Evidence-Based Practice Change on Nurse Staffing

Recommending an Evidence-Based Practice Change on Nurse Staffing Adesola Turner Walden University Nursing 6052- Section [46] Essentials of Evidence-Based Practice Current Issue • Purpose statement: Reduce work stressors associated with nursing using a more evidence based approach. • The healthcare organization that I belong to has a culture of emphasizing on quality work, performance, and always holds everyone accountable for their actions. Its readiness to change is low. • The organization’s current problem is the understaffing of nurses. • Stakeholders affected the most by the problem are the nursing staff and patients. • Stakeholders who will be involved if the issue is to be addressed is the chief nursing officer, nurse leaders, chief financial officer, and the chief executive. • The risks involved is financial loss and failure when implemented. Proposal • The knowledge-based idea is creating a staffing model that employs a mathematical optimization model to solve staffing issues in my organization. • This is based on studies two studies (Davis et al, 2014; Maass et al., (2017). In the two, the models solved the problem and overstaffing. Knowledge transfer plan 1. Creation of knowledge through documented research on medical centers, mathematical optimization specialists, and the organization’s databases. 2. Dissemination through a multidisciplinary team, where the problem is looked into department by department. 3. Organizational adoption and implementation through a multidisciplinary team, department by department. Outcomes The following outcomes are expected to improve. •Quality of care: measured by related deaths from understaffing, hospital length of stay, medication errors, and odds of adverse events occurring. Evidence-Based Practice Change on Nurse Staffing

These outcomes were used by the study carried out by Davis et al., (2014). •Cost of operations: Calculated by comparing the costs of operations of new compared to the old. •Nursing burnout rates: Measured through the Maslach Burnout Inventory (Nantsupawat et al, 2017). Critical Appraisal Summary • According to a study carried out by He et al., (2016), there are associations between nurse staffing and patient outcomes. Both nurses and patients are affected by understaffing. • According to Simpson et al., (2016), inadequate staffing leads to missed care, potential failure to rescue, and job stress and dissatisfaction. Lake et al., (2018), also finds this in neonatal intensive care units. • Franziska et al., (2015), also documents this in Swiss care units. . • Fortunately, this can be improved Improving addressing staffing and workloads. Evaluation Table • From the evaluation table, it is clear that managers in health organizations should advocate for higher staffing levels to solve the problem of understaffing (Lake et al., 2016). • This is because understaffing affects the timeliness of nurses, affects their ability to provide quality care, and affects their mental health (Simpson, 2016). • However, a hospital unit may not immediately see better results in patient outcomes when implanting changes to address the issue (He et al., 2016). • In order to ensure that the problem is not ignored, Monitoring of trends concerning the rationing of nursing should be encouraged more (Zúñiga et al., 2016). This will help solve the issues that is sometimes neglected. Evidence Table Explanation • From the evidence table, I learnt that the type of study carried out determines how accurate the evidence is. • This is shown by the level of evidence an analysis is scored higher. For example, the analysis by He et al., (2016), drew associations, a better way to reach conclusion. • One the other hand, the study by Franziska et al., (2015) where the data is highly subjective to the Swiss homes. • Carrying an analysis is therefore better when trying to find the best approach. Outcomes synthesis table Explanation • There is inverse correlation between nurse staffing and adverse events (two specifically) and more research is needed in this area (He., 2016). • Disparities in nursing care due to race does occur. Patient-to-nurse ratio was significantly higher in high-black hospitals (Lake et al., 2018). • Consistent themes from emerged as a consequence of inadequate staffing, as Simpson et al., (2016), shows. • Apart from looking into staffing, problems associated with nursing scarcity can be solved through teamwork and changing the care environment (Zúñiga, 2015). Evidence-Based Practice Change on Nurse Staffing

References Davis, A., Mehrotra, S., Holl, J., & Daskin, M. S. (2014). Nurse staffing under demand uncertainty to reduce costs and enhance patient safety. Asia-Pacific Journal of Operational Research, 31(01), 1450005. Maass, K. L., Liu, B., Daskin, M. S., Duck, M., Wang, Z., Mwenesi, R., & Schapiro, H. (2017). Incorporating nurse absenteeism into staffing with demand uncertainty. Health care management science, 20(1), 141-155. Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O. A., Thienthong, H., & Poghosyan, L. (2017). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International nursing review, 64(1), 91-98. Zúñiga, F., Schubert, M., Hamers, J. P., Simon, M., Schwendimann, R., Engberg, S., & Ausserhofer, D. (2016). Evidence on the validity and reliability of the German, French and Italian nursing home version of the Basel Extent of Rationing of Nursing Care instrument. Journal of advanced nursing, 72(8), 1948-1963. Simpson, K. R., Lyndon, A., & Ruhl, C. (2016). Evidence-Based Practice Change on Nurse Staffing

Consequences of inadequate staffing include missed care, potential failure to rescue, and job stress and dissatisfaction. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(4), 481-490. Uchmanowicz, I., Kirwan, M., Riklikiene, O., Wolfshaut–Wolak, R., Gotlib, J., & Schubert, M. (2019). Validation of Polish version of the Basel Extent of Rationing of Nursing Care revised questionnaire. PloS one, 14(3), e0212918. Simpson, K. R., Lyndon, A., & Ruhl, C. (2016). Consequences of inadequate staffing include missed care, potential failure to rescue, and job stress and dissatisfaction. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(4), 481-490. Lake, E. T., Staiger, D., Edwards, E. M., Smith, J. G., & Rogowski, J. A. (2018). Nursing care disparities in neonatal intensive care units. Health services research, 53, 3007-3026. … Evidence-Based Practice Change on Nurse Staffing