All organizations, including hospitals, have structured procedures and policies that encourage worker safety, regulatory compliance, and the provision of high-quality patient care in an effort to prevent disaster.
A change to the hospital's regular working procedures or schedule must be approved first, in accordance with hospital policy. As a result, before we apply our solution in the hospital, we will seek administration approval.
An individual should establish a powerful and enduring first impression when asking for permission to carry out a project (Goel, 2014).
This will be achieved by compiling a solid and evidence-based report detailing the necessity to add the number of beds as well as increase the number of nurses in the hospital. The report will then be presented to the hospital's board of directors for them to scrutinize it and determine if the proposed solution is viable.
However, prior to the actual presentation before the board, we will need to do a lot of preparation to ensure that the first impression we make will last.
The initial impression is always the strongest and also hard to counteract hence when seeking approval, we will make sure we make a good first impression. Our first step will be to form alliances with resident staff including nurses and doctors as well as key stakeholders responsible for giving the green light to carry out the project. Such alliances will provide us with a great chance to test the solution and also determine some questions that the board of governors might ask.
Alliances will help improve and expand on the proposed idea since it will enable us to understand the feelings of our audiences; following this, we will be able to improve on the idea to have it approved (Goel, 2014).
The second step after forming alliances will be to prepare for the meeting with the board of governors. This step will help us come up with responses to questions that might be asked during the meeting. Finally, we will shape our presentation so that it fits the needs of stakeholders involved; we will also keep the presentation simple for easier understanding in addition to answering all questions asked confidently to ensure that the stakeholders believe in our proposed solution (Goel, 2014).
Therefore, the method we will use to seek approval will be to present a report to the hospital's board of governors.
This report will be based on evidence collected from various reliable sources to ensure that the proposed solution will be viable. To guarantee that we receive the approval, we will also make sure that we meet important stakeholders prior to the presentation; this will help gather additional information to determine areas in the report that might need improvement. In addition, we will also position out the presentation in a manner that the audience is able to pinpoint the benefits that they stand to gain. Finally, we will ensure that we answer any questions asked confidently as this will safeguard the approval we will be seeking.
Description of current problem requiring change
The number of people visiting the hospital for different ailments has increased over the decades. For instance, there is an increased number of people visiting the hospital and reporting diabetes; such people are either admitted to the hospital or they can be given medication to take at home. Metformin is one of the drugs used to treat people with type 2 diabetes and it works by helping the body utilize insulin more effectively. Nurses are charged with the responsibility of handling these patients and at times the work is overwhelming; as a result, the nurse ends up overworked and she experiences burnout (Kieft, 2014).
Burnout among nurses has, therefore, become a more disturbing problem that has resulted from the increase in the number of people visiting the hospital for treatment.
Nurses are often overworked at the hospital where they spend the whole day taking care of countless numbers of patients (Liu, 2012). For instance, some people who present with a severe case of diabetes with serious symptoms are admitted to the hospital and it is the responsibility of the nurse to take care of such patients. Other patients have less severe symptoms that require only medication; it is the nurse's responsibility too to administer such medication. In this way, it is evident that the nurses have many responsibilities that ultimately lead to burnout (Kieft, 2014).
Burnout among nurses, in turn, has several consequences; one such consequence is seen in the quality of care provided to patients.
A tired nurse is not capable of providing a high quality of care hence in hospitals where nurses experience burnout there is a low quality of patient care (Liu, 2012). Another consequence is a high patient mortality rate and failure to rescue. A high mortality rate is as a result of poor quality of care while failure to rescue results from the fact that nurses are occupied and tired from attending to other patients.
In this way, we can conclude that there is a problem in that the increased number of patients visiting hospitals is causing burnout among nurses.
In turn, the burnout results in a poor quality of patient care as well as high patient mortality and failure to rescue. As such, there is need to implement a solution to this problem hence reduce patient mortality in addition to improving the quality of care provided by the nurses.
Explanation of proposed solution
To address the problem of burnout among nurses, the hospital will have to employ more nurses in addition to increasing the number of hospital beds. Such a solution will see to it that the problem of burnout among nurses is addressed. There is evidence to suggest that a hospital with few nurses requires that each nurse attends to a large number of patients in order to meet the needs of all the patients admitted to the hospital. In this way, the nurse is overworked through attending to too many patients. What is more, few nurses will often not be able to handle all the patients effectively hence leading to the provision of poor quality patient care. Also, hospitals with few numbers of beds exhibit poor quality of patient care; this result from the fact that the hospital's capacity is limited hence they can only take care of few patients at a time. Such workflow, in turn, causes delays in admitting patients which ultimately affects the provision of care. The only way to counter this problem is therefore to increase the number of beds in the hospital; in this way, the hospital will increase its capacity to treat more patients and also reduce delays experienced when admitting such patients. This will ultimately improve the quality of care provided in the hospital. The number of nurses working in the hospital should also be increased; this will increase the hospital's ability to serve patients effectively since the workload on individual nurses will have been reduced. Furthermore, more nurses increase the hospital's capacity to serve more patients effectively hence improving the overall quality of care.
