All Scholarly Articles must be within the past 5 years. APA format
The topic of my DNP project is “The Retention of nurses in the Labor and Delivery Arena.”
Week 5: Assignment: Project Planning and Preparation
Project planning will be an important aspect of your new role as a DNP-prepared nurse. The purpose of this assignment is to further explore the project planning process as you prepare for your DNP project. This assignment is an extension of the Week 2 and Week 3 assignments and any previous work you have done on your selected practice problem or for your DNP project planning.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
· CO 2: Formulate a needs-based organizational assessment to inform strategic leadership decision-making. (POs 3, 5, 7)
· CO 3: Develop strategies to lead project planning, implementation, management, and evaluation to promote high-value healthcare. (POs 3, 5, 7)
Page Requirement:
Length 4-5 pages – excluding title page and references.
Instructions
Review the Graduate Re-Purpose Policy in the Student Handbook, page 15
Repurposed Work (Chamberlain University Graduate Programs only): Graduate students have the opportunity to use previously submitted ideas as a foundation for future courses. No more than 50 percent of an assignment, excluding references, may be repurposed from another Chamberlain University course (excluding practicum courses). Previous course assignments that are deemed building blocks will be notated in the syllabus by the course leader. As with every assignment, students must uphold academic integrity; therefore, students must follow the guidelines for remaining academically honest according to the Academic Integrity policy. If the instructor is not made aware of the repurposing of an assignment, the submission will be treated as plagiarized work if not properly referenced
Use the following subheadings as Level 1 headers to organize your paper.
1. Introduction
a. Start your introduction with a powerful statement or two to stimulate interest.
b. Present the purpose of your proposed project. Begin your formal purpose statement by stating, “The purpose of the proposed (DNP) project is to…”
c. Provide a preview of what the paper will include with a strong thesis sentence.
2. Assessment
a. Describe the practice problem at the national level; support with data.
b. Describe the practice problem at the practicum site; support with data if available.
c. Identify and describe the sources of data from the practicum site. For example, Incident reports, readmission rates, infection rates, etc.
3. Planning—Evidence Synthesis
a. Present the updated evidence synthesis to identify the evidence-based practice (EBP) intervention to address the practice problem and need for change. (Use the synthesis from the week 2 assignment – be sure to accept track changes and update your Week 2 paper based on feedback provided by course faculty before adding to this paper).
i. Main points/salient themes that emerge from the sources (Cited)
ii. Compare and contrast main points/ themes from all sources (Cited)
iii. Objective rationale for the intervention based on the literature
4. Implementation
a. Clearly describe the DNP project evidence-based intervention.
b. Discuss the rationale for why this intervention was chosen.
c. Identify the survey/ instrument/ tool, if using one, and why it was selected.
i. If not using a survey/ instrument/ tool, how will you be collecting data? For example, chart audits.
d. Describe your implementation plan to include milestones.
5. Evaluation
a. Propose measurable outcomes for the project.
b. Describe how the outcomes will be evaluated.
6. Conclusion
a. Effectively summarize your project plans in one to two comprehensive yet concise paragraphs that clearly describe your project plans to include:
i. Explain how you will implement the project.
ii. Explain how you will evaluate the project.
7. APA Format
a. Uses appropriate Level I headers.
b. References and citations are in current APA format.
c. Paper length is 4-5 pages excluding the title and reference pages.
8. Clarity of Writing
a. Use of standard English grammar and sentence structure.
b. No spelling errors or typographical errors.
c. Organized around the required components using appropriate headers.
