Short Staffing in a Hospital Unit

Introduction

Healthcare institutions can use different clinical questions to formulate appropriate strategies that can promote the quality of care availed to their clients. Healthcare professionals can embrace the power of evidence-based practice in order to address the major issues affecting quality patient care (Nardi & Gyurko, 2013). Evidence-based practice is an approach whereby “informed values guided by clinical expertise and research findings are used to improve patient outcomes” (Ball, Doyle, & Oocumma, 2015, p. 119). The findings must be analyzed and critiqued to transform nursing in a positive manner (Hussain, Rivers, Glovert, & Fottler, 2012). Clinical Practice Guidelines (CPGs) are evidence-based resources or documents aimed at guiding the use of current evidence in nursing practice. Institutions and practitioners can use this CPGs as evidence-based ideas to address a wide range of clinical problems. A good example of such clinical issues is the current nursing shortage faced by many healthcare institutions.

The problem of nursing shortage continues to affect the quality of support and care delivered to many American citizens (Nardi & Gyurko, 2013). Kowalski and Kelley (2013) observed that the shortage was going to worsen over the next five years. Several factors have led to this nursing problem. For example, many practitioners and registered nurses (RNs) leave this profession every year (Littlejohn, Campbell, Collins-McNeil, & Khayile, 2012). The absence of qualified medical instructors and lack of funding have contributed to this shortage. Many students fail “to meet the minimum requirements for practice” (Nardi & Gyurko, 2013, p. 321). Experts believe that this problem has affected America’s healthcare sector for over six decades. Adequate measures have therefore been proposed in an attempt to deal with the nursing shortage. The targeted hospital unit has failed to achieve its potential because of this shortage.

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Scope and Purpose

This guideline seeks to present standardized recommendations that can make it easier for the targeted hospital unit to deal with the problem of nursing shortage. The recommendations are based on evidence-based scientific findings that have worked effectively in different healthcare settings (Littlejohn et al., 2012). The suggestions, if implemented properly, can address the existing nursing shortage and make the hospital unit successful.

Stakeholder Involvement

The targeted unit can achieve positive results if it involves a number of key stakeholders throughout the implementation process (Peterson et al., 2014). An effective plan was developed to guide the unit. Several professionals and players played a major role in realizing the targeted objectives. The stakeholders included:

  • Charge Nurses (CNs)
  • Health care providers
  • Hospital Unit Manager
  • Nurses and nurse aids
  • Physicians
  • Subordinate staff

These players were encouraged to present meaningful ideas and guidelines that could deal with the targeted question. The professionals identified the best skills and competencies towards addressing the healthcare issue (Peterson et al., 2014). The main focus was on the importance of hiring more nurses and nurse aides. The move was expected to produce positive results and make the hospital unit successful.

The target population included patients, family members, and members of staff. These individuals were critical towards promoting the performance of the healthcare organization. However, some conflicts of interest were expected to affect the implementation process. For instance, the health manager believed that the current workforce could be empowered in order to deal with the problem. As well, some nurses and caregivers indicated that they were being overworked (Ball et al., 2015). The patients were pushing the institution to provide evidence-based, timely, and quality care. These conflicting issues affected the quality of the targeted study.

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Rigor of Development

Evidence-based research findings can present meaningful ideas for policy implementation and improvement of nursing care. During the first phase, the authors selected various scholarly and peer-reviewed articles from different databases. The articles were then evaluated using the AGREE (Appraisal of Guideline Research and Evaluation) tool. The team selected quality arguments and ideas from the articles in order to develop appropriate recommendations (Peterson et al., 2014). The identified articles had been published within the past five years. They were also obtained from the databases presented below.

  • Medline
  • EMBASE
  • Project Muse
  • Cochrane
  • NHS Economic Evaluation Database

The next activity was to complete the second phase. The team used filters to select articles that focused on the issue of nursing shortage in clinical settings (Ball et al., 2015). The team also outlined the quality of the presented recommendations and argued. Information obtained from evidence-based sources and specialists in nursing practice was identified. Most of the articles embracing the use of qualitative research designs were targeted during the second phase.

