The Problem
The specific evidence-based topic chosen for this capstone project change proposal is the effects of nursing staff shortage and quality of care for patients. The issue is increasingly becoming a major problem in the healthcare facility I currently work for. According to Haddad et al. (2019), nursing shortage is caused by several factors among them, a large patient population, and a high number of those retiring every year. In the recent past, this issue has proven difficult to address due to the high cost of hiring and training new nurses.
The Setting
The nursing staff shortage is being witnessed in the long term care facility, specifically the special care unit. The unit exists to serve the elderly population (Aloisio et al., 2021). The total number of patients currently admitted at the facility is three hundred. Most of these patients are in need of services such as speech, occupational and physical therapy (Jung et al., 2018). These services are provided to prevent deterioration while, at the same time, improve individual’s social adjustment to stages of decline.
A Description
Nursing staff shortage in the long-term care facility is no longer a problem but a crisis. The facility receives a high number of patients every year with majority of them in need of specialized care. Most of these patients, especially the elderly have stayed in the facility for up to two years. This means that nurses must spend extra time caring for the needs of this population—they need both medical and personal support services since most of them cannot live independently. Therefore, high patient population, especially those aged 65 years, remains to a major cause of nursing shortage at the facility. According to Markides, and Rote (2019), the United States has the highest number of individuals over 65 years and above. As the population continue to age, the need for health services increases.
Effect of the Problem
There are many effects of nursing shortage with the first being low quality of patient care. Different studies, among them Ulrich et al. (2019), show a direct link between short-staffed facilities and low quality care. This is the case because nursing shortage means long shift hours and high patient-to-nurse ratios. These ratios increases waiting time, thus delaying the delivery of services. Another effect of nursing shortage relates to nursing burnout which is common in my facility (Marć et al. 2019). Some nurses at the facility often complained of being overworked and many of them experienced burnout. The problem is that as the aged nurses continue to leave, the remaining few were being forced to take up their roles. Finally, nursing shortage has a major impact on work environment: this is evidenced through the many cases of hospital acquired infections.
Significance of the Topic
Nursing shortage is associated with medical errors, high morbidity and mortality rates. In facilities with high patient-to-nurse rations, nurses experienced dissatisfaction and burnout (Austin et al. 2020). The patients also experienced high mortality compared to facilities with low patient-to-nurse rations. In other words, nursing shortage has a major impact on the nursing profession. Nurses working under stressful conditions are more prone to making mistakes. In fact, most of them are seen as delivering poor quality service which is an indication of incompetency.
A Proposed Solution
The proposed solution to address the nursing shortage at the facility is the implementation of a nurse residency program. This program will help graduate nursing students transition to dealing with the duties of being nurses (Ackerson et al. 2018). The aim is to offer mentorship to new graduates: they should be allowed to shadow the experienced nurses. This will ensure they spend a lot of time caring for patients before they are released to practice on their own.
References
Ackerson, K., & Stiles, K. A. (2018). Value of nurse residency programs in retaining new graduate nurses and their potential effect on the nursing shortage. The Journal of Continuing Education in Nursing, 49(6), 282-288.
Aloisio, L. D., Coughlin, M., & Squires, J. E. (2021). Individual and organizational factors of nurses’ job satisfaction in long-term care: A systematic review. International Journal of Nursing Studies, 123, 104073.
Austin, S., Fernet, C., Trépanier, S. G., & Lavoie‐Tremblay, M. (2020). Fatigue in new registered nurses: A 12‐month cross‐lagged analysis of its association with work motivation, engagement, sickness absence and turnover intention. Journal of Nursing Management, 28(3), 606-614.
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls
Jung, J. Y., Park, S. Y., & Kim, J. K. (2018). The effects of a client-centered leisure activity program on satisfaction, self-esteem, and depression in elderly residents of a long-term care facility. Journal of Physical Therapy Science, 30(1), 73-76.
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International Nursing Review, 66(1), 9-16.
Markides, K. S., & Rote, S. (2019). The healthy immigrant effect and aging in the United States and other western countries. The Gerontologist, 59(2), 205-214.
Ulrich, B., Barden, C., Cassidy, L., & Varn-Davis, N. (2019). Critical care nurse work environments 2018: Findings and implications. Critical Care Nurse, 39(2), 67-84.