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Quality Improvement Paper
Gary Stallings
Northern Kentucky University
DNP 805
July 24, 2021
Issue
The staff nurse retention rate has had close attention over the years due to the intensity of the matter and its resultant consequences affiliated with the turnover. The staff retention rate implies that the number of patients seeking medication is high compared to that of nurses. According to research, the impact of fewer nurses in the industry has facilitated poor health services (Eckerson, 2018). Therefore, this issue has forced both nurses and human resource management to implement intervention models to respond to those determinants in order to curb the nurse turnover rate. Recent studies have analyzed the relationship between nurse retention and job satisfaction, concluding that a low nurse retention rate leads to poor services(Eckerson, 2018).. This essay will discuss different quality improvement initiatives and plans that can be put in place to curb the rate of nurse retention.
Improvement Initiatives And Plan
To ensure that nurses don’t give up or lose interest in their line of work, certain initiatives are implemented to reduce this. Some of the initiatives include reducing mandatory overtime, increasing salary and benefits, and promoting a workplace culture of teamwork between physicians and nurses. By reducing the overtime period for nurses, they get enough time to rest and socialize with their families. Most nurses have left the health faculty due to an overload of work with less resting time. The nurses get overloaded with work as a result of the low nurse retention rate every year- the number of nurses reduces, increasing the ratio of work to that of active nurses in health facilities. Increasing the wages of nurses is another effective initiative that has proved to improve the nurse retention rate. Wages have a substantial influence on nurse retention as well as job satisfaction. In other studies, nurse turnover is a result of low wages paid to nurses. Low wages result in lazy nurses with less commitment and morale to offer quality services. However, Competitive pays combined with better benefits to nurses will increase the onboarding rate hence catering for the gaps in a health care facility. Benefits include receiving payment for overtime, holiday, vacation, lunch, hospital bills, and gift bonuses. Also, by promoting teamwork between nurses and physicians, the rate of nurse retention is bound to improve. This creates a positive environment for nurses as they feel supported by the other health team hence perceive their work to be so much easier(Collard, 2020). Nurses depict shared governance as a sense of fairness, assistance, and a feeling of control of nurses from facilities. According to research, shared governance is affiliated with empowerment (Vergara, 2017). Besides, this intervention has proved to increase the nurse retention rate as well as active job satisfaction.
Goal Of The Project/ Measurable Outcomes
The main aim of the project is to enhance the nurse retention rate. The project also facilitates a positive environment that promotes shared governance aspired to improve job gratification. It intends to take eight months for implementation to take place and rate the outcomes due to the quality improved measures in play.
Stakeholders
The stakeholders involved in this project include nursing managers, nursing administrators, operation coordinators, chief financial officers, and physicians in health facilities. Collaboration with these stakeholders helps identifies the determinants of low nurse retention rates and implementation of quality improvement initiatives. All these stakeholders have different responsibilities that aim to curb the nurse retention rates. For instance, the chief financial officer plays a part in giving out wages to nurses. By ensuring that nurses on overtime have been paid adequately, the rate of nurse retention will improve as many will feel motivated to keep on working. The nurse managers and administrators, on the other hand, ensure that nurses. The physicians also have a responsibility to offer assistance to nurses in times of complex situations so as to offer a favorable and encouraging environment at least to work. The operation coordinator controls and oversees the operation undertaken by nurses. Therefore the coordinator will have to spot out the immediate factors that may constitute to low nurse retention rate and respond to them as soon as possible to ensure a positive environment for nurses to work.
How Interprofessional Collaboration Impacts The Project
The interprofessional collaboration between these stakeholders and professionals will impact the project positively by facilitating in nurse retention rates. Through interprofessional collaboration, the rate of onboarding nurses will improve. More nurses are willing to be committed to working as long as they get better wages and benefits, all facilitated through the collaboration of the financial officer and the operation coordinator. Also, the collaboration between the nurses and the physicians will help reduce labor by offering assistance when needed (Pelletier et al., 2019). This will make more nurses stay at work as they feel comfortable knowing they have support from the physicians.
Quality Model, Implementation and Evaluation
The quality improvement model used in the project is the job-demand control model. This model ensures that job satisfaction and autonomy are achieved.In the model, nurses who face high demand during work with less control are probably to suffer from burnout. Equally, the model suggests that nurses who have plenty of work and lac autonomy in their system are more likely to have work stress leading to burnout and reduced nurse retention rate. Any health care facility can employ the model to improve the retention of nurses and job satisfaction.
