Assignment: Nursing Staffing Healthcare Issue Paper

Assignment: Nursing Staffing Healthcare Issue Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Nursing Staffing Healthcare Issue Paper Assignment: Analysis of a Pertinent Healthcare Issue Walden University NURS6053 Nursing Staffing Healthcare Issue Paper The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system. Assignment: Nursing Staffing Healthcare Issue Paper Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time. Assignment: Nursing Staffing Healthcare Issue Paper In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. Walden University NURS6053 Nursing Staffing Healthcare Issue Paper To Prepare: Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study. Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor. The Assignment (3 Pages): Analysis of a Pertinent Healthcare Issue Develop a 3-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Walden University NURS6053 Nursing Staffing Healthcare Issue Paper Summarize the strategies used to address t he organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. Assignment: Nursing Staffing Healthcare Issue Paper _week_2_assignment.docx article_3.pdf spread_too_thin.pdf the_continuing_saga_of_nurse_staffingpdf.pdf Assignment: Nursing Staffing Healthcare Issue Paper. 1 Title of Paper – Not Assignment # Your Name Walden University NURS 6053 Date Dr. E. Townsley 2 TITLE OF PAPER Title of Paper Remember to not write in first person. One of the skills of a leader is the ability to communicate effectively and efficiently. Introductory paragraph and purpose statement. This should provide your readers with their initial impressions of your argument, your writing style, and the overall quality of your work. A vague, disorganized, error-filled, off-the-wall, or boring introduction will probably create a negative impression. On the other hand, a concise, engaging, and well-written introduction will start your readers off thinking highly of you, your analytical skills, your writing, and your paper. Your introduction is an important road map for the rest of your paper. Your introduction conveys a lot of information to your readers. You can let them know what your topic is, why it is important, and how you plan to proceed with your discussion. ****The introductory paragraph is about the paper overall. For instance, if your paper is about nurse staffing, then the introductory paragraph would provide the national statistics about nurse staffing**** The purpose statement is written after completion of the introductory paragraph. A purpose statement is a declarative sentence which summarizes the specific topic and goals of a document. It is typically included in the introduction to give the reader an accurate, concrete understanding what the document will cover and what he/she can gain from reading it. To be effective, a statement of purpose should be: • Specific and precise – not general, broad or obscure • Concise – one or two sentences • Clear – not vague, ambiguous or confusing • Goal-oriented – stated in terms of desired outcomes ****The purpose statement is graded separately and needs to be complete and concise with only these four requirements**** 3 Walden University NURS6053 Nursing Staffing Healthcare Issue Paper TITLE OF PAPER National Healthcare Issue/Stressor Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Ensure all information is validated with current and credible citations/references. Informational Summary Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Ensure all information is validated with current and credible citations/references. Strategies Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. Ensure all information is validated with current and credible citations/references. Conclusion Your conclusion/summary is your chance to have the last word on the subject. The summary allows you to have the final say on the issues you have raised in your paper, to synthesize your thoughts, to demonstrate the importance of your ideas, and to propel your reader to a new view of the subject. It is also your opportunity to make a good final impression and to end on a positive note. Your summary can go beyond the confines of the assignment. This section pushes beyond the boundaries of the prompt and allows you to consider broader issues, make new connections, and elaborate on the significance of your findings. You should make TITLE OF PAPER 4 your readers glad they read your paper, and gives your reader something to take away that will help them see things differently or appreciate your topic in personally relevant ways.Walden University NURS6053 Nursing Staffing Healthcare Issue Paper It can suggest broader implications that will not only interest your reader, but also enrich your reader’s life in some way. It is your gift to the reader. 