Cost of Nursing Care
There are various ways to assess the cost of nursing care. For example, Nursing Costs Per Patient Day are based on monthly or quarterly data, which implies that the individual cases are not examined, and the cost of nursing care is calculated based on “average” patients, although there is no definition of an average patient (Welton & Harper, 2016). Another approach is to calculate the “sum of all nursing labor costs within a cost center by a budget period” (Welton & Harper, 2016, p. 9). Nursing Hours Per Patient Day model assesses all nursing hours in a unit within a specified time period (e.g. 24 hours).
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Recruiting can result in additional costs because of advertising, overtime work, and changes in schedule that demand investments, whereas productivity decreases due to understaffing or a vacant position. Retention can decrease the amount of money spent on advertisement, recruitment, training, and prevent reduced productivity, poorer quality of care (due to a lack of professionals or newly hired employees), and disruptions in work environment/culture. One of the major impacts of high turnover rates is decreased productivity and the increased possibility of medical errors due to understaffing. Furthermore, understaffing is also related to a higher incidence of hospital-acquired infections (Kaier, Mutters, & Frank, 2012).
Additional money is spent on the orientation and training of new employees. The cost assessment methods at my organization are based on monthly data; although they are useful for calculating the average cost per all nurses, they do not consider individual cases that could require more intense work or specific skills from an individual nurse with regard to an individual patient (Welton & Harper, 2016). I believe that the value-based framework, where actual patient-level nursing hours are used for the assessment, would be more suitable (Welton & Harper, 2016).
Strategic Planning Process
The strategic planning process in nursing care focuses on patient-centered care, decision-making process, evidence-based practice, innovation, and continuous learning. Patient-centered care helps nurses better understand patient needs, whereas the focus on the decision-making process allows nurses to ensure that the decisions will align with the treatment’s objectives and overall facility’s policies. Evidence-based practice has become the primary base of nursing care due to its efficiency and accountability (“Nursing Strategic Plan”, 2016).
Innovation relates to nurses’ ability to implement innovative techniques and practices into the treatment and care. At last, continuous learning is required because quality nursing care is ineffective if it is based on obsolete knowledge, strategies, and objectives. The strategic planning in nursing care delivery should align with the facility’s policies to avoid any ethical or managerial issues.
The planning process in my organization is effective because it successfully incorporates the strategic goals of the medical facility (e.g. reduce the number of medical errors, falls, etc.) into the strategic plans of nurses. However, some of the goals cannot be addressed adequately due to understaffing or prolonged schedules that negatively influence the overall productivity of nurses. What is more, my organization also needs to redevelop the methods of feedback assessment because it appears that the gathered feedback both from patients and from staff either remains unaddressed or is not analyzed correctly.
Despite the fact that the majority of the nurses strive to meet the facility’s goals, their wishes and demands are rarely taken into consideration. That is why I believe that nursing professionals need to play a more important role in strategic planning because they can provide information about particular issues that can be omitted by managers of the organization (e.g. the influence of 12-hour shifts on the number of medical errors).
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Kaier, K., Mutters, N. T., & Frank, U. (2012). Bed occupancy rates and hospital‐acquired infections—should beds be kept empty? Clinical Microbiology and Infection, 18(10), 941-945.
Nursing Strategic Plan. (2016)
Welton, J. M., & Harper, E. M. (2016). Measuring nursing care value. Nursing Economics, 34(1), 7-14.