Hospital staffing turnover

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Development of an evidence-based practice project must include the direct and indirect impact that will be encountered through implementation. Staff retention of newly hired nurses specific to the night shift is the focus of my project and its impact on the nurses, facility and community that is served. According to published reports, a supportive work environment, especially between managers and employees, creates a strong deterrent to nurses leaving an organization by improving perception of organizational support, employee engagement, team cohesion, and connection to the mission of the health-care setting (Kurnat-Thoma, Ganger, Peterson, & Channell, 2017).

Financial aspect – staffing cost/turnover cost

Hospital staffing turnover is projected to 5% to 5.8% of total hospital annual operating budget and is largely driven by the loss and necessary replacement of qualified nurses according to  Waldman, J., Kelly, F., Arora, S., Smith, H. (2010).

Proposal direct impact – hospital revenue/staffing costs,

Proposal indirect impact – patient outcomes, positive healing environment perception by staff/patients

Quality Aspect – High turnover in any industry can be a concern, especially those that are customer-centric. Industries that deal with people’s health are in an even more precarious position. Institutions with high attrition must consider how a “revolving door” of care providers affects the quality of care an institution is able to provide, and the satisfaction of patients with their overall experience according to Arena (2018).

Proposal direct impact –

Separation Costs – Continued benefits, temporary labor, overtime to existing employees

• Recruitment Costs – Job description, posting on job boards, screening candidates, interviewing candidates, assessing candidates

• Onboarding Costs – Orientation and training of new hire

Proposal indirect impact –

Loss of productivity

• Lack of staff while positions are being filled

• Increased pressure on existing staff to cover and pick up the extra work often leading to burnout

• Patients receiving less attention

• Pressure on current staff to train and then gel with the new employees

• Lack and lag of knowledge with new employees concerning institutional practices, workplace norms, team behaviors, and patient knowledge, familiarity, and care experience

Clinical aspect – unit cohesiveness/patient care

Many nurses leave their positions because of negative experiences with heavy or unrealistic workloads and due to feeling unheard and undervalued. Clinical nurses’ sense of disempowerment can be related to lack of leadership interventions. Clinical nurses may feel that managers are insensitive to their staffing needs, don’t support employee well-being, and don’t invest enough in staff education or clinical advancement according to Linnen and Rowley (February 2014).

Proposal direct impact – nurses will see themselves as stewards for their unit. “Nurses are leaders by virtue of their responsibilities; for them, empowerment isn’t a privilege, but a professional necessity” (Linnen and Rowley, 2014).

Proposal indirect impact –

–          Nurse advancement

–          Staff participation in policy and governance

–          Leadership support

–          Adequate staff and resources

–          Nurse/physician relations

Health Care-Related Problem and a Target Population

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Identifying a Health Care-Related Problem and a Target Population
 

Take a few minutes to think about the most pressing health-promotion and disease-prevention issues, such as those identified in “Healthy People 2020” and the Institute of Medicine’s Future of Nursing. Which one most calls your attention? Maternal, infant, and child health? Health communication and health information technology? Immunization and infectious diseases?
 

This course provide a venue for addressing issues such as one of these through the design of a program and associated evaluation. In order to design an effective program though, it is critical to narrow the focus from one of these larger issues to a specific problem and a target population.
 

This Discussion provides a forum through which you and your colleagues may support each other in first selecting a health-promotion and disease-prevention issue of national significance, and then identifying a problem and a target population to guide your program planning and evaluation efforts in this course.
 

To prepare:

 

  • Examine      the topics presented in “Healthy People 2020” and the Institute      of Medicine’s Future of Nursing. Select a health-promotion and      disease-prevention issue of national significance that has particular      resonance or appeal for you.
  • Review      literature related to the issue you have selected and, specifically, the      problem and target population you may choose to focus on as you move      forward with program planning.
  • Review      this week’s course text readings. What questions or concerns, if any, do      you have about how to identify a problem and a target population for      program planning and evaluation?

     

Note: For Application 1, you need to identify a health care–related problem and a target population to guide program planning as you move forward in the course. If you have not already done so, read the instructions for Application 1 (provided this week) as your work on this Discussion to guide your development of that assignment.
 

By tomorrow Tuesday 12/04/18 by 6pm, post a minimum of 550 words in APA format with at least 3 references from the list of the “Required Readings” below. Include the level one header as numbered below:

Post a cohesive scholarly response that addresses the following:

 

1) Share the national health-promotion and disease-prevention issue you have selected. Describe the problem and target population you will most likely choose for Application 1, as you have considered it thus far (See the list of topic areas below and select one).

