NURS 8100 Week 3 Discussion: Agenda Setting
A Sample Answer For the Assignment: NURS 8100 Week 3 Discussion: Agenda Setting
Clinical Practice Issue: Nurse-Patient Ratios
As the chair of the Nurse Peer Review Council at my institution, we review many problems that arise from clinical practice issues that are unresolved. In the first two months of 2022, we have reviewed clinical practice issues with the nurse-to-nurse handoff, staffing shortages, and failures to escalate the chain of command.
I have been a perinatal services director for over 10 years and in my time as a leader, I have often felt that the patient ratios in the perinatal services arena are not in alignment with the Association of Women’s Health and Neonatal Nursing (AWHONN) staffing acuity guidelines. Although these guidelines were created in 2010 to promote caring for patients in the perinatal period in a safe manner based on the acuity of the patient (Simpson et al., 2019) hospital financial colleagues do not understand the importance, and frequently these guidelines have to be overlooked to maintain compliance financially.
Having Trouble Meeting Your Deadline?
Get your assignment on NURS 8100 Week 3 Discussion: Agenda Setting completed on time. avoid delay and – ORDER NOW
The guidelines break down different types of diagnosis and acuity of specific clinical care scenarios and rank them into categories. This information is further broken down into the number of FTEs that would be appropriate to care for this type of patient. An example would be that any patient that is pushing while in labor would require a 1:1 patient ratio whereas three patients in triage could be cared for by one nurse. The problem with this is that patients can move in and out of different levels of acuity based on their course of labor up to and after delivery. From a financial and productivity perspective this does not make sense.
Staffing for a patient that begins at the lowest level of acuity then turns into the highest level of acuity, and then back to a moderate level of acuity after delivery is hard to measure from a productivity standpoint. This is even harder to maintain if departments are held to a productivity standard that is not in alignment with the patient ratios that mirror actual care a patient needs to receive during their hospital stay. The result is less safe care for patients, poor outcomes for mothers and infants, and staff dissatisfaction and burnout (Simpson, 2016).
Struggling to Meet Your Deadline?
Get your assignment on NURS 8100 Week 3 Discussion: Agenda Setting done on time by medical experts. Don’t wait – ORDER NOW!
I am currently working with an internal PI specialist piloting a program for the health care system that involves assessing the AWHONN staffing acuity guidelines and how often my labor and delivery unit is overstaffed or understaffed based on the AWHONN staffing acuity guidelines. We have collected eight months of data and have now created a presentation for the senior leadership team to help inform them of the need to deploy additional resources at a certain time of the day and on certain days of the week. This additional resource would increase the safety of care being provided to mothers and infants.
Some of the strategies I have used up to this point are in an agency for healthcare and research quality toolkit (AHRQ). The strategies include having a well-outlined plan that involves getting the right people on the team for the project, identifying a champion, communicating regularly with the stakeholders, and moving systematically through the stages of a project (www.ahrq.gov). By doing this the end-user has a well-developed objective presentation to support the need for a change. The importance of presenting a proposal that not only includes the need for change based on safety, but needs to include the financial, and operational impacts also.
References
Agency for Healthcare Research and Quality. (October, 2014). Designing and Implementing Medicaid Disease and Care Management Programs. Retrieved from https://www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm2.html
Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). Incorporation of the AWHONN Nurse Staffing Guidelines into Clinical Practice. Nurse Women’s Health, 23(3), 217–233. https://doi.org/10.1016/j.nwh.2019.03.003
Simpson, K. R., Lyndon, A., & Ruhl, C. (2016). Consequences of inadequate staffing include missed care, potential failure to rescue, and job stress and dissatisfaction. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(4), 481–490. https://doi.org/10.1016/j.jogn.2016.02.011
A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level.
This is insightful Erin, employee satisfaction is a critical factor in the success or failure of any healthcare system. Happy, satisfied employees are more likely to provide quality care than those who are disgruntled and unhappy (Lins et al., 2021). A recent study by the Commonwealth Fund found that employee satisfaction is a key ingredient in high-performing health systems. The study looked at six countries – Australia, Canada, France, Germany, Sweden, and the United Kingdom – and found that those with the most satisfied employees also had the best results in terms of quality of care and patient outcomes (Popa et al., 2018).
Most organizations consider flexibility scheduling as one of the major factors that can ensure employee satisfaction within the healthcare institutions. Flexible scheduling is an important part of ensuring the wellbeing of nurse’s roles in healthcare (Gomez et al., 2020). It can help to reduce stress levels and improve work-life balance. Additionally, it can allow nurses to better care for their patients by providing them with the time they need to perform their duties effectively. Informing the stakeholder about flexibility scheduling requires constant communication through different platforms such as workshops.
