Name
Capella University
FPX 6030: MSN Practicum & Capstone
Instructor’s name
September 28th, 2024
Final Project Submission
Abstract
In response to the timely pressure to solve nursing turnover concerns that are inextricably related to adverse patient outcomes, the present capstone project recommends an increase in nurse staffing in the long-term care facilities of Minnesota hospitals. Since then the COVID situation in the world has escalated these stressors, which is why nurses need interventions that would address their situation. Various studies show that the level of nursing burnout results in negative ramifications such as Health complaints, physical and psychological, high turnover, low job satisfaction, and an overall reduction in the quality of patient care (Kelly et al., 2021). The post-COVID environment has significantly exacerbated the stresses on nurses, emphasizing the need for targeted interventions. Research indicates that nursing burnout leads to a range of negative outcomes, including physical and mental health issues, increased turnover, and lower job satisfaction, all of which degrade patient care quality (McHugh et al., 2021). The project proposes a solution based on the American Nurses Association (ANA) guidelines recommending a nurse-to-patient ratio of 1:2 in emergency departments and 1:4 in long-term care units (Kelly et al., 2021). Studies conducted thus corroborate the statement that utilization of larger measures of staff-to-patient ratio is associated with reduced levels of medication mistakes, admissions, and number of burnt-out nurses, in addition to higher levels of patient satisfaction, and better quality of existence for the nurses.
Organizational Change
The organizational change suggested in this project revolves around the enhancement of the nursing staff to enhance the supply of nurses to the volume of patients. This shift is meant to improve the general welfare of the nurses since they lose morale due to burnout rates resulting from heavy workloads (Kutney et al., 2021). Since it will lead to improved safety of patients, efficiency of care, and satisfaction of patients it will have been crucial to enhance staffing levels to decrease burnout rates among employees. The literature evidence indicates that a direct relationship exists between increasing levels of nurse staffing and higher levels of nurses’ satisfaction as well as decreased burnout expectations; these findings explain better patient care quality and outcomes (Griffiths et al., 2019). The patient care project aims to enhance the ratio of nurses attending to patients to help the nurses handle the workload, set up a good environment for the patients as well as enhance quality services, reduce numerous medical mistakes, and at the same time, please the patients.
Introduction
Occupational stress and burnout, therefore, are receiving increased attention as health issues in the United States with the nursing profession being most affected. This project centers around the high rate of nurse attrition in the Minnesota hospitals’ long-term care units. The concern is on the nurses working in Minnesota and therefore the intended audience of this capstone project (Abbasinia et al., 2020). The research will be cross-sectional and will be conducted in long-term care units in selected healthcare facilities, the nurses will also be randomly sampled. The efficacy of the intervention will be assessed during follow-up visits to such hospitals. The problem of exploring and diagnosing nurse burnout is extremely important in the context of the negative impact of burnout on both the results in healthcare and the effectiveness of the nurses. If unmitigated, it is likely to worsen patient outcomes, frustrate nurses, and overstretch health facilities (Abadian et al., 2024). Further components are the herein outlined consultation of stakeholders, as well as the elaboration of detailed implementation concepts, action plans, and monitoring of effectiveness, to simultaneously improve patient satisfaction and nurses’ quality of work life. If used, different instruments such as the online dashboard, questionnaires, online forms, and surveys will be used to try to establish the success of the intervention.
Evaluation of the Best Available Evidence
To enhance the validity of the sources of information for clinical and organizational decision making several reliable journals and useful studies were chosen. The data collected to form the intervention plan to address the issue of low nurse-to-patient ratio was collected from an authentic databank (Bayless et al., 2021). One study highlighted the need to improve the nurse-to-patient ratio, identifying three key issues resulting from excessive workloads among nurses, although the causal relationship between these factors and the changes in behavior varies; employee emotional health challenges may lead to increased negative occurrences, and job satisfaction may also decline.
Problem Statement (PICOT)
Need Statement
This means that although COVID-19 escalated the level of Nurse burnout, this condition was prevalent even earlier, mainly because of Patient overload. Considering this challenge, the present project is designed to tackle the problem of the lack of nurse-patient ratios as an evidence-based approach to minimizing burnout (Wang et al., 2021). The end users are the patients and the aim is to enhance their experience, quality of care, and nurse health, and contain burnout costs. In an endeavor to come up with a broad assessment of the intervention, a group of nurses has been chosen to in the project.
Meeting this need is crucial because deterioration of the mandatory nurse-to-patient ratio resulting in burnout, shifts the negative impact not only on nurses but also on patients and the hospital. Consequences of nurse burnout include less satisfied nurses, less quality care to patients, increased rate of nurse turnover, Inadequate medical errors, and unsatisfied patients (Van et al., 2021). Also, burnout leads to high turnover costs in the hospitals all because of increased turnover rates among the nurses. Nursing turnover is caused by burnout or exhaustion among the nurses in that department.
The data used in this project comprise survey data collected from three healthcare facilities within 2018 and early 2019. Research showed that nurse burnout influenced job satisfaction and was responsible for the turnover figures raised by 12%. The studies also revealed that higher levels of nurse burnout correlate with reduced patient safety management services (PSMA) quality and care (Whitehouse et al., 2022). In addition, studies that took place in Alabama showed that medication errors were associated with burnout, job satisfaction, and experience and patient acuity in nurses working in the ICU. These findings underscore the pressing need for the proposed intervention because nurse turnover costs hospitals millions of dollars each year, according to the best available evidence.
