Applicable Change
The suggested change is an intervention focused on checking whether the increased number of nurses can promote employee retention, improve patient outcomes, and prevent medical errors. The problem of nurse understaffing in healthcare facilities is frequently reported to be the cause of severe outcomes both for employees and patients. The lack of personnel may lead to the decreased quality of care, which is a rather negative factor (Cimiotti, Barton, Gorman, Sloane, & Aiken 2014). Moreover, understaffing may result in such adverse outcomes as burnout and turnover, which necessitates finding solutions as soon as possible (Wendsche, Hacker, & Wegge, 2017). Therefore, the proposed change is a nursing intervention that involves the increased number of staff in nursing units.
Interventions are some of the most effective ways of implementing change. When arranged practically, such an approach may help to cope with serious problems or at least indicate why the suggested approach is not a successful one. Frequently, interventions are employed in one of the two groups of participants of experimental studies to show the impact of change. However, in the present case, the problem of nurse understaffing is present almost in all hospitals. Therefore, it will be possible to compare the results of the intervention introduced in one hospital with other institutions’ results or with the same institutions’ outcomes in a different period. Another asset of such an intervention is that it will be evidence-based, and its finding will serve as a basis for further evidence-based practice investigations.
The Proposed Implementation Plan with Outcome Measures
In order to arrange the intervention in the most effective way, it is necessary to create an effective implementation plan. The plan should cover the core milestones and should predict the time frames within which the project will be introduced, and its results will be analyzed.
The plan will cover the following phases:
- gathering the materials to justify the intervention
- introducing the project to hospital management
- setting the objectives and outlining the ways of reaching them
- hiring more nursing staff
- implementing the project
- evaluating the outcomes.
In the process of planning, it will be necessary to evaluate the additional costs and other resources that might be required during the intervention.
The implementation of the intervention is expected to cover the period of several months. The very intervention will take place within three months. The preparation to the project as well as the evaluation of results will require a few weeks. Prior to introducing the project, it is necessary to evaluate the levels of nurses’ burnout and patients’ satisfaction. These rates will be assessed for two weeks along with other indicators of the hospital’s work such as the incidence of patients’ falls and infections. The intervention will take place for three months. During this time, the information regarding patient satisfaction levels and nurses’ retention will be systematically collected. During one or two weeks after the intervention, the obtained data will be processed and the outcomes will be presented to the hospital management and all employees.
The outcome measures are the enhanced levels of patient and nurse satisfaction, the lowered number of medical errors, and the increased employee retention. If these measures are achieved, it will be possible to consider the intervention successful and suggest other institutions to use it.
Potential Barriers to Planning the Implementation and Ways of Overcoming Them
The most obvious obstacle that may occur in the process of preparing and implementing the intervention is the hospital administration’s refusal to spend more costs on hiring new personnel. Healthcare facilities may feel resistant to the additional expenditures that are necessitated by the suggested intervention measures. In order to overcome this barrier, it is necessary to provide the management of the hospital with a thorough analysis of the adverse outcomes of understaffing. The benefits of adequate nurse staffing should be emphasized and explained. In this way, healthcare institutions will be more likely to agree to increase the number of employees working in their units. In order to justify the need of hiring more nurses, the results of the study by Shin and Hyun (2015) may be used. Hospital managers should be informed that there is evidence of the positive correlation between nurse staffing and the quality of care. In another way, the negative manifestations of understaffing will be experienced both by the employees and their patients.
Another problem concerned with the implementation of change may be not the unwillingness of a hospital to hire additional personnel members but its inability to do so. More rooms may be needed as well as more equipment and other materials. In such case, a hospital may change its schedule system and suggest nurses working in shifts so that there are enough employees working simultaneously and there is no pressure regarding space and equipment for any of them.
There may be other barriers to planning the intervention implementation, but the mentioned ones are the most crucial. It is always necessary not only to work out the ways of improving the situation but also to predict the obstacles to the implementation and think of the approaches to overcoming them.
References
Cimiotti, J. P., Barton, S. J., Gorman, K. E. C., Sloane, D. M., & Aiken, L. H. (2014). Nurse reports on resource adequacy in hospitals that care for acutely ill children. Journal for Healthcare Quality, 36(2), 25-32.
Shin, J. H., & Hyun, T. K. (2015). Nurse staffing and quality of care of nursing home residents in Korea. Journal of Nursing Scholarship, 47(6), 555-564.
Wendsche, J., Hacker, W., & Wegge, J. (2017). Understaffing and registered nurses’ turnover: The moderating role of regular rest breaks. German Journal of Human Resource Management, 31(3), 238-259.