ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Sample Answer for ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053 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: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Title: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

The COVID-19 pandemic has initiated an upheaval in society and has significantly  cause  considerable stress during this pandemic. Healthcare professionals have been on the front line during this health crisis, particularly hospital nurses in all specialty. The focus of this study was to assess the high level of stress of healthcare workers during the first wave of the pandemic.

The COVID-19 pandemic by an international study is questionnaires disseminated from collecting online demographic and stress-related data over the globe, during the pandemic. Stress levels were evaluated using non-calibrated visual analog scale, from 0 (no stress) to 100 (maximal stress).

The main outcome was work-related stress, measured with the use of a visual analog scale i.e. a non-calibrated horizontal line ranging from minimum (0) to maximum (100). Visual analog scale of stress is a validated tool commonly used in daily practice. With this type of tool, participants can self-assess in a simple way the range of their possible feelings. Secondary outcomes were sociodemographic (age, sex), occupations (non-healthcare workers, medical doctors, paramedical staff), and working conditions (working in usual conditions, working in unusual conditions, interruption of work). This was a computerized questionnaire hosted on the secure REDCAP platform. It consisted of about 100 questions. The study presented here reports on the answers related to work-related stress. Depending on the answers given, individuals had access to all or part of the questionnaire.

Women Healthcare workers more affected:

In our study, whatever their profession, women had the highest levels of work-related stress during the first global lockdown. Our results concord with the literature revealing that women are more prone to stress, and may also suffer more from the negative psychological impact of the COVID-19 outbreak. Women often have a double life combining work and family life. This is even less reconcilable when both professional and family constraints increase. Indeed, families had to adapt to the closure of schools. Even in couples that shared the involvement in the education and care of children, women are still mostly implicated. Given these elements and the predominance of women in healthcare professionals, the WHO advised to study gender-specific consequences of the pandemic. Even if women have less severe forms of COVID, they were frightened of contracting COVID-19. They may also have been more impacted by the higher number of deaths and difficulties during the crisis. Women show greater psychophysiological concordance and consistency than men, and may therefore present more psychological vulnerability. Improving Work -Life  Integration (WLI) is likely to improve healthcare worker’s quality of life, organizational outcomes and, ultimately, quality of care for patients (Schwartz et al., 2018).,

Healthcare System Taking action on burnout

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ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053
ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

According to  National  Libraryy of Medicine During COVID-19, employers were noticing the need for intervention. Through employee assistance programs (EAPs) or health care insurance, mental health programs were offered. Some programs offered by mental health staff are stress reduction, cognitive restructuring and reframing, and grief counseling. Mental health can also help a nurse to recognize and admit to symptoms of burnout. COVID-19 was an introduction of EAPs and mental health checks that should occur routinely. Nurses will not always admit or even recognize that they need mental health support. However, if one knows the signs of burnout, they can see it in nurses.

The national collaborative, which rolled out in 2017, has three main goals: better understanding the challenges to clinician well-being, raising the visibility of clinician stress and burnout, and elevating evidence-based solutions. To date, the collaborative has received commitments from more than 150 organizations, including health systems, hospitals, medical schools and state medical boards, to improve clinician well-being and curb burnout.

Jonathan Ripp, MD, MPH, chief wellness officer at Mount Sinai Health System in New York City also co-chairs the national Collaborative for Healing and Renewal in Medicine, which this March co-published a first-of-its-kind charter in the Journal of the American Medical Association that outlines fundamental principles for supporting provider well-being. The charter has been endorsed by more than a dozen organizations, including the American Medical Association and Association of American Medical Colleges.

Preventing, promoting appropriate support for healthcare workers may significantly reduce the effects contibutind to burnouts in organization;

  1. Strong Interpersonal Relationships outside of work
  2. Work-Life Balance
  3. Healthy Lifestyle
  4. Decrease Stress
  5. Mindfulness
  6. Education
  7. Recognize Achievements
  8. Healthy work Enviroment
  9. Recommendtions
  10. Therapy

ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Conclusion

The COVID-19 pandemic has and will have consequences for every population. Nevertheless, healthcare professionals were more impacted than other workers by work-related stress. Paramedical staff were more impacted on than physicians. Across all occupational categories, age appears to mitigate work-related stress, and maybe due to the effects of experience. We were able to identify risk factors for high levels of work-related stress such as youth, female gender, paramedical professions and having maintained one’s professional activity. The impact of such a surge in work-related stress may inflict a second blow to already fragile healthcare systems. Adequately monitoring work-related stress and its effects on healthcare workers may be crucial to plan for post-pandemic adjustments. The finding that burnout and poor wellbeing are both associated with poorer patient safety has significant implications for policymakers and management teams within healthcare settings (Hall et al., 2016).

