26 Aug Development of an evidence-based practice
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
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