Summary
Nursing staff turnover is costly as it decreases the organization’s productivity and the quality of patient care. This proposal is based on the following data:
Quarterly retention rates for graduate nurses within a six-month period from hire are down 6%.
Nurses positions open = 180, applicants for open positions 28.
Nursing satisfaction with jobs decreased by 8%.
The number of nurses projected to retire within six months = is 47.
Increase of 18% in medication errors.
The overall average for readmission rates has increased by 5%.
Overall, client satisfaction with nursing care decreased 7%.
Innovative Practice Proposal
The Goal Attainment Theory describes a dynamic, interpersonal relationship in which a patient grows and develops to attain certain life goals. The theory explains that factors that can affect the attainment of goals are roles, stress, space, and time.
The model has three interacting systems: personal, interpersonal, and social. Each of these systems has its own set of concepts. The concepts for the personal system are perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are interaction, communication, transaction, role, and stress. The concepts for the social system are an organization, authority, power, status, and decision-making.
The Change Theory involves creating the perception that a change is needed, then moving towards the new, desired level of behavior and finally, solidifying that new behavior as the norm.
Description
The purpose of the project is to implement an evidence-based NRP at the practice site to improve nurse retention, job satisfaction, and intent to stay. The population of interest comprises nursing staff, including full-time, part-time, and per diem nurses. The variables in this project include nurses’ work environments, autonomy and control of work hours, and salary and benefits.
The creation of a positive nurse practice environment, improvement in salary and benefits, and the promise of autonomy to self-schedule are interventions proven to increase job satisfaction and nurse intent to stay.
One of the determinants that may be expected to influence job satisfaction is the degree of perceived autonomy that nurses enjoy in the way they do their job. A primary characteristic of nurses who are successful in home health care is the ability and willingness to adapt and move toward professional autonomy. Nurses who encounter high demands at work with little control are more likely to experience burnout (Bolandianbafghi et al., 2017).
The clinic can also increase pay per hour during weekend shifts, open more positions for nurses to work either only on weekends or weekdays and introduce a nurse refresher course aimed at registered nurses who have been away from the bedside for more than five years and want to return to work.
Relevance of the Innovation
This project was developed based on the issues identified in the clinic. It was noted that the hospital has a low staff retention rate, which is 6%. The clinic also experiences a number of medication errors. Bolandianbafghi et al. (2017) found that poor nurse satisfaction could result in mistakes that compromise patient outcomes. Further, the clinic will likely reduce readmission rates by adopting the proposed retention program because medication errors and nurse/patient satisfaction will improve.
Risks and Benefits
While the shared governance approach exists and is popularly utilized, it is not perfect. The model does not protect against groups conspiring against others, advocating for a change that is not accepted by all or many of the invested members (Hayden & Bodie, 2020). A faculty may make a decision that impedes the teaching or research of another member. If one faculty member desires to research or teach something that the majority of the faculty deems to be controversial, then in a shared governance model, they can stop that faculty member from doing so. Additionally, shared-decision making involves forming a council or a board of trustees, which may make biased financial decisions.
Barriers and Facilitators
The proposed strategy holds everyone at the same standards, and therefore, accountability will be a challenge. Holding people responsible for their behavior is a barrier to creating a positive work environment because some members could portray inappropriate and hostile codes. Staff education on ethical conduct is necessary to teach integrity, which is crucial in improving the work environment.
Automated nursing management ensures that compliance is monitored (Pepin et al., 2017). It generates greater ownership and accountability among the workforce, creating an environment where employees are more likely to complete their duties requirements accurately and on time.
Supportive Strategies
To address the nursing shortage, the practice organization recruits new graduate nurses to join the home health care agency. Although the organization provides new graduate nurses an opportunity to choose their own patient assignments, some require additional support. The level of job satisfaction also decreases in the younger generation of nurses. This group is less satisfied with the job due to limited experience and education. Therefore, on-the-job training of new recruits and current nurses will expand their knowledge and improve satisfaction with their deliveries. Wages have a significant effect on job satisfaction and nurse retention. In some studies, dissatisfaction with wages played the biggest role in nurse turnover (Shamsi & Peyravi, 2020).
References
Bolandianbafghi, S., Salimi, T., Rassouli, M., Faraji, R., & Sarebanhassanabadi, M. (2017). Correlation between medication errors with job satisfaction and fatigue of nurses. Electronic Physician, 9(8), 5142. Web.
Efendi, F., Kurniati, A., Bushy, A., & Gunawan, J. (2019). Concept analysis of nurse retention. Nursing & Health Sciences, 21(4), 422-427. Web.
Hayden, G. M., & Bodie, M. T. (2020). The Corporation reborn: From shareholder primacy to shared governance. Boston College Law Review., 61, 2419. Web.
PĂ©pin, J. L., Tamisier, R., Hwang, D., Mereddy, S., & Parthasarathy, S. (2017). Does remote monitoring change OSA management and CPAP adherence?. Respirology, 22(8), 1508-1517. Web.
Shamsi, A., & Peyravi, H. (2020). Nursing shortage, a different challenge in Iran: A systematic review. Medical Journal of the Islamic Republic of Iran, 34, 8. Web.