Understaffing in Organizations
Retention and recruitment are important practices in US hospitals. Most scholars agree that staff retention and adequate staff ratios are critical factors that impact nurses’ and patient outcomes (Chamanga et al., 2020). Recently, 75% of nurses admitted that due to work overloads, they omit to provide some type of care to the patients (Griffiths et al., 2018). Hence, understaffing and retention problems should be overcome through the purposeful efforts of nursing administrators, HR departments, and the top management of healthcare facilities.
Understaffing and Patient Outcomes
Patient outcomes are the first indicator that suffers from inadequate staffing. Recio‐Saucedo et al. (2018) suggest that the extent is great enough to impact patient mortality. The worsened outcomes are observed in individuals who receive all types of medical care, including patients in surgery, rehab units, nursing homes, and emergency floors. This means that the QI initiative on improving nurse retention and staffing ratios should be implemented urgently.
Introducing Nursing Leadership
In the United Medical Rehabilitation Center, there is a lack of nursing personnel, which creates a decreased quality of medical services. Hence, the QI initiative to change the situation is required, and the scholars suggest specific decisions to handle the problem. These are introducing nursing leadership practices, improving the work climate, and hiring more personnel. More personnel will lead to a more adequate nurse-per-patient ratio. No less importantly, leadership practices like weekly meetings and nursing role management will make the practice better established.
Changes in Scheduling
Other important solutions to the problem may include using specific tools to reschedule the nurses’ work. The general approach to scheduling the nurses’ shifts implies that they spend the same quality time with each patient, which is not true in practice. Therefore, the change in scheduling is proposed based on the experiment-based quantitative study. This change will consider the individual needs of patients depending on the types of their admissions. The new schedules will be more explicit regarding the specific time spent with each patient.
Using Technology
Technology is becoming increasingly integrated into the daily work life of the healthcare practitioner. Tools like EHR, telemedicine, and iPads for internal work with patients who have infectious diseases are today widely used in healthcare institutions. Systematization of the admission process can facilitate nurses’ daily work routines. The use of AI and IT tools is suggested to alleviate the nurses’ daily responsibilities of setting appointments, prescribing pills, and consulting patients regarding their health and treatment opportunities.
Generalization
Hence, the QI initiative for the United Medical Rehabilitation Center was developed. The implementation strategy of QI should entail establishing a clear leadership practice, changing scheduling based on new calculations for time spent with patients, and introducing technology to ease the daily admission process. This can be done with the efforts of nursing administrators, the HR department, and under the supervision of the top management of the United Medical Rehabilitation Center.
References
Chamanga, E., Dyson, J., Loke, J., & McKeown, E. (2020). Factors influencing the recruitment and retention of registered nurses in adult community nursing services: An integrative literature review. Primary Health Care Research & Development, 21.
Efendi, F., Kurniati, A., Bushy, A., & Gunawan, J. (2019). Concept analysis of nurse retention. Nursing & Health Sciences, 21(4), 422-427.
Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487.
Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: Systematic review. British Journal of Nursing, 30(5), 302-308.
Recio‐Saucedo, A., Dall’Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., & Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of Clinical Nursing, 27(11-12), 2248-2259.
So, K. H., Ting, C. W., Lee, C. P., Lam, T. T. N., Chiang, S. C., & Cheung, Y. T. (2021). Medication management service for old age homes in Hong Kong using Information Technology, Automation Technology, and the Internet of Things: Pre-post interventional study. JMIR Medical Informatics, 9(2), 19-22.