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Sample Answer for NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices 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.
- 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 (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
- Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
- Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
- Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
- Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
- Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
By Day 7 of Week 3
Submit your revised paper.
Submission and Grading Information
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- Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
- Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
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Submit Your Assignment by Day 7 of Week 3
A Sample Answer For the Assignment: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
Title: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
Healthcare organizations have competing needs because of the limited resources and reforms. The Quadruple Aim framework as well as innovative delivery models like value-based care implore providers to develop effective interventions to address these competing needs. Nursing shortage is a health care stressor or issue that implores organizations to develop policies and practices to tackle it and guarantee quality care outcomes (Koopmans et al., 2018). This paper focuses on the competing needs emanating from nursing shortage and development of relevant policies or practices. The paper also critiques the policy for ethical considerations, explains its strengths and challenges in ethics promotion.
Review of Nursing Shortage as Healthcare Stressor
Nursing shortage has significant implications on the quality of care that providers offer. Nurses are frontline care providers and first point of contact between patients and the healthcare system (Mattioni & Wilson, 2018). The first competing need that can impact nurse shortage are the financial needs of nurses in these organizations which contradicts the institution’s focus on profits or return on investment. The second need is patients attaining bet healthcare services as they pay for them and are entitled to quality. The need contradicts the one for nurses as it means that they must be willing to serve patients but are not well compensated. Further, their workload becomes more because of the shortage. They do not feel well remunerated for the efforts and are demotivated yet patients want quality care irrespective of their situation.
Relevant Policy Influencing the Stressor
The current organizational policy and practices of hiring new-graduated nurses is one of the issues contributing to the nurse shortage in the facility. The organization adopted this policy as a means of reducing the overall cost of running the facility because new-graduated nurses want experience and getting their first job is a significant anticipation as they want to gain experience as providers (Perry et al., 2018). However, as they get new and greener opportunities in other organizations, they leave leading to a significant workload for the remaining care providers who experience burnout. Eventually, they also leave and the problem is does not get a solution.
The current policy does not promote ethical values and principles of healthcare, especially the biomedical principles of beneficence, non-maleficence, and justice as well as autonomy. The policy fails to consider these ethical values for patients and even providers. The policy should ensure that the hired nurses are compensated well instead of giving them low wages leading to high turnover rates. The policy does not promote any ethical values as it exposes patient to low quality due high turnover rate.
The current policy can be effective if it focuses on hiring newly-graduated nurses and training them sufficiently so that they do not leave the organization. These new nurses should be motivated and inspired through good compensation, incentives, and leadership support to retain them. The competing needs should not be the ultimate determiners but quality of care and the retention of best and well-trained providers (Milliken, 2018). The change will ensure that nurses and patients interact and have quality services for mutual benefit and respect.
Nurse shortage is a critical healthcare stressor that needs effective strategies and approaches to address. Low nurse staffing levels threaten the quality of care and patient safety. Therefore, organizations, like ours, should develop effective interventions to ensure patient safety and quality of care.
Koopmans, L., Damen, N. & Wagner, C. (2018). Does diverse staff and skill mix of the team’s
impact quality of care in long-term elderly health care? An exploratory case study. BMC Health Service Research, 18(988). https://doi.org/10.1186/s12913-018-3812-4.
Mattioni, C. & Wilson, L. (2018). A collaborative approach to creating a perioperative nursing
recruitment and retention strategy: The official voice of perioperative nursing the official
voice of perioperative nursing. AORN Journal, 108(6), 675-678.
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
Perry, S.J., Richter, J.P. & Beauvais, B. (2018). The effects of nursing satisfaction and turnover
cognitions on patient attitudes and outcomes: A three-level multisource study. Health
Services Research. DOI: 10.1111/1475-6773.12997
A Sample Answer 2 For the Assignment: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
Title: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
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.
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 of 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 institutions 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 exists.
Relevant Policy Practice
The healthcare organization introduced a mandatory overtime policy as a way of dealing with increasing demand for 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 personnel 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 lead 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 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 to 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.
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 so as to 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.
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, an 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.
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 3 For the Assignment: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
Title: NURS 6053 WEEK 3 Assignment Developing Organizational Policies and Practices
The healthcare system encounters a host of pertinent issues that require interventions to improve the quality of care offered to patients and reduce costs. The Quadruple Aim framework focuses on ensuring quality access to care that leads to better patient experience, improvement of population health, reduced costs and enhancing the work life of healthcare providers (Arnetz et al., 2020). However, a pertinent healthcare issue that can impact this framework and public health in general as well as care delivery is personnel shortages, especially nursing shortage. The purpose of this paper is to discuss nursing shortage as a pertinent health issue and its impact on the organization.
