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NR-531 Week 2 Discussions
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Dear Dr. Scott and classA lack of skilled nurses touches all aspects of healthcare. As the nurse administrator at
SLMC, it is my responsibility to ensure that safe staffing levels are occurring on patient care
units. Hospitals with inadequate nurse staffing have been linked to negative patient outcomes
such as increases incidents of surgical site infections (SSI), catheter associated urinary tract
infections (CAUTI), ventilator associated pneumonia (VAP), central line associated blood stream
infections (CLABSI), and higher readmission rates. In today’s complex healthcare environment.
Additionally, the Center for Medicare and Medicaid Services (CMS) does not reimburse
hospitals for hospital acquired conditions and readmissions that they deem avoidable (Snavely,
2016). SLMC is already experiencing an increase in their readmission rates of patients with
heart failure and is not sure of the cause.
Before implementing this plan at SLMC, I would have a discussion with the Chief
Executive Officer (CEO) regarding my concerns related to patient safety and the quality of
nursing care being delivered. Although the addition of extra nursing assistants may assist in
completing patient care tasks, it is not a solution to address a nursing shortage and should be
implemented cautiously. The nurses will still have a higher nurse-patient ratio, may have to
delegate tasks to multiple CNAs, many of whom are newly hired, leading to gaps in care.
Adding a body is not always the answer. Several studies have demonstrated a clear association
between nurse staffing levels, skill mix and the outcomes of care such as increased UTIs and
VAPs (Twigg et al., 2016). The focus should be on why recruitment of nurses is so difficult and
strategies to support the nurses currently working at SLMC until more nurses can be onboarded.
Insufficient staffing levels can increase stress levels and burn out of nurses, which in turn
impacts job satisfaction and can lead to an increased nursing turnover rates. The possibility of
decreased reimbursement from adverse outcomes and the costs associated with frequent nurse
turn over could significantly impact the financial stability of SLMC. The addition of contracted
agency nurses may bridge the gap and support the nurses more effectively than nursing
assistants.
References
Snavely, T. (2016). Data watch. A brief economic analysis of the looming nursing shortage in
the United States. Nursing Economic$, 34(2), 98-100. Retrieved from
http://www.ajj.com/services/pblshng/nej/default.htm
Twigg, D., Myers, H., Duffield, C., Pugh, J., Gelder, L., & Roche, M. (2016). The impact of
adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient
outcomes: An analysis of administrative health data. International Journal of Nursing
Studies, 63, 189-200. doi:10.1016/j.ijnurstu.2016.09.008
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, Dear Melisa
You make a great point when you said that hiring extra nursing assistants only places a
band aide on a much larger problem. The fact that SLMC is having challenges recruiting nurses
is the real issue that needs to be addressed. As the Baby Boomers age, and a large portion of the
current nursing workforce nears retirement, the United States is expected to experience a
significant nursing shortage. This issue of increased demand and decreased supply makes the
recruitment and retention of quality nurses even more paramount. Many factors can influence
nurse recruitment and SLMC may need to take a deeper dive to figure out what their challenges
are. A study by Steele-Moses, Creel and Carruth (2018) found several themes surrounding what
was important to nurse’s when seeking employment. Although salary and health benefits were
also important, nurses were more concerned with their workload, schedules and reputation of the
hospital and unit. Nurses relied heavily on recommendations by peers about a hospital and word
of mouth can be more impactful than any advertising or recruitment strategies. Nurses want to
feel they are a valued member of the team and are supported in their work environment. Maybe
leaders at SLMC should start their recruiting by conducting interviews with their own staff.
Reference
Steele-Moses, S., Creel, E., & Carruth, A. (2018). Recruitment attributes important to new nurse
graduates employed on adult medical-surgical units. MEDSURG Nursing, 27(5), 310-
328. Retrieved from http://www.ajj.com/services/pblshng/msnj/default.htm
Dear Dr. Scott
In all honesty, I have never worked unlicensed assistive personnel (UAP), only certified
nursing assistants (CNAs). UAPs can be trained to perform some patient care tasks as well as
clerical tasks, which can be a useful combination in select healthcare settings such as an
outpatient doctor’s office. Since there is no set education or competencies for this group,
however, their roles should be clearly defined. They need to have close supervision by a licensed
healthcare professional such as a registered nurse. Delegated activities should be limited to
clearly defined and thoroughly described repetitive tasks that do not require the professional
judgment of a registered nurse (AWHONN, 2016). As a nurse administrator, I have many
concerns regarding the use of unlicensed assistive personnel, especially in the acute care setting.
In Pennsylvania, nurses are prohibited from delegating nursing tasks to UAPs, so if SLMC was
in Pennsylvania, the strategy of adding extra UAPs would be very ineffective (Pennsylvania
Department of Health, 2018). Nurses would continue to have an increased workload related to
the nursing shortage and may become fatigued and burned out. I would challenge the CEO to
entertain the idea of hiring agency nurses to help bridge the gap or CNAs at a minimum.
References
This study source was downloaded by 100000841138256 from CourseHero.com on 03-22-2022 08:22:06 GMT -05:00
https://www.coursehero.com/file/37163401/NR531-week-2-docx/
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