Population and Setting
The proposed intervention will involve the nurses of Minnesota State in addressing all the aspects linked to nurse burnout. The rationale for selecting this group comes from the increased difficulties in the course of COVID-19 involving strikes in some Minnesota hospitals, which created a shortage of healthcare resources, including nurses. The Minnesota Nurses Association has asked for more funding for this issue (Toles et al., 2021). Nonetheless, the insufficiency of employees has led to symptoms of comfort among nurses, mainly due to work overload over the pandemic. Nurse burnout can be defined as the level of mental and physical fatigue that nurses feel while being at work. Globally, burnout was reported to affect the psychological well-being of Nurses and they suffer from increased anxiety, stress, depression, and sleeping disorders.
Moreover, even if the nurses specify that they do not meet the criteria of proper mental and physical state, they will not be able to provide care to the patients with need, love, and empathy. The said bleak trend is especially manifest in healthcare establishments like Minnesota; where burnout with major effects on both the nurses and the patients is not negligible (Scott et al., 2021). Therefore, the matter of professional stress among the nurses has to be solved for the benefit of the nurses and communities and also to enhance the efficiency of the service provision by the hospitals. To address this problem I suggest staffing up to enhance the ratio of nurses to the patients in the long-term care units. This setting is crucial because the organization’s nurses in these units sometimes work under unbearable conditions, and they do more than their counterparts working in different units.
Quality Improvement Methods
The intervention of adjusting the number of patients served by a nurse is postulated to ease the process of improving nurse burnout in Hospitals. This intervention focuses on reducing the nurses’ burnout level in the hospitals and the provision of techniques on how to reduce the nurse-patient ratio and teach nursing meditation to the nurses.
Intervention Overview
An important intervention aimed at decreasing nurse burnout for nurses in Minnesota is meant to raise the ratio of nurses to the number of patients. This approach will align with the American Nurses Association (ANA) recommendations, suggesting ratios such as 1:ALSO 2 in critical care areas and 1:4 in emergency areas (Stubin, 2023). Nurses will be chosen using a sampling technique to obtain inclusive results regarding the outcomes of the intervention. To measure the shift in burnout levels, I will also visit and compare the performances of the nurses before and after the COVID-19 period.
As will be discussed below, this intervention holds significant potential for enhancing Minnesota’s nursing workforce principally because of its focus on burnout and its impact on care. That way, the nurse-to-patient ratio will be increased and will lead to the fact that nurses feel less pressure on their shoulders, thus nurses will feel more calm and more concentrated on their job (Suleiman et al., 2020). This development is presumed to contribute to a decreased burnout level. In addition, the intervention is most appropriate for the nurses in L.T.C. units because they are usually overburdened due to the prolonged caregiving nature of the work. Stressful chores demanding psychological and physical strength lead to valuable exhaustion. Research findings underpinning this approach stress the possibility of improving the quality of life of nurses and patients.
Comparison of Approaches
In addition to increasing the nurse-to-patient ratio, one can suggest other measures to prevent burnout among nurses in Minnesota, such as the use of meditation, yoga, and other types of physical training for employees. Both of them are implemented concurrently to help the nurses deal with stress and improve their quality of life. meditations, tension relieving masques, mind, and yogas (Renner et al., 2023). Specifically, the fixed-break schedule is effective in the context of the nursing profession, because it enables the nurse to practice mindfulness and meditation at any given, even a brief spare moment and in any location remotely convenient for him/her. These kinds of exercises are expected to be very short, yet very effective, as they will not add to their burden while offering great benefits.
In terms of the ratio of nurses to patients, the meditation intervention is much less time-consuming than increasing the staff-to-patient ratio (Renner et al., 2023). This intervention will not add to what they do as they will be encouraged to implement these best practices in their normal operations. Collectively these useful interventions aimed at fostering a better working environment that supports the readiness to work and improved health of the nurses.
Initial Outcome Draft
Altogether, the intervention that focuses on decreasing the number of occupants per nurse is expected to notably decrease burnout for Minnesota’s nursing personnel. In addressing the nurse-to-patient ratio issue, it will be possible to upgrade the ability of nurses in decision-making and the standards of the hospital services provided (Spaulding et al., 2021). Less nurse burnout is also likely to improve the stress and anxiety situations among the nurses resulting in healthier working conditions. As showcased by this paper, Supporting Emotional and Physical Health of Nurses While Improving Patient Care, I have a concern for persons-nurses-as humans and as care (Rojo et al., 2022). The administration’s efforts to minimize burnout for nurses can end in enhancing the health services in particular settings to be beneficial coming from both the healthcare staff members along with patient-centric foundations. In the end, this intervention not only treats the symptoms of burnout but also a pathway to creating a culture of care that improves health in the community.
Time Estimate
The development of the intervention is likely to last for about two months which will be a constructive channel as it will involve improvement analysis as well as a literature review on the efficacy of the intervention. A major task that may prove cumbersome during this phase is the process of identifying and collecting credible data concerning nurse burnout and its impact on nurses’ rate of morale and patients’ status, which in turn may slow down the project (Pollock et al., 2021). Although the overall implementation period is estimated to be one year, the time is deemed sufficient to accomplish the outlined project tasks. To assess burnout rates, assessments will be made before the COVID-19 pandemic and then post the intervention.
The activities are as follows: sample the nurses over two months complete key indicators by the 4th month and use Excel data over the next six months (Rony et al., 2024). Nonetheless, several factors that may influence this timeline include a scarcity of nurses, any existing work policies that may influence the implementation of the exercise, and low motivation of the nurses to participate in the intervention. Furnishing the aforementioned challenges will be crucial to prepare for the effectiveness of the intervention and other succeeding positive outcomes.
