NURS FPX 4905 Assessment 4 Proposal for Intervention

Proposal for Intervention

Student Name

Capella University

NURS FPX4905

Professor Name

Submission Date

Proposal for Intervention

Registered Nurses (RNs) shortage in Skilled Nursing Facilities (SNFs) needs a systematic staffing intervention. The shortage of RNs has caused poor care delivery with prolonged prompt evaluations, reliance on the Licensed Practical Nurses (LPNs), and exposure to poor patient outcomes such as medication errors and readmissions. The suggested intervention will be to introduce an RN flexible staffing model that will integrate evidence-based scheduling techniques, health information technology applications, and interprofessional collaboration to maximize RN utilization.

This method is based on studies that link adequate staffing of the RN with improved patient safety, reduced cost, and improved long-term patient care in SNFs. This intervention can assist with patient-centered, safe, and efficient care by designing staffing practices in a strategic way that would assist in providing care to a vulnerable population.

Practice Issue of Concern

The practice issue of concern that was determined is the shortage of RNs in the Skilled Nursing Facility where my practicum was held. Even though the facility offers 24-hour care, the number of RNs assigned is not enough to monitor clinical decision-making, hence a huge lapse in patient safety and quality of care.

At the moment, LPNs and Certified Nursing Assistants (CNAs) perform much of the direct care, and RNs often have multiple residents per shift, resulting in them having less time to assess comprehensively and/or plan care. There has always been scientific evidence that understaffing of RNs is linked to an increased incidence of falls, infections, and transfers in nursing homes (Harrington et al, 2020). This shortage is thus important to deal with to improve the results of the residents and give safe, effective, and holistic care delivery.

The problem specified is especially relevant to the area of BSN-prepared nursing leadership, as professional nurses are supposed to promote aspects of safe staffing rates and participate in quality improvements on a system-wide scale. The ANA Code of Ethics focuses on the duty of the nurse as it protects the well-being of their patients by discussing the unsafe practice settings (Numminen et al., 2024). Minimal RN staffing is not only an operational matter, but it is also a patient safety problem and needs integrated solutions. This gap requires leadership, evidence-based strategies, and collaboration in organizations to ensure that residents in SNFs are provided with the level of care that they require and deserve.

Current Practice

The current staffing model in the practicum location is based on the work of LPNs and CNAs led by RNs, but it does not have the capacity to meet the needs of the entire population. Even though RNs have the duty to administer medication and to clinically evaluate the residents, they are significantly understaffed, which results in slow reaction to the changes in the status of the residents.

The absence of staff also predisposes to a lack of documentation that may affect continuity of care and compliance with regulations (Bennett et al., 2021). Moreover, RNs have little time to work with the patients and families in terms of patient and family education; this leaves unfulfilled informational and emotional needs of residents and families. The process of staffing is often reactive as shifts are not planned and assigned based on the workload of the employees, but rather to the employees who are free at a particular time.

The facility does use an electronic health record (EHR) system to facilitate documentation, but does not use it efficiently to analyse staffing and distribute workloads. As an example, the system notes the intensity of the acuity of residents, but this is not always relied on to determine the number of staff required to work each shift. This throws inconsistencies where high acuity residents do not always get sufficient RN care (Moy et al., 2023). Whereas agency nurses have been provided in the past to fill missing staffing gaps, this would bring in a lot of expenses and would interrupt continuity of care. Consequently, the current practice results in the burnout of the staff, their low morale, and unstable patient outcomes.

Strategy for Enhancing Existing Practice

To overcome the problem of low RN staffing at the Skilled Nursing Facility, an acuity-based staffing system using scheduling software is proposed. Such a plan will ensure that the RN assignments will be based on the needs of the residents rather than preset ratios of residents, with real-time data about the residents being provided by the EHR to prioritize care of high acuity residents. Float pools and cross-training of personnel would also have the advantage of more flexibility in the event that the demand was high, or there was an unexpected absence of a person, thus eliminating the need to hire a person at high cost (Apaydin et al., 2022).

Interprofessional collaboration is also a theme in the model as the nurses, leaders, administrators and human resources work together in their quest to balance staffing with clinical priorities and financial feasibility. It has been found that structured, acuity-based staffing can be used to enhance patient safety, reduce adverse events, improve resident satisfaction, whilst providing a more stable and sustainable care environment (Demitria and Stafford, 2021). This plan will eventually enable the bank to be a productive workforce without any negative impact on the residents, who should always have access to quality care in a safe environment.

Changes Required for People and Processes

To achieve this approach to staffing, nurse managers should use the acuity scores of an EHR to base daily assignments to ensure that the needs of residents are met with the right level of RN supervision. Administrators play a key role in promoting the adoption of scheduling software, which helps to make the staffing processes efficient and reduce the amount of reactive coverage on shifts. RNs shall be able to properly document the acuity information and the LNPs and CNAs will have a greater level of delegation, a better allocation of their workload, and support with the delivery of care process (Mueller et al., 2024).

Staffing reviews should occur every week in order to draw trends, close gaps, and optimize processes in order to improve the same. Uniform and standardized means of float pool use and communication between units will also increase the uniformity and responsibility at an inter-team level. All these changes help to improve the quality of care provided, increase the safety of residents, decrease the amount of money spent on inefficiencies, and increase staff retention.

