Capstone Project Change Proposal Discussion Paper

Background

Nursing shortage is identified in relation to current rates of demands which are not fulfilled either in the present or in the recent past, and when compared with current nurses and those still in the institutions of learning. A shortage of nursing resources has been identified in multiple healthcare institutions in the United States and there are incidents of aged nurses that are not being replaced. Much of the aging nurses’ retirements are not substituted by an equal amount of new nurses. Marć et al. (2019) points out that the shortfall is not quantifiable, but most of it is characterized by a limited number of nurses who have to address an immense void in the vacancies of the healthcare system. The primary concern of this crisis is not in the case of uninsured nurses serving in private hospitals, but primarily registered nurses (RNs) that are less likely to be in government health care (“Nurse shortage linked to higher neonatal mortality, 2016) Capstone Project Change Proposal Discussion Paper.

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Problem statement

There is no positive benefit of nurses’ shortage as it has an adverse effect on patient ratios, safety, and care quality. Deficiencies of healthcare practitioners unfavorably influence the patients’ care as it increases the level of mortalities in healthcare institutions (Driscoll et al., 2018). From the monetary point of view, this nursing shortage impacts the healthcare clinic with a high mortality rate that is perceived as the asset loss to the wiped out patient in the search for rehabilitation. The study by Driscoll et al. (2018) found that a high nurse staffing level was linked to a lower mortality risk and nurse-sensitive outcomes during hospitalization. Mortality is, therefore, a loss to the nation’s jobs and skills resources. It is a tragedy for everyone involved because it has satisfactory staff; a health facility should provide any patient with reliable and appropriate social insurance Capstone Project Change Proposal Discussion Paper.

Late predictions have shown that the shortage is on the upward trend. Health staff placed on the sector from nursing institutions is not sufficient to take care of client demands. The comparison was seen on the enrollment levels (Marć et al., 2019). These are people who are willing to be healthcare providers, however, the learning institutions are not enough or have hardly any roles determined by the scale of the organizations. It has already been said, emergency departments are hit by retirements that are not substituted by a comparable amount on the industry. The new openings from the retirement age and the people who resign from the administration have not been superseded Capstone Project Change Proposal Discussion Paper.

Having arrived at this stage, the problem may be, the reason for the nursing shortage. There are a few explanations of why the loss cannot be avoided. This has been stated for a few reasons that there is a need for adequate offices to train enough nurses to fulfill the existing needs (Carnevale, Smith, and Gulish, 2015). Similarly n, due to the shortage of nursing professionals, a great number of individuals have been shown to be distressed. This was also the case with individuals avoiding this area. The status of a professional medical caregiver is poor and well known as a culture. It can be used as a justification for low rates of enrolment among people who agree that they have a duty to worry about getting wiped out as part of their lives. Likewise, it would be appropriate to take a proper look at the rewards offered to the registered nurses. It has been shown that the recruitment of medical staff is currently slow in comparison to the job they do (Driscoll et al., 2018). Execution iterations are not fully revised in the nursing sector. Registered nurses are often ineffectively compensated in comparison to other sectors. This results in a low degree of motivation, frustration, and, in any case, a halt Capstone Project Change Proposal Discussion Paper.

Purpose of the Change Proposal

The main purpose is to propose a change that will improve patient care quality at the healthcare institutions. Drennan & Ross (2019) suggest that nurse leaders should implement good evidence-based HRM practices known to decrease high rates of voluntary nurses’ turnover such as clear and well-understood nursing recruitment and retention strategies. Research conducted by WHO shows there are 21 million nursing and midwives shortages across the globe as in 2014 (Buchan, Duffield & Jordan 2015). Healthcare facilities have encountered a number of difficulties with regard to hiring and retaining skilled nurses relative to other sectors. .Despite the imminent threat, the goal is to take steps that can be extended to the execution of a strategic program that can enhance both the facilities provided and the rate of retaining nurses Capstone Project Change Proposal Discussion Paper.

PICOT

The change proposal uses the following picot statement:

Population

The organization is a large regional hospital with a 700-bed capacity that serves a diverse population of more than 100,000 people.

