NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

Introduction

NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

My proposal aims to increase patient satisfaction by reducing patient wait times and decreasing nursing errors. These are issues related to each other due to the rise in acutely ill patients presenting to our emergency department (ED) when we simultaneously lose valuable staff members due to high turnover rates. Due to this current situation, nurses are experiencing burnout stemming from a lack of support, which leads to unsafe practices and delays in care.

Objective

My objective is to streamline the care process by creating an interdisciplinary collaboration that helps our nurses provide safe patient care. This process will also save on resources, cut down patient wait times, and improve overall patient satisfaction. I will use the Plan-Do-Study-Act (PDSA) model to systematically lay out the planned proposal. To successfully carry out this plan, we must receive buy-in from all potential stakeholders across diverse expertise.

Questions and Predictions

NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

  1. How will interdisciplinary collaboration across teams support the proposed objective?
  • Currently, the overload faced by the ED is handled by ED nurses alone. This is leading to burnout and a high turnover rate. By creating interdisciplinary collaboration across units, we will bring in additional qualified team members who can share some weight and alleviate the high-stress levels. “The themes of “being on the same page,” “focusing on patients,” and “holistic care planning” underpinned the ideas of collaboration and improved patient-centered care, that is, benefits to patients” (Walton, V. et al. 2019)
  1. Which teams or units will be involved?
  • We will bring a few nurses from other floors with specific specialties to the ED. These will include med-surge, progressive-care, and intensive-care nurses. We will allocate patients to these nurses according to needs and acuity levels.
  1. How will this process be supervised and monitored?
  • The nursing supervisor in charge of the ED shift will be designated as the project manager. The various supervisors will discuss what is working and what is not during their shifts and make improvements as necessary.
  1. How will we get the intended buy-in?
  • Using a transformational leadership model will empower nurses to work together for a higher cause. We will also incentivize these rotations with a bonus of $250 per shift for nurses willing to pick them up. 

Change Theories and Leadership Strategies

“The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings” (Coury, J. et al. 2017). This is the format that I will be using for organizing and implementing the changes proposed since it follows a systematic four-step process that is easy to understand. The first step of this process is the P phase which stands for “plan.” During this phase, the aim or goal of the proposed changes is carefully thought out and analyzed. All stakeholders are identified, and plans are made to manage the changes.

Once the plans are in place, the next phase of the process commences. During the D or “do” phase of the PDSA cycle, all the plans implemented in phase one are put into action. The project managers must carefully manage this phase and consider all stakeholder concerns. Poor leadership during implementation can result in quick failure of the change process. To streamline the process further and reduce confusion, items such as flowsheets can be printed and handed out to all active parties involved in the changes. Patient surveys could be an additional tool to collect data at this phase.

Next comes the S or “study” phase. As the name implies, this phase is used to study the data collected to make tangible observations regarding the effectiveness of the changes implemented. For instance, in the case of our ED, it would be important to see if patient wait times were reduced and if patient satisfaction scores trended up. Equally important would be our turnover numbers and employee feedback. It is critical to measure the success of the change as it relates to time, energy, finances, and other resources used to implement it. Also significant to note during this phase are any unintended side effects that could have happened.

NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

The final step of the PDSA cycle is the “act” phase. During this phase, “the plan will be reevaluated based upon patient safety results and general morale and opinion of the team” (Coury, J. et al., 2017). Assuming the results are positive, the plan can then be used again in the future to create similar outcomes in different situations. In my opinion, the best leadership strategy to carry out this cycle would be transformational leadership. Transformational leadership is applied to nursing through four components which are “idealized influence; inspirational motivation; intellectual stimulation; and individual consideration” (Collins, E. et al. 2020). The ability to encourage personal leadership and accountability using this strategy lends itself well to creating an atmosphere of collaboration amongst various team members.

Team Collaboration Strategy

The roles of each stakeholder during this process is as follows:

  • Project Managers (Shift Supervisors)
    • Oversee all steps of the change process
    • Act as point of contact for all stakeholder issues
    • Communicate effectively and often with team
  • ED Nurses
    • Triage and deal with emergent conditions
    • Stabilize patients and focus on acutely ill patients
    • Determine acuity and patient handoff location
  • Med-Surge Nurses
    • Receive med-surge acuity level patients
    • Observe and hold patients in ED until rooms are available
  • Progressive-Care (PCU) Nurses
    • Receive PCU acuity level patients
    • Observe and hold patients in ED until rooms are available
  • Intensive-Care (ICU) Nurses
    • Receive ICU acuity level patients
    • Observe and hold patients in ED until rooms are available
  • ED Techs 
    • Float between all sections and assist nurses with needs
  • Clinical Nursing Assistants (CNA)
    • Float between all sections and assist nurses with needs

Required Organizational Resources

To carry out these changes, there will be two costs that must be added to the calculations. The first is the $250 bones incentive to nurses willing to pick up the shifts, and the second is additional salaries for per diem and travel nursing staff to fulfill the nursing shortage. Since there will be six ED nurses, two med-surge, two PCU, and one ICU nurse, this daily bonus adds up to an additional $2750 per shift for the nurses. When considering the 2 ED techs and 2 CNA’s required, we can add $1000 to the costs per shift in bonuses paid. 

NURS FPX 4010 Assessment 3 Interdisciplinary Plan Proposal NR

The average staff nurse salary is $35 per hour, while the average travel nurse salary is $100 per hour. The additional $250 bonus is still the cheaper route for our facility when considering these numbers. It incentivizes staff nurses to pick up extra shifts. It also reduces turnover as staff may consider staying since they are being paid better and working under more desirable circumstances. Having the ability to pull in more existing staff while reducing the number of travelers will positively impact our facility in the long run.

Understanding these numbers and planning finances accordingly is critical to the long-term health of the ED and hospital. “Hospitals under financial pressure may struggle to maintain quality and patient safety and have worse patient outcomes relative to well-resourced hospitals” (Akinleye, D. et al., 2019). When all these steps are carefully considered, a workable plan is feasible from human resources and financial perspectives. This plan in action will ultimately lead to better patient outcomes with shorter wait times and no medical errors while also building a more robust team environment in our ED.

References

References:

Walton, V., Hogden, A., Long, J. C., Johnson, J. K., & Greenfield, D. (2019). How Do Interprofessional Healthcare Teams Perceive the Benefits and Challenges of Interdisciplinary Ward Rounds. Journal of multidisciplinary healthcare12, 1023–1032. https://doi.org/10.2147/JMDH.S226330 

Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., D’Agostini, B., Taplin, S. H., Green, B. B., & Coronado, G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC health services research17(1), 411. https://doi.org/10.1186/s12913-017-2364-3 

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing standard (Royal College of Nursing (Great Britain): 1987)35(5), 59–66. https://doi.org/10.7748/ns.2019.e11408 

Akinleye, D. D., McNutt, L. A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PloS one14(8), e0219124. https://doi.org/10.1371/journal.pone.0219124 

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