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NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

Part 1:
Organizational or Patient Issue

What is the issue that you are trying to solve or improve?
Prolonged patient wait times
Patient dissatisfaction
Errors in care
Nurse burnout
Nurse turnover
Poor morale
My goal is 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. Nurses are experiencing burnout stemming from a lack of support, which leads to unsafe practices and delays in care.
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Why should you care?
Our hospital is a unit
Poor reflection on facility as a whole
Nursing ethics (Haddad LM. et al. 2021)

Although this is an immediate issue faced by the ED. The fallout will ultimately affect the image of the hospital and all staff members as a whole. We are a unit and the negative outcomes in the ED will ultimately affect the floors that our patients are admitted to. “There are four main principles of ethics: autonomy, beneficence, justice, and non-maleficence” (Haddad LM. et al. 2021).

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Part 2:
Relevance of an Interdisciplinary Team Approach

Why an interdisciplinary team approach?
This method encourages collaboration across expertise
Builds long-term relationships and a team mindset
Cross training heightens knowledge overall
“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)
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. This will build stronger relationships across units and also allow the sharing of information leading to higher levels of knowledge for all involved. “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)

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NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

Improved outcomes and attained goals!
Utilizes existing resources
Less turnover
Incentivizes staff members
Happier patients
By utilizing existing staff who know our system well, we will be cutting down training by a significant amount. We will also be using less resources and incentivizing staff members with bonuses. This will lead to less nurse turnover and happier patients overall.
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Part 3:
Interdisciplinary Plan Summary

Objective
Streamline care process
Plan-Do-Study-Act (PDSA) model
Get buy-in from stakeholders
My objective is to streamline the care process by creating an interdisciplinary collaboration that helps our nurses provide safe patient care. This process will 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.
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How will it work?
1) With buy-in from all stakeholders
2) With careful management
3) With systematic PDSA implementation
4) With excellent communication
Excellent communication is critical to getting the needed buy-in. Collaboration between management is crucial to a seamless change process using the PDSA model. Careful management of the PDSA process through every step must be prioritized by the project managers.
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NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

What will the team do?
Shift supervisors will act as project managers
Nurses with varying expertise will bring their knowledge to the ED
The team will meet often and communicate openly
The team will work together on the common goals of increasing patient safety and satisfaction
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. 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. 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.

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Part 4:
Implementation and Resource Management

Implementation
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
“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 roles of each stakeholder during this process is as presented in the slide.

NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

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Resource Management
Incentivize current staff to pick up shifts:
$250 per shift
Cut costs on hiring travelers:
$100 per hour
Cut down costs needed to train new hires by reducing turnover
Allow for easy rotation of staff by providing scheduling flexibility
“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). 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. 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.
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Part 5:
Evaluation

Metrics
Patient wait times
Patient satisfaction scores
Staff feedback
Unintended side effects
Cost analysis
To determine the success of failure of the plan, it must be evaluated using measurable data. In the final phase of the PDSA cycle “the plan will be reevaluated based upon patient safety results and general morale and opinion of the team” (Coury, J. et al., 2017). Tangible data collected will be used to evaluate the effectiveness of the changes implemented. 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.
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NURS FPX 4010 Assessment 4 Stakeholder Presentation NR

References:


Haddad LM, Geiger RA. Nursing Ethical Considerations. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/
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 healthcare, 12, 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 research, 17(1), 411. https://doi.org/10.1186/s12913-017-2364-3
Akinleye, D. D., McNutt, L. A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PloS one, 14(8), e0219124. https://doi.org/10.1371/journal.pone.0219124

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