NURS 6053 Week 1 Discussion Review of Current Healthcare Issues

NURS 6053 Week 1 Discussion Review of Current Healthcare Issues

NURS 6053 Week 1 Discussion Review of Current Healthcare Issues

Links to an external site.

Montero, A., Kearney, A., Hamel, L., & Brodie, M. (July 14, 2022). Americans’ Challenges with Health Care Costs. Kaiser Family Foundation. https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

National Healthcare Issue: COVD-19

COVD-19 pandemic currently has greatly impact Healthcare. According to the COVID-19 In December 2019, a pneumonia caused by a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China and has rapidly spread around the world since then.

Stressor to focus on

According to the COVID-19 surges have stressed hospital systems and negatively affected health care and public health infrastructures and national critical functions. Resource limitations, such as available hospital space, staffing, and supplies led some facilities to adopt crisis standards of care, the most extreme operating condition for hospitals, in which the focus of medical decision-making shifted from achieving the best outcomes for individual patients to addressing the immediate care needs of larger groups of patients. When hospitals deviated from conventional standards of care, many preventive and elective procedures were suspended, leading to the progression of serious conditions among some persons who would have benefitted from earlier diagnosis and intervention.

The conditions of hospital strain during July 2020–July 2021, which included the presence of SARS-CoV-2 B.1.617.2 (Delta) variant, predicted that intensive care unit bed use at 75% capacity is associated with an estimated additional 12,000 excess deaths 2 weeks later. As hospitals exceed 100% ICU bed capacity, 80,000 excess deaths would be expected 2 weeks later.

According to Vahedian-Azimi, et al., (2017) stress has anegative impact on both nurses and patient outcomes; with a greater impact to those working in critical care areas.  Hospitals reported a range of strategies to address their challenges and identified areas in which further government support could help as they continue responding to the pandemic. Broadly, the areas of government support included enhancing knowledge and guidance on the prevention and treatment COVID-19, including safe means to discharge patients with COVID-19; helping to fill gaps in hospital staffing, especially for nurses and certain specialists; continuing financial relief, especially to increase care to rural and underserved communities; and, encouraging widespread vaccinations to reduce the circulation of the virus.

Beyond the immediate needs in responding to COVID-19, the pulse survey documents hospitals’ perspectives about longer-term opportunities for improvement to address challenges that existed before, and were exacerbated by, the pandemic. These include reducing disparities in access to health care and in health outcomes; building and maintaining a more robust health care workforce; and strengthening the resiliency of our health care system to respond to pandemics and other public health emergencies and disasters.

Reducing Stress on Healthcare

According to the ANA The balance of safety and efficacy and the perception of personal risk versus overall benefit are at the core of acceptability of immunization practices. The known and potential benefits of a COVID-19 vaccine must outweigh the known and potential risks. ANA strongly recommends that registered nurses be vaccinated against COVID-19. All health care personnel (HCP), including registered nurses (RNs), should be vaccinated according to current recommendations for immunization of HCP by the CDC and Association for Professionals in Infection Control and Epidemiology (APIC).

ANA also believes that it is imperative for everyone to receive immunizations for vaccine-preventable diseases as vaccines are critical to infectious disease control and prevention. Moreover, nurses have a professional and ethical obligation to model the same health care standards they prescribe to their patients. There is now significant clinical evidence on the safety and effectiveness with approved COVID-19 vaccines being administered under the Food and Drug Administration’s (FDA) Emergency Use Authorization process.

Annals of Internal Medicine stated We need to be more aggressive about respiratory hygiene and placing restrictions on patients, visitors, and health care workers with even mild symptoms of upper respiratory tract infection. Potential policies to consider include the following: 1) screening all visitors for any respiratory symptoms that may be related to a virus, including fever, myalgias, pharyngitis, rhinorrhea, and cough, and excluding them from visiting until they are better; 2) restricting health care workers from working if they have any upper respiratory tract symptoms, even in the absence of fever; and 3) screening all patients, testing for all respiratory viruses (including SARS-CoV-2) in those with positive screening results regardless of illness severity, and using precautions (single rooms, contact precautions, droplet precautions, and eye protection) for patients with respiratory syndromes for the duration of their symptoms regardless of viral test results. A collateral benefit is that if a patient is subsequently diagnosed with COVID-19, staff who used these precautions will be considered minimally exposed and will be able to continue working.