Rubric
Week 5 Assignment Grading Rubric: Project Planning and Preparation (240 pts)
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Week 5 Assignment Grading Rubric: Project Planning and Preparation (240 pts) |
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Criteria |
Ratings |
Pts |
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This criterion is linked to a Learning OutcomeIntroduction Requirements: |
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30 pts |
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This criterion is linked to a Learning OutcomeAssessment of the Practice Problem Requirements: |
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40 pts |
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This criterion is linked to a Learning OutcomePlanning -Evidence Synthesis Requirements: |
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40 pts |
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This criterion is linked to a Learning OutcomeImplementation Requirements: |
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40 pts |
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This criterion is linked to a Learning OutcomeEvaluation Requirements: |
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40 pts |
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This criterion is linked to a Learning OutcomeConclusion Requirements: |
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30 pts |
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This criterion is linked to a Learning OutcomeAPA Style and Standards Requirements: |
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10 pts |
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This criterion is linked to a Learning OutcomeClarity of Writing Requirements: |
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10 pts |
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Total Points: 240 |
6
Organizational Needs Assessment
Devita Price
Chamberlain University
January 18, 2022
Organizational Needs Assessment
Over the past decade, the American population has increased significantly. The rapid population increase has increased the demand for healthcare services and a need to have more healthcare organizations and more healthcare practitioners. Farokhzadian et al (2018) indicated that the patient population has doubled over the past decade in all healthcare organizations in the United States. According to the previous American Nurses Association report, increase in patient population has imposed a major burden in nurses and other healthcare practitioners across the country resulting to a need to increase the number of healthcare organizations and nurse population. Other issues such as emerging infections like the covid-19 pandemic and Ebola have also facilitated the need for more nurses in hospitals (Buheji & Buhaid, 2020). However, the nurse population has always remained constant, leading to overburdening of nurses. My interview with James, a DNP nurse at the Lenox Hill Hospital, New York city, revealed a need to increase the nurse population to handle the increasing patient population in the organization. Increasing the nurse population is important because it will improve the quality of services delivered to patients, increase care outcomes, and reduce healthcare costs and time spent offering healthcare services. It will also reduce hospital congestion and readmissions.
Identification of the Practice Problem
Nurse shortage is a major problem in Lenox Hill Hospital today. The interview revealed that the organization is experiencing nurse shortage challenges characterized by an increased patient population. From the interview, it was evident that the effects of the pandemic have revealed the need to increase the nurse population in all healthcare organizations in the United States. Lenox Hill Hospital currently has 300 nurses with an average nurse population of about 3000 per day. This indicates that each nurse attends to about one hundred patients per day. According to James, the pandemic has increased the patient population to over 5000 per day, leading to a burden to nurses.
The report issued by Lasater et al. in 2021 showed the gap between the patient population and the nurse population and suggested a need for increasing the nursing population to enhance healthcare delivery and ensure adequate response to the covid-19 patients. Schwerdtle et al. (2020) showed that an inadequate nurse population has resulted in many deaths due to delayed care. In 2020, reports indicate that more healthcare workers died from the pandemic creating a bigger gap between the nurse and patient populations. The study revealed that more nurses died because of exposure to patients with the virus. Buheji & Buhaid (2020) also indicated that nurses experienced overworking hours, contributing to their exposure to the virus. The interview revealed that nurse shortage is a major problem in healthcare organizations across the United States today. Increasing the nurse population will help reduce the challenges imposed by the virus on healthcare workers and patients.
Stakeholders who have interest in the project outcome
The stakeholders interested in the project outcome include nurses, patients, hospital management, community, insurance organizations, and staff members. The project aims to determine the need to increase the nurse population in Lenox Hill Hospital and other healthcare organizations in readiness for other deadly variants of a pandemic to ensure that people get high-quality healthcare services and reduce congestion in a healthcare organization and reduce the number of deaths time used to access medical services. Increasing the nurse population will help reduce healthcare costs and time and reduce congestion in healthcare organizations (Rosenberg, 2019). The project will also help reduce demand for healthcare services and, as a result, will prevent insurance organizations from spending more funds on treatment. It will help the community by reducing infection rates. The hospital management will benefit from reduced hospital congestion, improved services, quality care outcome, and patient satisfaction. The organization will increase its returns from the change because it will attract more patients and community members due to its improved services.
The interview revealed that there had been a major debate in the organization on whether to increase the nurse population or to introduce technology such as telemedicine in response to the existing problems. The proponents of the debate argue that increasing the nurse population will have more impacts on the organization than technology. On the other hand, the opponents of the debate have advocated for the need to introduce new technology in addressing issues of congestion and increasing population. The opponents of this debate will be more likely to resist the change. They include stakeholders such as investors, the board of directors, government agencies, and donors. These stakeholders propose the need to enroll patients in the telemedicine programs to allow patients with acute conditions like cancer, covid-19, diabetes, stroke, hypertension, heart disease, and obesity to continue with their medication at the comfort of their homes. These stakeholders argue that telemedicine will reduce congestion in the hospital and ensure healthcare quality and care outcomes.
