advocacy for nursing shortage

In Module two, you were asked to describe an issue ADVOCACY FOR NURSING SHORTAGE and you hoped to improve and you created a presentation about the plan. This week, you will present on the progress and results you have made during the past 5 weeks.

Your policy change proposal could have been with state Board of nursing, local boards, state representatives, or members of Congress/Senate. Based on the issues you selected in Module two, that you were passionate about, researched in depth, and contacted the appropriate policy maker (preferably in person, but at least by emails or letters) – detail your position and the evidence that supports it, and explain your results, determination and outcomes for the contact with policy makers in a 20 slide PowerPoint presentation with audio and speaker notes on all content slides. Make certain to include your sources and a reference slide.

Advocacy for Nursing Shortage

Objectives

Identify Actions for advocacy

Identify evaluation strategies

Identify Actions for advocacy

Define advocacy and nursing advocates

Introduction

Nurse to patient ratio has been a prevalent challenge in many healthcare systems.

U.S ration – 12.06 nurses per 1000 population (Nurse Journal, 2022)

Recommended RN-to-Patient varies according to intensity of patient needs.

ICU and ER departments receive lowest RN-to patient while skilled nursing facilities like psychiatric ratio is high (Sharma & Rani, 2020).

(Paton, 2018)

Nurses to patient ratio has been one of the major challenges for practioners within the practice. The gold standard for nurse to staff ratio has never been determined. However, recommendations for the RN-to-Patient in hospitals range in between departments with lower ratios within the ER departments such as trauma patient in ER and ICU patient in ER where recommended ratio is 1:1 and 1:2 (Sharma & Rani, 2020). However, a single norm for all the units and healthcare organizations cannot be used for a fair approximation of how much staff and resources are needed. To estimate nurse-to-patient ratio different factors must be considered such as unit workload, patients’ dependency, skill mix, available proportion of nurses’ productive and non-productive activities, and variations in time and nursing care activities during the shift.

Cause of nursing shortage

Aging workforce

73% increase in Americans aged 65 years between 2011 and 2019 (Haddad et al., 2022).

Aging Population

Increased demand for care from aging baby boomer population

High turnover rates

National average 8.8 to 37.0% (Haddad et al., 2022)

A higher RN-to-patient ratio that the recommended is usually an indicator that the number of nurses are overwhelmed by the demand for their services. However, understanding of the primary issues surrounding nursing shortage are usually caused an aging workforce where there is an average one million nurses that are above the age of 50 years (Haddad et al., 2022). The increase in the number of nurses increases the demand for more nurses. As a result, nurses are usually subjected to burnout due to shortages.

Successful advocacy framework

Identify need for change

Develop Solutions

Implement solutions

Monitor Outcomes

Advocacy

The processes of supporting a cause by supporting its position

Leads to changes through influence of decision-makers towards a certain solution

Advocate – Person who advocates for the rights of others

The term “advocate” refers to someone who advocates for, defends, or promotes the cause or interest of another. The bulk of advocacy materials are produced by non-profit and special interest organizations that educate prospective advocates about how to influence public policy. On the other hand, advocacy refers to the practice of eliciting support for a cause or issue and convincing others to act. The Code of Ethics highlights the nurse’s responsibility to voice concerns about the hospital environment in a professional manner. Additionally, the Code of Ethics establishes a number of advocacy skills and behaviors that nurses should demonstrate.

Advocacy skills applied

Identifying the Issue

Investigated the issue using secondary sources

Obtained professional opinions from active RNs.

Gained a patient perspective on prevalence and impacts of nurses shortage.

