Analysis of a Pertinent Healthcare Issue: Short Staffing

Analysis of a Pertinent Healthcare Issue: Short Staffing- Develop a 3- to 4-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…

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Analysis of a Pertinent Healthcare Issue: Short Staffing

Paper details

Develop a 3- to 4-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.

•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.

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The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.

Use these 3 course specific resouces

• https://human-resources- health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3
• Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040
• Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005

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Solution

Analysis of Short Staffing

Introduction

Short staffing among nurses is among the critical issues affecting performance and outcomes within the organization. Short staffing occurs when the number of admitted patients surpasses the maximum capacity per nurse set by standards of quality and safety. While short-staffed shifts are nearly typical in most organizational departments, short staffing coupled with long working hours affects nursing outcomes and is a stressor that leads to poor outcomes such as nurse burnouts, medication errors, patient dissatisfaction, and falls.

Nationwide nurse shortages, high turnover rates among nurses, schedule access and rigidity as well as heavy workloads are among the critical factors of the stressor. It is imperative to examine short staffing to determine its impact, understand how other organizations address the issue, the potential strategies to mitigate the issue in the organization as well as the potential outcomes of the implementation.
Impact

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Nationally, short staffing combined with long working hours is linked to nurse burnout, which accounts for 17.5% of newly licensed RNs turnover with the first year, and up to one in three nurses leaving within two years. In the last three years, the organization has reported a turnover of 20% annually.

Short staffing is one of the critical issues leading to this phenomenon, with 32% of the nurses leaving coming from the ED, where short staffing and combined shifts are typical. Estimates show that replacing RNs due to burnout costs facilities an average of $60,000 (Haddad, Annamaraju, Toney-Butler, 2020). Besides the high turnover rates, recent surveys show a declining patient satisfaction reduces the ability of the organization to attract or retain patients. This could be among the factors limiting the organization’s revenue.

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The incidence of falls and safety issues within the facility is also linked to short staffing. Even though falls are keenly monitored in the facility, units with cases of short staffing have more cases of falls. Despite efforts of using bed alarms, delayed responses can be minimized by having sufficient nursing ratios. On a national scale, short staffing increases the risk of falls, which is closely associated with more extended hospital stays, high costs, and higher mortality among elderly patients.

Moreover, heavy workloads are associated with suboptimal patient care. Cases of infections, medication errors, and a higher number of complications are because of short-staffed shifts in the facility. With the growing sizes and increased complexity of healthcare systems, it is critical to institute measures of workforce planning that address the short staffing and long-work hours among nursing (Pittman, & Scully-Russ, 2016). The benefits will include improved patient outcomes, safe and high-quality care delivery, and better patient and nurse satisfaction.

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Summary of Two Articles

Taking Nurse Staffing Research to the Unit Level

Paulsen (2018) examines nurse-staffing issues at the unit level to determine the impact they have on clinical practice. Paulsen (2018) points out that nurse staffing measured by full-time equivalents and hours per patient day (HPPD) is inversely correlated with patient mortality and failure to rescue.

Secondly, nurses account for 30% of all healthcare salaries; hence having effective staffing frameworks plays a critical role in meeting organizational financial outcomes. Furthermore, failure to meet safety and quality issues is associated with high costs and a potential breakdown of operations, with nursing staffing playing an integral determinant role.

Differentially, Paulsen (2018) links patient acuity to nursing workload and unit workflow and notes that using patient acuity to make staffing decisions rather than solely relying on meeting nurse-patient ratios. Besides, unit workflow tasks such as admissions and discharges should be accounted for in staffing as they often result in workflow disruptions.

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Paulsen’s (2018) analysis also shows that longer shifts and a short time away from work precede increased patient mortality and poorer quality outcomes for pediatric patients. On the way forward, Paulsen (2018) calls for better data collection through nursing informatics to capture and equip unit-level staffing as well as patient outcomes.

Nurse Staffing, Nurses’ Prioritization, Missed Care, Quality of Nursing Care, And Nurse Outcomes
Cho, Lee, You, Song & Hong (2o20) analyze the correlation between nurse staffing, nurse prioritization, missed care, quality of nursing care, and nursing outcomes. Examining the impact of missed care in nursing outcomes offers a comprehensive understanding of the impact short-staffing has on nurses.

