The Retention of nurses in the Labor and Delivery Arena

Organizational Needs Assessment

Devita Price

Chamberlain University

January 18, 2022

Organizational Needs Assessment

Over the past decade, the American population has increased significantly. The rapid population increase has increased the demand for healthcare services and a need to have more healthcare organizations and more healthcare practitioners. Farokhzadian et al (2018) indicated that the patient population has doubled over the past decade in all healthcare organizations in the United States. According to the previous American Nurses Association report, increase in patient population has imposed a major burden in nurses and other healthcare practitioners across the country resulting to a need to increase the number of healthcare organizations and nurse population. Other issues such as emerging infections like the covid-19 pandemic and Ebola have also facilitated the need for more nurses in hospitals (Buheji & Buhaid, 2020). However, the nurse population has always remained constant, leading to overburdening of nurses. My interview with James, a DNP nurse at the Lenox Hill Hospital, New York city, revealed a need to increase the nurse population to handle the increasing patient population in the organization. Increasing the nurse population is important because it will improve the quality of services delivered to patients, increase care outcomes, and reduce healthcare costs and time spent offering healthcare services. It will also reduce hospital congestion and readmissions. The Retention of nurses in the Labor and Delivery Arena

Identification of the Practice Problem

Nurse shortage is a major problem in Lenox Hill Hospital today. The interview revealed that the organization is experiencing nurse shortage challenges characterized by an increased patient population. From the interview, it was evident that the effects of the pandemic have revealed the need to increase the nurse population in all healthcare organizations in the United States. Lenox Hill Hospital currently has 300 nurses with an average nurse population of about 3000 per day. This indicates that each nurse attends to about one hundred patients per day. According to James, the pandemic has increased the patient population to over 5000 per day, leading to a burden to nurses. The Retention of nurses in the Labor and Delivery Arena

The report issued by Lasater et al. in 2021 showed the gap between the patient population and the nurse population and suggested a need for increasing the nursing population to enhance healthcare delivery and ensure adequate response to the covid-19 patients. Schwerdtle et al. (2020) showed that an inadequate nurse population has resulted in many deaths due to delayed care. In 2020, reports indicate that more healthcare workers died from the pandemic creating a bigger gap between the nurse and patient populations. The study revealed that more nurses died because of exposure to patients with the virus. Buheji & Buhaid (2020) also indicated that nurses experienced overworking hours, contributing to their exposure to the virus. The interview revealed that nurse shortage is a major problem in healthcare organizations across the United States today. Increasing the nurse population will help reduce the challenges imposed by the virus on healthcare workers and patients. The Retention of nurses in the Labor and Delivery Arena

Stakeholders who have interest in the project outcome

The stakeholders interested in the project outcome include nurses, patients, hospital management, community, insurance organizations, and staff members. The project aims to determine the need to increase the nurse population in Lenox Hill Hospital and other healthcare organizations in readiness for other deadly variants of a pandemic to ensure that people get high-quality healthcare services and reduce congestion in a healthcare organization and reduce the number of deaths time used to access medical services. Increasing the nurse population will help reduce healthcare costs and time and reduce congestion in healthcare organizations (Rosenberg, 2019). The project will also help reduce demand for healthcare services and, as a result, will prevent insurance organizations from spending more funds on treatment. It will help the community by reducing infection rates. The hospital management will benefit from reduced hospital congestion, improved services, quality care outcome, and patient satisfaction. The organization will increase its returns from the change because it will attract more patients and community members due to its improved services. The Retention of nurses in the Labor and Delivery Arena

The interview revealed that there had been a major debate in the organization on whether to increase the nurse population or to introduce technology such as telemedicine in response to the existing problems. The proponents of the debate argue that increasing the nurse population will have more impacts on the organization than technology. On the other hand, the opponents of the debate have advocated for the need to introduce new technology in addressing issues of congestion and increasing population. The opponents of this debate will be more likely to resist the change. They include stakeholders such as investors, the board of directors, government agencies, and donors. These stakeholders propose the need to enroll patients in the telemedicine programs to allow patients with acute conditions like cancer, covid-19, diabetes, stroke, hypertension, heart disease, and obesity to continue with their medication at the comfort of their homes. These stakeholders argue that telemedicine will reduce congestion in the hospital and ensure healthcare quality and care outcomes.