Interprofessional Care to Improve Safety and Quality
The authorities expect that the implementation of interprofessional collaboration strategies will dramatically decrease readmission costs while increasing benefits for patients. The role of nurses can hardly be overestimated because most of the patients’ outcomes and safety outcomes rely greatly on sufficient nurse staffing and appropriate staffing ratios (Rony et al., 2024). Since any effort to improve the conditions in which nurses work will automatically imply improvements in health care delivery and safety to patients, large-scale changes must be effected.
The mindfulness meditation techniques suggested for the use of nurses, especially those practicing in critical or intensive care and long-term units are intended to cope with stress originating from psychological expectations and challenging work environment. In these, the nurses can be in a better position to fight their harsh working conditions and hence have better health though they have unhealthy mental health.
Moreover, the implementation of mindfulness in everyday work and groups results in valuable interprofessional nurses working in teams (Papastavrou et al., 2024). Doing so creates a more integrated and targeted framework of work, which is critical for providing continuous patient-centered minimum-risk services within facilities and structures of the healthcare system. In sum, it will only be advantageous to keep track of nurses’ requirements and their welfare, which would be favorable to the nurse’s alone while, in the process, being advantageous in augmenting the quality of the patient treatment received by the patient.
Literature Review
The results strongly support the need to look at ways of dealing with the burnout problem, especially the ratio of nurses to clients. Contrary to this conception, the author insists that such imbalance has negative impacts not only for the nurses, themselves but also for the patients they are taking care of (Papastavrou et al., 2024). A study identified three key organizational factors contributing to nurses’ mental health issues and burnout: 34% of the nurses had poor mental health, 40% of them had experienced some sort of trauma and 50% of the nurses had intentions to quit as a result of burnout. Further, the study reaffirmed core clinical factors including the relatively young ages of the nursing workforce, poor social support, and lack of preparedness for the conditions brought about by COVID-19 as contributors to today’s burnout. It was also realized that 31 % of the nurses complained of feeling mentally tired at work (Ozdemir et al., 2023).
Studies also identified a negative correlation between nurse burnout and patient safety management. As such, the authors recommended the enhancement of the environment of nursing and the promotion of additional enlightening studies of burnout significance. Thus, the results imply that raising the levels of nurses is necessary for the improvement of patient care outcomes. Also, workload is statistically significantly related positively to the nurse burnout variable (Peters et al., 2022). In these matters, there were considerations from the study to address by using mindful meditation as the intervention. It then said that through mindfulness, one can be able to deal with stress which is a major cause of burnout among nursing professionals. The study carried out in emergency departments of North India resembles exposure to mindfulness integrated into the nursing processes in conditions of high-stake pressure.
Health Policies Impacting the Need
The Hospital Patient Safety and Quality Care Nurse Staffing Standards Act was tabled in 2019 to standardize nurse staffing in different types of healthcare organizations for patients’ safety and purposes of quality care delivery. However, instead of imposing the same nurse-to-patient ratio for nursing practice across all settings, the Act flexibly allows ratios for departments or units (Nielsen et al., 2022). For example, it mandates a 1:The prediction ratio for long-term care units 1:1, emergency services 1:3, and for surgically specialized units 1:4. Various earlier works have shown that reducing the nursing staff to patient ratio could lead to an incremental modification of the level of staffing and at the same time patient acumen.
In this case, an important study was done in Australia to analyze the impact that accompanies a rise in the nurse-to-patient ratio on productivity in the healthcare segment. Also, it can be said that the nurse-to-patient ratio is connected with the demand, provided by the Affordable Care Act (ACA) that aimed at the increase of the number of people with health insurance; therefore, the need for services escalates, and so does the need for nurses (Nielsen et al., 2022). ACA intends to provide equal access to every American patient; in doing so, it increases the load of work for a nurse because he or she now has to treat more patients than before.
Intervention Plan for Patient and Population
Centered Care
Intervention Plan Components
The main strategies of the intervention plan are thus centered on a possible reduction of nurses’ patient load, the application of the structured intervention, and its assessment. Specifically, the proposed ratios are set at 1:3 for long-term care facilities and 1:2 for emergency care facilities (Melnyk et al., 2020). The projected duration for the implementation of this plan is one year so that the impact of the proposed changes on the target population of nurses and patients will be evaluated.
A detailed analysis of the proportion of nurses per patient means that with an increase in the number of patients, the stress level of the nurse will also increase as well as the level of burnout. This adjustment will help achieve a more realistic working condition that will enable care providers to meet each of the intervention aspects (Nho et al., 2023). During the assessment phase, the level of nurse burnout and the general health record of the patients will be reviewed to determine the new changes. It would also be expected that the intervention will result in a change in communication between nurses and students, an increase in the productivity of nurses as they address more concerns of the target group and a rationale towards a patient-centered approach to care.
Impact of Cultural Needs on the Intervention
The target nurses in Minnesota are a diverse mix of racial and cultural groups, such as whites, Hispanics, Blacks, Non-Latinos, and Latinos to capture the ethnic diversity in that state. This diversity has as well various cultures and languages which may act on the delivery of healthcare services and the acceptance of such services (Mintz et al., 2023). The population that concerns the nurses is also cross-sectional by gender and parenthood. Therefore, these cultural characteristics and needs play a big role in defining the development of the intervention to reduce the level of burnout among nurses. Large measures of the fit of work expectations for nurses concerning the cultural values of both the nurses and the clients they attend to are said to be imperative.
For example, cultural beliefs or traditions keep some of the nurses from ignoring some practices they believe are culturally and ethnically inappropriate for them which may cause them to be dissatisfied with their job and productivity (Li et al., 2022). Hence, management should be aware of these factors to facilitate better interaction between the patient and the nurse, increase the performance of the nursing staff, and ultimately increase the patient’s health status. Furthermore, long-term care units as such have their culture because they admit and care for patients with chronic or multiple health problems during an unbounded time. Given the cultural diversity in these settings, the cultural diversity of the nurses to patients and vice versa that help achieve satisfactory results in these areas is important.