Nursing Shortage and Impact on the Organization
Nurse staffing shortage is a critical issue that requires interventions because of its effects. Organizations and evidence from federal agencies like the Bureau of Labor Statistics and the American Nurses Association assert that there will be a significant increase in nursing jobs over the next five years compared to any occupation or profession. The Bureau of Labor Statistics indicates that over 176,000 openings will be available for nurses in healthcare due to newly created roles as a result of advanced education and the need to address physician shortage, nurses leaving the profession and those retiring because of their age (Broome et al., 2022). The BLS assert that the nursing shortage will continue to bite the healthcare delivery as more Americans with diverse needs get access to care due to reforms through legislations at both state and federal levels.
Nursing shortage has serious implications on the organizations, especially in critical care situations and the need to deliver quality patient-centered interventions. The increased number of patients per nurse means poor quality of care due to strain and associated fatigue. Nurse shortage is a leading cause of burnout and nurse turnover. For instance, figures from the organization’s leaders show that over ten nurses left the facility in the last two years due to working on long shifts. Data also indicates a rise trend of missed nursing care in the facility due to the shortage (Tamata et al., 2023). The implication is that nursing shortage in any facility leads to increased cost of care and high turnover rates. Having limited nurse of nurses also leads to increased risk of patients to adverse events like medication errors and falls which the organization cannot get reimbursed by the Centers for Medicare and Medicaid Services (CMS). As such, the entity loses funds when patients miss care or experience adverse events that preventable like falls, healthcare associated infections, and medication errors.
Summary of Studies on Nursing Shortage
In her article, Bourgault (2022) focuses on the issue of nursing shortage and work expectation for nurses caring for patients in critical care conditions. The article asserts that the COVID-19 pandemic, especially at its height during the Omicron wave, demonstrated the crisis of nursing shortage due to thousands of missed nursing care moments. Further, the article highlights the long hours that nurses are working, increased workload and patient acuity while others have to endure with mandatory overtime while also nursing health issues like COVID-19. The paper also highlights the unsafe conditions for nurses and other health care workers without protective personal equipment despite the heightened risk of infections. The implication is that the article highlights the current state of nursing shortage and need for innovative approaches to handle the situation. The article explores the need for policies to help organizations manage safe nurse-to-patient ratios.
The second article by Griffiths et al. (2018) identifies the association between nurse staffing and adverse patient events or outcomes, including mortality. The article asserts that by measuring the number and level of missed care, healthcare organizations can determine the adequacy of their nursing staff and develop innovative interventions to address the situation. The findings from the study indicate that low staffing levels lead to increased prevalence of missed care that result into poor patient outcomes.
Organizations Handling Nurse Staffing Shortage
Organizations are employing innovative approaches to deal with the nurse staffing shortage. These include a collaborative approach to ensure that nurses and their leaders can develop innovative approaches to improving care as opposed to all patients coming for physical visits. For instance, the integration of technologies like telehealth and telemedicine can help organizations address the issue. Nurses are on demand because of increased access to care through health care reforms and partly due to an aging population (Spurlock Jr., 2020). Therefore, organizations need effective leadership to inspire nurses to offer better solutions to care provision. Good working conditions as incentives for nurses in any facility are essential to addressing the nurse shortage. More fundamentally, reducing the turnover rates is also an effective strategy to address the issue. Flexible work schedule and shifts can also help alleviate the issue.
Strategies Used to Address Nursing Shortage
The articles are categorical that stakeholders can address the healthcare issue of nursing shortage through a raft of strategies. These include policies that focus on improving the work conditions and organizational efforts to enhance a collaborative approach among healthcare workers. Secondly, the use of technologies like telehealth and telemedicine can help nurses offer care remotely and reduce the current workload burden (Broome et al., 2021). The strategies are impactful to organizations positively since they are evidence-based practice and will lead to quality patient outcomes. These strategies will ensure that the facility has sufficient number of staff to cater to patients based on their needs. However, they require sufficient resources allocated by the management to attain their goals.
Nursing shortage is a serious healthcare issue that needs stakeholders, especially organizational managers and leaders to address to enhance quality patient outcomes. The articles used in this study demonstrate the need for nurses as innovative care providers to develop EBP interventions to improve care outcomes for patients. Policy interventions and other approaches will be important in addressing nursing shortage as a serious healthcare issue.
