Response to peers DQ one week two

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Response one: The problem facing my orgainization now is the short-staffing on the floors. The ED came up with a plan that involved the nurses, the nurse manager and the ED doctors, and we fixed our staffing problem. Now to get the floor nurses, their managers and the hospitalists to work together, hopefuly they can learn from our success.

Implcations for nursing are the following:

1) nurses speak to your manager and have that person arrange for a meeting with adminstators and the hospitalists they work with every day.

2) gather all the information you have about “near misses” on your floor, including falls, pressure ulcers, wrong medication administartions, lack of time to answer call bells, everything the nurses can think of that is caused by short staffing.

3) gather information on the cost of law suits payed out by the organization and/or their sister hospitals in the past because of this.

4) make a plan to present to adminstration how having the proper staff can prevent near misses and most of all, a sentinal event.

5) present a time frame to showing how long it will be approximately to see the difference in patient care, patient satisfaction, and a decrease in not only nurse burnout, but staff leaving for other jobs.

It costs money to hire new employees and then train their to your hospitals policies, procedures, etcetera. If those employees are unhappy after their 6 month probation period, they leave for a better job, now the hospital has to pay all over again for a nurse to be on training, instead of beig able to have the nurse they already trained for 6 months start on their own and boost the staffing. It’s a viscious cycle in many hospitals that I personally have seen.

“Nurse burnout is a physical, mental, and emotional state caused by chronic overwork and a sustained lack of job fulfillment and support. Common burnout symptoms may include physical or emotional exhaustion, job-related cynicism, and a low sense of presonal accopmplishment”.(Nursing,2019)

“Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes.Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets”.(Everhardt,2018)

Avoiding Burnout as a Nurse/Nursing.org>resources>nurse-burnout, 2019

The Effects of Nurse Staffing on Hospital Financial Performance: Competitive versus Less Competitive Markets. https://www.ncbi.nlm.gov>pmc>articles>PMC4543286, Everhart, D. 2018

Response two: Any organization to be successful and have high-quality patient care and safety should always be committed to delivering exceptional care to every patient in the community. The clinical issue or problem is facing is ventilator-associated pneumonia (VAP). In my four years of experience at my current working place, we realize that we are always open to challenges, face them, work on the solutions, and finally with persistence and perseverance, are able to reach the appropriate results. Ventilator-Associated Pneumonia (VAP), is the most common and most preventable complication in healthcare, associated with nosocomial infection during the patient’s stay in the hospital. The impaired physiology weakened the immune system, comorbidities and multi-organ failure of the patients increases the risk of potential adverse effects (Boltey, Yakusheva & Costa, 2017).

Our hospital is a long-term acute facility(LTAC), a respiratory facility, where patients are admitted with a ventilator through a tracheostomy for the purpose of weaning from ventilator and trach stoma healing process. Some patient has ET(Endotracheal Tube). Our patients could easily develop ventilator-associated pneumonia (VAP) is nosocomial infection. Due to the high staff turnover rate, new staff with less information on trach care, the facility has to be more proactive in ways of prevention of VAP, as new oncoming nurses would not be much experienced in carrying out the measures for the prevention of VAP. Taking infection into the consideration, VAP would be the potential clinical problem if not the VAP prevention modalities are strictly applied, which is a high menace in the place with high staff turnover exists. Leaders/managers should educate new staff on evidence-based strategies to prevent VAP such as hand hygiene, appropriate use of personal protective equipment, the elevation of the head of bed above 35 degrees, suctioning secretion in a timely manner and as needed, oral hygiene and repositioning. And second, the important implication should be adhering to the guidelines and protocols that should be monitored regularly to ensure compliance and to address any deficits identified. By promptly applying the interventions and starting the campaign to start educating nursing staff at the time of orientation and daily basis, frequent in-services by the respiratory team will definitely improve and correct the issue. Training the nursing staff is very important and highly effective by teaching appropriate cuff pressure, suctioning, and disinfecting hands, to prevent VAP. Training and workshops for newly hired nursing staff will be really helpful (Botley, Yakusheva & Costa, 2017).

Reference:

Boltey, E., Yakusheva, O., & Costa, D. K. (2017). American Nurse Today. Five Nursing Strategies to Prevent Ventilator-associated Pneumonia. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706660/

Response three: Medication adherence is an important public health challenge and a primary determinant of treatment success. Within the healthcare system, each patient receives a personalized medication regimen to meet their individual needs. To achieve an optimal state of health, patients must follow this regimen exactly as directed by their primary health provider. According to the World Health Organization (2019), medication adherence can have a more direct impact on patient outcomes than the specific treatment itself. Patients encounter diverse challenges to medication adherence and compliance which can affect their quality and length of life, as well as the overall health outcomes. Although the responsibility for medication adherence primarily falls on patients, healthcare professionals may help patients reduce or eliminate compliance barriers.

Medication adherence or the lack of has many implications for nursing. Medication nonadherence in patients leads to a substantial worsening of disease which requires more and increasingly complex nursing care, interventions, education, and supervision. Patient education plays an important role in achieving adherence. Therefore, nurses must spend enough time to educate patients and convince them about the benefits of the regimen. However, this can become a challenging task when faced with less than an ideal nurse to patient ratios and high acuity assignments.

Reference:

World Health Organization. (2019). ADHERENCE TO LONG-TERM THERAPIES: EVIDENCE FOR ACTION. Retrieved from https://www.who.int/chp/knowledge/publications/adherence_report/en/.

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