Theoretical Foundation
The Conservation of Resource Theory provides a context for the subject under discussion by examining the links between the concepts of nursing and burnout based on the reduction of resources. Burnout, according to this theory, happens due to the overload and depletion of vital products, which includes energy, objects, conditions, and personal characteristics, as far as the working capacities of the nurses are concerned (Jannati et al., 2022). All these contribute to burnout, as a nurse needs energy and sand, equipment, environment, and personality traits to complete his/her tasks efficiently. Based on COR Theory, the intervention strategy targets the ratio of nurses attending to the patients whose workload and resource exhaustion should be managed to improve patient safety, quality of care, and cost-efficiency.
Among the recommendations that have been proposed by the United States Medical Licensure Examination include, exercising, taking breaks, maintaining healthy diets and sleep working for a limited period, and taking time off, among others are very paramount in combating burnout (Khatatbeh et al., 2022). Most of the activities recommended by the United States Medical Licensure Examination include exercises, relaxation breaks, healthy dietary habits, and sleeping patterns, limited study time, and time off to avoid burnout. The following change in nurse staffing levels, therefore, is proposed: Additional nurse staffing hours would cover shifts with the fewest staff and provide enough margin to permit more vacation and personal days (Kutney et al., 2021). This is a good strategy because the proposed reduction in the number of patients each nurse cares for each shift reduces the risk of burnout to acceptable levels. Furthermore, due to the evaluation of the technological solutions, adding EHR, application dashboards, and online portals to the evaluation framework will be helpful for the intervention.
Justification of the Components of the Intervention
The Conservation of Resource Theory Model is used to underpin the intervention as it highlights the loss of performance and productivity arising from nurse burnout. A major priority of this plan is the enhancement of the nursing student/staff ratio and the number of patients for each staffed nurse, with a focus on LTCs where the ratio will be one nurse per three long-term care patients (Khatib et al., 2020). Previous studies show that modifications for elevating the nurse-to-patient ratio are justified since these changes make clinical and financial improvements. They include; increased patient satisfaction, improvement in the overall cost of service delivery, and reduction in both nurse fatigue and medical errors. Further, exercise and meditation may be explained by evidence as ways of reducing nurse burnout and are, therefore, part of the intervention. Technologies like EHR and the use of dashboards in the management of patient and hospital data enhance the application of the intervention as well as the health conditions of the nurses and patients.
Stakeholders, Policy, and Regulations
The changes that will be realized through new measures will impact patients, the nursing staff, members of the community, the overall hospital workforce, and employees within the finance department (Green et al., 2021). Some of the needs found unique to patients include; knowledge satisfaction, information needs especially concerning treatments, health education, and quality care needs.
This should mean having the right number of staff and distribution so that the nurses will not be overburdened with the number of patients that they attend to; because if they are handling several patients at once they’ll get very tired and will end up worsening the situation by offering substandard services in the LTCUs (Hvidhjelm et al., 2023). It will improve patients’ quality of care due to the right staffing where patients who require most attention will be attended to by the nurses.
Nurses are some of the workers in any health facilities, and for them, their vital needs are; time for self and family, participation in the decision-making processes, and good health; both physical and mental health. To meet these needs, managers need to embrace good managerial practices, promotion of cooperation among the workers and members, and advanced communication and managerial courses (Immonen et al., 2019). Every employee in a hospital management structure profits from a proper determination of many nurses to patients because it directly affects the quality of services delivered to patients. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act emphasizes appropriate nurse-to-patient ratios based on the type of care units, setting guidelines of 1:2 for emergency units and 1:3 for long-term care units. This policy promotes the objectives of the project of specifically relieving nurses’ workloads and preventing fatigue, thereby improving their effectiveness and decreasing their mistakes in administering medication; reducing readmission rates.
Ethical and Legal Implications
From the study, it is evident that higher rates of burnout in nurses are associated with health practice errors and ethical dilemmas of nurses in the emergency departments. They claim that incompetency compromises the stability of their decision-making capacity, the quality of patients, and general health services (Harnett et al., 2023). Therefore there is a high probability of readmission and so if an error occurs, it becomes expensive for the hospital and the patient. Another correlate of higher burnout is moral distress plus elevated turnover in the organizations.
Implementation Plan
Management and Leadership
This calls for adequate staffing and staff distribution in such a way that the nurses available will not be overworked by the number of patients they are attending to; thereby handling many patients at once will leave them very exhausted and therefore instead of helping worsen the situation they offer poor services within the LTCUs (Estrada et al., 2022). It will improve the patient’s quality of care due to the right staffing where the patient requires most attention will be attended to by the nurses. Nurses are some of the workers in any health facilities, and for them, they vital needs are; time for self and family, participation in the decision making processes, and good health; both physical and mental health.
To meets these needs, managers need embrace good managerial practices, promotion of cooperation among the workers and members, and advanced communication and managerial courses. Every employee in a hospital management structure profit from a proper determination of numbers of nurses to patients because it directly affects the quality of services delivered to patients (Deliktas et al., 2019). The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act emphasizes appropriate nurse-to-patient ratios based on the type of care units, setting guidelines of 1:2 for emergency units and 1:3 for long-term care units. This policy promotes the objectives of the project of specifically relieving nurses’ workloads and preventing fatigue, thereby improving their effectiveness and decreasing their mistakes in administering medication; reducing readmission rates (Darko et al., 2023). Therefore, the implementation of these standards can reduce costs of readmissions and mistakes, in accordance with the provisions of the Public Health Services Act that is working on the ratio of patients to nurses in healthcare organizations.
