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If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
I currently work as regional manager for a large company that oversees doctors’ offices. One of the main issues that affect us greatly is the rising cost of medication and patient compliance. There are many reasons healthcare cost rise. One reason is “The way the system is structured now, it is a cure-driven system, not a prevention-driven system,” (Morabito 2022) This statement means that we focus on fixing a problem rather than preventing the problem.
My company has created a new position within the company to monitor patients and to ensure the follow up in office for preventative procedures. The position is care managers the care managers call patients routinely monitoring for any disease exacerbation, schedule them for follow up appointments after ER, or hospital stays, and routine visits. It is said that the benefits of preventive health care are narrowly defined in terms of reductions in future morbidity and mortality.
Thus it is normally assumed that it is the final health gains alone which bear utility (Salkeld). If patients are diligent about frequenting their physician offices to get routine test, labs and procedures as well as maintaining a balanced diet many health disparities will ne prevented. Getting preventive care reduces the risk for diseases, disabilities, and death — yet millions of people in the United States don’t get recommended preventive health care services (Borsky).
Borksy, A., et al. (2018). Few Americans Receive All High-Priority, Appropriate Clinical Preventive Services. Health Affairs, 37(6).
Charlotte Morabito February 28, 2022 “Why health-care costs are rising in the U.S. more than anywhere else” retrieved on November 28, 2022 from https://www.cnbc.com/2022/02/28/why-health-care-costs-are-rising-in-the-us-more-than-anywhere-else-.htmlLinks to an external site.
Salkeld G. (1998). What are the benefits of preventive health care?. Health care analysis : HCA : journal of health philosophy and policy, 6(2), 106–112. https://doi.org/10.1007/BF02678116
One of the main healthcare issues right now is nursing shortage. In my current workplace we are often understaffed. I work in a COVID unit and one reason nurses do not stay is staff burnout. Thus, our hospital is hiring travel nurses to fill up these positions and also partnering up with local universities and colleges that offers nursing programs to encourage new graduates to apply at the hospital in exchange of loan reimbursement. The same is offered with current staff that wants to pursue further education in exchange for a work contract.
First and foremost, hospitals and other health care facilities must immediately invest in retaining our current nursing workforce. Burnout associated with COVID-19 working conditions and post-traumatic stress disorder is leading to an exodus of nurses. Some nurses are choosing to retire; others are abandoning hometown hospitals for more lucrative traveler positions. Some nurses are leaving the profession altogether (Washington Nurse, 2021).
According to the American Nurses Association (ANA): “By 2022, there will be far more registered nurse jobs available than any other profession, at more than 100,000 per year. With more than 500,000 seasoned RNs anticipated to retire by 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs for expansion and replacement of retirees, and to avoid a nursing shortage.”
In 2014, Thomas Bodenheimer, MD, and Christine Sinsky, MD, published an article reporting that staff burnout and dissatisfaction are associated with lower patient satisfaction, reduced health outcomes, and potentially increased costs. They recommended that organizations adopt the quadruple aim, citing that the fourth aim, improving the work life of health care clinicians and staff, is necessary to achieve the triple aim.
The authors noted that the work environment has a significant impact on employee well-being, and employees with poor well-being were less engaged and more negative about the workplace (Jacobs et al., 2018). Even the most perfectly designed delivery system will become dysfunctional if the leaders of the team lack the energy or desire to effectively carry out their responsibilities. Each staff member should feel fully engaged in support of the healthcare organizational mission. This enhances continuity of care, adding to the momentum of patient engagement.
COVID-19 INTENSIFIES THE NATIONAL NURSING SHORTAGE: For years, national nursing leaders and health care experts warned of a looming nursing shortage… Add a global pandemic, and that shortage is here. (2021). Washington Nurse, 51(3), 22–23.
Epperson, W. J., Childs, S. F., & Wilhoit, G. (2021). Provider Burnout and Patient Engagement: The Quadruple and Quintuple Aims. Physician Leadership Journal, 8(2), 72–76.
Jacobs, B., McGovern, J. , Heinmiller, J. & Drenkard, K. (2018). Engaging Employees in Well-Being. Nursing Administration Quarterly, 42 (3), 231-245.
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
The Assignment (2-3 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 2 to 3 page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
NURS_6053_Module01_Week02_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDevelop a 2-3 page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: · Describe the national healthcare issue/stressor you selected and its impact on your organization. · Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
25 to >22.0 pts
Excellent
The response accurately and thoroughly describes the national healthcare issue/stressor selected and its impact on an organization. …The response includes accurate, clear, and detailed evidence/data to quantify the impact of the national healthcare issue/stressor selected.