 

2) Provide your evaluation of the impact of the problem on population health using citations from existing literature.

 

3) Pose any questions or concerns you have related to your problem and target population, your literature review, and/or other issues related to designing and evaluating programs. Ask your colleagues for support in addressing these questions or concerns.

Topic Areas (Select one to answer question 1 above [make sure to select the one that would be easy to research and develop as all the many upcoming assignment will be based on it. Choose carefully please]).

The Topic Areas of Healthy People 2020 identify and group objectives of related content, highlighting specific issues and

populations. Each Topic Area is assigned to one or more lead agencies within the federal government that is responsible

for developing, tracking, monitoring, and periodically reporting on objectives.

1. Access to Health Services

2. Adolescent Health

3. Arthritis, Osteoporosis, and Chronic Back

Conditions

4. Blood Disorders and Blood Safety

5. Cancer

6. Chronic Kidney Disease

7. Dementias, Including Alzheimer’s Disease

8. Diabetes

9. Disability and Health

10. Early and Middle Childhood

11. Educational and Community-Based Programs

12. Environmental Health

13. Family Planning

14. Food Safety

15. Genomics

16. Global Health

17. Healthcare-Associated Infections

18. Health Communication and Health Information

Technology

19. Health-Related Quality of Life and Well-Being

20. Hearing and Other Sensory or Communication

Disorders

21. Heart Disease and Stroke

22. HIV

23. Immunization and Infectious Diseases

24. Injury and Violence Prevention

25. Lesbian, Gay, Bisexual, and Transgender Health

26. Maternal, Infant, and Child Health

27. Medical Product Safety

28. Mental Health and Mental Disorders

29. Nutrition and Weight Status

30. Occupational Safety and Health

31. Older Adults

32. Oral Health

33. Physical Activity

34. Preparedness

35. Public Health Infrastructure

36. Respiratory Diseases

37. Sexually Transmitted Diseases

38. Sleep Health

39. Social Determinants of Health

40. Substance Abuse

41. Tobacco Use

42. Vision

Required Readings

Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

  • Chapter 2, “Paint a Picture of Your Target Population:      Assessing Assets and Problems” (See      attached file).

This chapter presents valuable information for identifying your target population during program planning. Note: Some of the information in this chapter extends into needs assessment, which will be addressed in Week 4.

Kettner, P. M., Moroney, R. M., & Martin, L. L. (2017). Designing and managing programs: An effectiveness-based approach (5th ed.). Thousand Oaks, CA: Sage.

  • Review Chapter 1, “Contemporary Issues in Social      Services Program Planning and Administration” (See attached file).
  • Review Chapter 3, “Understanding Social Problems” (See attached file).

Review these chapters as needed to help you identify a health care-related problem for program planning and evaluation. For instance, you may find the problem analysis information on page 13 and pages 38–39 beneficial.

Adams, J. & Kaplow, R. (2013). A sitter reduction program in an acute health care system. Nursing Economics$, 31(2), 83–89.

Pinto, B.M., Waldemore, M., & Rosen, R. (2015). A community-based partnership to promote exercise among cancer survivors: Lessons learned. International Journal Behavioral Medicine, 22, 328–335 doi 10.1007/s12529-014-9395-5 

Tompa, E., deBoer, H., Macdonald, S., Alarngir, H., Koehoorn, M., & Guzman, J. (2016). Stakeholders’ perspectives about and priorities for economic evaluation of health and safety programs in healthcare. Workplace Health and Safety, 64(4), 163–174 DOI: 10.1177/2165079915620201.

Leading Health Indicators. (n.d.). Retrieved March 22, 2017, from https://www.healthypeople.gov/2020/Leading-Health-Indicators 

National Database of Nursing Quality Indicators. (n.d.). Retrieved March 22, 2017, from http://www.pressganey.com/solutions/clinical-quality/nursing-quality 

U.S. Department of Health and Human Services. (2010). Healthy People 2020. (n.d.). Retrieved March 22, 2017, from https://www.healthypeople.gov/sites/default/files/HP2020_brochure_with_LHI_508_FNL.pdf 

IOM Future of Nursing Report. (n.d.). Retrieved March 22, 2017, from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/IOM-Future-of-Nursing-Report-1

Required Media

Laureate Education (Producer). (2011). Design and evaluation of programs and projects [Video file}. Baltimore, MD: Author.