Conclusion

Laureate education (2015) states, that one thing that individuals and leaders can do to be prepared for healthcare challenges of the future is to develop cultural competency, gain skills to view multiple perspectives, and develop greater understanding the survival side of any healthcare organization. Having Beyond the immediate needs in responding to COVID-19, the pulse survey documents hospitals’ perspectives about longer-term opportunities for improvement to address challenges that existed before, and were exacerbated by, the pandemic. These include reducing disparities in access to health care and in health outcomes; building and maintaining a more robust health care workforce; and strengthening the resiliency of our health care system to respond to pandemics and other public health emergencies and disasters.

   References

ANA Board of Directors September 2020   www.NursingWorld.org/COVID19Vaccines/

Annals of Internal Medicine https://doi.org/10.7326/M20-0751

Centers for Disease Control and Prevention. (2020). Daily updates of totals by week and state. Retrieved June 2, 2020 from, https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Vahedian-Azimi, A., Hajiesmaeili, M., Kangasniemi, M., Fornes-Vives, J., Hunsucker, R. L., Rahimibashar, F., … Miller, A. C. (2017). Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study.  Journal of Intensive Care Medicine,  34(4), 311–322. doi: 10.1177/0885066617696853

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

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For the government to address the healthcare professional shortage, strategies can be considered to make nursing more appealing. Promote nursing through marketing and education to attract more young people to the profession (Marć et al., 2019). Showcasing nurse resilience during the pandemic can enhance the professional appeal. Financial incentives like salaries, loan forgiveness, and scholarships can make nursing more appealing amid the pandemic’s economic impact.

New staffing methods can be tried for hospitals to keep nurses and serve patients. Redistribute tasks and use technology to enable nurses to focus on patient care. Optimizing nurse staffing and workload can stretch nurses without sacrificing care. Supportive work environments, growth opportunities, mentorship programs, and work-life balance initiatives boost nurse retention (Marć et al., 2019).

We must consider if eliminating non-nursing tasks will increase nurse staffing and alleviate the shortage. We can optimize nurse staffing and prioritize patient care by reallocating tasks and utilizing technology. It can improve efficiency, decrease workload, and prevent nurse burnout (Marć et al., 2019). To implement changes, evaluate staffing and workflow thoroughly. Identify non-nursing tasks that can be delegated to other healthcare team members. By redistributing duties, nurses can focus on nursing duties. Using technology can streamline tasks and reduce nurses’ workload. EHRs, computerized orders, and scheduling systems reduce nurse paperwork and coordination time (Norful et al., 2018). Tech advancements allow nurses to focus on patient care and decision-making. Delegating tasks must balance patient safety and non-nursing duties. Training, communication, and guidelines are crucial for smooth transitions and a collaborative healthcare team.

The practice of nurses punching a time clock can be reevaluated to align with the professional status of nursing. The transition towards a system prioritizing trust, accountability, and outcomes over stringent clock-in and clock-out schedules can acknowledge nurses as professionals and enable them to exercise their professional discretion. Other strategies include mentorship and career development for new nurses. We can also improve nursing’s public image through awareness campaigns and showcasing their diverse roles and impact. Improving nurse-patient ratios, staffing, and workload management can help to address burnout concerns (Shadadi et al., 2018). Another consideration could be partnering with educational institutions and healthcare organizations to provide nursing students with a smooth education-to-practice transition and practical experience. It is also essential to Invest in nursing specialization and ongoing professional development.

In conclusion, a diverse strategy of recruitment, retention, recognition, and supportive work environments is essential to attract and keep nursing professionals. In the post-COVID era, reevaluating their duties can also enhance healthcare efficiency. By delegating tasks and using technology, nurses can focus on nursing responsibilities, improving patient care, and dealing with staff shortages.

References

Kirk, M. (2015). Reviewing education challenges and solutions for health professionals in community care. British Journal of Community Nursing, 20(10), 504–510. https://doi.org/10.12968/bjcn.2015.20.10.504

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician Comanagement: A theoretical model to alleviate primary care strain. The Annals of Family Medicine, 16(3), 250–256. https://doi.org/10.1370/afm.2230

Shadadi, H., Sheyback, M., Balouchi, A., & Shoorvazi, M. (2018). The barriers of clinical education in nursing: A systematic review. Biomedical Research, 29(19). https://doi.org/10.4066/biomedicalresearch.29-18-1064

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International nursing review, 66(1), 9-16.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national

healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

Nurses play an integral role in the health care system. They provide acute care for patients in emergency rooms and intensive care units and administer medicine and other daily essentials throughout our country’s hospitals. But far too often, nurses are overworked and under-supported as hospital administrators seek to lower costs and boost profits.

