Assignment: Nurses Shortage and Its Impact on Quality of Care

Practicum Assignment: Organization Meeting Summary

Preparation to begin your DNP Project begins with the meeting with an organization to explore a gap in practice or a practice change that you might address as your DNP Project. Preparing for this meeting includes following the instructions in your NURS 8302 course and reviewing the guidelines for your practicum assignment 1. Address the following in a 4–5-page paper using the APA 7 template for writing graduate papers found at https://academicguides.waldenu.edu/writingcenter/templates/general

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Introduction

Identify the organization, location, and participants at the meeting. Indicate the role each person plays in the organization.
How did you first approach the organization?
Why did you select this organization?
Does the organization have a key person for the organization who oversees students doing DNP projects?
If there is no key person, who represented nursing and/or nursing students at the meeting.

Describe the DNP Project

Describe exactly what you did to explain the DNP project process at Walden University.
What questions did the participants have and how did you respond?
How did you and the organization identify possible gaps in practice or practice changes that might be addressed by the DNP project.
Describe the gap or problem and cite two sources that justify the gap or problem in nursing.
What approach (clinical practice guideline, staff education, quality improvement initiative) did you discuss to address a practice gap or practice change?
What questions did the organization representatives have, and what were your responses?
How does the proposed practice change support positive social change, diversity, equity, and inclusion?

Project Team

Who would be the key stakeholders and potential team members (e.g. organization leader, project mentor) for a project to address gap in practice or practice change?

Next Steps

Describe the information that you provided to the organization regarding the next steps in the process.
What questions were asked?
What responses did you have?
What decisions were made?

Evidence

Explore three sources of current evidence (no older than five (5) years) that could support the project initiative. You may include the two citations you cited under the Describe the DNP Project section.

Citation	Evidence Type	Sample, Sample size, Setting	Findings that help address the gap in practice or practice change

Summary

Summarize the strengths and weaknesses of the meeting.
What would you have done differently?
What additional information do you need before you meet with your faculty advisor in NURS 8702, project mentoring course.

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Nurses Shortage and Its Impact on Quality of Care

During the DNP project, I visited XXX Hospital located in XXX to identify a gap in practice or a practice change that can be addressed in my DNP Project. I arranged a meeting with the Director of Nursing Services (DNS), two charge nurses, and two bedside nurses. The DNS oversees and manages the services provided by the nursing staff in the organization. The charge nurses supervise nursing staff in specific units and coordinate daily administrative duties, like nursing assignments, schedules, and patient care. Besides, bedside nurses are tasked with providing nursing care to patients.

I first approached the organization through the DNS and informed her of my interest in carrying out my DNP project. The organization was selected because it is the largest hospital in the county and plays a major role in promoting health for a large population. The organization has a student mentor who oversees students partaking in projects in the hospital and represented me in the meeting. The purpose of this paper is to describe the DNP project, the project team, and the evidence supporting the project.

The DNP Project

I explained to the participants that the DNP project at Walden entails identifying a problem in nursing practice and addressing it using evidence-based practice (EBP). I mentioned that a DNP student has to arrange a meeting with the representative of the organization and faculty advisor to identify the practice problem and set the goals that the project seeks to achieve. In addition, the student should identify a project mentor and additional stakeholders who will support them in undertaking the project. Besides, one should discuss the project’s strengths, weaknesses, opportunities, and threats with the mentor and stakeholders and have the site approved by the organization representative, project mentor, and faculty advisor.

The participants inquired about the potential impact of the DNP project on the organization and the staff. I responded that the project would identify and address a practice problem, which would benefit the organization and the employees affected by the issue. They also asked how I would identify the best solution to address the problem and how the intervention would be evaluated. I explained that solutions would be identified from evidence-based research and analyzed to ensure they are practical and applicable to the organization based on its structure, culture, and available resources. Besides, I explained that evaluation would be conducted during implementation and after and will be compared to the pre-intervention period. We identified possible gaps in practice or practice change by asking the participants about the challenges nurses encounter in daily practice and how they impact the efficiency and quality of patient care. We analyzed each challenge presented by the participants by examining which had a weighty impact on patient care and outcomes.

Nursing shortage and its impact on the quality of care was the identified problem in nursing practice that carried the most weight. Witczak et al. (2021) explain that nursing shortage forces nurses to limit patient care and prioritize nursing interventions from their clinical judgment. This can result in restricting or disregarding planned nursing care, which increases the risk of adverse patient outcomes. Nursing shortage contributes to decreased quality of patient care and threatens patient safety due to missed nursing care. Rosenberg (2019) explains that lower levels of nurse staffing increase mortality risk during a hospital stay. Nursing shortage increases the workload for nurses, which increases the incidences of medical errors that significantly affect patients’ safety and outcomes.

The staff education project proposed to help address the nursing shortage and improve the quality of care is educating the organization’s leadership team on investing in the professional development of nurses. I identified that the organization’s leadership could promote nurses’ career development and retention by having organizational programs and activities aimed at career development (Yu et al., 2022). The organization’s representatives asked how staff career development would reduce the turnover rate. I explained that employees’ turnover intention is imminent based on their opinion of staff development and is closely associated with an intention to leave. They also asked about the career development programs suitable for nurses. I identified continuing professional development (CPD) programs, sponsorship to nursing conferences, short-term specialization courses, Leadership and management courses, and nursing up-grading courses.

