Evidence-Based Management Practice - Research Paper Example

 Evidence Based Management Practice Abstract Several hospitals have adopted and executed various staffing methods in order to deliver quality of care to the patients within the background of intrapartum settings. In this regard, two vital methods comprising Hours Per Patient Day (HPPD) and patient acuity are used in different hospitals with the intention of offering better care to the patients. Relating to this particular research, it can be apparently observed that both the aforesaid staffing methods are used in an extensive manner in various hospitals, ensuring greater patient security. For smooth adoption along with execution of the above discussed methods, it is to be affirmed that certain vital aspects need to be taken into concern. These aspects comprise identification of staffing levels and recognition of nurse-sensitive outcomes among others. I. Introduction A. Background The two crucial factors that comprise deficiency of registered nurses and augmented workload have every potential towards threatening the health as well as the quality of care of the individuals. From the viewpoint of evidence based management practice, it is to be stated that nurse staffing is often regarded as one of the crucial factors which broadly determines the nature of the outcomes of the patients by a greater level (Clarke & Donaldson, n.d.). It can be stated that two vital aspects like patient acuity and Hours Per Patient Day (HPPD) play a decisive role in affecting the satisfaction scores of the patients at large particularly in an intrapartum nursing unit based setting. In this regard, HPPD is regarded as a frequent expression which tends to justify the level of man-hours needed for caring patients in hospitals. In precise, this particular facet trails as well as measures the time that the nurses serve to the patients for enhancing their health along with well-being (Mediware Information Systems, 2013). On the other hand, the facet of patient acuity within the background of nursing staff is often considered to be an intensity care based measurement aspect which is required for patients towards enhancing their well-being as well as quality of care by a significant level (Mediware Information Systems, 2013). With this concern, the rationale of this study is to determine whether HPPD or patient acuity effect the scores relating to patient satisfaction or not especially in an intrapartum nursing unit based system. B. The Question On the basis of the above discussion, the research question can be framed as: Does staffing an intrapartum nursing unit based on HPPD versus patient acuity effect patient satisfaction scores? By taking into concern the above framed question, it can be answered as well as analyzed with the support of PICO format: P or ‘Population’ is the registered nurses I or ‘Intervention’ is the adoption, execution along with the advancement of current management nursing practices in staffing for providing better care services to the patients in an intrapartum nursing unit based system C or ‘Comparison’ is to watch and develop the performances of the registered nurses O or ‘Outcome’ is to offer effective care to the patients in an intrapartum nursing unit based setting II. Literature Search, Review and Synthesis ‘Nurse Staffing and Quality of Patient Care’ by AHRQ (2007) What themes emerged from these studies? One of the significant themes of this particular study is that both patient acuity as well as HPPD affects satisfaction scores of the patients broadly in different nursing unit based settings. These settings comprise surgical, intensive care units and intrapartum among others (AHRQ, 2007). Does the studies support/not support the management practice/answer the question? In order to resolve whether the aspects of HPPD or patient acuity affect satisfaction scores of the patients, it can be apparently observed in this particular study that both the aforesaid important aspects support the evidence-based management practice. This is in terms of recognizing the increased effect of staffing especially on patients safety in an intrapartum nursing unit based system along with other different settings (AHRQ, 2007). How confident are you of the findings of individual studies and studies as a whole? The literature findings from this study represent that the level of effect in the patient satisfaction scores within the background of an intrapartum nursing unit based setting varies owing to the influence of certain vital factors. These factors encompass measures as well as activities of nurse staffing, patient ratios along with reduction in terms of relative risks among others (AHRQ, 2007). Labor and Delivery Nurse Staffing as a Cost-Effective Safety Intervention by Blegen & Wilson (2010) What themes emerged from these studies? In this particular study, it can be viewed that there exists an interrelation between nurse sensitive outcomes and staffing levels which imposes significant impact upon an intrapartum nursing unit based setting by a considerable