ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.

Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

• Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
• American Nurses Association. (2015). Code of ethics for nurses with interpretive statements

Links to an external site.

. Silver Spring, MD: Author. Retrieved from
https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).

• Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice
• Links to an external site.
• . OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from
  http://ojin.nursingworld.org/MainMenuCategories/AN…  

Milliken, A. (2018). Ethical awareness: What it is and why it matters

Links to an external site.

. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/AN…

• Respond to at least two of your colleagues by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. 
• Post 1
• T. N

Introduction

    The competing needs of patients, providers, and administration in the healthcare setting are prevalent. One such situation is occurring where I am working right now. The limited reimbursement for primary care patients creates a more tense environment. Recently, one of the nurse practitioners asked for a new scale for weighing babies in the pediatric setting. They had had the previous scale for 15 years and often had to reset it. There were five email exchanges to ask why they needed this scale, implying they may not need it. The office is not a money maker for the hospital system, so resources are more limited than in other areas. 

• Reimbursement for Services
• An estimated 30 percent of family care practices that are independently owned are at risk of closing. The number of primary care providers is already low, adding to financial hardship and limited pay, and the lack of providers will only worsen if something is done differently (Goroll et al., 2021). This lack of reimbursement leads to fewer resources, less staffing, and higher employee burnout. The team has to see so many patients in a day to be a profit that they burn out in the process. 
• Conclusion

The rub occurs due to a lack of money; the provider is expected to provide more care and see more patients while not being paid, as well as other areas of medicine, and with higher stress levels. The reimbursement or payment model has to be improved, or this field will need more providers and resources. Almost 90 percent of primary care providers report that less than 25 percent of revenue comes from prospective payment, leading to them depending on mass volume. The payment for primary care is inadequate,  leading to income disparities between providers, which affects providers’ career choices.

Resources

Andoh-Adjei, F.-X., Nsiah-Boateng, E., Asante, F. A., Velden, K. van der, & Spaan, E. (2019). Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana. PLoS ONE, 14(8), 1–13. https://doi.org/10.1371/journal.pone.0221195

Goroll, A.L., Greiner, A. C., & Schoenbaum, S. C. (2021). Reform of Payment for Primary Care – From Evolution to Revolution. The New England Journal of Medicine, 384(9), 788–791. https://doi.org/10.1056/NEJMp2031640

Post 2

S. A.

The issue and stressor at my current organization is patient safety. This is an area that is monitored heavily organization wide. It has been a difficult time after the organization has returned to pre-covid19 patient volume.  When the facility is working with inadequate staffing to meet the needs of the patients. Patient safety is a challenging area in healthcare. In the treatment area in the emergency department psychiatric patients and medical patients are in the same treatment area.  The emergency department can be overwhelmed with the number of medical and psychiatric, which creates an unsafe situation. Safety is defined as the ability to monitor, adapt and respond to emergencies (Stevenson, 2024).  

The emergency department in which I work is a small ED with only eleven beds. The unit gets overfilled with patients each day and it becomes challenging to maintain patients’ safety in an organization where admission to psychiatric unit is a slow and lengthy process. Medical patients are also slowly moving into inpatients bed due to multiple requirements placed in by inpatients units as well as admitting medical teams. The other challenge in this ED is that our population is an aging population with multiple comorbidities. The comorbidities such as diabetes, hypertension and heart failure as well as mental health conditions pose a challenge to patient safety. Aging papulation and increased comorbidity call for a proactive interdisciplinary approach to keep patients healthy (Amalberti, 2019). Emergency department providers must work with primary care providers to keep patients healthy and independent in the community.

A safe staffing is necessary to keep patient safety at an optimal level. A survey of nurses raises a concern for patient safety as many nurses said they would not report a mistake by another colleague due to unsafe staffing (Ely, 2019). Patient safety is an important piece of information to keep in mind when scheduling staff for all the shifts in the unit. Not having enough staff to meet the demands of the unit in providing care for patients hinders patient safety.  Short staffed hospitals  increases risk to patient safety issues, causes nurse burnout on staff (Ely, 2019).

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.