Since World War II, nursing has faced cyclical shortages (Hatmaker, n.d). The shortage that beset the country in the late 1990s and early 2000s was directly tied to the fight to create managed care as a means of reigning in health care’s growing costs. What appears to be a chronic nursing shortage has sparked significant interest from key stakeholders, including state and federal politicians, educators, health care executives, and manufacturers. The efforts of these groups have had a favorable influence on the shortage, resulting in an increase in RN employment and enrollment in nursing schools. The economic downturn in the United States in 2009 alleviated some of the country’s nurse shortages in numerous locations (Hatmaker, n.d). This was largely due to many retired nurses re-entering the workforce due to economic pressures, nurses who planned to retire retaining their positions, some part-time nurses taking full-time positions, and hospitals treating fewer patients as a result of many people delaying procedures or foregoing care due to insurance loss (Hatmaker, n.d).Recent study indicates that attention on the nurse shortage is having a beneficial effect: an unexpected number of young women entered the nursing profession between 2002 and 2009, resulting in a faster rise in supply than expected. The number of full-time registered nurses aged 23 to 26 increased dramatically over that time period, by 62 percent—a rate of growth not seen since the 1970s (Hatmaker, n.d). Despite this encouraging sign of stabilization, workforce analysts warn nurse educators, policymakers, employers, and other stakeholders that significant additional progress is necessary if the country is to meet the rapidly growing demand for professional nurses at a time when the population is aging, more people are living with chronic conditions, and health care reform is poised to dramatically increase access to care.

Potential Solution

Technology incorporation

Positive Impacts on Nursing Shortage

Telehealth improves accessibility to previously inaccessible regions

Provision of healthcare remotely

Reduced costs of healthcare by reducing ER visits

Developing Solutions

Nurse burnout has played a role in the United States’ nurse shortage. Prolonged emotional and physical stress can make nurses feel overworked, causing them to leave their practice setting. Telehealth’s growing technology has the potential to alleviate nurse workload pressures by needing fewer nurses to provide good care.Additionally, telehealth enables nurses to access regions identified as lacking in health professionals. This includes rural places with a shortage of healthcare staff; telehealth helps address these shortages by effectively treating patients remotely. These technological improvements in telehealth have the potential to drastically reduce healthcare costs by lowering emergency department visits and hospital admissions.

Cont.…

Decreased Human Error

Understaffed workers at highest risk of doing mistakes

Technology simplifies routine procedures

Reduced tests duplications or delay

New technologies have the potential to significantly minimize the probability of human error. Nurses who work long hours or in understaffed wards make more mistakes. The introduction of modern medical technologies has simplified routine medical procedures. Automated IV pumps, for example, can be used to monitor the medicine dosage provided to patients. This simplifies the process of altering the drip volume and dosage. Additionally, EHRs aid in the reduction of mistakes at the point of care. EHRs can help reduce duplication of tests or treatment delays due to the ease with which data can be accessed.

Cont.…

Improved Accessibility

Electronic Health Records (EHR) improves patient care outcomes through increase in accuracy

Patients can receive care remotely through technology assisted monitoring

Electronic health records (EHRs) have reshaped the landscape of healthcare information technology in profound ways. An electronic health record (EHR) is a digital depiction of a patient’s medical history. It may include, but is not limited to, progress notes, providers, problems, medications, and test findings. EHRs can improve patient care by enhancing the accuracy and clarity of medical records and making data more accessible to healthcare providers, physicians, and patients. Telehealth developments have also made a substantial contribution to accessibility. Through remote patient monitoring, live video conferencing, and mobile health applications, telecommunications technology has facilitated the delivery of nursing care to geographically separated patients. Access to high-quality treatment has become easier for those living in remote geographic areas in today’s society.

2. Solution

Policy Changes

New graduate sign-on bonuses

International Nurse staffing

Increased Diversity builds on key competences of nurses

International staffing associated with stabilized workforce and addresses low nursing staffing

On average, healthcare firms allocate some money for each newly employed nurse’s sign-on incentive. The nurse executive stated that nurses who get sign-on bonuses frequently work for the organization for less than a year. Furthermore, nurses who get early sign-on bonuses have a worse retention rate than anticipated. Thus, nurse leaders in healthcare settings should develop a three-year commitment sign-on incentive program for newly graduated nurses.

3. Solution

Define and improve organizational culture

Transparent reward and recognition strategies

Patient-centered approaches

Improve communication strategies

Provision of career growth and development opportunities.

