NURS FPX 4905 Assessment 2 Define and Analyze Your Healthcare Process Problem or Issue of Concern

Define and Analyze Your Healthcare Process Problem or Issue of Concern

Healthcare organizations need to reassess the quality of their clinical and operational processes in order to protect patient safety, increase the quality of care provided, and effectively manage their costs. In my practicum experience in a Skilled Nursing Facility (SNF) that predominantly serves the geriatric population, I have been able to observe how staffing patterns and especially the presence of registered nurses (RNs) have a direct effect on the patient care outcomes.

One of the key problems observed in the practicum site is the lack of RNs that negatively affects supervision, care planning, medication administration, and interdisciplinary care coordination. The paper provides an analysis of the practicum facility, the clinical and operational decision-making practices observed, and the issue of RN staffing shortages, and explains what effects this problem has on patient outcomes, organizational quality, and healthcare costs, in general.

Practicum Site Description

I am achieving my practicum requirements in an SNF that delivers long-term and post-acute services to an elderly clientele. The institution specializes in chronic illnesses like dementia, diabetes, hypertension, and cardiovascular disease management in addition to the provision of rehabilitation and palliative care. Out of the 55.8 million or more than 65-year-old adults in the U.S., 1.3 million of them reside in nursing homes, or 2.3% of the aged population (Hallstrom, 2023). Most of the nursing home patients need medication management, daily living, and complicated medical care.

The facility has a workforce of approximately 120 healthcare workers and consists of certified nursing assistants, licensed practical nurses, physical and occupational therapists, dietitians, social workers, and a small number of registered nurses. Even though the team is relying on providing holistic andhooked person care, the small number of RNs presents a problem in maintaining a regular evaluation, care planning, and interdisciplinary coordination of this at-risk geriatric group.

Clinical and Operational Decisions at the Practicum Site

The most vital clinical judgments in the SNF have to do with the oversight and provision of safe and high-quality care to geriatric patients with complicated health demands. The registered nurses are tasked with care planning, taking medication, and conducting overall assessments to determine the changes in the status of patients. These choices play a crucial role in minimizing negative events like wrong medication, infection, or hospital readmission. The Agency of Healthcare Administration (AHCA) reported that RN and other nursing staff shortages are moderate to high in 87% of nursing homes. (Heiks & Sabine, 2022). RNs in this facility are also instrumental in organizing the interdisciplinary care and making sure that therapy, dietary, and social services are a part of the individualized patient plans.

On the operational level, the daily workflow is to be coordinated with the staff allocation, therapy sessions scheduling, and the proper coverage of medication administration and direct patient care. A small staff of RNs can enforce the licensed practical nurses (LPNs) and certified nursing assistants (CNAs) to assume a greater number of roles, which increases the likelihood of mistakes and care delays (Beynon, 2020). As a nursing undergraduate student, I will be observing, recording, and assisting in the care, which will be supervised, as well as making contributions in the interdisciplinary conversations. The presence and contribution of RNs are critical in the organization and patient safety since these clinical and operational processes have a direct impact on the reduction of hospital transfers, prevention of falls, and management of chronic conditions, which directly influence health outcomes.

Process Issue Identification

The shortage of RNs is one of the most acute healthcare process concerns at the SNF that has a direct effect on the quality of provided care and organizational performance. The key to effective nursing care is RNs, as they have to monitor the staff, care plans, and provide timely assessment and treatment (James, 2022). Nevertheless, the number of RNs is low, which means that the facility has to depend on LPNs and CNAs. The shortage of RN personnel not only lowers the quality of consistency in the care planning, but also slows the ability of timely detecting the alterations of the state of the patient, making the geriatric group highly vulnerable and at even higher risk of complications.

This problem of RNs has been even more pronounced due to the nature of the medical needs of the residents and the acuity of care they need as well. The elderly patients who have several comorbidities, including cardiovascular disease, diabetes, and dementia, must be under proper supervision to prevent preventable hospitalizations and adverse events. It is indicated that registered nurse staffing shortages in nursing homes correlate with increased fall rates, infections, and hospitalization, which have adverse impacts on patient outcomes and organizational outcomes (Zhang et al., 2022). The problem at the practicum site is reflected in tension among current nursing teams, the lack of timely coordination between various disciplines, and the lack of follow-ups in terms of patient assessment. This underscores why RN shortages are not merely an operational issue but also a patient safety crisis that needs to be addressed swiftly and supported by evidence-based approaches.

Impact Analysis

The high turnover of registered nurses in SNFs has significant consequences in the provision of care to patients, safety, and performance. RNs are critical in staff supervision, diagnostic procedures, prescribing drugs, and interdisciplinary coordination, yet they are few in number, which means that the services rendered are disjointed and slow (James, 2022). Because of this, the elderly residents are exposed to higher risks of falls, infections, and medication errors, which need timely and qualified responses. The lack of RNs undermines the comprehensive, patient-centered care that SNFs are supposed to provide.

The situation is worsened by financial and operating problems because understaffing is an additional factor led to higher readmission rates and longer stays of patients. Nursing homes contribute to preventable hospital readmissions that strain the U.S. healthcare system to the tune of 26 billion dollars every year, making a significant burden on the resources (Healthstream, 2021). The SNF frequently uses temporary agency nurses to ease the situation, thereby increasing the cost of running the facility and creating continuity issues. It is also worsened by staff burnout and turnover, which compels the management to spend more money on recruitment and training. The cycle reduces the stability of the workforce and has adverse impacts on organizational sustainability. Finally, the shortage of RNs poses a great threat to the patients and facilities.

Systemic factors are at the hierarchy of this crisis, rendering SNFs less desirable working conditions than hospitals. There are also a few career and professional development opportunities that discourage nurses from having long-term commitment in SNFs. All these issues become a vicious cycle in which recruitment issues, retention problems, and poor patient care ensue. The shortage is likely to persist and threaten the quality, safety, and effectiveness of geriatric care unless a specific policy on the workforce is adopted.

Conclusion

Staffing of SNFs with registered nurses is a severe problem that negatively impacts patient safety, quality of care, and organizational efficiency. Seniors need competent care, and ineffective staffing puts the patients at risk of injuries and undermines comprehensive care provision. Low wages, excessive workloads, and a lack of career development opportunities are some of the factors that encourage burnout and turnover, thus establishing a cycle of staffing instability. Strategic measures such as enhanced retention initiatives, competitive remuneration, and the development of the workforce are needed to deal with this issue. Through these changes, SNFs will be able to support patient safety, decrease resource overload, and improve the quality of geriatric care as a whole.

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