The proposed practice change is fundamental to nurses’ lifelong learning and makes up a crucial aspect of ensuring nurses’ knowledge and skills are up-to-date. The professional development program supports positive social change since it will expand nurses’ practical knowledge. This will increase their motivation and job satisfaction resulting in reduced intention to leave and low turnover rates (Ten Hoeve et al., 2020). The practice change will also foster diversity since nurses will be supported to specialize in a wide range of nursing specialties equipping them with the knowledge and skills to provide quality care to a diverse patient population. Reducing nursing turnover through professional development will reduce the nursing shortage, ensuring all patients receive the same quality of nursing care, thus promoting equity.

Project Team

The DNP project’s key stakeholders and team members will include the DNS, hospital administrator, Human Resource Manager, and project mentor. These stakeholders will be valuable in helping implement the staff education project since they are involved in the administrative tasks of the hospital. The project mentor will guide me in the DNP project to ensure it is effectively implemented and evaluated.

Next Steps

The next steps in the DNP project process will be to get approved for committee and program director review once the faculty advisor verifies that the site approval is set for a formal review. I will then develop a question to guide the project and conduct a rigorous review of evidence. The organization reps asked how the faculty would approve the site and how I would develop the question. I explained that the university has a DNP Site Approval Rubric that guides the review and that I would use a question development tool to create the question. The representatives decided to support me in implementing the project in the organization.

Evidence

Citation	Evidence Type	Sample, Sample size, Setting	Findings that help address the gap in practice or practice change
Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta-synthesis of the literature. BMC nursing, 20(1), 1-13. https://doi.org/10.1186/s12912-021-00579-2	Level I	25 articles	Nurses value Continuing professional development and consider it important to professionalism and lifelong learning. This improves job satisfaction and promotes high standards of nursing care through competent practice.
Vázquez-Calatayud, M., Errasti-Ibarrondo, B., & Choperena, A. (2021). Nurses’ continuing professional development: A systematic literature review. Nurse education in practice, 50, 102963. https://doi.org/10.1016/j.nepr.2020.102963	Level I	Nine articles	Continuing professional development (CPD) continues throughout nurses’ careers, and ensuring their knowledge and skills are up to date is crucial. Boosting nurses’ CPD enhances their retention at hospitals.
Hu, H., Wang, C., Lan, Y., & Wu, X. (2022). Nurses’ turnover intention, hope, and career identity: the mediating role of job satisfaction. BMC nursing, 21(1), 1-11. https://doi.org/10.1186/s12912-022-00821-5	Level III	500 nurses Five comprehensive tertiary hospitals	Career identity affected turnover intention through nurses’ job satisfaction. Strengthening career identity was a critical measure for nursing managers to improve job satisfaction, reduce turnover intention, reduce turnover rate and improve the quality of care.

Summary

The meeting was a success owing to strengths like the participants actively identifying the challenges nurses face in delivering care. The participants also acknowledged that a solution was needed to address the practice problem, which motivated them to give suggestions of what the DNP project could involve. However, we encountered challenges when coming to a final decision on the practice problem that the project should prioritize since the participants argued that the problems they identified had more weight than others. In a different situation, I would have looked at the impact of each identified problem using hospital records to convince the participants of the issue that had a major impact on patient outcomes. I will need additional information on the extent of the nursing shortage in the organization with evidence from statistics on turnover and retention rates in the past five years. This will convince the faculty advisor that the problem should be addressed in the DNP project.

References

Hu, H., Wang, C., Lan, Y., & Wu, X. (2022). Nurses’ turnover intention, hope, and career identity: the mediating role of job satisfaction. BMC nursing, 21(1), 1-11. https://doi.org/10.1186/s12912-022-00821-5

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta-synthesis of the literature. BMC nursing, 20(1), 1-13. https://doi.org/10.1186/s12912-021-00579-2

Rosenberg, K. (2019). RN shortages negatively impact patient safety. AJN The American Journal of Nursing, 119(3), 51. https://doi.org/10.1097/01.NAJ.0000554040.98991.23

Ten Hoeve, Y., Brouwer, J., & Kunnen, S. (2020). Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses. Journal of advanced nursing, 76(3), 836–845. https://doi.org/10.1111/jan.14281

Vázquez-Calatayud, M., Errasti-Ibarrondo, B., & Choperena, A. (2021). Nurses’ continuing professional development: A systematic literature review. Nurse education in practice, 50, 102963. https://doi.org/10.1016/j.nepr.2020.102963

Witczak, I., Rypicz, Ł., Karniej, P., Młynarska, A., Kubielas, G., & Uchmanowicz, I. (2021). Rationing of Nursing Care and Patient Safety. Frontiers in psychology, 12, 676970. https://doi.org/10.3389/fpsyg.2021.676970

Yu, X., Huang, Y., & Liu, Y. (2022). Nurses’ perceptions of continuing professional development: a qualitative study. BMC nursing, 21(1), 162. https://doi.org/10.1186/s12912-022-00940-z