Organizational Policies and Practices to Support Healthcare Issues

Organizational Policies and Practices to Support Healthcare Issues

NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

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.

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

The main discussion will need at least 3 references and also in APA 7 format

The two discussions below will need at least three references all in APA 7 format each

Thomas discussion

Competing needs in the world of healthcare exist on a number of levels including the national level and also at the most local levels.  I normally work on a COVID free orthopedic unit that focuses mostly on diabetic amputations, elective joint replacements and surgeries following orthopedic trauma.  Initially during the pandemic, we halted our elective surgeries which was consistent with national guidelines (Diaz et al., 2020).  As numbers stabilized, we began elective surgeries again, but recently we have seen numbers of COVID cases increase locally.  In the past few weeks, we have started taking on more medical/surgical patients in order to make room for COVID patients on other medical surgical floors. 

The competing needs in this situation include the needs of the hospital in terms of freeing up beds for COVID patients, staffing needs on my unit as we are taking on more patients, and also resources that we need in order to care for this new group of patients.  The competing needs of the hospital in this case with regard to caring for COVID patients and also caring for other medical surgical patients resulted in a policy change on my unit.  The policy change in this case was our switch from a unit that cared for orthopedic patients only to one that was more inclusive of other medical/surgical patients.

The stressor that I selected for the previous discussion was care of the elderly.  One area of conflict that I constantly see is the desire of family members to provide care for patients in the home when they are unable to fully meet the needs of the patient.  Some patients require 24 hour care and unfortunately many families are not able to fully provide that care.  Caring for the frail elderly in the home is often preferred.  However, informal care providers are often presented with the challenges of self-care, educating themselves about how to provide care, finding additional support, and a lack of societal recognition for the role that they play in healthcare (Plöthner et al., 2019).  Despite the best efforts of family members and assistance from home care services, the level of care is still lacking, which places the patient at risk for declining health status. 

The competing need in this instance is the medical needs of the patient, competing with the ability of the family to provide those services or at least set up home care.  A review by Hirschman and Hodgson (2018) identified several evidence-based approaches that may help to delay transition of care to skilled nursing facilities among patients with dementia.  Programs such as the New York University Care Giver Intervention, Goals of Care intervention, MIND at home and Partners in Dementia Care help families to obtain the skills and resources required to provide adequate care to the dementia population in the home setting.  The overarching theme is that while competing needs do exist in this area, education can help to reduce the burden on families and possibly help them to achieve the goal of home care for their loved ones.

Fortunately, policies are in place that prevent elderly patients from living at home when they are unable to receive adequate care.  Recently I worked with at patient that suffered from severe dementia and his wife and children were working very hard to get approval to have him stay at home as opposed to being discharged to a skilled nursing facility.  The patient is still on our unit, but it is questionable how the scenario will play out.  At this point, a hearing is pending to determine if the patient requires a conservator. 

In the state of Connecticut, a conservator of the person is assigned to individuals determined to be unable to competently care for themselves.  The conservator of the person is responsible for all matters including those related to finances and healthcare (“Conservatorships,” n.d.).  Policy in this case will overrule the desires of the family to keep the patient at home and ultimately, the patient will be placed in the appropriate care environment.

Conservatorships.  (n.d.).  Retrieved from https://www.ctprobate.gov/Pages/Conservatorships.aspx.

Diaz, A., Sarac, B. A., Schoenbrunner, A. R., Janis, J. E., & Pawlik, T. M. (2020). Elective surgery in the time of COVID-19. The American Journal of  Surgery, 220(2), 300-302.  Retrieved from https://www.americanjournalofsurgery.com/article/S0002-9610(20)30218-X/pdf.

Hirschman, K. B., & Hodgson, N. A. (2018). Evidence-based interventions for transitions in care for individuals living with dementia. The Gerontologist, 58(suppl_1), S129-S140.  https://doi.org/10.1093/geront/gnx152.

Plöthner, M., Schmidt, K., De Jong, L., Zeidler, J., & Damm, K. (2019). Needs and preferences of informal caregivers regarding outpatient care for the elderly: A systematic literature review.  BMC geriatrics, 19(1), 82.  https://doi.org/10.1186/s12877-019-1068-4.

Bill’s discussion

Organizational Policies and Practices to Support Healthcare Issues

Competing Needs

Competing needs can have a significant impact on the development of policy. This is mainly because the policy’s primary objective is to align with the needs (Tinetti et al. 2019). Therefore, in cases where there are competing needs, such as the needs of the patients, workforce, and resources, policy development can be challenging. For example, a policy to ensure the efficiency of service needs to consider the issue of nurses’ workload, stress, and burnout. Therefore, the policy would be required to address burnout, anxiety, and workload before proposing efficient health care strategies.

Specific Competing Need

Quality is a specific competing need in health care that affects nurse burnout. In health care organizations, nurses are expected to provide high-quality service that ensures the client’s safety and satisfaction (Saban et al. 2019). However, the issue of nurse burnouts in different health organizations affects this need. Thus, despite being expected to deliver high-quality services, the nurses could be limited to various problems such as stress and lack of motivation due to burnout.

The significant impacts of the competing needs include medical errors, nurse turnover, depletion of organization resources, and patient dissatisfaction. A high nurse turnover would require the organization to invest in new hires, which often require comprehensive training before adapting to the organization’s culture. Due to the stress and exhaustion associated with burnouts, the nurses will deliver lo quality services, which can result in increased errors and patient dissatisfaction.

How Policy Address the Issue

A policy can address these issues by ensuring that the nurses and the patient’s needs are addressed. In most cases, the nurses’ needs are a prerequisite to meeting patients’ needs. Nurses satisfied with their work will often be motivated, thus delivering high-quality work as observed by De Simone et al. (2018). In this case, the policy should address the nurse’s issues, such as reduced workload and shift hours to reduce burnout cases. This will, in turn, reduce the turnover rates as well as improve patient satisfaction rates.

References

De Simone, S., Planta, A., & Cicotto, G. (2018). The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses’ turnover intention and patient satisfaction. Applied Nursing Research, 39, 130-140.

Saban, M., Dagan, E., & Drach-Zahavy, A. (2019). The relationship between mindfulness, triage accuracy, and patient satisfaction in the emergency department: A moderation-mediation model. Journal of Emergency Nursing, 45(6), 644-660.

Tinetti, M. E., Naik, A. D., Dindo, L., Costello, D. M., Esterson, J., Geda, M., … & Kang, G. (2019). Association of patient priorities–aligned decision-making with patient outcomes and ambulatory health care burden among older adults with multiple chronic conditions: a nonrandomized clinical trial. JAMA Internal Medicine, 179(12), 1688-1697.

ADDITIONAL INSTRUCTIONS FOR THE CLASS – Organizational Policies and Practices to Support Healthcare Issues

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Organizational Policies and Practices to Support Healthcare Issues

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. Organizational Policies and Practices to Support Healthcare Issues

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. Organizational Policies and Practices to Support Healthcare Issues

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Organizational Policies and Practices to Support Healthcare Issues

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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