One may encourage greater staff cohesion by adding more team events into the corporate culture. A team has been formed to develop activities in which the entire organization may engage in order to help improve employee retention at one of the nursing hospitals. There is no one-size-fits-all solution to the nurse shortage. The nursing deficit in the United States will require a comprehensive solution that includes various new initiatives, including tuition reimbursement, nurse externship programs, and expediting the nurse recruitment process.

Building Support

Communicate importance of addressing nursing shortage issues

Increasing knowledge about the required changes

Importance of safe nurse ratio

Improved patient care quality and patient safety

Improved patient care access

Reduced propensity for errors

According to a 2017 study published in the Annals of Intensive Care, higher nurse staffing ratios were associated with a lower chance of survival. According to an examination of 845 patients, when nurses adhered to a hospital-mandated patient-nurse ratio, cases were 95 percent more likely to survive (Nursing Journals, 2022). Additionally, the Agency for Healthcare Research and Quality (AHRQ) has shown a correlation between nurse staffing ratios and patient safety. The capacity of nurses to safeguard patients is dependant upon their presence at the bedside. Increasing the number of patients assigned to nurses naturally decreases their ability to offer safe care. Numerous notable studies have shown a relationship between nurse staffing ratios and patient safety, demonstrating that when nurse patient load grows, the likelihood of patient safety incidents, morbidity, and even death increases.

Evaluation of Results

Measuring trends in nursing care turnover intention

Survey nurses for identification of their intentions to change

Analyzing trends in the number of employees that have quit their jobs

Evaluating the number of nursing students enrollments

Evaluating propensity of medication errors

One of the most effective strategies for evaluating turnover intentions involves measuring turnover intentions among patients through the use of surveys and conducting empirical analysis in the number of turnover among the employees. Analyzing the trend will reflect the effectiveness of incorporating technology in alleviating risks such as employee burnout. There are other two strategies that could be used in evaluating the impacts of the implemented programs.

Cont.…

Measuring trends in nursing care turnover intention

Evaluating the number of nursing students enrollments

Negative student enrollment reduces availability of nursing practioners

Analyze trends in completion rates for students

Evaluating propensity of medication errors

Reduced number of student enrollment in nursing programs is usually associated with reduces availability of nursing practioners. Analysis of the trends involves identifying the completion rates of student practioners for the nursing students. This analysis will help the stakeholders identify impacts of policy changes in incentivizing increased enrollment of students. One of the incentives involves financial incentives for students seeking to enroll in the program.

Cont.…

Measuring trends in nursing care turnover intention

Evaluating the number of nursing students enrollments

Evaluating propensity of medication errors

Measure self-reported errors by nurses

Analyze trends in medication errors reported by patients

Finally, evaluation of the strategies will also include analyzing the propensity for errors within the healthcare settings. It is noteworthy that nursing shortages are directly linked to the probability of occurrence of errors due to staff burnout. Thus, the impacts of the strategies of addressing nursing shortage will be identified through analysis of the placebo effect of implementing those particular strategies. In addition, improved nursing care is associated with development of improved quality of care by nurses due to the ability for nurses to handle several patients remotely.

Conclusion

Nursing shortage is prevalent within contemporary healthcare systems

Solutions

Technology incorporation

Policy changes to incentivize enrollment and retention

Recommendations

Leverage on technologies like telehealth

Improving support among employees during implementation

Indicators of success

Reduced turnover rates

Reduce Errors

Increased perception of nursing practice among aspiring students

References

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing Shortage. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK493175/

Hatmaker, D. D. (n.d.). Workforce Advocacy and the Nursing Shortage. https://nursekey.com/workforce-advocacy-and-the-nursing-shortage/

Nursing Journals. (2022). The U.S. Nursing Shortage: A State-by-State Breakdown. https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown/

Paton, F. (2018). Nurses called to stand up for mandated nurse-to-Patient ratios. Nurseslabs. https://nurseslabs.com/nurses-called-stand-mandated-staff-patient-ratios/

Sharma, S., & Rani, R. (2020). Nurse-to-patient ratio and nurse staffing norms for hospitals in India: A critical analysis of national benchmarks. Journal of Family Medicine and Primary Care, 9(6), 2631. https://doi.org/10.4103/jfmpc.jfmpc_248_20

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