In doing so, the study demonstrates that there is a direct relationship between the level of burnout in the nurses and their improper health practices and ethic concerns across the emergency departments (Cai et al., 2021). They claim that incompetency compromises the stability of their decision-making capacity, the quality of patients, and general health services. Therefore there is high probability for readmission and so if an error occurs, it becomes expensive for the hospital and the patient. Another correlate of higher burnout is moral distress plus elevated turnover in the organizations.
Delivery and Technology
The action plan is one of the ways of getting to the implementation of the plan as noted above. The action plan will decrease the nurse-to-patient ratio depending on the needs of a particular hospital environment. For instance, in low-complicated long-term care units, the ratio will be one nurse to three patients while in highly complicated urgent care units the ratio will be one nurse to two patients (Danno et al., 2021). The action plan will be expounded through engaged workshops by the nurses. From there, the plan will be forwarded to other authorities of relevance for ratification. As for personnel management, the target nurses will work under the auspices of the nurse managers who will supervise the activity and training of the nurses.
Evaluation of Current and Emerging Technology
Integration of current and emerging technology will improve the relevance and practicability of the plan for the target population, the patients, as well as the health care unit. It could also enhance the relations between the top players such as e-mailing, telephony, and electronic health records as well as the other relevant forms of communication (Dincer et al., 2021). The management can make the application of a Learning Management System (LMS) beneficial in enhancing the knowledge of nurses and patients as well. Regarding the idea of its application, it can be used to help nurses improve their training and practice by enabling them to access a large number of data in a short time.
As for the delivery methods example of a recent technology that can help improve the delivery methods is Artificial Intelligence (AI) (Cai et al., 2021). AI is a tech devised approximately intellect; it replicates intellect for ingesting the info in it. Examples of such AI tools include chat bots to solve issues that customers encounter, smart personal assistants to improve a particular user’s agenda, and recommendation systems to provide the most appropriate solution to a problem.
Stakeholders, Policy, Regulations
This research will involve nurses and other members of the finance department, patients, and any ordinary citizen from the community. The patient’s needs are communicated as communication, protection, information, help, independence, and clarification of health literacy. These are areas in decision-making, teamwork, and enhanced communication with the patients and other related professionals in need of improvement (Brazier et al., 2024). Nurse work environment needs. The need for managers is to lead, build a team, communicate, and be creative in problem-solving. A proposal of change in the reformation of the intervention plan to be implemented reveals that all the needs of the stakeholders will be improved.
It is crucial to appreciate that the following two health regulation policies are tied to this plan implementation: the Affordable Care Act and Nurse Staffing Standards for Hospitals respectively for the Patient Safety and Quality Care Act (Abadian et al., 2024). The former policies are associated with the likelihood of high turnover of nurses during the extension of health insurance. Bettering the areas of access to health care translates into an increase of the flow of patients that nurses will have to address in various capacities; therefore separately enhancing the ratio of nurses to patients. About the mentioned problem, ACA provided a solution that distinguished between the establishments that provided inpatient and outpatient services.
Some specified staffing of nurses for patients is provided by the Quality Care Act. For instance, the medical care units should recommend a nurse-to-patient ratio of 1. These ratios are 4: 1 for the dental unit and 3:1 for the emergency unit. For the improvement of the plan the following created policies can be useful during the implementation of the plan.
Timeline
It is expected that the plan will take one year to be implemented to ensure the impact of COVID-19 on the target population is well assessed before and after the COVID period. This timeline is deemed reasonable and sufficient for performing several activities, such as surveying and sampling the nurses during the first sixty days, evaluating the KPIs during the fourth month, and evaluating the outcome for the next six months. However, three possible risks may affect the process changes in some government policies, low motivation of the nurses who will be involved in the sampling, and worst still the nurses may not be available for sampling. Such issues mean that activity-based strategies will have to be adopted to prevent the achievement of these challenges and efficient implementation.
Evaluation Plan
Defining Outcomes
The intervention will focus on improving nurses’ wellness and patients’ prognosis as a consequence of redesigning the environment to reduce burnout. Through supporting the ability of nurses to work without excessive levels of stress, the initiative targets aspects of mental and physical well-being, with the understanding that increased wellbeing should lead to greater performance with regard to the care of patients (Bayless et al., 2021). This way, the measures of patients managed per nurse will also be reduced, and the quality of care delivered to each patient will greatly enhance translates to better patient health status and safety from adverse effects of medication administration-related errors. Also, nurses will become more effective in their duties because of easy workload hence improving the hospital health services (Abadian et al., 2024). Nevertheless, the present intervention can be expected to have one clear consequence for salary costs – the hospital must employ as many nurses to guarantee the planned ratio of nurses to patients. This type of staffing investment is important in maintaining the obtained positive impact of the intervention for more than just a week, as well as the overall benefit for patients and nursing personnel.
Evaluation Plan
The assessment of the efficacy of the intervention plan will be based on the findings of the nurses’ questionnaires and patients’ structured interviews and questionnaires with their families. These surveys are necessary to determine how effective the plan is for the management and then look for any gaps that may already be present (Darko et al., 2023). The current and proposed nurse-to-patient ratios, the nurses’ feedback as well as analysis of patients’ charts are some of the basic facts that must be presented in the evaluation of the plan’s impacts.