  • “Defining a      Population Health Problem” (featuring Dr. Melissa Willmarth, Dr. Debora Dole,      and Dr. Donna Shambley-Ebron)

You may view this course video by clicking the link or on the course DVD, which contains the same content. Once you’ve opened the link, click on the appropriate media piece.

In these videos, Dr. Melissa Willmarth, Dr. Debora Dole, and Dr. Donna Shambley-Ebron provide insights related to defining health care-related problems.

Optional Resources

Algera, M., Francke, A. L., Kerkstra, A., & Van der Zee, J. (2004). Integrative literature reviews and meta-analyses: Home care needs of patients with long-term conditions: Literature review. Journal of Advanced Nursing, 46(4), 417–429.

This article compares literature in the field to determine a profile for people with long-term health care conditions who utilize home care services.

Madden, S. G., Loeb, S. J., & Smith, C. A. (2008). An integrative literature review of lifestyle interventions for the prevention of type II diabetes mellitus. Journal of Clinical Nursing, 17(17), 2243–2256.

This article is an example of an integrative literature review that identifies aspects of nursing programs aimed at prevention of type II diabetes, effectiveness of such programs, and compliance with lifestyle changes after such programs.

Obesity Prevention Practices

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE:

If you cannot locate a doi number, this is how the reference should look. 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                          MAIN POST

Nursing leaders such as clinical directors must stay on top of the latest findings to keep their nursing staff up to date with new evidence-based practices. My clinical director is over the Emergency Room and has many roles to keep the ER running. As a leader, she is constantly trying new things for patients and the ER.  Clinical Directors are responsible for building and keeping an atmosphere that supports staff (Knickman & Kovner, 2015). My Clinical Director wants employees to be involved in decision making in the ER. Several years ago, she got approval by upper management to start Shared Governance Committee. Shared Governance is designed to involve nurses in their practice to make decisions about their work (Bieber & Joachim, 2015). I did my two-year term and enjoyed helping to better our ER. Employees feel that their opinions are validated. As a committee, we have established new processes for the ER. It is imperative for the clinical director to be a team player. The hospital where I work is a teaching hospital. We are constantly trying new ER processes, such as patient flow and new processes in regard to patients with myocardial infarctions, strokes, and sepsis. Our clinical director advocates for new procedures. She stays current on the latest nursing standards. She is always looking for ways to help nurses to ease stress on their daily workload. Shared Governance structure is set up to repair clinical problems and build leadership skills (Gordon, 2016).

                                                              References

Bieber, P., & Joachim, H. (2016, February 14). Shared Governance: A Success Story. Ebsco, 62-66. http://dx.doi.org/10.1016/j.mnl.2015.09.011

Gordon, J. N. (2016). Empowering Oncology Nurses to Lead Change Through Shared Governance Project. Ebsco, 688-690.

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

The practice of health care provider

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The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith. Refer to Chapter 2 of Called to Care for the list of questions. Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 1,500-2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

  1. How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)
  2. In George’s analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS?
  3. What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?
  4. Given the above, what options would be morally justified under each religion for George and why?
  5. Finally, present and defend your own view.

Support your position by referencing at least three academic resources (preferably from the GCU Library) in addition to the course readings, lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. A total of six references are required according to the specifications listed above. Incorporate the research into your writing in an appropriate, scholarly manner.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

obese care plan

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 titlet: community health planning 

diabetes,hypothyroidism,obese

care plan include ,assessment,planning,implementation,evaluation.

I attachment the example 

 Turnitin for grading 

APA style,3 reference

Summary Of Red Cross

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hi please I just need a one page summary about the attached powerpoint

palliative in healthcare

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explain the palliative in healthcare?

Frequencies And Percentages

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 Understanding Frequencies And Percentages

Walden’s and the School of Nursing’s perspectives

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Post a description of one or more significant ways in which Walden’s and the School of Nursing’s perspectives (i.e., vision, mission, social change message, and outcomes) relate to your professional and academic goals and to your becoming a scholar-practitioner. Include how you plan to incorporate social change into your professional and academic goals.

Support your Discussion assignment with specific resources used in its preparation using APA formatting. You are asked to provide a reference for all resources, including those in the Learning Resources for this course.

health care in the United States

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 Post your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance