The Models of Nursing Management - Essay Example

Name : xxxxxxxxxxx Institution : xxxxxxxxxxx Title : Discussion of the models of nursing management Tutor : xxxxxxxxxxx Course : xxxxxxxxxxx @2010 Introduction Nursing models are operational models that provide a different and efficient nursing practice compared to the traditional ones. The model’s objective is always aimed at provision of better care to the patients in facilities that provide long-term care, in organizational settings as well as primary hospitals. According to Satterley (2004), there has been interest in nursing models driven mainly by concerns over the workforce getting hampered by a continuous problem of deficit inexperienced staff and novice staff.ion. This hinders professional growth of nursing practice. The models became more important for application in various roles of practices which were advanced and which started developing and consolidating in not only acute, but also critical care, as well as chronic and settings of community care (Eaton, 2000). Even though the models may be implemented throughout the organization, their specific redesigning of nursing is felt at the level of nursing unit, which is at the patient care delivery. They are often different from the traditional ways in that they are innovative, are based on performance competencies as well as educational levels, their unit level have self-management to some extent, and contain higher nursing or even multidisciplinary employment with primary nursing elements. The nursing models critically put into consideration the cost of care provision as well as the efficiency and skills needed. This work presents a comprehensive study on a model that may give not only insight into required nursing staff capacity, but also provide opportunities for improvement of capacity utilization. The capacity management model Aging staff Population that is aging, emerging technology, growing patient expectations, increasing cost of healthcare, growing pressure for quality improvement and the need for short period of patient stay have all made nursing resource management very crucial currently. For instance in Europe alone there has been a considerably high and increasing health care demand, with the patients deeply expecting improvement in quality as well as service of health care while still there is an additional burden of strict tighter budgets as well as availability of resources being greatly restricted (Visser, 1997). All these and other additional problems experienced in nursing led to the development of a model that can effectively address these issues, the capacity management model. The term capacity management is coined from the adjustment of a resource capacity to satisfy the demand that has been planned. Therefore capacity management model is a concept that has been designed to bring the desired changes to the resources so as to meet the desired demand. This is one of the most influential tools in the provision of better and efficient nursing practice. The systems of capacity management give more insight into the resources that are crucial and needed in nursing practice, for instance equipment and staff. In the hospital care for the inpatients, details on beds as well as the capacity of nursing both daily and annually is very crucial to capacity management. This paper provides the capacity model which is comprehensive and which provides more insight into the capacity of nursing staff that is needed as well as improvement opportunities on utilization of capacity on the ward level. This model always offers different ideas on the best and most efficient ways for improvement of the capacity utilization. The model uses the most recent data on specifically the wards to provide opportunity for calculation of the staffing requirements. The capacity that is needed can be annually calculated as well as calculated for every shift using the model which also supports decisions on the operational, strategic as well as tactical levels. This is because it allows evaluation of the working processes, comparison of the wards, and comparison of staff budgets with the capacity needed, calculation of the consequences resulting from LOS and the production target changes as well as the evaluation of the wards in consideration of the capacity of the nursing staff that is needed. The capacity model therefore is an important tool for supporting discussion of issues regarding capacity management in consideration of the wards and the hospital management especially by providing both quantitative as well as objective insight into the requirements of both beds as well as the staff. A diagram showing the model outlines (Elkhuizen et al, 2007) Apart from offering efficiency and providing cost reduction, this model offers more knowledge into opportunities of enhancing the processes of working as well as reducing the workload hence enabling the nurses to have an easy work. There is also a lot of benefit to both the nurses and the patients when nurses are employed adequately (Adams, 2003; I&2). This model uses data on historical utilization rather than the beds that are available thereby signifying that the annual production and the utilization fluctuations are put into consideration, as well as giving a better comparison in wards and also between the calculated and the current staff numbers. This model can also use less data with fewer details for instance the average or full bed utilization in every shift. This model does not only help in the hospital-wide planning, but also it helps in capacity improvement by keenly analysing the capacity utilization on individual hospital units (Sochalski, 1997). Strategies of introduction