Evaluation Of Workload Management

Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

The case scenario portrayed Jackie, as a typical nurse who was conflicted and stressed out from both the demands of family and of the workplace environment. At home, she was pressured by her husband to take on extra overtime to supplement and augment the family’s income. Thus, in spite of feeling that her skills were not current, Jackie signed up with her previous hospital to be on the flexible staffing pool (Badzek, et al., 1998). As expected, “Jackie found the work extremely stressful. She rarely had the same unit and patient assignment” (Badzek, et al., 1998).

Strategic Planning is an essential first step in the development of a result-base accountability system,” (Schilder, 2013, p. 1). In strategic planning an organization must know their goals, missions, and how to reach them. Health care facilities are in huge demand for the elderly and for people who lives in low-income communities. A person who receives good quality health care services can prevent the spread of contagious diseases. This paper will describe the need of the community, population it is serving, and a brief description of the facility.

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

Within the staffing effectiveness report, most data collected indicated a downward linear trend. This downward trend is a positive outcome. However, 4E has an upward linear trend which needs to be improved. The linear trend of nursing hours compared to the number of falls and pressure ulcers indicate an increase in nursing hours do not guarantee drop in falls or pressure ulcers. The performance trends show a gradual increase in the number of falls and pressure ulcers. A closer look is needed to identify reasons for the correlation between greater nursing hours and increased falls. This may be due to a need for increase in nursing staff and limiting the number of hours the nurse can work

The research article was written by MacPhee, Dahinten, and Havaei (2017) shared their aim of study which was to understand the effect of the unit. The job and task-level workload factors on three adverse patient outcomes (medication errors, urinary tract infections, and patient falls) and two nurse outcomes (emotional exhaustion and job dissatisfaction). These higher workloads to show adverse outcomes due to staffing ratios.

Change of shift in the nursing profession is unique (Caruso, 2007). Information is transferred between nurses verbally and through written communication. In many facilities shift report from one shift to another involved sitting down and getting all your orders from a caredex and then talking with the previous nurse face to face going over pertinent information regarding their patients. This type of report usually happens in a report room or sometimes in the hallways or other common

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

The practice setting I am currently interning at is the Community Mental Health for Ingham, Clinton, and Eaton counties (CEICMH), specifically within the Families Forward department. This department within the CEICMH works closely with children who are experiencing serious emotional disturbances and behavioral concerns, as well as offering needed support to their family. The services provided include inpatient and outpatient therapy, emergency services and urgent care, early intervention services, and wraparound services. My role within Families Forward is as an intern in the Wraparound program. Wraparound facilitators provide service to families by creating a plan to help the family navigate through the child’s treatment process to assure

2. Preparation – The worker then meets with the family members and understands their problems and situations and then invites them to participate in it

Maurice William’s understands that social workers get tired because of their relentless job responsibilities, therefore, she makes sure they don’t experience burn out since it is her responsibility to keep the families intact (Laureate Education, Inc., 2011). Since she is not out in the field visiting the homes, she puts her faith in her upper management team to be able to listen and pay attention to any problems or potential future problems (Laureate Education, Inc. 2011). Since she is unable to be out in the field, Williams uses her supervisory skills to train her staff to be able to identify potential problems and also to report back to her what the problems are. If there were problems out in the field (i.e., foster parents, foster children), she shoulders the full responsibility to make sure that the problems are addressed and resolved, or modify changes that are in the best interest of the children.

One important result that is occurring because of the lack of staff is the neglecting of tasks and more responsibility. Nurses are reporting that a lot of nursing tasks that are applicable to patient safety and good nursing are being left out. Nurses discussed how patient and family preparation for

2) Introduction of computerization into the planning and budgeting process and introduction of “e-disclosure” to employees.

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.