22 to >19.0 pts
Good
The response describes the national healthcare issue/stressor selected and its impact on an organization. …The response includes accurate data to quantify the impact of the national healthcare issue/stressor selected.
19 to >17.0 pts
Fair
The response inaccurately or vaguely describes the national healthcare issue/stressor selected and its impact on an organization. …The response includes vague or inaccurate data to quantify the impact of the national healthcare issue/stressor selected.
17 to >0 pts
Poor
The response inaccurately and vaguely describes the national healthcare issue/stressor selected and its impact on an organization or is missing. …The response includes vague and inaccurate data to quantify the impact of the national healthcare issue/stressor selected or is missing.
25 pts
This criterion is linked to a Learning Outcome· Provide a summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor. · Explain how the healthcare issue/stressor is being addressed in other organizations.
30 to >26.0 pts
Excellent
Response includes a complete, detailed, and specific summary of two outside resources (articles) reviewed on the national healthcare issue/stressor selected. …The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.
26 to >23.0 pts
Good
Response includes an accurate summary of two outside resources (articles) reviewed on the national healthcare issue/stressor selected. …The response explains how the healthcare issue/stressor is being addressed in other organizations.
23 to >20.0 pts
Fair
Response includes a vague or inaccurate or incomplete summary of outside resources (articles) reviewed on the national healthcare issue/stressor selected. …The response vaguely or inaccurately explains how the healthcare issue/stressor is being addressed in other organizations.
20 to >0 pts
Poor
Response provides a vague and inaccurate summary of outside resources (articles) reviewed on the national healthcare issue/stressor selected or summary is missing. …The response vaguely and inaccurately explains how the healthcare issue/stressor is being addressed in other organizations or explanation is missing.
30 pts
This criterion is linked to a Learning Outcome· Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. · Explain how the strategies may impact your organization both positively and negatively. Be specific and provide examples.
25 to >22.0 pts
Excellent
Response includes a complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor. …Response accurately and thoroughly explains how the strategies may impact an organization both positively and negatively, with specific and accurate examples for each.
22 to >19.0 pts
Good
Response includes an accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor. …Response explains how the strategies may impact an organization both positively and negatively with at least one specific example for each.
19 to >17.0 pts
Fair
Response includes a vague or inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor. …Response vaguely or inaccurately explains how the strategies may impact an organization both positively and negatively. …Response may include some vague or inaccurate examples.
17 to >0 pts
Poor
Response provides a vague and inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor or summary is missing. …Response vaguely and inaccurately explains how the strategies may impact an organization both positively and negatively or explanation is missing. …Response does not include any examples.
25 pts
This criterion is linked to a Learning OutcomeResource Synthesis
5 to >4.0 pts
Excellent
Using proper in-text citations, the response fully integrates at least 2 outside resources and 2 or 3 course-specific resources.
4 to >3.0 pts
Good
Using proper in-text citations, the response fully integrates at least 2 outside resources and 1 course-specific resource.
3 to >2.0 pts
Fair
Using proper in-text citations, the response minimally integrates outside and course-specific resources.
2 to >0 pts
Poor
The response does not integrate outside and course-specific resources or no in-text citations are used.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (three or four) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains a few (one or two) APA format errors.
3 to >2.0 pts
Fair
Contains several (three or four) APA format errors.
2 to >0 pts
Poor
Contains many (five or more) APA format errors.
5 pts
Total Points: 100
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.
To Prepare:
Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.
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https://waldenu.instructure.com/courses/21534/external_tools/retrieve?display=borderless&url=https%3A%2F%2Fwaldencanvasprod.kaf.kaltura.com%2Fbrowseandembed%2Findex%2Fmedia%2Fentryid%2F1_7u5n3hb6%2FshowDescription%2Ffalse%2FshowTitle%2Ffalse%2FshowTags%2Ffalse%2FshowDuration%2Ffalse%2FshowOwner%2Ffalse%2FshowUploadDate%2Ffalse%2FplayerSize%2F766x431%2FplayerSkin%2F51364222%2F
When discussing the topic of patient advocacy, it is vital for nurses to know their role and responsibility to help achieve this significant aspect of healthcare. With national nursing shortages, nurses are being pulled in multiple directions throughout their shift and their ability to truly be present with their patient and form a trusting relationship has become compromised.
Despite how busy they are, nurses always have the duty to stand up for their patients and ensure that their concerns, wants, and needs are addressed. According to Milliken (2018), “Nurses must first recognize the potential ethical repercussions of their actions in order to effectively resolve problems and address patient needs” (para. 2). In other words, it is imperative for nurses to understand their ethical obligation to advocate for their patients.