In the face of aggressive cost-cutting, minimum staffing levels are necessary to ensure the safety of patients and nurses. Adequate nurse staffing is key to improving patient care and nurse retention, while poor staffing endangers patients and drives nurses from the profession. Unfortunately, staffing problems are only set to get worse as baby boomers age and the demand for health care services grows, making staffing a growing concern for nurses and patients alike.

Safe Staffing Practices Improve Patient Care Outcomes

In 1999, California became the first state to pass a law setting a legal maximum patient-to-nurse staffing ratio in order to improve patient care. Since it was fully implemented in 2004, research specific to California has shown measurably improved patient outcomes, in line with the broader academic consensus about the positive impact of lowering nurse workloads.

• The most comprehensive study of the impact of the law came out in 2010 and compared hospitals in California to hospitals in New Jersey and Pennsylvania. Researchers found significantly better health outcomes in California, including lower surgical mortality rates, reduced inpatient deaths within 30 days of admission and a lower likelihood of death from failing to properly respond to symptoms.[1]

• These conclusions are backed up by a 2018 meta-analysis of other research, which found for every increase of one nurse, patients had a 14 percent decrease in risk for inhospital mortality.[2] An earlier analysis produced similar results, showing in 2007 that an increase of one full-time registered nurse in a unit per day would result in nine percent fewer hospital-related deaths in the ICU, 16 percent fewer deaths for surgical patients and six percent fewer deaths for medical patients.[3]

• In long-term care facilities, patients with more direct RN time (30 to 40 minutes daily per patient) reported fewer pressure ulcers, acute care hospitalizations, urinary tract infections, urinary catheters, and less deterioration in their ability to perform daily living activities.[4]

• While increased nurse staffing greatly improves patient outcomes in hospitals with positive nurse working conditions, it has little to no effect in hospitals that otherwise have poor nurse working conditions. Good nursing work environments are characterized by positive working relationships between doctors and nurses, active nurse involvement in hospital decision making, management responding to nurse patient care concerns, continuing education programs for nurses and constant quality improvement for patient care programs.[5]

Inadequate Staffing Endangers Nurses and Patients Alike

The Bureau of Labor Statistics estimates that demand for registered nurses will increase 15 percent between 2016 and 2026, and 438,000 new nursing jobs will be created over this ten-year period.[6] This increase in demand only stands to compound the existing nursing shortage and other hospital staffing problems, described by the American Nurses Association (ANA):

I too discussed nursing shortages as a healthcare issue. It was interesting to read your views and research on the topic. My initial reaction to nursing shortages was to target the work environment and compensation issues that nurses face which lead to shortages. However, when I dug a bit deeper into researching about this; my eyes were opened to an entire world of reasons why there are shortages. “It is critical to include the systematic issues in education, health delivery systems and the work environment. Further, the impact of reimbursement, legislation, regulation and technological advances must also be considered.

Failure to consider the relationships among these aspects limits the full appreciation of the nursing workforce shortage complexity.” (aacnnursing.org, 2022) Shortages are prevalent in the media amongst bedside nurses but extends to all specialties of practice. I was astounded at how much of a faculty shortage there is as well. How does an aspiring nurse achieve success in the first step of their career without the proper educators and resources? Let’s not forget the mounting stress of how these shortages will impact them upon entering the field as graduate nurses. “The shortage has pros and cons for nursing students. One pro is being able to find a job quickly after graduation.

A key disadvantage, though, is that nursing programs have fewer openings. For students, this means acceptance into a program may be more challenging.” (nursejournal.org,2022) The issue with the pro here is that graduate nurses will have astronomical ratios, which is unsafe for all involved. Nurses, even of novice status should not have 6-7 patients on a progressive care unit, or 4 ICU patients. Patients come first. That’s what we are taught and that’s how it should stay, but what if a system is put into effect where both patients and providers are #1. Also, these nursing shortages drop patients to last on the list of priorities. That’s another discussion completely.

American Association of Colleges of Nursing: The Voice of Academic Nursing. (n.d.). Retrieved September 1, 2022, from https://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Reverse-Shortage

Writers, S. (2022, August 29). Post-pandemic nursing shortage: What it means for aspiring nurses. NurseJournal. Retrieved September 1, 2022, from https://nursejournal.org/articles/post-pandemic-nursing-shortage/