieve some of the charting burdens the nurses are faced with. Charting by exception allows the nurse to enter the initial assessment into Epic. All other assessments that shift are charted by what changed from the initial assessment. So, if the patient was alert and oriented x3 initially at 1900 but by 0400 the patient is sedated the neuro section would need to be entered into Epic. This has saved nurses an immense about of time.
This should be put into place for all nurses charting systems to free up their time. It may be challenging to do this for clinic visits but I’m sure it could be done. When this was first rolled out nurses were hesitant due to the “not charted, not done” way of thinking that was engrained into nurses’ heads during nursing school but the legal team at the hospital states that this type of charting would be sufficient if ever taken to court. Here we can see how documenting resources conflicts with the quality of time spent with the patients. Ultimately if the documentation resources are improved the quality time patients and nurses long for will also be improved. Improving clinical documentation is definitely a time-honored vision (Hay, P., Wilton, K., & Cumerlato, M., 2019).
Thank you for your post. I agree with you that there are many healthcare problems today, especially regarding nurse staffing shortages. According to Bong (2019), the United States has been having a crucial need for registered nurses, and research suggests this course will continue through 2025. Nurse turnover is broadly caused by moral distress, and new graduate nurses are not retaining hospital positions (Bong, 2019). As you stated, Covid-19 brought about many things, including the astonishingly high turnover across the nation’s working population, referred to as the ‘Great Resignation’ (Kurtzman et al., 2022).
In your post, you shared that you care for patients with HIV. This patient population is severely underserved. As a psychiatric nurse in an inpatient recovery treatment center, our population is tested for HIV. Infrequently we have patients newly diagnosed with HIV, and I understand the myriad problems and competing needs that come with this diagnosis. Our patients are addicted to drugs or alcohol, are often mentally ill, and are sometimes homeless. Thank you again for your post and for serving such a vulnerable population.
References
Bong, H. E. (2019). Understanding moral distress: How to decrease turnover rates of new graduate pediatric nurses. Pediatric Nursing, 45(3), 109-114.
Kurtzman, E. T., Ghazal, L. V., Girouard, S., Ma, C., Martin, B., McGee, B. T., Pogue, C. A., Riman, K. A., Root, M. C., Schlak, A. E., Smith, J. M., Stolldorf, D. P., Townley, J. N., Turi, E., & Germack, H.-ley. (2022). Nursing workforce challenges in the post-pandemic world. Journal of Nursing Regulation, 13(2), 49–60. https://doi.org/10.1016/s2155-8256(22)00061-8
A Sample Answer 4 For the Assignment: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
Title: NURS 6053 Organizational Policies and Practices to Support Healthcare Issues
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.
References
AANP. (2022, April 15). State Practice Environment. Retrieved September 26, 2022, from https://www.aanp.org/advocacy/state/state-practice-environmentLinks to an external site.
Duru, D. C., & Hammoud, M. S. (2022). Identifying effective retention strategies for front-line nurses. Nursing management (Harrow, London, England : 1994), 29(1), 17–24. https://doi.org/10.7748/nm.2021.e1971Links to an external site.
Gotanda, H. G., Kominski, G. K., Elashoff, D. E., & Tsugawa, Y. T. (2021, July). Association Between the ACA Medicaid Expansions and Changes in Cardiovascular Risk Factors Among Low-Income Individuals. NIH National Library of Medicine. Retrieved September 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/33483808/Links to an external site.
HealthLeaders, & Cheney, C. C. (2022, September 28). Sentara Healthcare Boosts Efforts to Address Social Determinants of Health. HealthLeaders Media. Retrieved February 26, 2023, from https://www.healthleadersmedia.com/clinical-care/sentara-healthcare-boosts-efforts-address-social-determinants-healthLinks to an external site.
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practiceLinks to an external site.Links to an external site.. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.htmlLinks to an external site.
Milliken, A. (2018). Ethical awareness: What it is and why it mattersLinks to an external site.Links to an external site.. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01.
Neff, D.F., Yoon, S. H., Steiner, R.L., Bumbach, M. D., Everhart, D., & Harman J.S. (2018). The impact of Nurse Practitioner Regulations on Population Access to Care. Nursing Outlook, 66(4), 379-385
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple AimLinks to an external site.Links to an external site.. Journal of the American Board of Family Medicine, 31(4), 588–604.
Savioli, G., Ceresa, I. F., Gri, N., Bavestrello Piccini, G., Longhitano, Y., Zanza, C., Piccioni, A., Esposito, C., Ricevuti, G., & Bressan, M. A. (2022). Emergency Department Overcrowding: Understanding the Factors to Find Corresponding Solutions. Journal of Personalized Medicine, 12(2), 279. https://doi.org/10.3390/jpm12020279Links to an external site.
Zambrano, J. Z. (2022, September 13). Discussion-Week 3 [Online forum post]. Walden University Discussion Forum Module 2. Retrieved September 13, 2022, from https://class.waldenu.edu/webapps/discussionboard/do/message?action=list_messages&course_id=_16995826_1&forum_id=_10196143_1&discussion_board_entry&conf_id=_4377742_1&message_id=_127431235_1Links to an external site.