5 TITLE OF PAPER References Blouin, A. S., & Podjasek, K. (2019). The Continuing Saga of Nurse Staffing: Historical and Emerging Challenges. Journal of Nursing Administration, 49(4), 221–227. https://doiorg.ezp.waldenulibrary.org/10.1097/NNA.0000000000000741 Cho, E., Chin, D. L., Kim, S., & Hong, O. (2016). The Relationships of Nurse Staffing Level and Work Environment With Patient Adverse Events. Journal of Nursing Scholarship, 48(1), 74–82. https://doi-org.ezp.waldenulibrary.org/10.1111/jnu.12183 Kuwata, K. (2017). Spread Too Thin: The Case for Federally Mandated Minimum Nurse-ToPatient Ratios in Hospitals. Loyola of Los Angeles Law Review, 49(3), 635–659. Retrieved from https://search-ebscohostcom.ezp.waldenulibrary.org/login.aspx?direct=true&db=a9h&AN=123824511&site=edslive&scope=site Formatting for references starting on this page. Ensure you follow the guidance in Chapter 7 of the APA manual for all references. *****for full points on the grading rubric one of the items is to have at least three current and credible references****Current means – five years or less old****You can use any resources except Wiki, etc as identified in the syllabus to complete your assignments and discussions **** HEALTH POLICY AND SYSTEMS The Relationships of Nurse Staffing Level and Work Environment With Patient Adverse Events Eunhee Cho, PhD, RN1 , Dal Lae Chin, PhD, RN2 , Sinhye Kim, MSN, RN3 , & OiSaeng Hong, PhD, RN, FAAN, FAAOHN4 1 Associate Professor, College of Nursing & Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea 2 Postdoctoral Scholar, School of Nursing, University of California, San Francisco, San Francisco, CA, USA 3 Research Assistant, College of Nursing & Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea 4 Professor, School of Nursing, University of California, Walden University NURS6053 Nursing Staffing Healthcare Issue Paper San Francisco, San Francisco, CA, USA Key words Korea, nurse staffing, patient adverse events, patient outcomes, work environment Correspondence Dr. Dal Lae Chin, University of California, San Francisco (UCSF) School of Nursing, 2 Koret Way, N531H, San Francisco, CA 94143-0608. E-mail: [email protected] Accepted: October 27, 2015 doi: 10.1111/jnu.12183 Abstract Purpose: The purpose of this study was to examine the relationships of nurse staffing level and work environment with patient adverse events. Design: This cross-sectional study used a combination of nurse survey data (N = 4,864 nurses), facility data (N = 58 hospitals), and patient hospital discharge data (N = 113,426 patients) in South Korea. Methods: The three most commonly nurse-reported adverse events included administration of the wrong medication or dose to a patient, pressure ulcers, and injury from a fall after admission. Multilevel ordinal logistic regression was employed to explore the relationships of nurse staffing level (number of patients assigned to a nurse) and work environment (Practice Environment Scale of the Nursing Work Index) with patient adverse events after controlling for nurse, hospital, and patient characteristics. Findings: A larger number of patients per nurse was significantly associated with a greater incidence of administration of the wrong medication or dose (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.007–1.016), pressure ulcer (OR = 1.01, 95% CI = 1.007–1.016), and patient falls with injury (OR = 1.02, 95% CI = 1.013–1.022). A better work environment had a significant inverse relationship with adverse events; the odds of reporting a higher incidence of adverse events were 45% lower for administration of the wrong medication or dose (OR = 0.55, 95% CI = 0.400–0.758), Walden University NURS6053 Nursing Staffing Healthcare Issue Paper followed by 39% lower for pressure ulcer (OR = 0.61, 95% CI = 0.449–0.834) and 32% lower for falls with injury after admission (OR = 0.68, 95% CI = 0.490–0.939). Conclusions: This study found that a larger number of patients per nurse and poor work environment increase the incidence of patient adverse events, such as administration of the wrong medication or dose to a patient, pressure ulcers, and injury from falling after admission. The findings suggest that South Korean hospitals could prevent patient adverse events by improving nurse staffing and work environment. Clinical Relevance: Healthcare strategies and efforts to modify adequate nurse staffing levels and better work environments for nurses are needed to improve patient outcomes. South Korea is experiencing an increase in the incidence of chronic diseases due to the rapid growth of its aging population and higher rates of risky health behaviors, 74 such as smoking and alcohol consumption (Organization for Economic Cooperation and Development [OECD], 2012). According to the OECD’s Health Care Quality Journal of Nursing Scholarship, 2016; 48:1, 74–82. C 2015 Sigma Theta Tau International Work Environment and Adverse Events Cho et al. Review, despite increased investments in hospitals, greater accessibility to hospital care, and advanced medical technologies, the Korean health system continues to deliver a relatively lower quality of health care than other OECD countries (OECD, 2012). For example, a study by Aiken, Sloane, et al. (2011) that used data from nearly 100,000 nurses in nine countries between 1999 and 2009 found that nurses in South Korea (68%) were more likely to report that the quality of patient care on their unit was only fair or poor (as opposed to good or excellent) than nurses in other countries (only 11% of nurses in Canada). Therefore, the quality of care in South Korea remains a considerable public health challenge. Walden University NURS6053 Nursing Staffing Healthcare Issue Paper The quality of health care is often evaluated using