The hospital management and staff will greatly influence the proposed changes. The management is the decision-makers and has the final say in all proposed changes. The nurse will benefit from the proposed change because they will be delivered with prolonged working hours and congestion. They will enjoy a clean and safe working environment from the proposed changes because their number will enable them to improve their service delivery, save time and respond to patient concerns as soon as they are reported.
Criteria for nurse prioritization
Nurse shortage is a major issue in the practicum site. A DNP nurse identified the issue in Lenox Hill Hospital. James is a high-ranking decision-maker in Lenox Hill Hospital. He participates in strategic development and decision-making process. The role of James is to ensure that nurses’ welfare is upheld and that nurses work in a safe, secured, and protected environment. The proposed project aligns with the practicum site’s mission and vision, which requires nurses to work in a safe and clean environment and ensure all staff members’ welfare within the organization. The project also aligns with the organizational commitment to ensure the community’s wellbeing. The corporate social role of the organization is to ensure the wellbeing of the community by providing quality and excellent services and safety to its workers.
Gap Analysis Template
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What is currently happening in the practicum site? |
What should be happening in the practicum site based on current evidence? |
What is the gap between what is currently happening and what should be happening (this is your practice gap)? |
Why is there a gap in practice? What factors are contributing to the gap in practice? |
What evidence do you have to demonstrate there is a practice gap? |
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There is a shortage of nurses despite a constant increase in patient population due to the threats imposed by the pandemic. |
There should be enough nurses to help reduce the impacts of the pandemic because it will be easier to use evidence-based approaches to determine appropriate approaches to treat patients. |
There is a big gap between nurse population and patient population as evident in nurse to patient’s ratio leading to poor service delivery, congestion, and high healthcare costs. The number of patients has doubled over the years with the number of nurses remaining constant leading. The nurse-to-patient ratio is 1:150. |
The gap is contributed to due to lack of a proper recruitment plan, and delay in the allocation of funds to pay part-time nurses. |
The increase in the number of readmissions, deaths and infections from contagious diseases in the organizations shows reduced quality in healthcare services and lack of enough nurses to address patient needs. |
Conclusion
The major challenge in many healthcare organizations is how to deal with the pandemic. Many organizations have responded by enrolling telemedicine services, while others are thinking about increasing nurse population in response to increasing patient population. The proposed organizational need in this paper is an increase in the nurse population to help reduce the number of deaths, readmissions, and infections from contagious diseases. This paper identified a need for more nurses to help reduce congestion and increase quality and care outcomes. Increasing the nurse population is a more significant opportunity because it will help the organization cope with challenges imposed by the virus and population increase.
Buheji, M., & Buhaid, N. (2020). Nursing human factor during COVID-19 pandemic. Int J Nurs Sci, 10(1), 12-24.
Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 1-13.
Karlsson, A. C., Gunningberg, L., Bäckström, J., & Pöder, U. (2019). Registered nurses’ perspectives of work satisfaction, patient safety and intention to stay–A double‐edged sword. Journal of nursing management, 27(7), 1359-1365.
Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Martin, B., Reneau, K., … & McHugh, M. D. (2021). Chronic hospital nurse understaffing meets COVID-19: an observational study. BMJ Quality & Safety, 30(8), 639-647.
Rosenberg, K. (2019). RN shortages negatively impact patient safety. AJN The American Journal of Nursing, 119(3), 51.
Schwerdtle, P. N., Connell, C. J., Lee, S., Plummer, V., Russo, P. L., Endacott, R., & Kuhn, L. (2020). Nurse expertise: a critical resource in the COVID-19 pandemic response. Annals of Global Health, 86(1).
1
Devita Price
Chamberlain University
January 11, 2022
Evidence Synthesis
Compensation Issues in nursing
There has been an increasing demand for high-quality care over a few years in the U.S. A variety of therapies have been shown to improve patient outcomes. However, minimal studies have been performed on identifying how to deliver effectively and efficiently (Por, 2008). Therefore to enhance patient care outcome, it is essential to discover how to ensure the wellbeing of employees for effective delivery of services because the foundation of any effective care system is a productive workforce. The aim of this paper is to synthesize various evidences to address compensation issue in nursing.