The hospital management and staff will greatly influence the proposed changes. The management is the decision-makers and has the final say in all proposed changes. The nurse will benefit from the proposed change because they will be delivered with prolonged working hours and congestion. They will enjoy a clean and safe working environment from the proposed changes because their number will enable them to improve their service delivery, save time and respond to patient concerns as soon as they are reported. The Retention of nurses in the Labor and Delivery Arena

Criteria for nurse prioritization

Nurse shortage is a major issue in the practicum site. A DNP nurse identified the issue in Lenox Hill Hospital. James is a high-ranking decision-maker in Lenox Hill Hospital. He participates in strategic development and decision-making process. The role of James is to ensure that nurses’ welfare is upheld and that nurses work in a safe, secured, and protected environment. The proposed project aligns with the practicum site’s mission and vision, which requires nurses to work in a safe and clean environment and ensure all staff members’ welfare within the organization. The project also aligns with the organizational commitment to ensure the community’s wellbeing. The corporate social role of the organization is to ensure the wellbeing of the community by providing quality and excellent services and safety to its workers. The Retention of nurses in the Labor and Delivery Arena

Gap Analysis Template

What is currently happening in the practicum site?

What should be happening in the practicum site based on current evidence?

What is the gap between what is currently happening and what should be happening (this is your practice gap)?

Why is there a gap in practice? What factors are contributing to the gap in practice?

What evidence do you have to demonstrate there is a practice gap?

There is a shortage of nurses despite a constant increase in patient population due to the threats imposed by the pandemic.

There should be enough nurses to help reduce the impacts of the pandemic because it will be easier to use evidence-based approaches to determine appropriate approaches to treat patients.

There is a big gap between nurse population and patient population as evident in nurse to patient’s ratio leading to poor service delivery, congestion, and high healthcare costs. The number of patients has doubled over the years with the number of nurses remaining constant leading. The nurse-to-patient ratio is 1:150.

The gap is contributed to due to lack of a proper recruitment plan, and delay in the allocation of funds to pay part-time nurses.

The increase in the number of readmissions, deaths and infections from contagious diseases in the organizations shows reduced quality in healthcare services and lack of enough nurses to address patient needs.

Conclusion

The major challenge in many healthcare organizations is how to deal with the pandemic. Many organizations have responded by enrolling telemedicine services, while others are thinking about increasing nurse population in response to increasing patient population. The proposed organizational need in this paper is an increase in the nurse population to help reduce the number of deaths, readmissions, and infections from contagious diseases. This paper identified a need for more nurses to help reduce congestion and increase quality and care outcomes. Increasing the nurse population is a more significant opportunity because it will help the organization cope with challenges imposed by the virus and population increase.

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References

Buheji, M., & Buhaid, N. (2020). Nursing human factor during COVID-19 pandemic. Int J Nurs Sci, 10(1), 12-24.

Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 1-13.

Karlsson, A. C., Gunningberg, L., Bäckström, J., & Pöder, U. (2019). Registered nurses’ perspectives of work satisfaction, patient safety and intention to stay–A double‐edged sword. Journal of nursing management, 27(7), 1359-1365.

Lasater, K. B., Aiken, L. H., Sloane, D. M., French, R., Martin, B., Reneau, K., … & McHugh, M. D. (2021). Chronic hospital nurse understaffing meets COVID-19: an observational study. BMJ Quality & Safety, 30(8), 639-647.

Rosenberg, K. (2019). RN shortages negatively impact patient safety. AJN The American Journal of Nursing, 119(3), 51.

Schwerdtle, P. N., Connell, C. J., Lee, S., Plummer, V., Russo, P. L., Endacott, R., & Kuhn, L. (2020). Nurse expertise: a critical resource in the COVID-19 pandemic response. Annals of Global Health, 86(1).