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Intervention

An effective recruitment strategy is providing support and transition programs for newly hired nurses and implementing a collaborative leadership style to foster teamwork and group cohesion. Retention strategies that reduce nursing turnover are giving flexible work schedules, providing opportunities for career advancement, recognizing, and rewarding performers. (Johnson et al., 2016)These strategies do not only help to create a positive work environment but also inspire nurses to work. The aforementioned strategies also ensure that nurses practice to the full scope of their training. According to Goodare (2017), implementing good HRM strategies in nursing practice influences a decrease in nurses’ workloads, prompting them to take a workload that is more realistic than not only boosts their job satisfaction but also reduces fatigue, and intention to leave the practice Capstone Project Change Proposal Discussion Paper.

Comparison

The analysis methodology will evaluate the prior approaches promoted by previous experts in comparison to what the healthcare agency is doing to minimize the nursing shortage. Strategies involve long-term usages, such as recruiting seasoned workers and new strategies, such as enhancing connectivity and increasing coordination.

Outcome

To determine the educational requirement that would strengthen organizational abilities in order to improve the patient’s safety and quality of care provided. This is clear even when good coordination is accomplished, that they work for sufficient hours to cope with job-related exhaustion. The outcome will be enhanced the delivery of quality care and patient safety. Moreover, there will be improved retention levels and an impressive turnover.

Time

The project requires a year to improve the quality of care and the safety of the patient at the healthcare institution. The period for the research is distributed over ten weeks for the capstone project.

Therefore the PICOT question reads, Do inadequate nursing staffing levels in a healthcare agency impact nurse to patient ratio, patient safety, and quality of care Capstone Project Change Proposal Discussion Paper.

Literature Search Strategy Employed

The research will use peer-reviewed articles from 2015 to 2020 in support of the capstone project of how inadequate staffing in healthcare facilities affects patient’s mortality rates. The Grand Canyon University library supported the research project. Among the keywords used in deciding the correct articles include nursing shortage, nurse to patient ratios, and registered nurses.

Evaluation of the Literature

The literature review focused on both qualitative and quantitative studies of which eight articles were used to analyze the impact of the number of registered nurses in the different healthcare agencies. The study looked more closely at the influence of the other organizations and the fundamental causes that lead explicitly or indirectly.

Applicable change or nursing theory utilized

The improvement in the framework used involves the usage of evidence-based practice where changes are produced from time to time. Written research from the peer-reviewed articles produced the details needed since the different measures taken over time can be seen. Healthcare facilities are diverse and met with many obstacles that require them to improvise on their provision of care from time to time. The biggest problem facing the healthcare system is the inadequate staff, which has impaired the provision of services Capstone Project Change Proposal Discussion Paper.

Proposed Implementation Plan with Outcome Measures

Management should coordinate educational programs to understand the principles of nurse retention by reducing the workload and offering instruction. n As a consequence, the management should be in a position to come up with measures to understand the benefits offered by enhanced incentive programs and to strengthen trust. This would be an enhancement to the mission and vision statements already identified. In turn, administrators should include recommendations about how to minimize stress by recruiting additional staff at the healthcare department. In fact, operating as a team would improve family life as each nurse would feel a sense of belonging to the community rather than simply becoming an employee.

Identification of Potential Barriers to Plan Implementation, And A Discussion Of How These Could Be Overcome

Rigidity is one of the main hindrances to the health agency’s recommendations for improvement (Haddad et al., 2020). Management seems hesitant to adjust as it mentions the burden of retaining a number of trained nurses. However, several of the nurses employed here do not see themselves staying there for the next two or four years. In the earlier suggested proposals to expand care at the medical center, the expense of recruiting and educating nurses would be minimized. Techniques should encourage retention levels and enhanced facilities Capstone Project Change Proposal Discussion Paper.

References

Buchan, J., Duffield, C., & Jordan, A. (2015). ‘Solving’ nursing shortages: do we need a New Agenda? Journal of Nursing Management23(5), 543-545.

Carnevale, A. P., Smith, N., & Gulish, A. (2015). Nursing: Supply and demand through 2020.

Drennan, V. M., & Ross, F. (2019). Global nurse shortages—the facts, the impact, and action for change. British medical bulletin130(1), 25-37.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing17(1), 6-22.

Goodare, P. (2017). Literature review: Why do we continue to lose our nurses?. Australian Journal of Advanced Nursing, The34(4), 50.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing.

Johnson, W. G., Butler, R., Harootunian, G., Wilson, B., & Linan, M. (2016). Registered nurses: The curious case of a persistent shortage. Journal of Nursing Scholarship48(4), 387-396.

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International nursing review66(1), 9-16 Capstone Project Change Proposal Discussion Paper.

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this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system. PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures. Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Capstone Project Change Proposal Discussion Paper