Reference

Bangasser DA, Eck SR, Ordoñes Sanchez E. Sex differences in stress reactivity in arousal and attention systems. Neuropsychopharmacology. 2019;44: 129–139. pmid:30022063

Broche-Pérez Y, Fernández-Fleites Z, Jiménez-Puig E, Fernández-Castillo E, Rodríguez-Martin BC. Gender and Fear of COVID-19 in a Cuban Population Sample. Int J Ment Health Addict. 2020; 1–9. pmid:32837428

Dutheil F, Duclos M, Naughton G, Dewavrin S, Cornet T, Huguet P, et al. WittyFit—Live Your Work Differently: Study Protocol for a Workplace-Delivered Health Promotion. JMIR Res Protoc. 2017;6: e58. pmid:28408363

Dutheil F, Pereira B, Moustafa F, Naughton G, Lesage F-X, Lambert C. At-risk and intervention thresholds of occupational stress using a visual analogue scale. PLoS One. 2017;12: e0178948. pmid:28586383

Lesage F-X, Berjot S, Deschamps F. Clinical stress assessment using a visual analogue scale. Occup Med. 2012;62: 600–605. pmid:22965867

Lesage FX, Berjot S. Validity of occupational stress assessment using a visual analogue scale. Occup Med Oxf Engl. 2011;61: 434–436. pmid:21505089

National Library of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882221/

Notman MT, Nadelson CC. Medicine: A Career Conflict for Women. Am J Psychiatry. 1973;130: 1123–1127. pmid:472890

Rossi R, Socci V, Talevi D, Mensi S, Niolu C, Pacitti F, et al. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. An N = 18147 web-based survey. Psychiatry and Clinical Psychology; 2020 Apr.

Sandanger I, Nygård JF, Sørensen T, Moum T. Is women’s mental health more susceptible than men’s to the influence of surrounding stress? Soc Psychiatry Psychiatr Epidemiol. 2004;39: 177–184. pmid:14999449

Schwartz, S. P., Adair, K. C., Bae, J., Rehder, K.J., Shanafelt, T.D., Profit, J., & Sexton, J.B 2018. Work-Life balance behaviors cluster in work settings and relate to burnout and safety culture: Across-sectional survey analysis BMJ Quality & Safety, 28 (2), 142-150. Doing: 10.1136/bmjqs 2018-007933

The National’s Health https://www.thenationshealth.org/content/48/8/1.3

Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17: 1729. pmid:32155789

A Sample Answer 2 For the Assignment: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Title: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

The COVID-19 pandemic has revealed many critical issues in the national healthcare system in the United States. The nursing shortage is among the top priorities because the whole system relies on nursing practitioners as the backbone. The statistics emphasize the urgent measures taken at each level of the government. As of March 2022, almost every state had taken executive actions to address the shortage, such as issuing temporary licenses to put nursing students to work (Zhavoronkova et al., 2022). The problem is significant enough to disregard the impact of competing needs in healthcare delivery.

Nursing shortage results from the impact of various external forces on the healthcare system. These include but are not limited to the aging population, aging workforce, nurse burnout, and population growth (Haddad et al., 2022). Therefore, the demand for registered nurses will be the highest among all professions. The reported growth will be at a faster rate (9%) than all other occupations, with more than 275,000 additional nurses being needed until 2030 (Haddad et al., 2022). The government actively invests in the development of nursing education and encourages more people to enter the profession and address the shortage. Nevertheless, the impact of competing needs in healthcare delivery persists. The available nurse workforce does not have sufficient resources to address all primary care needs. Alternative approaches such as preventative and chronic disease interventions and outpatient care models help close the gap, but they do not suffice (Korownyk et al., 2017). The nursing shortage is inextricably linked to diversity, aging, and education accessibility. For instance, the number of nurses has not kept up with the aging US population (Zhavoronkova et al., 2022). It implies that the new policies need to be comprehensive, addressing the factors and aspects of the healthcare issue.