patient outcomes. Patient adverse events (including medication error, fall, urinary tract infection, pneumonia, and pressure ulcer) and patient mortality are frequently used to assess patient outcomes (Kane, Shamliyan, Mueller, Duval, & Wilt, 2007; Lang, Hodge, Olson, Romano, & Kravitz, 2004; Stalpers, de Brouwer, Kaljouw, & Schuurmans, 2015). Because nurses represent the largest group of hospital employees who deliver most of the direct patient care, nurse care is one of the most important areas of quality of health care and patient safety (Institute of Medicine [IOM], 2011). Nurse staffing level (e.g., patient-to-nurse ratio) plays a significant role in the outcomes of hospital patients (Aiken et al., 2014). Much of the literature published in connection with studies conducted in the United States and Europe and reviews of the literature and meta-analyses have demonstrated the relationship among the level of nurse staffing in hospitals, patient mortality, and adverse patient events. Better patient-to-nurse staffing ratios have been significantly associated with lower rates of hospital mortality, failure to rescue, cardiac arrest, hospital-acquired pneumonia, patient fall, pressure ulcer, or other adverse events (Aiken, Sloane, et al., 2011; Cho et al., 2015; Kane et al., 2007; Needleman, Buerhaus, Stewart, Zelevinsky, & Mattke, 2006; Rafferty et al., 2007; Stalpers et al., 2015). Furthermore, previous studies suggest that a better nursing work environment is associated with higher levels of quality and patient safety and fewer patient adverse events (Aiken, Cimiotti, et al., 2011; Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Aiken, Sloane, et al., 2011; Cho et al., 2015; Friese, Lake, Aiken, Silber, & Sochalski, 2008; IOM, 2004). Better work environments often include ardent nurse participation in hospital affairs, a solid nursing foundation for quality of care, strong nurse leadership, adequate resources, and good working relationships between doctors and nurses (Aiken, Cimiotti, et al., 2011; Lake, 2002). Thus, nurse staffing level and nurse work environment should be considered critical factors that influence adverse patient events in South Korea. Journal of Nursing Scholarship, 2016; 48:1, 74–82. C 2015 Sigma Theta Tau International Although there is strong empirical evidence from several studies in the United States and Europe (Kane et al., 2007; Lang et al., 2004; Stalpers et al., 2015), little is known about whether the significant associations of patient outcome with nurse staffing and nurse work environment are also present in South Korean hospitals. Therefore, the purpose of this study was to examine the relationships of nurse staffing level and nurse work environment with patient adverse events. Walden University NURS6053 Nursing Staffing Healthcare Issue Paper Numerous previous studies conducted in the United States (Aiken, Cimiotti, et al., 2011; Blegen, Goode, Park, Vaughn, & Spetz, 2013; Blegen, Goode, Spetz, Vaughn, & Park, 2011; Cho, Ketefian, Barkauskas, & Smith, 2003) and recently in nine European countries (Belgium, England, Finland, Ireland, the Netherlands, Norway, Spain, Sweden, and Switzerland; Aiken et al., 2014) have identified several nurse (e.g., nursing education, unit type), hospital (e.g., hospital size, teaching status), and patient characteristics (e.g., age, comorbidities) that affect patient outcomes, which were included here as covariates. Based on previous research evidence, the theoretical perspective for this study is that appropriate nurse staffing level and nurse work environment in hospitals may ensure the quality of health care they provide, and in turn affect the health outcomes of hospital patients. Patient outcomes in this study are measured by patient adverse events, including administration of the wrong medication or dose, pressure ulcer, and injury from falling after admission. We adjusted for other covariates, including nurse, hospital, and patient characteristics that are correlated with patient adverse events. We hypothesized positive relationships among a larger number of patients per nurse, poor work environment, and incidence of patient adverse events, after controlling for nurse, hospital, and patient characteristics. Methods Setting and Sample This study was conducted with a combination of nurse survey data, facility data, and hospital discharge data from South Korea using a common research protocol and instruments established by Aiken and colleagues in the United States and other countries (Aiken, Cimiotti, et al., 2011; Aiken et al., 2014; Aiken, Sloane, et al., 2011).Walden University NURS6053 Nursing Staffing Healthcare Issue Paper The nurse survey data were collected from 60 randomly selected hospitals out of all 295 acute hospitals with 100 or more beds in all seven metropolitan cities and all nine provinces in South Korea. In order to assure the representativeness of hospitals selected, these 60 hospitals were selected by a stratified random sampling method based on location (Seoul, other metropolitan areas, and 75 Work Environment and Adverse Events provinces) and bed size (100–399, 400–699, 700–799, and 1,000 or above). Units were also randomly selected from the list of units at each hospital by using a random table. The number of nurses varied