In order to have a smooth transition during the introduction of the capacity management model, the teams that are responsible for the implementation of new practices in nursing should have guidelines and work within the management framework of the change so that the expected goals can be achieved with minimum resistance considering that if there are no guide lines then coordination of the activities will be difficult which may lead to failure as well as the staff’s loss of confidence on the model. It should be considered that proper and efficient working coordination counteracts the reasons for refusal of the model. Since group balance or the status quo of individuals can be disrupted by change, resistance is always inevitable. Some staff members are always very reluctant to accept this model because it aims at providing efficiency which might affect the comfort zones of some staff for instance the model aims at providing efficient service delivery which is likely to maximize the labour output of the staff in order to reduce cost and optimize on the labour resource, this may mean an additional load to the staff who might have been accustomed to some usual task. It may also involve maximizing the working hours which may mean that the working speed may be high. Such characteristics of the model are not always favourable to some staff members who may have also been accustomed to a reluctant way of working. The reasons for the resistance may include increased stress due to the fact that the work load may appear more than usual and work pressure as well as performance, which is paramount ,may demand more concentration, strength and time, the stress may also develop due to change of the working condition therefore making the staff to be against the model. Poor understanding of the whole idea behind the new model may also culminate in to resistance especially when it is considered by the staff as a tool aimed at deliberately undermining their responsibilities or even when some concepts within the model are not properly understood, especially considering that different individuals are always sensitive to issues pertaining to their work or lifestyle thereby giving a reason for the resistance to the model. Uncertainty is also another reason for the resistance since the staff may not know the consequences of adopting the model, especially whether it will favour them or put their job at risk. Other reasons for resistance include denial, self interest, personality, motivation as well as ownership and trust. Therefore the strategies that can effectively bring change are mainly based on slow introduction, participation, facilitation, psychological ownership and trust development (Curtis & White 2002). Some of the steps vital in the introduction of the new model include slow introduction which helps in providing a step by step model exposure to the staff therefore avoiding the idea of getting them surprised and hence provoking their rejection of the model. This is a model that may need more effort from the staff and therefore should be introduced in bits so as to be adopted as a perfect model for management of performance. The staff should also be encouraged to participate since they will finally be the determinants of the model’s performance. Without their participation this model may not be accepted considering that it deals with their roles in the settings and that it will demand a lot of sacrifice from them. The staff should also be prepared psychologically to accept this model and develop a trust for the model so that there are no divisions within the management over adoption of the model. When the trust is developed then the staff will be psychologically prepared for the new change. This therefore creates the need for a better understanding of the setting where the change is expected, acquiring organizational support,evaluaton of the practice that is currently used and also involving the staff in the whole process (Wright and McCormack, 2001). Team work is also a very vital strategy and is composed of skill mix, joint thinking, coordination, recognition of professional importance and also acknowledgement of the interactional relationships important in the communication process (McCallin, 2001). Other successful implementation tools include identification of participants’ level of involvement, function clarification as well as the description of various relationship types expected. Setting where change is to be implemented need to be understood properly so as to be able to design better ways of introducing the change. The support from the staff is very crucial and therefore should be considered so as to be able to implement the model with as little resistance as possible. Evaluation of the practice which is currently used is essential so as to determine where the changes are expected as well as for comparison purposes. Team work development should also be paramount among the strategies since it consists of the skill mix which is essential in defining the role of different individuals and enhancing of joint thinking. The introduction of these changes should be on step by step basis until the staff learn and appreciate the importance of the application of the model to be applied in the setting. The phases for effective, smooth and accepted transformation include the planning face which involves the teams getting introduced to project officers, outlining of the timelines, objectives as well as the plan, organization of forum for team information on their roles and their responsibilities likewise to the officer, and also determination of the outcomes expected from every phase. From the planning face this process goes further to