References
Gomez, S., Anderson, B. J., Yu, H., Gutsche, J., Jablonski, J., Martin, N., … & Mikkelsen, M. E. (2020). Benchmarking critical care well-being: before and after the coronavirus disease 2019 pandemic. Critical care explorations, 2(10). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587602/
Lins, M. G., Zotes, L. P., & Caiado, R. (2021). Critical factors for lean and innovation in services: from a systematic review to an empirical investigation. Total Quality Management & Business Excellence, 32(5-6), 606-631. https://doi.org/10.1080/14783363.2019.1624518
Popa, I., Ştefan, S. C., Morărescu, C., & Cicea, C. (2018). Research regarding the influence of knowledge management practices on employee satisfaction in the Romanian healthcare system. Amfiteatru Economic, 20(49), 553-566. https://www.ceeol.com/search/article-detail?id=686828
To prepare
- Review this week’s media presentation, focusing on the insights shared by Dr. White and Dr. Stanley on agenda setting and identification of stakeholders.
- Brainstorm clinical practice issues that you believe are worthy of being on your organization’s systematic agenda.
- Who are the stakeholders who would be interested in this clinical practice issue?
By Day 3
Post a cohesive response that addresses the following:
- In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.
- What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues providing additional strategies for informing and persuading stakeholders. Include additional research evidence that supports the importance of their identified clinical practice issue.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
As the chair of the Nurse Peer Review Council at my institution, we review many problems that arise from clinical practice issues that are unresolved. In the first two months of 2022, we have reviewed clinical practice issues with the nurse-to-nurse handoff, staffing shortages, and failures to escalate the chain of command.
I have been a perinatal services director for over 10 years and in my time as a leader, I have often felt that the patient ratios in the perinatal services arena are not in alignment with the Association of Women’s Health and Neonatal Nursing (AWHONN) staffing acuity guidelines. Although these guidelines were created in 2010 to promote caring for patients in the perinatal period in a safe manner based on the acuity of the patient (Simpson et al., 2019) hospital financial colleagues do not understand the importance, and frequently these guidelines have to be overlooked to maintain compliance financially.
The guidelines break down different types of diagnosis and acuity of specific clinical care scenarios and rank them into categories. This information is further broken down into the number of FTEs that would be appropriate to care for this type of patient. An example would be that any patient that is pushing while in labor would require a 1:1 patient ratio whereas three patients in triage could be cared for by one nurse. The problem with this is that patients can move in and out of different levels of acuity based on their course of labor up to and after delivery. From a financial and productivity perspective this does not make sense.
Staffing for a patient that begins at the lowest level of acuity then turns into the highest level of acuity, and then back to a moderate level of acuity after delivery is hard to measure from a productivity standpoint. This is even harder to maintain if departments are held to a productivity standard that is not in alignment with the patient ratios that mirror actual care a patient needs to receive during their hospital stay. The result is less safe care for patients, poor outcomes for mothers and infants, and staff dissatisfaction and burnout (Simpson, 2016).
I am currently working with an internal PI specialist piloting a program for the health care system that involves assessing the AWHONN staffing acuity guidelines and how often my labor and delivery unit is overstaffed or understaffed based on the AWHONN staffing acuity guidelines. We have collected eight months of data and have now created a presentation for the senior leadership team to help inform them of the need to deploy additional resources at a certain time of the day and on certain days of the week. This additional resource would increase the safety of care being provided to mothers and infants.
Some of the strategies I have used up to this point are in an agency for healthcare and research quality toolkit (AHRQ). The strategies include having a well-outlined plan that involves getting the right people on the team for the project, identifying a champion, communicating regularly with the stakeholders, and moving systematically through the stages of a project (www.ahrq.gov).
By doing this the end-user has a well-developed objective presentation to support the need for a change. The importance of presenting a proposal that not only includes the need for change based on safety, but needs to include the financial, and operational impacts also.
References:
Agency for Healthcare Research and Quality. (October, 2014). Designing and Implementing Medicaid Disease and Care Management Programs. Retrieved from https://www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm2.html
Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). Incorporation of the AWHONN Nurse Staffing Guidelines into Clinical Practice. Nurse Women’s Health, 23(3), 217–233. https://doi.org/10.1016/j.nwh.2019.03.003
Simpson, K. R., Lyndon, A., & Ruhl, C. (2016). Consequences of inadequate staffing include missed care, potential failure to rescue, and job stress and dissatisfaction. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(4), 481–490. https://doi.org/10.1016/j.jogn.2016.02.011
NURS 8100 Week 3: The Policy Process
NURS 8100 Week 3 Discussion: Agenda Setting Rubric Detail
Select Grid View or List View to change the rubric’s layout.
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*. NURS 8100 Week 3 Discussion: Agenda Setting
|
7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
|
6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*. NURS 8100 Week 3 Discussion: Agenda Setting
|
0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
|
| CONTENT KNOWLEDGE |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.
|
7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course. NURS 8100 Week 3 Discussion: Agenda Setting
|
6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course
|
0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course. NURS 8100 Week 3 Discussion: Agenda Setting
|
| CONTRIBUTION TO THE DISCUSSION |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.
|
7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature
|
6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas. NURS 8100 Week 3 Discussion: Agenda Setting
|
0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
|
| QUALITY OF WRITING |
6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
|
5
|