Evidence from literature review to support proposed solution
Several research studies can be cited as support for the solution proposed above; for instance, the study conducted by Aiken (2008) revealed that indeed the hospital environment has a significant effect on patient mortality and nurse outcomes. Hospitals with better care environment exhibited decreased patient mortality and improved satisfaction among nurses due to less burnout. As such, the hospital should take this into consideration and improve their care environment by hiring more nurses and buying new beds (Aiken, 2008).
What is more, another study by Kieft (2014) showed that nurses also had an impact on patient outcomes. The number of nurses, as well as their level of education, seemed to correlate with the rate of mortality among patients. Hospitals with more and well-educated nurses record lower mortality rates than hospitals with few nurses. As a result, the hospital should take it upon themselves to hire more nurses with adequate training and education (Kieft, 2014).
Another article by Kiwan & Mathews (2013) also supports the proposed solution to increase the number of nurses and beds in the hospital. According to the study, hospital environments have an effect on the work life of nurses; for instance, the staffing of nurses has an effect on their level of exhaustion. In turn, the work life of nurses has a direct effect on patient outcomes. Nurses with a high level of exhaustion fail to effectively take care of their patients hence negative patient outcomes (Kiwan & Mathews, 2013). Finally, a study conducted in Guangdong, China by Liu (2012) revealed that there was a high rate of secondary infections among patients in hospitals where nurses reported higher job demands and workload. Such shows that overworking nurses affects the overall quality of healthcare provided to patients (Liu, 2012).
Taking evidence from these studies, it is, therefore, a good idea to increase the number of nurses as well as the number of beds in the hospital. This solution will see to it that the workload on nurses is reduced. Also, the quality of healthcare will be improved since burnout among nurses will reduce and the capacity of the hospital to serve more patients will be increased.
Discussion of implementation logistics
Implementation of a solution often proves hard since it is a tedious job getting the staff to adapt to the new change. Therefore, the hospital will have to capitalize on all resources available to implement the proposed solution. There are a number of models designed to guide people as they transform evidence into practice; for instance, the Knowledge to Action Framework (KTA Framework) is used as a guide on how knowledge is implemented into action (Bick, 2010). The KTA Framework has several steps which include adapting the knowledge and evidence to the local needs, assessing any barriers to the use of that knowledge and evidence, tailoring the solution to fit the needs of the local people, monitoring the progress of the proposed solution, evaluating the outcomes and sustaining the use of the new knowledge (Bick, 2010).
In our case, the solution is adding the number of nurses and beds in the hospital; the first step will be to adapt this knowledge to the local setting. Such will involve looking for a room to place the new beds as well as determining the amount of money the hospital will spend on the project. The second step will involve assessing any barriers which might include lack of enough funds to carry out the project. Thirdly, we will tailor the solution to fit the needs of the hospital and finally, we will monitor any changes to determine if the intervention had a positive impact on patient outcomes.
Identify resources required for implementation
Various resources will be required for the successful implementation of the proposed solution. For instance, financial resources will be the most critical component for the successful implementation of the solution. The hospital will require finances to buy more beds as well as to hire more nurses and maintain them. The land will also be a necessary resource where the hospital can build new buildings to accommodate the new beds. Finally, the hospital will require an information management system to manage patient and staff records, hence ensuring the smooth running of work.
References
Bick, D., Graham, I. D., & Sigma Theta Tau International. (2010). Evaluating the impact of implementing evidence-based practice. Chichester, West Sussex: Wiley-Blackwell.
Liu, K., You, L., Chen, S., Hao, Y., Zhu, X., Zhang, L., & Aiken, L. H. (2012, May). The relationship between hospital work environment and nurse outcomes in Guangdong, China: A nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476–1485.
Kiwan, M., & Mathews, A. (2013). The impacts of work environment of nurses on patient safety outcomes. Journal of Nursing Studies, 50(2), 250-270.
Kieft, R., Brouwer, B., & Francke, A. (2014). How nurses and their work environment affect patient experiences of quality care. Journal of Health Services Research, 14, 100-160.
Aiken, L., Clarke S.P., & Sloane, D. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223-229.
Goel, S. D. (2014). Textbook of Hospital Administration. London: Elsevier Health Sciences APAC.
