Applicable change or nursing theory utilized
The quality, mortality, and general conditions of patients are closely related to the performance of staff. Nurse understaffing poses a serious issue due to increased life expectancy, low birth rate, an accelerating number of people who require medical assistance (Wendsche et al., 2017).
Several strategic and theoretical approaches were conducted to reduce the shortage of staff. Implementing nursing theory in developing and structuring organizational procedures could be a critical entity in eliminating the understaffing problem. In addition, the issue requires complex investigation by managing the working schedule, enhancing work satisfaction level, and improving the efficiency of nurses (He et al., 2019). Possible modifications in solving the problem of staff deficit mainly include transformations in staffing tools, scheduling, frequency of rest breaks, and cost.
Proposed implementation plan with outcome measures
The proposed plan examines many parameters in dealing with the understaffing of nurses and elevating their efficiency. The measures consist of scheduling with quick-response methods (Schoenfelder et al., 2020), regulating nurses’ turnover by regular rest breaks (Wencshce et al., 2017), and increasing the cost-effectiveness of the hospitals (Griffiths et al., 2020). According to Schoenfelder et al. (2020), a significant focus is directed to advanced planning, including control over patient flow and the quality of staff’s performance in a plan’s implementation. The quick-response method in managing schedules conducts the following goals: to communicate with patients and organizational units, to reduce the nurses’ workload, and to assess the effectiveness (Schoenfelder et al., 2020).
This method allows to react and control nurses’ management abilities on a daily basis. For example, a study administered by Schoenfelder et al. (2020) revealed that the procedures related to overcrowding, red alerts, and emergencies become significantly organized. Moreover, the availability of information regarding current conditions and required actions allowed to control a working schedule. Overperforming and receiving undesired shifts is not surprising in the understaffing conditions. Nevertheless, quick-response scheduling management provides information about nurses’ availabilities, preferences, wages, as well as data about the number of available beds and patient categories (Schoenfelder et al., 2020). An adequately designed time-management system could reduce this problem.
Another component of the proposed plan is introducing regular rest breaks for nurses. As mentioned by Wendsche et al. (2017), understaffing is accomplished mainly by negative factors such as increased staff turnover produced by a high workload, reduced job satisfaction, and lack of communication with colleagues. Scheduled regular rest breaks mandatory for all employers to provide an opportunity to recover and stress relief. In European Union, such practice is necessary for working more than six hours per day (Wendche et al., 2017). It helps not to drop psychological and emotional motivation as well as regain physical strain.
In some situations, the shortage of personnel is explained by the poor financial conditions of the hospitals. This case requires cost-effective modeling to distribute finances properly. Griffiths et al. (2020) state that flexible staff deployment could be an efficient approach regarding employers’ understaffing. This method demand to classify patients according to their needs and assign nurse based on its status including temporary hiring or floating staff between units (Griffith et al.,2020). Shifts administered by patient demands could help to maintain a flexible schedule.
Discussion of how evidence-based practice was used in creating the intervention plan
The plan is a combination of different strategies directed to the same issue of nurse understaffing. The problem of understaffing and its consequences mentioned in the study examined by Louly et al. (2017), proves that effective schedule management could partially deal with this problem. The same study provided statistics that the hospitals annually lose 300 Full-Time Equivalent (FTE) nurses.
In contrast, Wendsche et al. (2017) analyzed 80 German geriatric nursing teams. The results showed that regular rest breaks allow controlling annual turnover and preventing predicted burn over among nurses. On the other hand, economic modeling study conducted by Griffiths et al. (2020) displayed that staffing plans with a more detailed dataset were more cost-effective. Flexible-staff deployment was crucial in managing finances in the nurse scarcity conditions.
Plan for evaluating the proposed nursing intervention
Implementation of the offered strategy requires a comprehensive course of action, including system analysis and educational sessions. The simplest solution to deal with the understaffing problem is to increase the number of employers. However, an increased number of nurses does not guarantee effective and organized work. Moreover, in some cases hiring new staff members is financially impossible. The proposed plan covers all possible considerations regarding this issue, including time management, cost-effectiveness, and productivity. This strategy suggests not only possible modifications in hospital operations but also considers the mental and psychical health of healthcare workers.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Despite its positive sides, this approach has drawbacks as well. Firstly, the time scheduling of the nurse workforce is highly complicated because of the complex organizational levels and multi-phase planning (He et al., 2019). Moreover, the planning could vary based on geographical location and technologies implemented. Additionally, patient demand uncertainty must be considered to create a flexible schedule (He et al., 2019). Talking about regular rest breaks, it could be interrupted due to complications related to the patient’s health (Wendche et al., 2017). There are no significant barriers to the implementation of a cost-effective policy. However, the application of all methods is highly dependent on patients’ categories and hospital departments.
Griffiths, P., Saville, C., Ball, J. E., Jones, J., & Monks, T. (2021). Beyond ratios – flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation and economic modelling study. International Journal of Nursing Studies, 117, 103901. Web.
He, F., Chaussalet, T., & Qu, R. (2019). Controlling understaffing with conditional value-at-risk constraint for an integrated nurse scheduling problem under patient demand uncertainty. Operations Research Perspectives, 6, 100119. Web.
Louly, M. A., Gharbi, A., Azaiez, M. N., Bouras, A., Mostafa, A., & Sayed, A. (2017). A staffing tool to improve efficiency at a nursing department. International Journal of Engineering Research and Applications, 07(01), 91–96. Web.
Schoenfelder, J., Bretthauer, K. M., Wright, P. D., & Coe, E. (2020). Nurse scheduling with quick-response methods: Improving hospital performance, nurse workload, and patient experience. European Journal of Operational Research, 283(1), 390–403. Web.
Wendsche, J., Hacker, W., & Wegge, J. (2017). Understaffing and registered nurses’ turnover: The moderating role of regular rest breaks. German Journal of Human Resource Management: Zeitschrift Für Personalforschung, 31(3), 238–259. Web.