Developing Organizational Policies and Practices
As healthcare organizations continue inventing interventions for addressing the nursing shortage, competing needs affect policy formulation and practice immensely. Competing needs represent organizational priorities that must be addressed concurrently. Among many competing needs, organizational resources affected the nursing shortage significantly. According to Hamlin (2023), a nursing shortage in organizations intensifies when organizations cannot replace the aging workforce or adopt innovative approaches to meet the increasing patient visits due to chronic illnesses. Adequately-resourced organizations are better positioned to address these challenges hence preventing a nursing shortage. The other competing need is workforce needs. As healthcare organizations adjust their procedures and implement innovative care delivery approaches, staffing needs should be prioritized. The implication is that new interventions to optimize health outcomes should not burden the current workforce. An additional workload can cause burnout, resulting in nurse turnover (Shah et al., 2021). As a result, a balance between the organization’s and staff’s needs is crucial when making decisions regarding the nursing shortage.
Policy to Influence the Nursing Shortage
Policies and practices vary in relevance and practicality in addressing healthcare issues. The nursing shortage can be effectively addressed by implementing technologies such as telehealth and telemedicine. Broom et al. (2021) observed that telehealth and telemedicine could help nurses to provide patient care remotely and reduce the current workload burden. Remote care reduces physical visits to healthcare providers and ensures patients receive timely care.
Ethical Considerations, Strengths, and Challenges
Besides competing needs, healthcare practitioners should be aware of barriers and facilitators of technology implementation in care. Ethical considerations associated with telehealth/telemedicine include equity of access, data protection, and confidentiality (Solimini et al., 2021). Since technology is not evenly distributed and affordable, it would be challenging to provide equitable care through telehealth/telemedicine. Primary strengths of the intervention include quick patient care delivery, a reduced workload, and reduced infections by minimizing physical interactions in healthcare settings. Challenges include implementation setbacks such as patients’ technology literacy, nurses’ attitude toward technology, and security issues.
Other Practice Changes
As healthcare organizations continue implementing telehealth, interventions to prevent nurse burnout should be prioritized. As Shah et al. (2021) conjectured, a nursing shortage is a leading cause of nurse burnout since it increases nurses’ workload. Given that, practice changes like leadership support, collaborative care, and opportunities for social interaction should be implemented. These interventions will increase nurses’ satisfaction with their job and enable them to participate in patient care actively and passionately. Burnout prevention will further reduce costs associated with nurse turnover.
The nursing shortage is a composite healthcare issue that should be addressed competently and comprehensively. As healthcare organizations implement different policies and practices, competing needs should guide them in decision-making. Telehealth/telemedicine can help nurses to provide patient care remotely and reduce the current workload. However, its implementers should be aware of its ethical limitations, such as privacy and the inability to offer equitable care.
Arnetz, B. B., Goetz, C. M., Arnetz, J. E., Sudan, S., vanSchagen, J., Piersma, K., & Reyelts, F.
(2020). Enhancing healthcare efficiency to achieve the Quadruple Aim: An exploratory study. BMC research notes, 13(1), 1-6. DOI: 10.1186/s13104-020-05199-8
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert
clinician to influential leader (3rd ed.). New York, NY: Springer.
Bourgault, A. M. (2022). The nursing shortage and work expectations are in critical condition: Is
anyone listening? Critical Care Nurse, 42(2), 8-11. https://doi.org/10.4037/ccn2022909
Griffiths, P., Recio-Saucedo, A., Dall’Orca, C. Briggs, J., Maruotti, A., Meredith, P. & Missed
Care Study Group (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487. DOI: 10.1111/jan.13564.
Hamlin, K. (2023). Why is there a nursing shortage? NurseJournal. https://nursejournal.org/articles/why-is-there-a-nursing-shortage/
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469-e2036469. doi:10.1001/jamanetworkopen.2020.36469
Solimini, R., Busardò, F. P., Gibelli, F., Sirignano, A., & Ricci, G. (2021). Ethical and legal challenges of telemedicine in the era of the COVID-19 pandemic. Medicina (Kaunas, Lithuania), 57(12), 1314. https://doi.org/10.3390/medicina57121314
Spurlock Jr, D. (2020). The nursing shortage and the future of nursing education is in our hands.
Journal of Nursing Education, 59(6), 303-304. DOI: 10.3928/01484834-20200520-01.
Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors
affecting shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247-1257. https://doi.org/10.1002/nop2.1434