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Part 1:
Organizational or Patient Issue

What is the issue that you are attempting to settle or improve?Prolonged patient stand by timesPatient dissatisfactionErrors in careNurse burnoutNurse turnoverPoor moraleMy goal is to increment patient fulfillment by diminishing patient stand by times and diminishing nursing mistakes. These are issues connected with one another because of the ascent in intensely sick patients introducing to our crisis division (ED) when we all the while lose valuable staff individuals because of high turnover rates. Medical caretakers are encountering burnout coming from an absence of help, which prompts dangerous practices and postponements in care.3

For what reason would it be a good idea for you care?Our hospital is a unitPoor reflection on office as a wholeNursing ethics (Haddad LM. et al. 2021)

Although this is a prompt issue looked by the ED. The fallout will at last influence the picture of the hospital and all staff individuals all in all. We are a unit and the adverse results in the ED will at last influence the floors that our patients are confessed to. “There are four fundamental standards of ethics: independence, helpfulness, equity, and non-maleficence” (Haddad LM. et al. 2021).

Part 2:
Relevance of an Interdisciplinary Team Approach

Why an interdisciplinary team approach?This method supports collaboration across expertiseBuilds long-term relationships and a team mindsetCross preparing increases information overall”The subjects of “being on the same wavelength,” “focusing on patients,” and “comprehensive consideration planning” supported the thoughts of collaboration and improved patient-focused care, that is to say, advantages to patients” (Walton, V. et al. 2019)By making interdisciplinary collaboration across units, we will get additional qualified team individuals who can share some weight and alleviate the high-feelings of anxiety. This will fabricate stronger relationships across units and also allow the sharing of information prompting more significant levels of information for all involved. “The subjects of “being on the same wavelength,” “focusing on patients,” and “all encompassing consideration planning” supported the thoughts of collaboration and improved patient-focused care, that is to say, advantages to patients” (Walton, V. et al. 2019)

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NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

Improved outcomes and attained goals!Utilizes existing resourcesLess turnoverIncentivizes staff membersHappier patientsBy utilizing existing staff who realize our framework well, we will be cutting down training overwhelmingly. We will likewise be using less assets and incentivizing staff individuals with bonuses. This will prompt less nurse turnover and more joyful patients overall.7

Part 3:
Interdisciplinary Plan Summary

ObjectiveStreamline care processPlan-Do-Study-Act (PDSA) modelGet buy-in from stakeholdersMy objective is to streamline the consideration cycle by creating an interdisciplinary collaboration that assists our nurses with providing safe patient consideration. This cycle will save money on assets, cut down persistent stand by times, and work on by and large quiet satisfaction. I will utilize the Plan-Do-Study-Act (PDSA) model to methodicallly spread out the planned proposition. To effectively do this plan, we should get buy-in from all expected stakeholders across different expertise.9

How will it work?1) With buy-in from all stakeholders2) With cautious management3) With precise PDSA implementation4) With great communicationExcellent communication is critical to getting the required buy-in. Collaboration between the executives is pivotal to a consistent change process using the PDSA model. Cautious administration of the PDSA interaction through each step should be prioritized by the project managers.10

NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

What will the group do?Shift bosses will act as project managersNurses with varying skill will bring their insight to the EDThe group will meet frequently and convey openlyThe group will work together on the common objectives of increasing patient wellbeing and satisfactionWe will bring a couple of nurses from different floors with explicit strengths to the ED. These will include prescription flood, moderate consideration, and intensive-care nurses. We will dispense patients to these nurses according to needs and acuity levels. The nursing boss responsible for the ED shift will be assigned as the project chief. The different managers will examine what is working and what isn’t during their movements and make enhancements as the need might arise. Using a transformational initiative model will engage nurses to work together for a more noble end goal. We will likewise incentivize these rotations with a bonus of $250 per shift for nurses willing to get them.

