TRANSFORMATIONAL PROPOSAL 1 Running head: TRANSFORMATIONAL PROPOSAL 1 Abstract Inadequate nurse staffing

TRANSFORMATIONAL PROPOSAL 1

Running head: TRANSFORMATIONAL PROPOSAL 1

Abstract

Inadequate nurse staffing is a clinical concern because it negatively affects job satisfaction, burnout, and patient care. Addressing staffing constraints will help realize universal health coverage and enhance patient safety as the Affordable Care Act envisioned. This paper aims to explore the causes of inadequate staffing and subsequently examine the best practices that can help solve the problem. Based on the theoretical nursing framework of Jean Watson’s caring theory, this project will enhance the work environment by supporting nurse well-being and quality patient care. The project has three main objectives: identifying the leading causes of insufficient staffing, developing strategies to improve staffing, and examining the effects of staffing constraints on job satisfaction and patient care. A literature search in databases such as PubMed, ScienceDirect, and CINAHL will help locate sources for developing evidence-based interventions. If needed, the literature search will be expanded to other databases to ensure that the project is based on quality and accessible research. The research findings will be shared with classmates and faculty members and published as an open-access article. The main goal is to address staffing inadequacies so that nurses will be better placed to offer the best care to their patients. This project will look at the economic implications of improved staffing and produce actionable recommendations for any healthcare administrator.

Topic Statement/Background

There is a universal consensus that nurses are vital to an effective healthcare system. Their importance is highlighted by Needleman et al. (2020) and Dall’Ora et al. (2022), who exhibit their impact on patient safety. While their significance is evident to all stakeholders, the key issues that affect their service delivery still need to be addressed. One such issue is staffing, which is not a recent problem but a historical issue. Staffing issues are occasioned by multiple factors, including high turnover due to dissatisfaction, inequitable distribution of work, and the lack of educators. Low staffing leads to medical errors, higher mortality, and increased turnover. In hospitals with a high patient-to-nurse ratio, nurses may experience burnout and dissatisfaction, and some may quit. While some U.S. states have implemented measures to address these issues, much needs to be done to improve health outcomes, incentivize prospective nurses to join the profession, and enhance the well-being of existing nurses.

Research Question

The research question is: how can adequate staffing be facilitated to enhance job satisfaction, reduce burnout, and provide better care to patients? The question aims to examine the main causes of inadequate staffing and determine modalities for ensuring that this intractable menace is controlled. Sub-questions that will be probed include: Which staffing models are more associated with reduced nurse burnout? What are the financial implications of adequate staffing? How does the nurse-to-patient ratio impact patient outcomes?

Theory Connection

Nursing theories facilitate excellence in relation to developing effective interventions. Selecting a theory that aligns with the intervention being developed ensures that the core issues are addressed and increases the chances of a positive outcome. This project utilizes the human caring theory developed by Jean Watson to guide its focus. The theory places a commitment to the welfare of patients and nurses. It views caring as a moral and ethical ideal rather than task-oriented behavior. Addressing staffing inadequacies is vital in creating a supportive environment that empowers nurses to deliver quality care. The theory highlights the need for adequate time to allow nurses to truly relate to their patients, a dimension often compromised when staffing levels are inadequate. Focusing attention on the nurse’s self-care and well-being is crucial in addressing burnout by improving staffing.

Objectives

Understand the primary factors of understaffing within the last two years based on the literature review of at least ten articles published within the last five years.

Learn the evidence-based strategies for improving staffing and their potential impact on increasing nursing retention by at least ten percent within twelve months.

Analyze the impact of improved staffing on job satisfaction, burnout rates, and the quality of care delivered based on the data collected through interviews and surveys within six months.

Recommend at least two best practices for improving understaffing within six months.

Recommend at least two policy changes for improving understaffing within one year.

Literature Search

The literature search will be guided by specific search terms. They include “nursing staffing levels,” “nurse burnout,” “nurse job satisfaction,” “patient care quality,” and “healthcare staffing strategies.” All searches will be conducted in PubMed, CINAHL, and Google Scholar. The preliminary searches have identified vital studies, including but not limited to McHugh et al.’s (2021) research into hospital nurse staffing and patient mortality and Aiken et al.’s (2021) research on the association between improved staffing and health outcomes. The challenges in finding relevant literature include subscriptions to access some sources, information overload, and database limitations.

Dissemination

The completed work will first be shared with classmates for peer feedback. Their feedback will assist in locating areas of weakness and identifying new research questions. Changes will be made based on the input, and the revised work will be submitted to the tutor for guidance and direction. The tutor will assist in identifying gaps and biases inherent in the project, recommend ways to enhance the credibility of the research and suggest additional studies to explore to enhance the quality. After making changes based on the tutor’s comments, the work will be resubmitted to the tutor for reassessment. If the tutor is satisfied with the work, the next vital step is to consider publishing it as an open-access article.

References

Aiken, L. H., Simonetti, M., Sloane, D. M., Cerón, C., Soto, P., Bravo, D., … & Lake, E. T. (2021). Hospital nurse staffing and patient outcomes in Chile: a multilevel cross-sectional study. The Lancet Global Health, 9(8), e1145-e1153.

Dall’Ora, C., Saville, C., Rubbo, B., Turner, L., Jones, J., & Griffiths, P. (2022). Nurse staffing levels and patient outcomes: a systematic review of longitudinal studies. International Journal of Nursing Studies, 134, 104311.

McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet, 397(10288), 1905-1913.

Needleman, J., Liu, J., Shang, J., Larson, E. L., & Stone, P. W. (2020). Association of registered nurse and nursing support staffing with inpatient hospital mortality. BMJ quality & safety, 29(1), 10-18.