Before implementing the interventions, a quick survey and analysis will be done on the initial turnover rates as well as their salaries and benefits to draw a reference point. The increment of salary to nurses will be implemented by first running a background check on the nurses to see whether their basic needs were met by the amount of pay they got. Their salaries will be compared to the amount of work done, including the overtime hours. Therefore nurses who have shortages in their wages will be given relief in their subsequent month’s salary. In addition, making overtime hours highly paying will encourage nurses to keep on doing their job despite the few challenges they might face (Bugajski, 2017). Also, the mandatory overtime working hours for the nurses will be reduced. This will be implemented by rescheduling the overtime periods to fit in the interest of most nurses. Besides, the overtime hours will further be broken down into small periods so that nurses could feel less overworked during this time. By doing so, nurses will have the opportunity to pick on shorter overtime working periods so that they have adequate time to attend to their personal activities. This flexibility in overtime shifts will generally improve the nurse retention rates as more nurses will be available at work at free will. The reduction of overtime hours is expected to will take three months for it to be effective. The initiative of creating a positive environment will be implemented through promoting shared governance. More physicians will be dispatched to assist nurses in their work so as to reduce work overload. By giving nurses a voice in their work schedules and workflow, areas of urgent concern will be spotted, and in collaboration with other stakeholders, the nurse administration will provide the necessary equipment of work to facilitate an easy and conducive environment. Implementation of this initiative will take four months to be fully in play.
Types of Measure
Evaluation of the quality improvement initiatives will be done using different tools to get the measures of the outcome due to the dependent variables. The dominant dependent variables affiliated with the project include job satisfaction and wages. Supportive leadership and autonomy are the independent variables as it is hypothesized they will increase nurses job satisfaction hence increasing the nurse retention rates. The salary to nurses is a dependent variable that has been varied in most healthcare facilities to retain workers. Thus, an increase in workers’ salary and benefits will possibly make nurses feel contented and appreciated for their work; hence, they will tend to remain at work, improving the nurse retention rates. It will also increase the onboarding of nurses as many will feel motivated to work for better salaries. Also, by providing a positive environment for nurses to work, nurses will tend to stay longer in their line of work.
GOAL: To improve the nurse retention rate
GOAL: To improve the nurse retention rate
EFFECTS
Job satisfaction
Increased nurse retention
Reduced job stress and overload of work
EFFECTS
Job satisfaction
Increased nurse retention
Reduced job stress and overload of work
OUTPUTS
More employed nurses
Increased salaries and benefits to nurses
Favorable working schedules for nurses
OUTPUTS
More employed nurses
Increased salaries and benefits to nurses
Favorable working schedules for nurses
INPUTS
More trained nurses
Enough medical equipment
Salary increment
INPUTS
More trained nurses
Enough medical equipment
Salary increment
ACTIVITIES
Increasing the onboarding process
Increasing salary in accordance with overtime working hours.
Reducing of overtime working hours
ACTIVITIES
Increasing the onboarding process
Increasing salary in accordance with overtime working hours.
Reducing of overtime working hours
Reliability and Validity
There exist several types of validity and reliability. Those that will apply to this project include test –retest reliability, internal consistency reliability, and construct validity. Test retest validity assumes that there is no change in the constructs (Pelletier, 2019). Thus, when applied when a same test is applied to the result twice and different times it should produce same results. Internal consistency indicates how items reflecting the same construct produce similar results. Thus, it will be applied in the project to determine work characteristics reflect on employee retention. Construct validity established if a construct measures what it was intended to measure. Since the Home Health Care Nurses’ Job Satisfaction test ranges from 0.64 to 0.83 an alpha within the range or above will imply validity. Any value less than the range shows a demerit in the research indicating a low validity.
Benchmarks
The project aims to reduce the rate of nurse turnover; therefore, it will be able to achieve standards that are closely in line with the national benchmarks. Primarily, implementation of the initiatives will foster quality care to patients due to the increased number of nurses. This shows that the project will be able to maintain a good nurse-to-patient ratio, therefore, reducing the workload, alleviating job stresses and burnout. The national health standards imply that every health facility needs to maintain a high nurse-to-patient ratio to achieve the main objective, which is to provide quality health to all. More so, the project intends to foster job satisfaction to nurses, which is a national standard to ensure nurses are able to deliver their services effectively. The project will thus achieve its goal of improving the nurse retention rate and job satisfaction through the implementation of the initiatives; increased salaries, reduced overtime, and the presence of a positive environment and autonomy.
References
Bugajski, A., Lengerich, A., Marchese, M., Hall, B., Yackzan, S., Davies, C., & Brockopp, D. (2017). The importance of factors related to nurse retention: Using the Baptist Health nurse retention questionnaire, part 2. JONA: The Journal of Nursing Administration, 47(6), 308-312.
Collard, S. S., Scammell, J., & Tee, S. (2020). Closing the gap on nurse retention: A scoping review of implications for undergraduate education. Nurse education today, 84, 104253.
Eckerson, C. M. (2018). The impact of nurse residency programs in the United States on improving retention and satisfaction of new nurse hires: an evidence-based literature review. Nurse education today, 71, 84-90.
Pelletier, L. R., Vincent, C., Woods, L., Odell, C., & Stichler, J. F. (2019). Effectiveness of a psychiatric–mental health nurse residency program on retention. Journal of the American Psychiatric Nurses Association, 25(1), 66-75.
Vergara, J. Y. (2017). Implementation of a mentorship program to increase staff satisfaction and retention in critical care. Nurse Leader, 15(3), 207-212.
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