the development phase where participants’ involvement is very crucial. The model that has been proposed is then presented. Comparison between the current and the proposed nursing practice then takes place. The results are then used on the next step, the implementation phase, where the method and procedure of data acquisition is put into consideration with the growing staff acceptance of the model. Team work is also strengthened through regular sessions of team debriefings which might also be used to explore and identify the issues of practice that are emerging. The evaluation phase may rely on assumptions that the environment of practice plays a pivotal role on the model’s effective implementation and that in as much as the environment is improved. It should be able to provide more satisfaction for both the patients as well as the nurses. Debriefing is important in this phase as well as the identification of the new and emerging practice issues which still enhances team ownership. The result of these sessions should be weighed in consideration of the expectations from the session, there should also be proper auditing of the nursing care aspects for the trial. Evaluation of the data collection methods should also be considered. The findings with adequate details on the results, is then presented to the concerned authorities for further approval. Quality management model Quality can be termed as the resemblance extent between the roles of healthcare with the care that is truly granted. Quality management model has the role of providing mechanisms for the effective monitoring of care given to patients and which is implemented by the healthcare professionals with the use of resources that are cost-effective. The nursing programmes that are based on quality management have their concern on the nursing care’s quantitative assessment as provided by the nursing practice standards that are proved. They also give the nursing practitioners motivation in aiming at excellence in the quality care delivery as well as having openness and flexibility in the experimentation with the innovative ways for changing the outmoded systems. The quality management field is both old as well as modern in the field of nursing with the profession of nursing gaining a position that is very distinct in the look for healthcare’s quality. The model entails the elements which are closely related and which include planning the quality, development of setting for objectives and active communication of standards, development of the indicators, setting of the threshold, data collection using set standards for the practice of nursing and application of the solutions for improvement of care. All of these are, meant to provide the quality needed. Therefore the quality management methods are for the provision of quality measures as well as implementation of the continuous improvement in the quality of care in various healthcare settings and also for provision of the professional accountability for the achievement of administrative nursing practices that are very competitive and entailing professional value. The capacity management method therefore becomes very crucial in helping achieve all these values since it aims at utilizing the resources in an efficient way. Considering that if the resources are adequately distributed there will be reduction to the cost of provision of the healthcare thereby enhancing optimum resource utilization. The quality management model aims at providing quality care to the patients and therefore it has to have adequate number of staff to be able to carry out these duties effectively and in a timely manner, this also entails the professional staffs who are responsible for the provision of specialized health care services. The fact that prompt service provision is one of the most desired qualities among patients signifies that resources have to be well planned as well as be adequately and readily available for immediate attention to the patient .There is also the need for ensuring that the setting meets the requirements for provision of better healthcare, to which there is need for the calculation of patient – nurse ratio. Conclusion Nursing has been one of the most troubled sectors within the healthcare system, with characteristics of low numbers of professional nurses, the aging of many nurses ,financial deficits, and also the desire by the patients to be attended to promptly. Such problems have created instincts for model developments for better handling of the situations, more so the capacity management model that has the desired qualities in maintaining the balance between work force and other resources. The capacity management model is also very crucial in providing support to the decisions on capacity for strategic, operational and tactical levels. Bibliography Bartram, T., Joiner, T., & Stanton, P., 2004, Factors affecting the job stress and job satisfaction of Australian nurses: implications for recruitment and retention. Contemporary Nurse, 17(3):293-304. Satterly, F., 2004. Where have all the nurses gone? The impact of the nursing shortage on American Healthcare Prometheus, Prentice Hall, NY. Eaton, N., 2000. Children's community nursing services: models of care delivery. A review of the United Kingdom literature. Journal of Advanced Nursing, 32(1): 49-56. Elkhuizen et al ,2007. BMC Health Services Research. 7:196   doi:10.1186/1472-6963-7-196 Visser, J., 1997. Helping hospitals making the trade-off between service and resource utilization. A production control perspective. Internal report, Faculty of Technology Management, Eindhoven University of Technology. Eindhoven. 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