In conclusion, the nursing shortage remains a central healthcare problem in the United States. It has many aspects and is related to other issues. Ignoring those related problems may not result in effective outcomes and a considerable increase in the nursing workforce. A more comprehensive approach is necessary for the government to ensure a long-term solution.

References:

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing.

Korownyk, C., McCormack, J., Kolber, M. R., Garrison, S., & Allan, G. M. (2017). Competing demands and opportunities in primary care. Canadian Family Physician63(9), 664-668.

Zhavoronkova, M., Custer, B. D., Neal, A., & Schweitzer, J. (2022, May 23). How To Ease the Nursing Shortage in America. Center for American Progress. Retrieved September 13, 2022, from https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/

A Sample Answer 3 For the Assignment: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Title: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

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 4 For the Assignment: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

Title: ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES NURS 6053

This discussion explores the competing needs of health policy that are challenged to coexist with improved patient outcomes. Change adaption is difficult, is often met with resistance, and is perceived as burdensome. Healthcare organizations routinely default to a transactional approach to meet governmental regulations through cutbacks and organizational strain resulting in cultural degradation and ethical concerns (Kelly & Porr, 2018). Nurses are immersed in the reality of these unintended consequences of change. Ethical principles governing nursing practice drive nurses to speak up to protect their practice landscape (Milliken, 2018).

Value-based healthcare (VBHC) aims to reduce healthcare spending through a collaborative model while improving patient outcomes. This model presents itself as a win-win on paper but needs to be more evidently self-aware. Collaboration is not an inherent skill of all healthcare-related professionals. Furthermore, collaboration takes time many do not have within their busy schedules afflicted by a national workforce shortage. Utilizing health information exchanges (HIEs) can assist in time management barriers. However, HIE proficiency requires training and is not a universal solution as it faces ongoing patient privacy issues for participation and consent (Vest & Gamm, 2010).

The VBHC model is an active reimbursement model in outpatient community mental health, but practices still need to be assimilated. In the video, Buttaro (Walden University, 2012) discusses a common dilemma in meeting the needs of the underserved in outpatient care when encountering complex individuals that require a higher level of care. Many clients lack natural and community supports. Homelessness, persistent mental illness, and substance use complicate patient care and require extensive intervention. A full nurse schedule that allows a 30-minute time slot to achieve patient care needs is a daily uphill battle. Nurses driven by their principles strive to advocate, refer patients for support, and connect with family members and professionals, which requires time and critical thinking (Milliken, 2018). The care pathway needed to provide necessary interventions is seldom commensurate with the time available within the nurse’s workday. Nurses must decide what aspect of their duties must receive less attention. Robust charting is an organizational requirement. Patient advance and care is an ethical requirement. Working overtime can lead to burnout and patient safety risks and deviates from the nurse’s personal responsibility to take care of themselves.

Policy is the overarching force through which change happens. Rubino (Walden University, 2009) reminds us that change is necessary for all healthcare environments to address competing needs and is not an inherently negative paradigm. Reconciliation of policy and the reality of practice can align with transformational leadership within an organization. Nurses must be a voice that innervates incremental change with the potential for meaningful impact (Kelly & Porr, 2018). Nurses on my unit have spoken out about high-risk clients and the need for complex case management and collaboration. Leaders respond to data and request that nurses bring specific cases for discussion at site-based meetings with stakeholders. Numerous cases illustrated and quantified that high-need patients were straining healthcare resources through frequent rehospitalization, and crisis interventions unveiling that outpatient care was not meeting their needs. A response was implemented as a universal synchronized one-hour weekly block of care coordination time for each clinician. This time can be used for team meetings, case management, extended patient care, or charting overflow. Collaborative care has genuinely benefited from this alignment in schedules by maximizing relationships on behalf of patients. This small change needs to be evolved and revisited as an iterative process.