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Part 4:
Implementation and Resource Management

ImplementationProject Managers (Shift Supervisors)Oversee all means of the change processAct as point of contact for all stakeholder issuesCommunicate successfully and frequently with teamED NursesTriage and deal with developing conditionsStabilize patients and spotlight on intensely sick patientsDetermine acuity and patient handoff locationMed-Flood NursesReceive med-flood acuity level patientsObserve and hold patients in ED until rooms are availableProgressive-Care (PCU) NursesReceive PCU acuity level patientsObserve and hold patients in ED until rooms are availableIntensive-Care (ICU) NursesReceive ICU acuity level patientsObserve and hold patients in ED until rooms are availableED TechsFloat between all sections and help nurses with needsClinical Nursing Partners (CNA)Float between all sections and help nurses with needs”The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings” (Coury, J. et al. 2017). This is the configuration that I will use for organizing and implementing the progressions proposed since it follows a methodical four-step process that is straightforward. The jobs of every stakeholder during this cycle is as presented in the slide.

NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

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Asset ManagementIncentivize current staff to get shifts:$250 per shiftCut costs on hiring travelers:$100 per hourCut down costs needed to train recently added team members by reducing turnoverAllow for simple rotation of staff by providing scheduling flexibility”Hospitals under financial tension might battle to maintain quality and patient safety and have more regrettable patient outcomes comparative with well-resourced hospitals” (Akinleye, D. et al., 2019). To complete these changes, there will be two costs that should be added to the calculations. The first is the $250 bones incentive to nurses willing to get the shifts, and the second is additional salaries for outlay and travel nursing staff to satisfy the nursing deficiency. Since there will be six ED nurses, two med-flood, two PCU, and one ICU nurse, this everyday bonus amounts to an additional $2750 per shift for the nurses. While considering the 2 ED specialists and 2 CNA’s required, we can add $1000 to the expenses per shift in bonuses paid. The typical staff nurse salary is $35 each hour, while the typical travel nurse salary is $100 each hour. The additional $250 bonus is as yet the less expensive course for our facility while considering these numbers. It incentivizes staff nurses to get additional shifts. It also reduces turnover as staff might consider staying since they are being paid better and working under additional helpful conditions. Having the ability to pull in really existing staff while reducing the quantity of explorers will positively impact our facility in the long run.14

Part 5:
Evaluation

MetricsPatient wait timesPatient satisfaction scoresStaff feedbackUnintended side effectsCost analysisTo determine the outcome of disappointment of the plan, it should be evaluated using quantifiable information. In the final period of the PDSA cycle “the plan will be reevaluated based upon patient safety results and general morale and opinion of the group” (Coury, J. et al., 2017). Substantial information collected will be used to evaluate the viability of the progressions implemented. For the situation of our ED, it would be vital to check whether patient wait times were reduced and assuming patient satisfaction scores trended up. Equally significant would be our turnover numbers and worker feedback. It is critical to gauge the outcome of the change as it connects with time, energy, finances, and different assets used to carry out it. Also important to note during this stage are any unintended aftereffects that could have happened.16

NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

Outline

  • This presentation entails
  • Organization/ Patient Issue
  • Interdisciplinary Collaboration
  • Evidence-based interdisciplinary plan
  • Implementation of Solution with Stakeholders

Organization/Patient Issue

  • Excessive workload
  • Prolonged treatment time
  • Time management
  • Psychological stress

Relativity with Interdisciplinary Collaboration

  • Increased coordination
  • Patient-focused care
  • Time and financial management
  • Increased focus on high-risk patients

Evidence-based Inter-professional Framework

  • PDSA (Plan-Do-Study-Act) cycle
  • Participation of all stakeholders
  • Increased care for the patients

Implementation of Interdisciplinary Plan

  • Gynecologist will oversee the plan
  • PCU nurses will help in post-recovery
  • CAN nurse will help in emergency deliveries
  • Midwives will help in constant monitoring of mother and newborn