Assumptions

The strategy assumes that nurse managers, RNs, and support staff members are ready to implement an acuity-based staffing strategy and are properly trained. It is based on the assumption that the EHR and scheduling systems of the facility can be modified to provide in-the-moment staffing decisions for staff options.

The strategy is also founded on sufficient administrative support and cooperation with human resources to support float pools and cross-training programs. It also assumes that the involvement of the staff would be improved in case the distribution of work were more even. Lastly, it assumes that better outcomes will be seen when staffing is adjusted to acuity needs among residents.

Improving Quality, Safety, and Cost-Effectiveness

The use of an acuity-based staffing model backed by the implementation of scheduling technology can radically change the quality of care provided in the Skilled Nursing Facility. By establishing the RN assignments according to the level of acuity of the residents, the facility will be able to provide the patient with more complicated care needs with a prompt evaluation and intervention, which will eliminate the possibility of preventable complications (Apaydin et al., 2022).

This has a positive impact on the safety level as it reduces the lack of care, errors in medication, and delays in responding to the changes in the resident’s situation. Better continuity in RN oversight is also helpful in promoting better resident satisfaction and improved clinical outcomes, which represent better quality of patient-centered care.

On the cost side, the approach will decrease the number of costly agency nurses who are used by streamlining internal staffing and making use of cross-trained employees and float pools. Improved workload allocation has its benefits as it will reduce the burnout and turnover of nurses, which is costly in long-term care facilities. In the long run, considerable cost savings are also the result of the reduction of adverse events, readmission of patients, and emergency transfers (Grant et al., 2020).

The short term costs may include some investments in scheduling software and employee training, with the long term benefits of greater efficiency, safety of care delivery and sustainable staffing solutions, the costs are outweighed thus the strategy proves to be viable and economically viable.

Application of Technology in the Strategy

The proposed staffing strategy makes extensive use of the integration of technology, especially EHR technology and scheduling software, in order to better the decision-making process and allocation of resources. EHR-based acuity scores help to offer real-time insights into the clinical needs of residents, aiding nurse managers to allocate RNs more effectively and ensure balanced workloads (Sequeira, 2022).

This application of the use of technology is appropriate because it is a direct response to the problem of staffing gaps compromising safety and quality in the Skilled Nursing Facility. Leveraging EHR ensures accuracy in the recording of the patient’s conditions, while scheduling platforms ensure ease in communication, minimal errors, and overreliance on the agency staff (Sequeira, 2022). Additionally, these tools help to increase staff accountability, promote interprofessional collaboration, and provide administrators with measurable data to help assess the effectiveness of their staffing. The integration of technology ultimately leads to a safer, more efficient, cost-effective environment for the residents and staff.

Implementation of the Improvement Strategy at Clinical Site

At the Skilled Nursing Facility, implementation of thetoity-based staffing strategy would start with staff training to document correct patient acuity data in the EHR software and use scheduling software to match staff with resident needs. This phased approach allows staff the time to adjust with new processes without disruption of patient care and ultimately will promote the sustainable, technology-driven model of safe and efficient staffing.

Site Specific Challenges and Solutions

Some of the challenges at the Skilled Nursing Facility involve resistance by staff, lack of knowledge of scheduling tools, inconsistent usage of EHR, high patient acuity, and budgeting. Phased training, beginning with nurse managers, will be helpful with incremental adoption. Scalable scheduling systems incorporated with already existing EHRs help offset the financial burden. A staffing coordinator will oversee the compliance to ensure that it is adopted and there is little disruption to resident care.

Interprofessional Collaboration to Support Strategy Implementation

Interprofessional collaboration is the key to the success of the acuity-based staffing strategy at the Skilled Nursing Facility. When these roles are in coordination with one another, the facility can create a consistent, equitable, and sustainable staffing process that strengthens the care delivery as a whole.

Collaboration also extends to clinical practice by making sure RNs, LPNs, and CNAs are communicating clearly about resident care needs and distributing their workloads. Regular interdisciplinary meetings provide an opportunity to review the acuity data, share challenges, and develop proactive solutions for staffing gaps. Shared use of EHR systems enables all members of the team to have access to accurate resident information, enhancing coordination and minimizing errors (Morgan, 2023). This open communication promotes a culture of accountability and transparency, with each member of the staff knowing their part in ensuring safe and efficient care.

By fostering trust among roles and valuing everyone’s input within the team, the practice of interprofessional collaboration can help to reduce burnout, enhance staff retention, and ultimately enhance resident safety and satisfaction (Manuel et al., 2024). Such collaborative practices also foster a culture of accountability and shared responsibility that helps to support long-term improvements in care delivery.

Conclusion

The proposed acuity-based staffing strategy specifically addresses the issue of having limited RN availability in the Skilled Nursing Facility by matching assignments to resident needs with the use of EHR-driven acuity data, scheduling software, and float pools. This method ensures the quality and safety of care, it helps to reduce the delay in interventions, and also helps in retaining the staff as the workload is distributed.

Site-specific issues like staff resistance, training needs, and budget constraints can be addressed by phased education, scalable technology, and a staffing coordinator to ensure compliance. With high levels of interprofessional collaboration, the strategy leads to sustainability, decreased costs associated with turnover and readmissions, and ultimately to improved patient-centered outcomes for the vulnerable population of patients within the facility.

To get the 3rd assessment of this: NURS FPX 4905 Assessment 3