Implementation of Safe Staffing - Essay Example

Safe Staffing: Implementation of Safe Staffing Implementation of Safe Staffing In the context of the work setting, the safe staffing plan considers patient factors, ward factors and nursing staff factors. The plan proposes that a thorough analysis and observation of the nursing needs that each patient requires in any particular ward. The safe staffing plan shall be implemented based on outcomes of such analysis so that the specific needs of every patient are catered for. That calls for a holistic approach that considers individual patient factors such as disabilities, difficulties arising from patient’s specific conditions, level of emergency and care needed and continuous presence of a nurse in a ward. With a reliable outcome of assessment, the management should staff each ward based on such specific needs without generalizing statistics and trends. Nursing staff factors to consider in the safe staffing implementation include relevant qualification, skills and competency (DeNisco and Barke, 2012). Other supportive care approaches such as communication and nursing clinical support to the specific healthcare should be considered in the decision. Finally, safe staffing will also consider patient turnover in every ward. The turnover projection should take care of both planned and unplanned admissions that characterize the ward. Patient turnover will determine the amount of resources to avail. Safe staffing, therefore, calls that additional resources be set aside for emergencies where extra resources may be needed. Such include the number of RN on emergency list. They offer emergency service in the face of unplanned admissions. Other resources that go hand in hand with that include a few beds set aside for such responses depending on the likelihood of such events. Ease of access of resources should be considered so that a ward is self-sufficient to prevent lapse in time during situations of emergency responses. I will work with the existing resources in the ward by reorganizing and redeploying the human resource and equipment within the ward while taking into consideration the existing interdependency that may exist within the wards (DeNisco and Barke, 2012). The EBP model discussed in class informed the development and monitoring of the plan in the following way. First, the EBP has been used to determine the clinical expertise consideration that the safe staffing approach shall be based on relevant skills and expertise (Jones and Jenkins, 2014). It has also been applied through the assessment and observation of patient factor as determinants for safe staffing. Finally, it has informed the monitoring process by advocating for implementing the strategy based on existing statistics that characterize the specific healthcare needs in a ward. The feasibility of implementing the plan will depend on the readiness with which the leadership accepts the plan and implements it downwards. Given that the plan insists on best practices, some of which RN may not be implementing, it may be seen as a change process. Therefore, I will approach it a change process within the existing practices so that it is not perceived as entirely new. I will work with senior RNs to agree on the implementation. Such senior RNs are health practitioners with the requisite skills, experience and expertise gathered through years of practice. By discussing and designating them a supervisory role to play within their day to day work, the junior RNs will be in a position to learn from them and implement the strategy to deliver patient care. That approach will be preceded by training classes in a discussion model that allows everyone to voice out their concerns. All concerns will be addressed prior to the implementation. At the beginning of the implementation, the average nursing staff requirement in any 24-hour period will not be radically changed. All the changes will be implemented smoothly over time. The safe staffing implementation also takes note of the average nursing hours required by every patient within every 6-month-period. That would ensure that bed utilization rather than bed occupancy is considered as the workload begins from there. It is only then that the required nursing skill mix and shift allocation will be implemented (Jones and Jenkins, 2014). That way, the feasibility of the plan is guaranteed. An outcome tool that would be evaluate the extent to which the project goal is achieved is will try to analyze the extent to which safe staffing has improved both patient care and healthcare delivery. The developed tool (see appendix) measures the extent to which RNs deliver patient safe patient care. For instance, safe staffing tool would assess whether the patient fell or not in any 24-hour-period. It will also assess the effects of such risks. It will also assess whether medical administration to patients followed the doctor’s prescription or whether there was a deviation. RNs factors such as taking a break and the effect it has on patients will also be assessed. In order to implement safe staffing, the tool would also analyze whether RNs were attending to the patient during their normal schedules or as an overtime session. The adequacy of resources and machinery available for use within the ward will captured and assessed. The validity, reliability and appropriateness of the outcome measure can be seen to stem from the specifics that the assessment tool achieves. In terms of its validity, it focuses on patient outcome in terms of nursing approaches used. That is because the objective is closely aligned with safe staffing. Safe staffing has to improve caregiving of whom the patient factors are the first indicator of success (Jones and Jenkins, 2014). As pertains to reliability, the tool has been designed to be entered by a RN, a physician and a senior RN or ward in-charge. It captures information such as working schedule, medicine administration and equipment as a vital resource in patient care. It is appropriate for this proposed project as it addresses vital areas of observation adequately. Outcome measure data shall be collected using questionnaires, hospital statistics and observation by the senior RNs in-charge of wards. The nature of questions in the questionnaire shall be varied from close ended to open ended questions. The questionnaires shall specifically address the objectives of the proposed project. Given that the item to be assessed is the extent to which the safe staffing strategy has impacted on delivery of nursing