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Introduction
In an acute care Hospital, does implementation of mandatory policies securing adequate nurse-to-patient ratios (1:5), compared to the current staffing model, decrease the patient length of stay in 1 year? Having inadequate or inappropriate nursing staff to meet patients also needs results in unsustainable workloads and negatively impacts the health and well-being of staff. ICN (2018) reported that inadequate or insufficient nurse staffing levels increase the risk of compromised care
Organizational Culture and Readiness
Organizational culture is about how employees think, feel and behave. Readiness assessment measures an organizations preparedness to go through change. Assignment majors on Atrium Health Hospitals readiness for change and strategies to implement Evidence-Based Practice (EBP). The hospital has a culture that supports change with a clear strategy for safe, quality and compassionate healthcare services. All employees know their roles and responsibilities. Hospital leadership promotes change by encouraging accountability in levels. Hospital management has developed efficient communication that emphasizes on behavior and practice to accelerate change.
Organization Readiness Tool
The readiness assessment tool is (ORCA) Organization Readiness to Change Assessment. ORCA investigates, identifies and evaluates the readiness of an organization to implement EBP. Research has shown that healthcare professionals must be committed and informed for EBP to be implemented smoothly. Atrium Hospital will sustain the change if professionals advance their education since it will be much easier for them to understand how it works. EBP implementation will improve the leadership of the hospital and increase access to information. Major barriers of implementing EBP are uninformed and inexperienced nursing staff. For EBP to be successful, nurses must be educated on how it functions.
Stakeholders and Team Members for EBP Project
Stakeholders are nurse educators, nurse managers and physicians, while team members are the nurses. Educators educate nurses on the EBP and how to run it. Managers justify changes in EBP by discussing the practices with nurses (Mthiyane & Habedi 2018). Facilitate education and training for nurses. The roles of physicians in EBP are to formulate clear questions for patients problems. Study clinical literature and the importance of evidence gathered. Nurses undergo training to implement the EBP and also report any issues to managers and physicians.
Strategies to Facilitate Readiness
Leading stakeholder discusses with the other stakeholders the readiness of the organization to change Miake et al. (2020). Discussions on the mission statement and values of the organization are done. Priorities, products and services of the organization are determined, as well as stakeholders new roles and responsibilities. Change is implemented in departmental capacities from top to bottom and, ultimately, the whole organization. ICT software makes nursing practice fast, accessing patient information. Budget for data transfer and staff training. Ensure it meets requirements and proceed with transfer (Acharya, 2019). Train staff and troubleshoot for errors. ICTs like EHR help reduce documentation errors hence improving patients safety. It Keeps patients history and helps nurses to know if they have any allergies to prescribed drugs, thus helping prevent legal issues.
Problem Statement and Literature Review
Nurse-to-patient ratios are now more challenging than before due to cost-cutting. Patient safety has become crucial with the increased nursing staff Shin et al. (2018). Quantitative methods of research were used to determine the effects of safe nurse staffing. Inclusion criteria; nurse staffing is a severe concern. Government legislation can secure enough workers. Registered nurses were excluded from research regardless of identical conditions. According to Shin, a study at a Swiss university hospital in 2018 ascertained that shifts with low staffing increased mortality risk by 10%. RN should not be replaced with untrained personnel; this is in line with PICOs statement. Low nurse staffing increases the risks of nurse burnout due to work overload.
Change Model
Models guide the process of change. Topic identification depends on; national quality strategies like consumer assessment of healthcare providers and systems surveys and initiatives. PICOT format focuses on priority evidence to answer the decision point questions. Inter-professional skills to plan and evaluate projects are allowed during team selection. Systematic research is conducted by the team who weighs quality, quantity and risks. The team engages patients and families and incorporate value and preference (Musy et al. 2021). Guidance for piloting practice change and developing a plan to reach planned change. The team identifies and engages vital personnel since integration needs new change and champions. The team conducts an audit and assesses the impact of the program and the actual effect against the desired effect.
Implementation Plan
Implementing change is a complicated and gradual process involving many parties. Three months required to implement regulations for understaffing. Resources for implementation. Budget, trainer, laptops and projectors required for presentation. Questionnaire for data collection. Progress on of intervention and weekly report. Analysis and interpretation. The questionnaire used for evaluation (Griffiths et al. 2020). Survey was distributed to nurses and other workers. Policies executed in an integrated manner. New interventions implemented and guidelines for participants. Weekly progress reports for efficiency. Stakeholder training and opposition from professionals on new measures for appropriate staffing. High training costs are solved by increased public awareness. Achievement of the expected cost. Charges are distributed and professionals are compensated.
Evaluation Plan
The expected outcome is that the study will have concrete findings to combat staffing issues. It is expected that increasing nursetopatient ratio will reduce the risk of adverse effects for patients. Questionnaires, audio recorders for interviews and hospital care records can also be used since data is collected electronically (Griffiths et al. 2020). Questionnaires are the most preferred. Pearson correlation coefficient is an appropriate statistical test. Determines the relationship between nurse ratio and improved patient outcome. Multiple-choice, dichotomous and open-answer questions the most preferred for questionnaires. If results do not meet expectations, many strategies are applicable. The researcher should have an analysis of what failed or have patient-centered questions. First, utilize inter-professional reflective practice to ensure the efficacy of daily EBP.
Conclusion
In this paper, the organizational readiness for change in Atrium Health Hospital was discussed, along with various strategies to implement EBP in the organization. Healthcare processes and systems were recommended to improve quality, safety, and cost-effectiveness in the organization, stakeholders and team members were identified and their duties were specified. Employee evaluation, lunch breaks, professional development, and other non-work-related tasks can take personal time. Nurses responsibility and core duty are to provide high-quality health care to patients. For nurses, patient care is a priority, and most of the above actions can be transferred to other competent staff, freeing up the nurses time.
References
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Blumenthal, K.G, Acker, W.W, Li, Yu, Holtzman, N.S., Zhou, Li. (2017). Allergy Entry and Deletion in the Electronic Health Record. PMC 2017 Mar; 118(3): 380381.
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Shin, S., Park, J. H., & Bae, S. H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing outlook, 66(3), 273282. Web.
Musy, S. N., Endrich, O., Leichtle, A. B., Griffiths, P., Nakas, C. T., & Simon, M. (2021). The association between nurse staffing and inpatient mortality: A shift-level retrospective longitudinal study. International Journal of Nursing Studies, 120(103950), 103950. Web.
Griffiths, P., Recio-Saucedo, A., DallOra, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 14741487.
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