Evidence-based intervention synthesis for the compensation issues
1. Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse advocacy: Adopting a health in all policies approach. Online Journal of Issues in Nursing, 23(3).
Nursing Policy advocacy
According to Williams, Phillips & Koyama (2018), nurses can address compensation issues through engaging in politics. Williams, Phillips & Koyama (2018) has shown that DNP nurses can engage in political activities and champion patient and community issues in the national government through active participation in policymaking and politics. According to Williams, Phillips & Koyama (2018), DNP nurses engage in politics in various ways; voting, campaigns, contributing money towards political causes, writing a letter about the nursing issue for publication, wearing party souvenirs supporting a candidate for election, attending district meetings for nursing organizations, running for a political seat in the national politics or the organization. The following is the outcome of my engagement with community politics. According to Williams, Phillips & Koyama (2018), DNP nurses can address compensation issues through coming up with policies regulating their minimum pay and through nursing organizations, they can collectively bargain for their rights of adequate pay and also better pay structures.
2. Grace, P. (2018). Enhancing nurse moral agency: The leadership promise of doctor of nursing practice preparation. OJIN: The Online Journal of Issues in Nursing, 23(1),
Enhancing nursing moral agency
The evidence issued by Grace (2018) has been applied to address many practice issues including inadequate pay among nurses. According to Grace (2018), nurse motivation in workplace can help address the challenges they experience with inadequate pay and lack of accomplishments in their work. The study shows that nurses should be motivated in their work through giving them intrinsic and extrinsic compensation. The report has shown that motivation is one of the ways to increase the nurse morale and make them prosper in whatever they do. The report has also shown that having a well designed pay structure can help address the challenges of lack of morale that might lead to low quality care delivery services and outcome.
3. Collins, J. D., McMullen, J. S., & Reutzel, C. R. (2016). Distributive justice, corruption, and entrepreneurial behavior. Small Business Economics, 47(4), 981-1006.
Distributive justice
Economic distributive justice focuses on the equitable distribution of resources in society. There are various resources in society, such as food, shelter, healthcare, infrastructure, education, employment opportunities, and security. The focus of economic distributive justice is to ensure that these resources are equitably allotted to society. For instance, in the case of a lifeboat, the decision of those to be sacrificed and those to be spared maybe when the boat is about to capsize due to too much weight or when the amount of food available in the boat cannot sustain everyone in the boat and others have to be sacrificed usually a difficult decision. The theory can be used as an intervention measure for the challenges imposed by the effects of inadequate pay in nursing. This theory suggests that employees should be compensated equitably. When nurses are compensated equitably, they will have fulfillment in their work and become more productive.
Synthesis of the literature
Summary of the literature
Increasing compensation for healthcare workers is a significant issue at my workplace. The ability to fulfill the healthcare organization’s needs to offer quality services for good care outcomes has been challenged by a lack of joy and meaning in our workplace. There is a lack of sense of accomplishment and purpose in our contributions. Lack of morale is one major issue that affects many employees because they can’t find the importance in their daily work and lack of a feeling of success and fulfillment that results from meaningful work. As evident in my workplace environment, three of the nurses indicated that they are considering leaving the practice; two of the nurses threatened to leave the exercise due to poor morale, and the other one was worried that her job was affecting her health. A survey conducted this year showed that 40 percent of the employees are feeling like resigning from their current positions by claiming that they are not satisfied with their jobs.
In addressing this challenge, some barriers have been identified to be associated with the translation of evidence in addressing compensation issues among health workers. The obstacles that prevent the conversion of evidence have been identified to be complex; they can be classified into two categories-individual characteristics and organizational factors. Individual barriers that have been reported include insufficient knowledge about the evidence, lack of competence in reading and evaluating the evidence, lack of knowledge of statistical analysis, lack of time and lack of authority to change practice. On the other hand, system barriers include lack of access to the evidence, inadequate resources to implement change and lack of support from staff and colleagues. Strategies adopted by the interventions presented in this paper include examining the evidence at three levels: the micro level, the meso level and the macro level. Micro involves examining the evidence on patients and clinicians; the meso level consists of reviewing the evidence within the system of the organization, and the macro-level consists of reviewing the evidence in economic and political perspective.