The researchers measure nursing staffing by determining the patient to RN ratio and perceived staffing adequacy. Cho, Lee, You, Song & Hong (2o20) find that nurses who took care of more patients and perceived staffing to be insufficient reported missing more nursing activities.

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Further, the study underlined that high-priority activity, such as turning the patient and full documentation, were commonly missed by nurses with heavy workloads. Emotional support was also limited as most nurses working on more patients. Besides, Cho, Lee, You, Song & Hong (2o20) also show that missed care and nursing staffing substantially influenced patient safety and quality of nursing care as reported by nurses and also job satisfaction and the intent to leave.

How Short Staffing Is Addressed In Other Organizations

Increasing staffing levels is the primary anecdote for short-staffing in most organizations. In an analysis of 28 facilities, 19 approached the issue by increasing nurse-staffing levels to reduce individual nurse workloads (May, Bazzoli, & Gerland, 2006). Secondly, some organizations initiated changes in the roles and responsibilities of nurses.

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In this, the facilities created teams of nurses to address critical patients, support staff to address the patient’s personal needs and older nurses to help with paperwork and administrative roles. Further, of the 28 facilities, 14 made changes on the unit layouts by redesigning stations and introducing new technology for communication and information sharing as well as automation (May, Bazzoli, & Gerland, 2006). The outcomes include better patient outcomes and higher nurse satisfaction.

Strategies used to address the organizational impact of Short Staffing.

In the short-term, organizations are utilizing more temporary staff to reduce the impact on short staffing on patient outcomes and the quality of care and safety. Per-diem nurses, as well as traveling nurses, fill individual shifts to help reduce the workloads of nurses and introduce flexibility in scheduling and staffing (May, Bazzoli, & Gerland, 2006). To address concerns of quality and experience, facilities create internal agencies for per-diem nurses that effectively check on quality issues.

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Besides the use of temporary workers, organizations also use salary and financial benefits to attract and retain nurses. A combination of bonuses, rewards, and benefits help improve nurse satisfaction and improves engagement. This helps sustain and retain nurses, which, in turn, minimized disruptions due to high turnover rates.

Long-term strategies include establishing frameworks that support and encourage nursing education and professional progression. Organizations that offer training were highly likely to have nurses with high work commitment and have access to large pools of nurses to cater for the excess workloads. Moreover, perquisites such as tuition reimbursement, and flexible schedules helped improve the capability of organizations to attain and retain quality nurses.

Creating a supportive and flexible work environment is also linked to better nursing outcomes and a commitment to reducing nursing staffing issues (Poghosyan, Norful, & Laugesen, 2018). This included engaging in scheduling decisions and establishing reliable data collection approaches to help progressively improve scheduling.

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The positive and negative impact of addressing Short Staffing

The strategies will improve patient and nurse outcomes in the facility. The best solution is to increase nursing staffing levels per unit. However, the approach may have huge-cost implication and requires systematic frameworks for orientation and quality assurance. The organization can also bring in more temporary staff. By doing so, the organization will be able to reduce the workloads of each nurse, creating more time to deliver quality care to patients sufficiently.

However, it is imperative to implement quality and safety guidelines to ensure the new nurses maintain and improve quality care delivery. Improving the salary and benefits of nurses will also boost attrition and facilitate better care delivery. Taking part in nursing education will also improve the organization’s ability to retain and attain new nurses. However, these are long-term plans with huge-cost implications

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References

• Cho, S. H., Lee, J. Y., You, S. J., Song, K. J., & Hong, K. J. (2020). Nurse staffing, nurses’ prioritization, missed care, quality of nursing care, and nurse outcomes—International Journal of Nursing Practice, 26(1), e12803.
• Haddad LM, Annamaraju P, Toney-Butler TJ. Nursing Shortage. [Updated 2020 Mar 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/
• May, J. H., Bazzoli, G. J., & Gerland, A. M. (2006). Hospitals’ Responses to Nurse Staffing Shortages: Hospitals’ actions have a positive impact, but can it be sustained in the long run? Health Affairs, 25(Suppl1), W316-W323.
• Paulsen R. A. (2018). Taking nurse-staffing research to the unit level. Nursing Management, 49(7), 42–48. https://doi.org/10.1097/01.NUMA.0000538915.53159.b5
• Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human resources for health, 14(1), 56.
• Poghosyan, L., Norful, A. A., & Laugesen, M. J. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York State: Physicians and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. https://doi.org/10.1097/JXX.0000000000000040

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