Nurses have the power to influence policy. In the video, Freshman (Walden University, 2009) advises that the process begins with self-awareness and understanding the environment and why circumstances exist. Complaining is not the solution. Competencies in data collection, observation, and evidence-based knowledge must be leveraged to grab the attention of stakeholders. Nurses with high-emotional intelligence are effective in unifying organizational values with personal values.

The shortage of healthcare providers, including physicians and nurses, is a growing concern in many emergency rooms (ER). A few reasons contributing to the need are the hospital’s difficulty hiring and retaining staff, lack of funding, and increased demand for emergency services. Many hospitals implemented policies to help reduce the shortage, such as offering incentives or modifying working hours. To cover the lack of providers, many staff took extra shifts that interfered with their well-being, personal lives, and work performance. With the increased working hours, many nurses started facing ethical dilemmas because they were not providing the best care for their patients and putting them at risk due to the high work level. (Duquesne University, 2020)

To avoid medical errors and promote patient safety, the state of California mandated in an emergency room a nurse-to-patient ratio of 1:4 at all times. The nurse-to-patient ratios in California are considered some of the most stringent in the United States and have been credited with improving patient outcomes and reducing nurse burnout. (National Nurses United, n.d.)

Duquesne University (2020) Ethical issues in nursing: Explanations & solutions. https://onlinenursing.duq.edu/blog/ethical-issues-in-nursing/Links to an external site.

National Nurses United (n.d.) What does the California ratios law actually require. https://www.nationalnursesunited.org/what-does-california-ratios-law-actually-require

Grading Rubric

Performance Category 100% or highest level of performance

100%

16 points

Very good or high level of performance

88%

14 points

Acceptable level of performance

81%

13 points

Inadequate demonstration of expectations

68%

11 points

Deficient level of performance

56%

9 points

 

Failing level

of performance

55% or less

0 points

 Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

Presentation of information was exceptional and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in one of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
 

Presentation of information is unsatisfactory in two of the following elements:

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements

  • Provides evidence of scholarly inquiry relevant to required TD topic(s).
  • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
  • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
  • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
 16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
Application of Course Knowledge

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

Presentation of information was exceptional and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:

  • Applies principles, knowledge and information from scholarly resources to the required topic.
  • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements

  • Applies principles, knowledge and information and scholarly resources to the required topic.
  • Applies facts, principles or concepts learned scholarly resources to a professional experience.
  • Application of information is comprehensive and specific to the required topic.
   10 Points 9 Points  6 Points  0 Points
Interactive Dialogue

Initial post should be a minimum of 300 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated all of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 3 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 2 of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:

  • Initial post must be a minimum of 300 words.
  • The peer and instructor responses must be a minimum of 150 words each.
  • Responses are substantive
  • Responses are related to the topic of discussion.
  8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
Grammar, Syntax, APA

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

The source of information is the APA Manual 6th Edition

Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

  • 0-3 errors in APA format

AND

  • Responses have 0-3 grammatical, spelling or punctuation errors

AND

  • Writing style is generally clear, focused on topic,and facilitates communication.
The following was present:

  • 4-6 errors in APA format.

AND/OR

  • Responses have 4-5 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is somewhat focused on topic.
The following was present:

  • 7-9 errors in APA format.

AND/OR

  • Responses have 6-7 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is slightly focused on topic making discussion difficult to understand.
 

The following was present:

  • 10- 12 errors in APA format

AND/OR

  • Responses have 8-9 grammatical, spelling and punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.
 

The following was present:

  • 13 – 15 errors in APA format

AND/OR

  • Responses have 8-10 grammatical, spelling or punctuation errors

AND/OR

  • Writing style is not focused on topic, making discussion difficult to understand.

AND/OR

  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
The following was present:

  • 16 to greater errors in APA format.

AND/OR

  • Responses have more than 10 grammatical, spelling or punctuation errors.

AND/OR

  • Writing style does not facilitate communication
  0 Points Deducted 5 Points Lost
Participation

Requirements

Demonstrated the following:

  • Initial, peer, and faculty postings were made on 3 separate days
Failed to demonstrate the following:

  • Initial, peer, and faculty postings were made on 3 separate days
  0 Points Lost 5 Points Lost
Due Date Requirements Demonstrated all of the following:

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

Demonstrates one or less of the following.

  • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.