Support for evidence intervention
The solutions presented in this paper for addressing compensation issue in nursing have been widely applied and adopted in many countries including Singapore, and Malaysia and they have worked adequately. The solutions presented include policy advocacy, enhancement of morale agency and economic distributive justice model. In Singapore, the theory of economic distributive model was used to balance the pay of all nurses in the country based on their job groups and level of expertise. The implementation of the model made the country to reduce nursing strikes by 80 percent and enhance care outcome by 50 percent.
Moreover, it helped reduce mortality rates by 10 percent and also improved the quality of care in all the healthcare organizations. The nursing advocacy policy was adopted in Australia and Malaysia and they have had significant impact in healthcare sectors in the two countries. Australia is one of the countries that offer quality healthcare services in the world. It also records low death rates from acute illnesses such as cancer, diabetes, and heart disease. Finally, the enhancement morale agency intervention was used in Canada and India to address compensation issue in nursing and as result; the two countries have enjoyed excellent care services, good relations among nurses and accomplishments at work by the nurses. From the analysis of these evidences, it is clear that these interventions can be applied by any country to address the challenges of compensation in the U.S, and France.
In conclusion, this paper has identified inadequate compensation as a practice issue in my organization. Nurses in my organization have gone through series of go slows, strikes and demonstrations for low pay and lack of proper pay strategy. the issue has affected healthcare service delivery and at the same time has affected the quality of care outcome in my organization. This paper has presented three evidence-based interventions for addressing compensation issue in my organization-nursing policy advocacy, economic distributive justice model and enhancement of nursing morale agency. This paper has presented how these evidence-based interventions can be applied to address compensation issue in my organization.
References
Collins, J. D., McMullen, J. S., & Reutzel, C. R. (2016). Distributive justice, corruption, and entrepreneurial behavior. Small Business Economics, 47(4), 981-1006.
Grace, P. (2018). Enhancing nurse moral agency: The leadership promise of doctor of nursing practice preparation. OJIN: The Online Journal of Issues in Nursing, 23(1),
Por, J. (2008). A critical engagement with the concept of advancing nursing practice. Journal of nursing management, 16(1), 84-90.
Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse advocacy: Adopting a health in all policies approach. Online Journal of Issues in Nursing, 23(3).Nursing Policy advocacy
Appendix
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Article Number |
Author and Date |
Evidence Type |
Sample, Sample Size, Setting |
Findings That Help Answer the EBP Question |
Observable Measures |
Limitations |
Evidence Level, Quality |
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1 |
Williams, S. D., Phillips, J. M., & Koyama, K. (2018) |
Nursing policy advocacy |
· N/A |
Nursing policy advocacy has been successful in Australia and Malaysia Nursing policy advocacy has helped reduce nursing strikes and demonstration Nursing advocacy policy has helped improve care outcome and care quality |
Nursing policy advocacy reduced mortality rate by 10 percent within 12 months in Australia Nursing policy advocacy approach reduced nursing strikes in Australia by 80 percent |
Poor coordination of nursing organizations lack or presentation of nurses in policymaking stages It is expensive and takes a lot of time to implement |
The evidence level and quality rating for this intervention approach is 9/10 |
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2 |
Grace, P. (2018) |
Enhancing nursing morale agency |
· N/A |
Has been applied in Singapore It has minimized conflicts in nursing practice Improved morale of nurses |
Motivated nurses in all healthcare organizations Improved revenue in healthcare sector Reduced anxiety and stress among nurses |
Can be faced with communication barriers Only applicable in developing countries due to low living standards in those countries Only suitable in organizations that offer both intrinsic and extrinsic pay |
Evidence level and quality rating is 6/10 |
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3 |
Collins, J. D., McMullen, J. S., & Reutzel, C. R. (2016) |
Distributive justice model |
· N/A |
Has been successful in India and Canada Is used in many developing countries Suitable in ensuring equity Suitable in a diverse workplace |
Promoted revenue in healthcare sector in India by 20% for a period of 3 years Reduced mortality rate by 5% for a period of 12 months Promoted job security in India |
Expensive to implement Time consuming Not reliable |
The quality rating for distributive justice approach is 8/10 |
Attach a reference list with full citations of articles reviewed for this Practice question.