Local rate to patient health status will be used for monitoring this data by management; subsequent reviews will be made with the help of electronically generated dashboards after 15 days (Griffiths et al., 2019). This will be done by comparing the baseline data with the outcomes to assess the level of achievement towards the project objectives using data from nurses, from the patient’s side, and from the record. The latter is based on some assumptions such as the feasibility of using questionnaires to collect data and the usefulness of hospital dashboards to track the mentioned above KPIs.
Discussion
Advocacy
It’s important to be able to motivate, mobilize, motivate, and lead others in a direction that aligns with the objectives of the organization. This paper also recognizes nurses as key players in building and maintaining interprofessional relationships because they are the principal caregivers with direct contact with patients (Immonen et al., 2019). Measures like safety huddles and good communication measures can be employed in the healthcare sector to improve collaboration and therefore come up with the best results for patients.
It was assumed that increasing the nurse-to-patient ratio would be advantageous for the nursing occupation and healthcare institutions (Kutney et al., 2021). Effective intervention will enhance the experiences of patients, the health status of nurses, and more so, the efficiency of hospitals so that other health sectors can embrace and fulfill the positive changes oriented toward the nursing profession. This development of a broader leadership position for nurses as the change agents and leaders in health organizations is pointed out here.
Hiring more nurses means that patients will be attended to by many nurses rather than the current single nurse attending to many patients which in one way will cause burnout among nurses as well as poor ratings on the general health of patients (Jannati et al., 2022). These enhancements will help the nurses manage their caseload whilst integrating well with other members of the health care provision. The paper also concludes that nurses who have less distraction in their working environment reduce cases of errors such as medication errors therefore working towards reducing patient readmissions.
Future Steps
Cultural factors have to be addressed in the intervention project to boost its utility. It also means that by acknowledging that the patient has a certain cultural background the care can then be given in consideration of that culture’s norms (McHugh et al., 2021). Towards this, focused efforts are needed to incorporate culturally appropriate training and education for nurses in connection with socially skilled cultural sensitivity to inform the acquisition of requisite values and knowledge to embrace patients’ admitted culture.
Performing cultural assessments will again be intensified through the use of technological tools like dashboards and EHRs. These technologies assist in the proper management and tracking of information flow required by the healthcare teams for assessments and or evaluations. This capability enables intervention that is relevant to the cultural requirements of patients on time (Nielsen et al., 2022). However, organizations’ adoption of nursing models such as Team Nursing (TN) which sees a team of nurses work under the supervision of a team leader also steps up healthcare performance. This is where the collaborative efforts of the team were more effective when managed by transformational leadership to deliver services that meet the needs of both patients and nurses. Islamic cultural sensitivity and teamwork are therefore relevant approaches to enhancing global health care quality.
Reflection on Leading Change and Improvement
In this project, I have learned new ways of how to better lead change and manage projects in healthcare organizations. I have gained good leadership knowledge in this area and got an opportunity to practice teamwork and change management. To this, I understand that the achievement of these skills shall help me in my future practice, as I shall be able to manage interpersonal processes, make effective organizational decisions, and manage processes of communication efficiently (Peters et al., 2022). Moreover, with the help of this project, I will include and lead a campaign seeking to enhance the nurse-to-patient ratio to reduce burnout among the former.
NURS FPX 6030 Assessment 6 Conclusion
Lastly, based on the results of this study, it is recommended that increasing the number of nurses to the number of patients in the long-term care facilities within the hospitals in Minnesota be the proposed intervention to help in addressing the burn out among the nurses and enhance the outcomes of patient care (Papastavrou et al., 2024). It is an effective method of responding to the severe shortage of nurse resources by supporting strategies and thus delivering better care and reduced errors as well as readmissions. The results of the study stress the necessity to tackle burnout as a way to promote a ready and satisfied workforce and enhance the standard of patients’ treatment, especially in the COVID-19 era.
NURS FPX 6030 Assessment 6 References
Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151.https://journals.sagepub.com/doi/10.1177/0969733019832950
Abadian, L., Alavi, N. M., & Tagharrobi, Z. (2024). Clinical nursing competency during epidemics: a qualitative content analysis. BMC nursing, 23(1), 306.https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01977-y
Bayless, A. K., Wyatt, T. H., & Raynor, H. (2021). Self-regulation in pediatric nursing literature: An evolutionary concept exploration. Research and Theory for Nursing Practice, RTNP-D-20-00084. Advanced online publication. https://connect.springerpub.com/content/sgrrtnp/35/3/222
