Introduction
In order to ensure quality in patient safety and patient care, appropriate efforts should be taken to develop appropriate nurse to patient ratio for the nursing staff. Staffing is the management activity that provides suitable and adequate personnel to fulfill the organization’s objective (Grohar-Murray & Langan, 2011). Staffing pattern plays an important role in the quality of care that nurses provide. It is important in the improvement of patient care because it allows management to hire and have an acceptable number of personnel that can provide quality and proper care to the patients.
It has been recognized that there are problems in the nursing industry that affects the quality of care for the patients and the quality of working conditions. In response to this concern, internal and external initiatives need to be addressed. These include increasing training hours, improving content for certified nursing assistants and creation of an accountability system for individual nursing homes (Saver, 2013). Nursing homes and networks of nursing homes should work in collaboration to look for ways to foster the quality of nursing homework and care. Some of these initiatives include improved worker training, developing new and more positive workplace environment and creating patient responsive communities (Cowen, & Moorhead, 2011). To build a long-term care industry, what has been done already should be known. Problems with care quality should be addressed as soon as they are detected. Failure to take action will make them become less visible as patients and nurses become accustomed to it. This means that the society often miss some serious problems in quality of healthcare.
The Change I Wish To Initiate
Changing requirements of the patient’s needs call for the health care environment to evolve. The organizations need an immediate plan for this change. Use of flexible resources is one of the areas that need to be addressed immediately. These resources are float-pool nurses who meet the changing needs of the patient population as they help hospital administrators have adequate and qualified nurse per unit effectively (Buerhaus, Staiger, & Auerbach, 2009). Due to economic constraints, nursing leaders may be challenged to maintain safe nurse to patient ratio, reduce patient length of stay and manage patient awareness. There is the reliability with float-pool nurses following training and familiarity with the firm as opposed to staffing agencies with nurses who do not work strictly for the organization (Saver, 2013). Therefore, this approach has become of great improvement to patient care. It is easier and safer to provide great care to patients with cross-trained and competent nurses who work in various areas within the hospital. These nurses can benefit healthcare organizations. Report from float-pool nurses shows that they receive more difficult assignment than regularly scheduled unit staff. Nurses who accept unit staffing in response to the changing patient care needs are float-pool nurses (Sullivan, Garland, & Sullivan, 2010). Trends in staffing have shown that patient numbers would not balance registered nurse workload. There should be a method for looking at workload and patient acuity together in which controlled variable staffing are created to help control the cost and provide enough caregivers. These nurses have become an important part of the nursing workforce within a hospital. Cost saving is also a benefit of having a hospital float-pool. This method is used when the hospital is understaffed and requires hiring outside nurses (Saver, 2013). It is a good interest on financial for the hospital to avoid using outsourced nurses if possible. Working as a float-pool nurse allows them to be aware with new trends in medicine. They also get an opportunity to work and interact with different people, make them independent and more marketable.
The Rationale for the Change
Of all the services provided in a hospital, the nursing service is the closest to the patient. The nurses are with the patient 24 hours of the day and 7 days in a week. Nursing personnel comprises the largest proportional of the hospital staff. Therefore, changes and improvement of nursing personnel is a vital factor in establishing and maintaining acceptable standards of nurse care for patients. Observed evidence could be the best evidence that can be offered as a guide to provide adequate patient care. Setting the standards of nursing services of the hospital depends largely upon the judgment of the judges themselves guided by the director of nursing services (Sullivan, 2010). The philosophy of nursing upon which this judgment is based is of paramount importance. Nurses have the responsibility of attending to the personal needs of the patients constantly through the day and night. It is their desire as well as their responsibility to give every patient individual care. In order to achieve this, nurses must be fully equipped with knowledge of analyzing the nursing needs of the victim while relating it to aspects of their lives. Planning, directing, organizing and co-coordinating the individualized care of hospital patient is the most important function of the hospital nursing service. Other nursing functions and activities related to it such as personnel management, maintaining an appropriate environment for patient care, development of personal and working relationships and development of educational programs are functions that revolve around the individual care of the patient. Changes upon communication should be initiated and drawn clearly; because effective working relationships in a hospital depend on effective communication. Each member of the staff should know how their work contributes to the care of the patient and how it fits in with that of the others to provide total hospital services to the patients (Sullivan, 2010). The use of organizational charts of the hospital and the nursing services can help realize the change. This shows the level of ability and responsibility and indicates to the workers their correct place in the organization. Regular communication among nursing personnel makes the nurses remain constantly aware of the needs of the patient of what is done for them and how it is done (Zerwekh & Garneau, 2011).