based on the number of beds of hospitals and types of units. Thus, we selected units in different proportions based on the number of beds of hospitals and types of units. Namely, in the hospitals with 100 to 699 beds, all units were included, while 50% from all general wards and one from each type of special unit (e.g., intensive care unit, perioperative unit, and emergency room) in hospitals with 700 to 999 beds were randomly selected, and 20% from all general wards and one from each type of special unit of units in hospitals with 1,000 or more beds were randomly selected. All nurses working in the selected units on the date of data collection were invited to complete the survey. The surveys were distributed to nurses at each hospital. Once the participating nurses completed the survey in private, the completed questionnaires were placed in sealed envelopes and dropped in locked boxes located in each unit at each participating hospital to ensure anonymity. The staff of the department of nursing at each participating hospital mailed the unopened boxes to the principal investigator. The total of 5,103 registered nurses (RNs) from 60 hospitals were invited to participate in the study, and 4,910 completed the survey, a response rate of 96.2%. Walden University NURS6053 Nursing Staffing Healthcare Issue Paper This study was able to achieve the high response rate because the design involved recruiting hospitals first and then sampling nurses directly from participating hospitals, which tends to achieve a higher response rate than recruiting individual nurses (Aiken et al., 2012; Aiken, Sloane, et al., 2011). In addition, as demonstrated in an earlier study (Aiken, Sloane, et al., 2011), a high response rate is often found in Asian countries. More detailed information on the nurse survey is published elsewhere (Aiken, Sloane, et al., 2011; Cho et al., 2013). The facility data and hospital discharge data were collected by the Health Insurance Review Agency (HIRA) in South Korea. The hospital discharge data of patients who underwent general, orthopedic, or vascular surgery in 2008 and who were between the ages of 19 and 89 years were included in the analysis. The hospital discharge data were aggregated to the hospital level in order to adjust the case mix of patients, which represents the difference in severity of illness and the characteristics of patients across hospitals. The hospital discharge data of 2 of the total 60 hospitals were not available. Therefore, this study analyzed the combined data of 58 hospitals, 113,426 patients, and 4,864 nurses. The study protocol was approved by the institutional review board of the authors’ affiliated university. 76 Cho et al. Measures Adverse events. Three nurse-reported adverse events were examined as outcome variables. Nurses were asked how often patients received the wrong medication or dose and how frequently patients experienced pressure ulcer or fall with injury after admission. Nurses rated the frequency of each adverse event on a 7-point Likert scale that ranged from never to every day. These nurse-reported adverse events have been used in many international studies and reported as reliable and valid measures (Aiken, Sloane, Bruyneel, Van den Heede, & Sermeus, 2013; Ausserhofer et al., 2013; Cina-Tschumi, Schubert, Kressig, De Geest, & Schwendimann, 2009; Kelly, Kutney-Lee, Lake, & Aiken, 2013; Lucero, Lake, & Aiken, 2010; Van Bogaert et al., 2014). Nurse staffing level and work environment. The nurse staffing level was assessed using a single selfreport questionnaire regarding the number of patients each participating nurse had cared for on his or her last shift. The nurse work environment was measured using the Korean version of the Practice Environment Scale of the Nursing Work Index (PES-NWI), which has demonstrated good validity and reliability (Cho, Choi, Kim, Yoo, & Lee, 2011). Walden University NURS6053 Nursing Staffing Healthcare Issue Paper The Korean version of the PES-NWI has 29 items with five subscales consisting of nine items regarding nurse participation in hospital affairs (e.g., opportunity for staff nurses to participate in policy decisions); nine items to assess nursing foundations for quality of care (e.g., written, up-to-date nursing care plans for all patients); four items for nurse manager ability, leadership, and support of nurses (e.g., a nurse manager who is a good manager and leader); four items that investigate the staffing and resource adequacy of a facility (e.g., enough RNs to provide quality patient care); and three items for collegial nurse–physician relations (e.g., physicians and nurses have a good working relationship). Each item was rated on a 4-point Likert scale, ranging from “1 = strongly disagree” to “4 = strongly agree,” and a higher score indicated a more supportive work environment. Cronbach’s alphas for the five subscales of the Korean version of the PES-NWI ranged from 0.80 to 0.93. To calculate the composite score, the subscale scores of individual nurses were aggregated to the hospital level mean, and the distance of the hospital level mean from the median for all hospitals on five subscales was determined; these values ranged from 0 to 5. Hospitals were categori … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10