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After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.

#1:

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Turnover of nurses related to employee engagement is a huge issue in todays hospitals. Methods to improve retention can include some optional and some mandatory professional development courses, facilitating a better work life balance with self-scheduling, and tuition reimbursement for applicable classes and course work. When considering methods to address this issue some very important aspects need to be addressed. The first aspect is the financial one. There is always an up and a down side financially to any new process improvement. The up side of improvements to decrease turnover are obvious; lower retention saves money by reducing the number of replacement employees who need to be trained and oriented annually. In addition to this there will be savings by the reduction of position advertisement costs. The expense will come in the form of interventions to change the working environment and culture of department or healthcare system. In the short term these expenses will most likely exceed the money saved. However, as the project moves forward savings will be realized. The quality aspect comes in the form of an improved environment for nurses to work in where they are encouraged to develop professionally in a manner that supports patients and an effective work life balance. Reducing turnover will improve overall organizational quality by improving the knowledge and experience base of the organization. Clinically, the impact of a process improvement to decrease nursing turnover will lead to a more effective level of quality care due to the increasing in departmental skill and knowledge found with the retention of nursing staff. One could predict that this will also improve outcomes for patients. An additional improvement to the clinical aspect the increased level of continuing education. This is because part of any good nosing retention program implements methods for professional development and specialty training that is paid for and encouraged by the healthcare system.

References

Nasabi, N. A., & Bastani, P. (2018). The Effect of Quality of Work Life and Job Control on Organizational Indifference and Turnover Intention of Nurses: A Cross-Sectional Questionnaire Survey. Central European Journal of Nursing & Midwifery, 9(4), 915–923. https://doi-org.lopes.idm.oclc.org/10.15452/CEJNM.2018.09.0024

Nursing staff retention: Effective factors. (2017). Annals of Tropical Medicine & Public Health, 10(6), 1467–1473. https://doi-org.lopes.idm.oclc.org/10.4103/ATMPH.ATMPH_353_17

#2:

 

Creating a position involves a huge financial review and multiple approvals throughout the institution. Taking into consideration that annual budgeting is monitored quarterly, currently there are available funding for new hires which could allow for conversion of two positions to be full time discharge nurses. Although this would take away two staff nurses for patient care, it will significantly alleviate the load and stress nurses experience when caring for patients that are discharging. The assigned nurse will still be responsible for completing the assessment and administering medication however, all teaching and paperwork will be completed by the discharge nurse, and the discharge nurse will ensure coordination to transport the patient to the lobby. Understandably, change is difficult for some however, this could show to be beneficial and productive. By alleviating the burden of discharging a patient nurses can tend to multiple other patients requiring their attention. Furthermore, these full-time discharge nurses will make follow-up phone calls one to two weeks after discharge to assess the discharged patients and make recommendations and referrals as needed. Doing so will minimize the chances of readmission due to infection and/or secondary diagnoses. It has been found that patients that receive some form of follow up after discharge have a more desirable outcome and less likely to experience readmissions due to lack of follow-up.

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