A policy that is greatly impacting patient advocacy is nurse staffing. Clarke and Donaldson (2008) write, “Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes. Nurse staffing is a crucial health policy issue on which there is a great deal of consensus on an abstract level (that nurses are an important component of the health care delivery system and that nurse staffing has impacts on safety” (para. 1).
Not only is the nursing shortage an issue for patient advocacy, it is an issue regarding patient safety as well. Griffiths et. al. (2018) analyzed the relationship between nurse staffing levels and patient outcomes and found that “omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy” (para. 2). This relates to patient advocacy because by omitting care, nurses are not fulfilling certain aspects of care that patients deserve to receive. One way to address the issue of failing patient advocacy is to first address the national nursing shortage.
Clarke SP, Donaldson NE. Nurse Staffing and Patient Care Quality and Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 25. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2676/Links to an external site.
Griffiths P, Recio-Saucedo A, Dall’Ora C, Briggs J, Maruotti A, Meredith P, Smith GB, Ball J; Missed Care Study Group. The association between nurse staffing and omissions in nursing care: A systematic review. J Adv Nurs. 2018 Jul;74(7):1474-1487. doi: 10.1111/jan.13564. Epub 2018 Apr 23. PMID: 29517813; PMCID: PMC6033178.
Milliken, A. (2018). Ethical awareness: What it is and why it matters Links to an external site.Links to an external site.. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved fromhttp://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.htmlLinks to an external site.
Competing needs in healthcare can include the needs of patients, the workforce, and resources that may impact policy development. The competing needs should work with the policy and not against it. The health of nurse work environments is the focus of my discussion. Work environment health has been shown to affect both patient and nurse outcomes.
A part of the quadruple aim is that nurses feel joy and find fulfillment in their work. This healthy workplace environment translates into job satisfaction, decreased burnout, and improved patient care outcomes. A healthy work environment enables nurses to provide the highest standards of compassionate patient care while being fulfilled at work (Ulrich et al., 2022).
As a result of the COVID-19 pandemic, early studies have found that nurses are fearful, distressed, and traumatized; many intend to leave the profession. In research by Zhao et al., nurses in China who provided direct patient care during the worst outbreak phase experienced significant psychological distress.
Still, their work environments could mitigate psychological distress. Less distressed nurses had managers with an inclusive leadership style. Inclusive leaders involved their staff in decisions, a form of empowerment that created workplace environments that were perceived to be mentally healthy.
Before the pandemic, the nursing workforce was already under strain. The challenge will be creating conditions to maintain and sustain a healthy nursing workforce. This challenge begins with nurse and healthcare leaders whose leadership and management styles create healthy, productive workplace environments for their staff and whose leadership values align with the models of nursing care that they are promoting (Gottlieb et al., 2021).
Nurses’ job satisfaction and psychological, emotional, and physical health are related to autonomy, agency, and empowerment. These factors are affected by nurse leadership, the culture in their units and their organization, and the opportunities created for staff. Nurse managers can facilitate empowering work conditions and promote collaborative inter-professional and intra-professional relationships (Gottlieb et al., 2021).
Policies must seek to empower their staff and provide autonomy and agency. Resources must be provided for education for both staff and managers. Resources can prove challenging. Encouraging managers and staff to collaborate and provide time for such may also seem daunting, but in the end, it will be worth the expense of a healthy, happy staff and improved patient outcomes.
Gottlieb, L. N., Gottlieb, B., & Bitzas, V. (2021). Creating Empowering Conditions for Nurses with Workplace Autonomy and Agency: How Healthcare Leaders Could Be Guided by Strengths-Based Nursing and Healthcare Leadership (SBNH-L). Journal of Healthcare Leadership, Volume 13, 169–181. https://doi.org/10.2147/jhl.s221141Links to an external site.
Ulrich, B., Cassidy, L., Barden, C., Varn-Davis, N., & Delgado, S. A. (2022). National Nurse Work Environments – October 2021: A Status Report. Critical Care Nurse, 42(5), 58–70. https://doi.org/10.4037/ccn2022798Links to an external site.
Zhao, F., Ahmed, F., & Faraz, N. A. (2020). Caring for the caregiver during COVID-19 outbreak: Does inclusive leadership improve psychological safety and curb psychological distress? A cross-sectional study. International journal of nursing studies, 110, 103725. https://doi.org/10.1016/j.ijnurstu.2020.103725
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
The Assignment (1-2 pages):
Add a section to the 2-3
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