Brazier, J. F., White, E. M., Meehan, A., Shield, R. R., Grabowski, D. C., Rahman, M., & Gadbois, E. A. (2024). Rethinking infection control: nursing home administrator experiences during the COVID-19 pandemic. Journal of the American Medical Directors Association, 25(8), 105071.https://www.jamda.com/article/S1525-8610(24)00493-6/abstract
Cai, S., Yan, D., & Intrator, O. (2021). COVID-19 Cases and death in nursing homes: The role of racial and ethnic composition of facilities and their communities. Journal of the American Medical Directors Association, 22(7), 1345–1351.https://www.jamda.com/article/S1525-8610(21)00427-8/fulltext
Darko, E. M., Kleib, M., Lemermeyer, G., & Tavakoli, M. (2023). Robotics in nursing: Protocol for a scoping review. JMIR Research Protocols, 12, e50626.https://www.researchprotocols.org/2023/1/e50626
Danno, C. H., Esteves, L. S. F., & Bohomol, E. (2021). Quality improvement programs and the professional nursing practice environment: An integrative review, 74(1), e20200108.https://www.scielo.br/j/reben/a/jLvTjBqYCVs3PbMKDbcgwjL/?lang=en
Dincer, B., & Inangil, D. (2021). The effect of emotional freedom techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial. Explore (New York, N.Y.), 17(2), 109–114.https://www.sciencedirect.com/science/article/pii/S1550830720303839?via%3Dihub
Deliktas, A., Korukcu, O., Aydin, R., & Kabukcuoglu, K. (2019). Nursing students’ perceptions of nursing metaparadigms: A phenomenological study. The Journal of Nursing Research: JNR, 27(5), e45.https://journals.lww.com/jnr-twna/fulltext/2019/10000/nursing_students__perceptions_of_nursing.7.aspx
Estrada, L. V., Harrison, J. M., Dick, A. W., Luchsinger, J. A., Dhingra, L., & Stone, P. W. (2022). I am examining regional differences in nursing home palliative care for black and hispanic residents. Journal of Palliative Medicine, 25(8), 1228–1235.https://www.liebertpub.com/doi/10.1089/jpm.2021.0416
Griffiths, P., Mariotti, A., Recio Saucedo, A., Redfern, O. C., Ball, J. E., Briggs, J., … & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: Retrospective longitudinal cohort study. BMJ Quality & Safety, 28(8), 609-617.https://qualitysafety.bmj.com/content/28/8/609
Green, A. A., & Kinchen, E. V. (2021). The effects of mindfulness meditation on stress and burnout in nurses. Journal of Holistic Nursing: Official Journal of the American Holistic Nurses’ Association, 39(4), 356–368.https://journals.sagepub.com/doi/10.1177/08980101211015818
Hvidhjelm, J., Berring, L. L., Whittington, R., Woods, P., Bak, J., & Almvik, R. (2023). Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset violence checklist. Journal of Psychiatric and Mental Health Nursing, 30(4), 637–648. https://doi.org/10.1111/jpm.12905
Harnett, G., & Collins, M. (2023). Nursing in rural, remote and isolated settings: A literature review. Rural and Remote Health, 23(1), 8159.https://www.rrh.org.au/journal/article/8159
Immonen, K., Oikarainen, A., Tomietto, M., Kääriäinen, M., Tuomikoski, A. M., Kaučič, B. M., Filej, B., Riklikiene, O., Flores Vizcaya-Moreno, M., Perez-Cañaveras, R. M., De Raeve, P., & Mikkonen, K. (2019). Assessment of nursing students’ competence in clinical practice: A systematic review of reviews. International Journal of Nursing Studies, 100, 103414.https://www.sciencedirect.com/science/article/abs/pii/S0020748919302214?via%3Dihub
Khatib, R., Lee, G. A., Marques-Sule, E., Hopstock, L. A., O’Donnell, S., Svavarsdóttir, M. H., Andreae, C., Vellone, E., Goossens, E., Strömberg, A., Kjellström, B., Jaarsma, T., & Stewart, C. (2020). They are evaluating the extent of patient-centered care in a selection of ESC guidelines. European Heart Journal. Quality of Care & Clinical Outcomes, 6(1), 55–61.https://academic.oup.com/ehjqcco/article/6/1/55/5497486
Kelly, L. A., Todd, M., Tuttle, R., & Birkeland, K. (2021). The impact of nurse staffing ratios on nurse and patient outcomes: A systematic review. Journal of Nursing Administration, 51(1), 20-29.https://journals.lww.com/jonajournal/abstract/2021/01000/an_exploration_of_characteristics_and_behavioral.7.aspx
Kutney, A., Sloane, D. M., Aiken, L. H., & McHugh, M. D. (2021). Nurse staffing, burnout, and healthcare-associated infection in acute care hospitals: Cross-sectional study. Journal of Nursing Care Quality, 36(2), 87-92.https://journals.lww.com/jncqjournal/fulltext/2021/04000/continuous_video_monitoring__implementation.9.aspx
Khatatbeh, H., Pakai, A., Al, T., Onchonga, D., Amer, F., Prémusz, V., & Oláh, A. (2022). Nurses’ burnout and quality of life: A systematic review and critical analysis of measures used. Nursing Open, 9(3), 1564–1574.https://onlinelibrary.wiley.com/doi/10.1002/nop2.936
Jannati, Y., Babajani, A., Kolaei, M. G., Mohsenipouya, H., Mousavinasab, N., Gorji, M. A. H., & Mamun, M. A. (2022). Evaluating patient satisfaction with nursing services before and after implementation of the health system transformation plan in Iran: A cross-sectional study. Health Science Reports, 5(4), e710.https://onlinelibrary.wiley.com/doi/10.1002/hsr2.710
Li, Y., Cai, X., Mao, Y., Cheng, Z., & Temkin-Greener, H. (2022). Trends in racial and ethnic disparities in coronavirus disease 2019 (COVID-19) outcomes among nursing home residents. Infection Control and Hospital Epidemiology, 43(8), 997–1003.https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/trends-in-racial-and-ethnic-disparities-in-coronavirus-disease-2019-covid19-outcomes-among-nursing-home-residents/634909D53F962EAAC0DB88CE895690BB
McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratios on nurse burnout, job dissatisfaction, and missed care: A cross-sectional study in the US. BMJ Quality & Safety, 30(7), 614-623.https://qualitysafety.bmj.com/content/30/8/639