level. It is worth mentioning that the facets comprising HPPD and patient acuity largely influence nurse-sensitive outcomes resulting in effecting the satisfaction scores of the patients at large. It has been apparently observed in this study that the above discussed aspects influence nurse-sensitive outcomes in terms of determining patient security within the background of intrapartum nursing unit based situation (Blegen & Wilson, 2010). Does the studies support/not support the management practice/answer the question? It can be affirmed that this particular study supports the management practice of determining HPPD and patient acuity affecting satisfaction scores of the patients in terms of identifying the impact of nurse staffing on patient security with regard to the background of an intrapartum nursing unit based setting. Owing to the intrinsic challenges especially in isolating, describing as well as evaluating the influence of HPPD and patient acuity on nurse-sensitive outcomes, the effect in the satisfaction scores of the patients has gained momentum by a greater level (Blegen & Wilson, 2010). How confident are you of the findings of individual studies and studies as a whole? The literature findings from this particular study denote that both patient acuity and HPPD have the potentials of affecting satisfaction scores of the patients within the background of an intrapartum nursing unit based setting. The literature also depicts that the aspects such as nurse-sensitive outcomes, staffing levels and care levels among others can be taken into concern in order to obtain a better idea about how HPPD or patient acuity effect satisfaction scores of the patients (Blegen & Wilson, 2010). Intrapartum Nursing Caring of Multiples by Lindner (2011) What themes emerged from these studies? In this particular study, the significance of patient acuity linked with an intrapartum nursing unit based setting has been highlighted. In this similar concern, it has been apparently observed that the registered nurses must possess greater experiences in order to deliver secured and effectual intrapartum management related practices to the patients in different circumstances. The elements that can be found in patient acuity are the symptoms and the conditions pertaining during the triage position of the patients. These particular elements can be viewed to be affecting the satisfaction scores of the patients by a greater level (Lindner, 2011). Does the studies support/not support the management practice/answer the question? It can be affirmed that this particular study might support the management practice concerning the determination of affecting the satisfaction scores of the patients by a certain degree. This can be owing to the reason that the study recognized the elements of patient acuity which contribute towards affecting the patient satisfaction scores at large (Lindner, 2011). How confident are you of the findings of individual studies and studies as a whole? In order to validate the findings of this study, it can be stated that different elements of patient acuity like symptoms and the conditions prevailing during the triage position of the patients influence nursing staff and thereby affect their satisfaction scores by a greater level. From this particular study, it can be revealed that staffing an intrapartum nursing unit based upon patient acuity effects patient satisfaction scores as compared to HPPD. Moreover, the study also depicted certain multiple case studies in which patient satisfaction scores can be viewed to get affected by the different elements of patient acuity (Lindner, 2011). The Impact of the Nursing Hours per Patient Day (NHPPD) Staffing Method on Patient Outcomes: A Retrospective Analysis of Patient and Staffing Data by Twigg, Duffield, Bremner, Rapley & Finn (2010) What themes emerged from these studies? This particular study highlights that HPPD method relating to staff nursing is often adopted as well as executed as a “bottom up” approach affecting the satisfaction scores of the patients within the circumstance of an intrapartum nursing unit based mechanism. The study also revealed that certain fundamental elements belonging to HPPD that comprise intervention levels, patient complexity, patient turnover and presence of greater dependency beds among others largely assure security of the patients affecting the patient satisfaction scores by a greater level (Twigg, Duffield, Bremner, Rapley & Finn, 2010). Does the studies support/not support the management practice/answer the question? In this similar concern, it can be stated that the study might support the management practice concerning staffing an intrapartum nursing unit based on HPPD versus patient acuity as it depicted broader execution of HPPD as a “bottom up” approach affecting patient satisfaction scores at large (Twigg, Duffield, Bremner, Rapley & Finn, 2010). How confident are you of the findings of individual studies and studies as a whole? After acquiring a brief idea about the contents of the study, it can be affirmed that