A thorough analysis of the content was done in order to come up with useful recommendations. Different frameworks such as the Evaluation and Equality in Health (EEH) were used to ensure the information could be replicated in different healthcare settings (Hussain et al., 2012). The approach made it easier for the team to come up with beneficial recommendations for the hospital unit.

Recommendations

The completed document outlined several aspects and practices that can make a difference for many healthcare institutions. The important thing is for hospital units to be aware of the unique challenges and complexities affecting their health care practices (Nardi & Gyurko, 2013). The major recommendations identified by the team are presented below.

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  • The health manager can hire more nurses to address the nursing shortage
  • The hospital can reschedule the duties and roles of its current workers
  • Patients and patient advocates can be involved in the treatment process in order to improve service delivery
  • Leadership is critical towards supporting the performance of different workers
  • The unit can hire and train more nursing aids
  • Volunteers can be attracted to improve service delivery

The GRADE system was used to monitor the strengths and weaknesses of the listed recommendations. In order to select the most desirable recommendations, the system considered the appropriateness of each approach towards “reducing costs of care, improving quality, and promoting safety” (Peterson et al., 2014, p. 61). These aspects made it easier for the group to come up with the above list of recommendations.

Every individual working in the hospital unit should embrace the best competencies in order to support the needs of the targeted patients. New practices should be introduced in order to attract more caregivers and nurses. The manager should also embrace the best leadership practices. This approach can be critical towards improving the morale of the current workers and reducing the rate of turnover (Nardi & Gyurko, 2013).

Implementation

The hospital should examine the presented list of recommendations in order to come up with the best implementation strategy. The unit manager will then analyze the unique needs of the current workers. The grievances obtained from different patients can be used to dictate the best implementation process (Peterson et al., 2014). The next move will be to hire more nurses and nurse aides. These practitioners should possess the required competencies in order to produce quality results.

Issues of costs should also be considered before hiring more workers. For instance, the institution should be able to pay these new recruits. As well, volunteers can be identified and attracted in order to boost the unit’s performance (Kowalski & Kelley, 2013). The guidelines and provisions provided by the hospital should be consulted throughout the implementation process. The selected recommendations should be implemented immediately in order to deliver positive results. Families and patients should be involved throughout the process in an attempt to produce quality outcomes.

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Conclusion

Kowalski and Kelley (2013) believe that “nursing shortage remains a major challenge in the United States and other parts of the world” (p. 72). Healthcare institutions should examine their unique issues associated with this healthcare problem. With this knowledge, such organizations will outline the best practices and initiatives in order to improve the quality of care availed to their patients. Institutions can decide to hire more nurses, attract volunteers, and empower the existing workforce (Hussain et al., 2012). As well, healthcare facilities can combine these strategies to produce tangible results and support the needs of their patients. The above evidence-based recommendations will make it easier for the targeted hospital unit to improve the quality of care provided to its patients. This approach will also make it one of the leading providers of timely, quality, evidence-based, and sustainable care to more patients.

Reference List

Ball, K., Doyle, D., & Oocumma, N. (2015). Nursing Shortages in the OR: Solutions for New Models of Education. AORN, 101(1), 115-136.

Hussain, A., Rivers, P., Glovert, S., & Fottler, M. (2012). Strategies for Dealing with Future Shortages in the Nursing Workforce: A Review. Health Services Management Research, 25(1), 41-47.

Kowalski, K., & Kelley, B. (2013). What’s the ROI for Resolving the Nursing Faculty Shortage? Nursing Economics, 31(2),70-76.

Littlejohn, L., Campbell, J., Collins-McNeil, J., & Khayile, T. (2012). Nursing Shortage: A Comparative Analysis. International Journal of Nursing, 1(1), 22-27.

Nardi, D., & Gyurko, C. (2013). The Global Nursing Faculty Shortage: Status and Solutions for Change. Journal of Nursing Scholarship, 45(3), 317-326.

Peterson, H., Barnason, S., Donnelly, B., Hill, K., Miley, H., Riggs, L.,…Whiteman, K. (2014). Choosing the Best Evidence to Guide Clinical Practice: Application of AACN Levels of Evidence. Critical Care Nurse, 34(2), 58-68.

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