Mintz, Y., Aswani, A., Kaminsky, P., Flowers, E., & Fukuoka, Y. (2023). Behavioral Analytics for Myopic Agents. European journal of operational research, 310(2), 793–811.https://www.sciencedirect.com/science/article/abs/pii/S0377221723002588?via%3Dihub
Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to improve mental health, well-being, physical health, and lifestyle behaviors in physicians and nurses: A systematic review. American Journal of Health Promotion: AJHP, 34(8), 929–941.https://journals.sagepub.com/doi/10.1177/0890117120920451
Nho, J. H., & Park, S. (2023). Research trends in the Korean Journal of Women Health Nursing from 2011 to 2021: a quantitative content analysis. Korean Journal of Women Health Nursing, 29(2), 128–136.https://www.e-whn.org/journal/view.php?doi=10.4069/kjwhn.2023.06.20.1
Nielsen, S., Langensiepen, S., Madi, M., Elissen, M., Stephan, A., & Meyer, G. (2022). Implementing ethical aspects in the development of a robotic system for nursing care: A qualitative approach. BMC Nursing, 21(1), 180.https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-022-00959-2
Ozdemir, H., & Kilicarslan, E. (2023). The effect of technology-based interventions on child and parent outcomes in pediatric oncology: A systemic review of experimental evidence. Asia-Pacific Journal of Oncology Nursing, 10(5), 100219.https://apjon.org/article/S2347-5625(23)00037-9/fulltext
Peters, M. D. J., Godfrey, C., McInerney, P., Khalil, H., Larsen, P., Marnie, C., Pollock, D., Tricco, A. C., & Munn, Z. (2022). Best practice guidance and reporting items for the development of scoping review protocols. JBi Evidence Synthesis, 20(4), 953–968.https://journals.lww.com/jbisrir/fulltext/2022/04000/best_practice_guidance_and_reporting_items_for_the.3.aspx
Papastavrou, E., Chiappinotto, S., Gastmans, C., Igoumenidis, M., McCabe, C., Suhonen, R., Palese, A., & PROMOCON Consortium (2024). Ethics in undergraduate nursing degrees: An international comparative education study. Nursing Ethics, 9697330241247322. Advance online publication. https://journals.sagepub.com/doi/10.1177/09697330241247322
Pollock, D., Davies, E. L., Peters, M. D. J., Tricco, A. C., Alexander, L., McInerney, P., Godfrey, C. M., Khalil, H., & Munn, Z. (2021). Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics. Journal of Advanced Nursing, 77(4), 2102–2113.https://onlinelibrary.wiley.com/doi/10.1111/jan.14743
Rony, M. K. K., Parvin, M. R., & Ferdousi, S. (2024). Advancing nursing practice with artificial intelligence: Enhancing preparedness for the future. Nursing Open, 11(1), 10.1002/nop2.2070.https://onlinelibrary.wiley.com/doi/10.1002/nop2.2070
Rojo, E., Maestre, J. M., Piedra, L., Esteban, J., Sánchez, B., Hoz, V., & Del Moral, I. (2022). Interprofessional team training with in situ simulation to improve the quality of cardiopulmonary resuscitation. Journal of Healthcare Quality Research, 37(2), 92–99.https://www.sciencedirect.com/science/article/abs/pii/S2603647921000993?via%3Dihub
Renner, C., Jeitziner, M. M., Albert, M., Brinkmann, S., Diserens, K., Dzialowski, I., Heidler, M. D., Lück, M., Nusser-Müller-Busch, R., Sandor, P. S., Schäfer, A., Scheffler, B., Wallesch, C., Zimmermann, G., & Nydahl, P. (2023). Guideline on multimodal rehabilitation for patients with post-intensive care syndrome. Critical Care (London, England), 27(1), 301.https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04569-5
Spaulding, E. M., Marvel, F. A., Jacob, E., Rahman, A., Hansen, B. R., Hanyok, L. A., Martin, S. S., & Han, H. R. (2021). Interprofessional education and collaboration among healthcare students and professionals: A systematic review and call for action. Journal of Interprofessional Care, 35(4), 612–621.https://www.tandfonline.com/doi/full/10.1080/13561820.2019.1697214
Suleiman, N., Gomez, J. L., Aguayo, R., Cañadas, G. A., De La Fuente, E. I., & Albendín, L. (2020). The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis. Journal of Advanced Nursing, 76(5), 1124–1140.https://onlinelibrary.wiley.com/doi/10.1111/jan.14318
Stubin C. A. (2023). Steps toward a resilient future nurse workforce. International Journal of Nursing Education Scholarship, 20(1), 10.1515/ijnes-2022-0057.https://www.degruyter.com/document/doi/10.1515/ijnes-2022-0057/html
Scott, S. M., & Scott, P. A. (2021). Nursing, advocacy, and public policy. Nursing Ethics, 28(5), 723–733.https://journals.sagepub.com/doi/10.1177/0969733020961823
Toles, M., Colón-Emeric, C., Moreton, E., Frey, L., & Leeman, J. (2021). Quality improvement studies in nursing homes: A scoping review. BMC Health Services Research, 21(1), 803.https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06803-8
Van, G. H., Huisman-de Waal, G. G. J., Vermeulen, H., & de van der Schueren, M. A. E. (2021). Effects of nursing nutrition interventions on outcomes in malnourished hospital inpatients and nursing home residents: A systematic review. International Journal of Nursing Studies, 117, 103888.https://www.sciencedirect.com/science/article/pii/S0020748921000201?via%3Dihub
Whitehouse, C. L., Harris, C., Charlton, P., & Hare, N. (2022). The changing paradigm of research delivery during a pandemic. A reflective account. Nurse Researcher, 30(2), 12–17.https://journals.rcni.com/nurse-researcher/evidence-and-practice/the-changing-paradigm-of-research-delivery-during-a-pandemic-a-reflective-account-nr.2022.e1832/abs
Wang, M., Jiang, Y., Han, W., Jiang, L., & Mao, C. (2021). Summary of the best evidence for the prevention of intraoperative unplanned hypothermia in patients undergoing laparoscopic surgery. Gland Surgery, 10(9), 2790–2798.https://gs.amegroups.org/article/view/79462/html