HPPD is viewed to be one of the most effective staffing methods which is executed in different hospitals affecting the satisfaction scores of the patients in terms of enhancing their quality of care. By conducting a comprehensive analysis of the study, it can be affirmed that staffing an intrapartum nursing unit based on HPPD effects patient satisfaction scores at large (Twigg, Duffield, Bremner, Rapley & Finn, 2010). Article 5: Factors Associated With Labor Support Behaviors of Nurses by Barrett & Stark (2010) What themes emerged from these studies? One of the vital themes of this particular study is that it demonstrated staffing an intrapartum nursing unit based on HPPD effecting patient satisfaction scores by a greater level. This can be justified with reference to the fact that nursing staff based on HPPD mechanism offers greater aid to the patients within the background of intrapartum conditions. These conditions comprise newborn along with birth events, long-terms maternal associated outcomes, labor events and instant maternal based psychological outcomes among others (Barrett & Stark, 2010). Does the studies support/not support the management practice/answer the question? As the above discussed study remained much focused upon portraying the conduct of staffing an intrapartum nursing unit based on HPPD, it can be stated that the study supported the management practice by a certain degree (Barrett & Stark, 2010). How confident are you of the findings of individual studies and studies as a whole? After conducting a detailed analysis of the study, it can be stated that the validity of the findings is quite appropriate as it assessed the continuous effect of intrapartum support with usual care of the patients (Barrett & Stark, 2010). Recommendations After acquiring a comprehensive idea about staffing an intrapartum nursing unit based on HPPD versus patient acuity effect patient satisfaction scores, it can be affirmed that certain significant aspects need to be considered for proper implementation. In this similar concern, the aspects comprise identification of nurse-sensitive outcomes, recognition of the factors influencing staffing levels and determination of the existing affiliation among patient security, outcomes and quality. It is worth mentioning that the deliverance of quality care to the patients especially belonging to an intrapartum circumstance is essentially influenced by various crucial factors that entail experience along with the knowledge of the registered nurses and different human factors. It can be stated that these particular factors might impose extensive impact upon staffing an intrapartum nursing unit based on HPPD versus patient acuity effecting patient satisfaction scores by a considerable level. Thus, the above discussed factors must be taken into concern with utmost importance for proper implementation of the aspects i.e. HPPD and patient acuity with the intention of staffing effective nurses. This is in order to provide better quality of care to the patients within the context of intrapartum settings or environment (Barrett & Stark, 2010). Conclusion From the overall analysis, it can be affirmed that nurse staffing within the background of evidence based management practice plays a decisive role in delivering quality of care to the patients by a greater level. It has been apparently observed that two important aspects such as patient acuity and HPPD broadly affect patient satisfaction scores by a greater level in terms of influencing nurse-sensitive outcomes and determining staffing levels. For staffing an intrapartum nursing unit based on HPPD versus patient acuity effecting patient satisfaction scores, it is quite indispensable to recognize the factors influencing staffing levels and assessing the existing affiliation amid patient security, outcomes and quality. References AHRQ. (2007). Nurse staffing and quality of patient care. Evidence Report (151), pp. 1-103. Blegen, M., & Wilson, B. L. (2010). Labor and delivery nurse staffing as a cost-effective safety intervention. Journal of Perinatal and Neonatal Nursing 24(4), pp. 312-319. Barrett, S. J., & Stark, M. A. (2010). Factors associated with labor support behaviors of nurses. The Journal of Perinatal Education 19(1), pp. 12-18. Clarke, S. P., & Donaldson, N.E. (n.d.). Background. Nurse Staffing and Patient Care Quality and Safety, pp. 1-25. Lindner, S. L. (2011). Intrapartum nursing caring of multiples. Retrieved from http://www.medscape.com/viewarticle/757735 Mediware Information Systems. (2013). Managing to nursing HPPD. Retrieved from http://www.mediserve.com/blog/inpatient-rehab/managing-to-nursing-hppd/ Mediware Information Systems. (2013). Defining acuity. Retrieved from http://www.mediserve.com/blog/inpatient-rehab/defining-acuity/ Twigg, D., Duffield, C., Bremner, A., Rapley, P, & Finn, J. (2010). The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: a retrospective analysis of patient and staffing data. International Journal of Nursing Studies 48. 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