The Audience You Need To Convince
The directors of the department of the personnel services since they are involved in the development of the description. Furthermore, specification for the jobs and copies of files are placed in their offices for reference. These can assist in the process of recruiting appropriate candidates from which the director of nursing services can select appropriate candidate for positions of the nursing staff (Grohar-Murray, 2011).
Every hospital would want to provide the highest standards of care to the patients. Despite the wishes and efforts by the hospital leaders, serious problems continue to affect long-term care (Grohar-Murray, 2011). Initially, there are facilities that need to be corrected. This work is aimed at helping healthcare providing organizations and their staff to implement changes that will provide a higher quality of patient care. Contemplating of a comprehensive organizational-wide culture change or implementing the best practices in the clinical area with knowledge about how to implement and manage change will help achieve the goal. This will enhance suggestions about preparing the organization for change, assisting the nursing staff take ownership of the changes and sustaining the changes over the time. A long-term change is more likely when it is well understood by the staff and supported across organization (Zerwekh, 2011). Change should be inclusive of all nurses. Concentrating only on the staff who will be involved in the new exercise is not enough and cannot give a sustained change. By embracing this change, most nursing home staff will be committed, hardworking and intelligent. This will present as a supporting efforts that will improve care quality, quality of life for the patients and quality of the working environment (Cowen, 2011). Effective educational programs for nurses will be guided by the codes of adult education and supported by the environment (Zerwekh, 2011). In order to achieve and sustain clinical practice changes, knowledge and skills of individual caregivers and the organizational processes that support them are required. A successful change can be more likely to occur and be sustained when organization structures and processes are aligned to support the change (Saver, 2013).
The Benefits to the Institution
Significant changes among staff members make them engage in new behaviors and form new relationships within the institution. This can assist and support staff to develop skills, tactics and relationships that will lead to successful and sustained change (Buerhaus, 2009). Through doing several assessments, employees will identify their strengths, weaknesses and other organizational needs. Completion of repeated preparation activities makes the organization begin to identify clinical areas that need to be addressed. This will be supported by a well formed team.
Developing effective teams requires highly inclusive individuals who are able to practice institutional changes, plan for implementation of the changes and oversee those changes. Leaders are able to make the difference between success and failure. Furthermore, they can easily establish the degree of change, the quality offered and the level of patient’s satisfaction. These strategies are essential in establishing a successful institution.
The nursing staff also need to be certified. These changes lead to all department heads and other staff becoming certified nursing assistants and even maintenance staff. They feel confident and responsible while executing their performances to the patients (Sullivan, 2010). This enables all staff to function in response to the needs of the patients. These nurses may continue doing the bulk of hands-on patient direct care, and all nursing staff is able to assist when needed. This is something the institution requires from the nurses (Buerhaus, 2009). Another important aspect includes cross training of the staff in the nursing activities. Staff members are assigned a primary job duty in which they spend the most time. All staff members are expected to complete the routine function.
The Group to Lead the Initiative
Administrators and unit nurses can be best suited to initiate these changes because they recognize the necessity for improvement in health care, quality and work life and quality in long term care. Each of them clearly recognizes the important link between these. They also acknowledge the important role of frontline workers in providing high quality care. The importance of empowering the staff includes the quality of their work experience that includes the effectiveness of their work (Buerhaus, 2009). Moreover, each of these initiatives clearly identifies organizational culture as a vital part of the current quality problem necessary to focus the change. While many of the organizations that engage in cultural change are thriven, transferring change of culture from successful organizations to new environments has been very difficult. Many organizations involved in cultural change initiatives have failed to achieve a major improvement in either quality of care or quality of work life (Cowen,2011). This is because organizations that have succeeded in transforming their cultures are unable to tell others exactly what they did to achieve the transformation (Buerhaus, 2009). In addition, individuals who involve in these initiatives have often not succeeded in performing the daily demands of sustaining the organization while also transforming the way things are done. They often do not allot enough time to document what they are doing. This results to lack of useful documentation concerning successful implementation of culture change (Cowen, 2011). Vague suggestions about promoting innovation, empowering staff’s critical thinking and increasing collaboration are not valuable to the organization wanting to replicate the changes. People only describe how change was achieved from their point of view and understanding (Zerwekh, 2011).