NURS FPX 4010 Assessment 4 Stakeholder Presentations NR

  • Adopt, adapt or abandon cycle
  • If adopting with no change, roll out the improvement
  • Set improvement goals
  • predict what will happen
  • Plan the cycle (who,where,what and how)
  • Decide what data to gather
  • Fully analyse
  • Compare data predictions
  • Examine learning
  • Carry out the plan
  • Document any problem encountered and observations
  • gather data

Resource Management

  • Motivate the workers for working in overtime shifts
  • $250 for each overtime
  • Reduce the temporary employees
  • Increase in hourly increment to $100
  • Reduce the income of current staff for investing in training
  • Flexible staff allocation

Outcomes of the Plan

  • Increased patient-satisfaction
  • Decreased workload on obstetric nurse
  • Decrease in the undesired results
  • Sound work environment
  • More compliance to the organization’s principles

References

Musinguzi, C., Namale, L., Rutebemberwa, E., Dahal, A., Nahirya-Ntege, P., & Kekitiinwa, A. (2018). The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda. Journal of Healthcare Leadership, Volume 10, 21–32. Reference

Patricia, K.-M., Victoria, M.-K., Kabwe, C., Micheal, K., & Judith, C. (2020). Implementing evidence based practice nursing using the PDSA model: Process, Lessons and Implications. International Journal of Africa Nursing Sciences, 100261. Reference

Prybutok, G. L. (2018). Ninety to Nothing: a PDSA quality improvement project. International Journal of Health Care Quality Assurance, 31(4), 361–372. Reference

Safari, K., Saeed, A. A., Hasan, S. S., & Moghaddam-Banaem, L. (2018). The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. International Breastfeeding Journal, 13(1). Reference

Soemantri, D., Kambey, D. R., Yusra, R. Y., Timor, A. B., Khairani, C. D., Setyorini, D., & Findyartini, A. (2019). The supporting and inhibiting factors of interprofessional collaborative practice in a newly established teaching hospital. Journal of Interprofessional Education & Practice, 15, 149–156. Reference

Xie, M., Lao, T. T., Ma, J., Zhu, T., Liu, D., Yu, S., Du, M., Sun, Q., & Ma, R. (2021). Impact of childbirth policy changes on obstetric workload over a 13-year period in a regional referral center in China – implications on service provision planning. BMC Pregnancy and Childbirth, 21, 610. Reference

Boamah, S. A., Spence Laschinger, H. K., Wong, C., & Clarke, S. (2018). Effect of Transformational Leadership on Job Satisfaction and Patient Safety Outcomes. Nursing Outlook, 66(2), 180–189. Reference

Campos, M. S. de, Oliveira, B. A. de, & Perroca, M. G. (2018). Workload of nurses: observational study of indirect care activities/interventions. Revista Brasileira de Enfermagem, 71(2), 297–305. Reference

Christoff, P. (2018). Running PDSA Cycles. Current Problems in Pediatric and Adolescent Health Care, 48(8), 198–201. Reference

Galiano, M. A., Moreno Fergusson, M. E., Guerrero, W. J., Muñóz, M. F., Ortiz Basto, G. A., Cardenas Ramírez, J. S., Guevara Lozano, M., & Larraín Sundt, A. (2023). Technological innovation for workload allocation in nursing care management: an integrative review. F1000Research, 12, 104. Reference

Jankelová, N., & Joniaková, Z. (2021). Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship. Healthcare, 9(3), 346. NCBI. Reference

Knudsen, S. V., Laursen, H. V. B., Johnsen, S. P., Bartels, P. D., Ehlers, L. H., & Mainz, J. (2019). Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects. BMC Health Services Research, 19(1). Reference

Loganathan, T., Rui, D., Ng, C.-W., & Pocock, N. S. (2019). Breaking down the barriers: Understanding migrant workers’ access to healthcare in Malaysia. PLOS ONE, 14(7), e0218669. Reference

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