care and promoted patient satisfaction levels. The data shall capture feelings of patients who are about to be discharged. Simple questions such as how they found the entire facility, care and attitude towards work will be assessed to find out what areas need improvement. For instance, patients would answer: Whether there was a RN by within a reasonable reach to them during the day when they needed assistance Whether they felt their pain management drugs were administered on time On the other hand, the outcome measure data on safe staffing will seek to find out from RNs and caregivers how the new change impacted their life. For instance, they will need to answer with a “yes”, “somehow” or “no” responses on whether the implementation of the safe staffing approaches: Made patient nursing care easier than before Had no effect on their patient nursing care Made their work slightly complicated Made their work too complicated Made them work for longer hours than before Made them work for fewer hours than before Has improved staffing challenges faced in the ward Has improved equipment challenges faced in the ward Amongst other things, this approach will give outcome measure data that would inform the implementation process so that areas that require intervention will be responded to immediately. RNs will also have an open-ended response on what they think of the safe staffing strategy as part of the overall change witnessed in the healthcare facility. Other sources of date for measuring outcomes of the project would be hospital statistics on admissions, relocation and discharge. Such will be found in hospital inventories. Senior RNs and supervisors will also give their experience on what they have observed in the initial implementation of the safe staffing approach. The resources for the evaluation plan shall be very critical for the success of the project. Given the nature of the project, a team of trained personnel shall be used to gather information. The team shall comprise senior RNs in-charge of the wards in the healthcare facilities where piloting is taking place. The number shall depend on the number of healthcare facilities identified for the initial piloting. Given that the data being collected is based on observation, short interviews and recording, resources required will be stationery and audio recorders for later clarifications. The audio will be instrumental in collecting patient feedbacks in a conversational way so that they are not strain with having to wait for the interviewer to finish entering responses. It should be noted that only patients who have been cleared for discharge owing to complete recovery could be included asked questions. Apart from the paper-based resources, electronics will also be used to finish the statistics part for analytical purposes. Computer programs may be preferred. However, the computer or calculator resources can be used at the end of the exercise. This implies that 3-5 computers would suffice. Other resources shall be facility records and inventory from which valuable data shall be retrieved. The practicality of the evaluation plan has been informed by the nature of the project. Having in mind that the aim of implementing this project is to guarantee safe staffing, the approach is about redesigning the existing system. Such redesign only touches where change is seen to be needed. Other practices that are running smoothly in line with safe staffing regulations shall not to be touched. In that regard, the project has sought to work in close partnership with supervisors, senior RNs and other RNs in the implementation. Being aware that the approach is aimed at making their caregiving experience more professional and reduce strain on their side, the understanding is they now own the project. The project assesses both patient outcomes and nursing outcomes. It also analyzes the ease with which proper and functioning equipment would make their caregiving experience easier that it is currently. Therefore, the design only seeks to collect what is observable within their day-to-day activities. The responses have been reduced major to a “yes”, “no” and “somehow” responses, which are ticked as may be appropriate. The resources identified for use such as paper based resources and hospital statistics are readily available. Statistical instruments such as electronic calculators are also easily available. For recording purposes, the age of technology has also allowed phones to have recording features such that no additional equipment may be required. To that extent, the evaluation plan is very feasible. For the future of the solution, the project shall be an ongoing process in which periodic results will be taken every six weeks. The outcome measure data shall be taken after every six weeks with a window of one week of assessment and one week of compiling results. Complete evaluation, therefore, will be complete after every two months (8 weeks). By assessing the extent to which the safe staffing approach has helped improve patient experience and staff experience, adjustments will be proposed and their effects assessed in the subsequent evaluation period. Items that shall be found to be strongly supporting healthcare delivery shall be maintained. Those that are seen to impact negatively on the caregiving done away with and if they do not show improvement even after their modifications. That is because the change has to be practical. A website shall be dedicated for communication of the project and its results to external parties so that data is easily available for observation and further analysis. References DeNisco, S.M., and Barke, A.M. (2012). Advanced Practice Nursing: Evolving Roles for the Transformation of the Profession. Burlington: Jones & Bartlett Learning. Jones, R.J., and Jenkins, F.C. (2014). Safe and Effective Staffing Levels for the Allied Health Professions: A Practical guide. Oxford: Otmoor Publishing. Appendix Patient Safe Staffing and Health Care Evaluation Form Patient’s Name: Age: Gender: Marital Status: Patient Factors Staff Factors Nursing and Equipment Factor Effects on Patient Effects on Patient moderate Severe Moderate Severe Normal Overtime Falls by Patient Medication Administration Error (Omission) Nursing working schedule Missed breaks by nurses on duty Available Not Available/ busy Resources and machinery needed for nursing care Name of RN in-charge of Patient: Sign: Name of Doctor in-charge of Ward: Sign: Confirmed and Signed by Senior RN in-charge of the Ward Name: Sign: Recommendations Read More