The Proposed Timeline
Many people have underrated the importance of regular pre-scheduled meetings in implementing key changes within the organization. Leading team members are not only seen as the primary staff resource for all change in information but also as role models. Having consistent frequent meetings will guarantee that the leading team has current information at their possession and that energy is sustained (Linggi, 2012). Regular meetings will help keep the ball rolling and will provide a model to other teams in the institution. Meetings should be set in advance to avoid conflicts in scheduling. Decisions made early in the process will support attendance possibly through a reward system. If many people are absent, a forum on how to update other members of the staff about the recent changes in each department and any other pressing issue, the need to be addressed immediately should be developed. One major barrier that the teams encounter mostly is pushing tasks even when majority of team members are not present (Sullivan, 2010). The required collaboration for implementation of change across all organizational levels and the creation of a decision-making structure for engaging front line workers, mid-level manager and the top management is what leads to a sense of work empowerment. As decision-making continues, it becomes clear that each worker has an important part to perform. This may include identification of the problem and development of solutions to those problems (Linggi, 2012). This will clearly help change activities to frontline work. Most clinical problems experienced in long-term care involve multiple types of work, cross shift, multiple levels of the organization and multiple departments. Teams must direct the practice changes in time to allow each organization to improve clinical services outcome (Saver, 2013).
Measures of Success
A clear and consistent criterion for how team success will be measured should be developed. Measuring the success of a team is complex and should incorporate all activities. The leadership team should carefully review team progress constantly and discuss any action it would like to take regarding the team (Saver, 2013). The team should work with other teams to ensure the reviews are not punishing, but are acting as a tool for ensuring that initiatives remain focused and continue moving forward at a reasonable pace. The leadership team should also treat the reviews as such. The team review outcomes should be discussed with the team in a non-threatening way, seeking feedback on the issues that the team might have experienced (Sullivan, 2010). There should also be plans for addressing the concerns with the team. This will reduce team frustration and increase team success.
The team should also develop its own goals and the management offering a consultancy role. Team objectives should be clearly stated in writing, and they should clearly reflect steps being taken by the team. When a team is clear on a specific task that they must achieve, the probability of planning and implementing will be increased. Team goals might be broad but objectives should be easily measured and achievable (Saver, 2013). Nursing leaders should adopt practical measures to succeed. There is the need of removing barriers in changing patterns and assist teams in the implementation of the changes.
Conclusion
The growing needs of the patients have made the nursing homes and hospitals implement ways to have a good patient to nurse ratio. Moreover, the situation has called for competent nursing staff who can address the concerns raised by the patients. In essence, this situation requires a good staffing pattern that will ensure there are an adequate number of the nursing who personnel who are competent to attend to the patients’ needs and give good care to the patients in the nursing units at any given time. The explored concepts are aimed at helping healthcare providing organizations and their staff to implement changes that will raise the quality of care to the patient.
References
Buerhaus, P. I., Staiger, D., & Auerbach, D. I. (2009). The future of the nursing workforce in the United States: Data, trends, and implications. Boston: Jones and Bartlett Publishers.
Cowen, P. S., & Moorhead, S. (2011). Current issues in nursing. St. Louis, Mo: Mosby Elsevier.
Grohar-Murray , M. E., &Langan, J. (2011). An Overview of Organization and Management. Leadership and Management in Nursing. Upper Saddle River: Pearson Education
Linggi, D., & AMN Healthcare. (2012). 2012 survey of registered nurses: Job satisfaction, career patterns and trajectories. San Diego, CA: AMN Healthcare.
Saver, C. (January 01, 2013). Survey finds staffing patterns stable but positions hard to fill. Or Manager, 29, 9, 7-10.
Sullivan, E. J., Garland, G., & Sullivan, E. J. (2010). Practical leadership and management in nursing. Harlow, England: Pearson.
Zerwekh, J. A. G., &Garneau, A. Z. (2011). Nursing today: Transition and trends. St. Louis: Saunders.
