HLT 362 Quality Improvement Proposal 

Grand Canyon University HLT 362 Quality Improvement Proposal – Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University  HLT 362 Quality Improvement Proposal  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for HLT 362 Quality Improvement Proposal                                

Whether one passes or fails an academic assignment such as the Grand Canyon University  HLT 362 Quality Improvement Proposal  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for HLT 362 Quality Improvement Proposal                                

The introduction for the Grand Canyon University  HLT 362 Quality Improvement Proposal    is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for HLT 362 Quality Improvement Proposal                                

After the introduction, move into the main part of the HLT 362 Quality Improvement Proposal       assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for HLT 362 Quality Improvement Proposal                                

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for HLT 362 Quality Improvement Proposal                                

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for HLT 362 Quality Improvement Proposal 

Nurses are professionally mandated to provide high-quality care regardless of situations and work environments, which informs HLT 362 Quality Improvement Proposal. Attaining this goal requires nurses to be conversant with quality improvement essentials and adopt the appropriate approaches to achieve high outcomes consistently. The evidence-based practice (EBP) approach is highly recommended for nurses engaging in quality improvement. The approach ensures that interventions are supported by scientific evidence, hence problem-centered and relevant to nursing. As nurses continue to work in complex work environments, a commitment to achieve high patient outcomes should dominate their routine goals. The purpose of the HLT 362 Quality Improvement Proposal paper is to describe a practice issue and propose a quality improvement initiative based on evidence-based practice.

Problem or Issue in Practice or Organization

Nursing environments encounter many issues that harm patient care in varying magnitudes. Medication errors are among such issues, defined as failure in the treatment leading to patient harm, including injury and health complications (Tansuwannarat et al., 2022). Medication errors result in death and permanent damage if not effectively addressed. Salar et al. (2020) found that medication errors are common in today’s practice since between 16 and 27% of nurses commit a medication error. The high prevalence and the magnitude of impacts underline the need for practical interventions to avert the dangers of medication errors.

Awareness of the causes and setting where medication errors occur is fundamental for effective decision-making and solutions. According to Bell et al. (2023), medication errors are common in environments with a high workload due to the eventual fatigue that reduces attention and vigilance. Such settings include the emergency department, intensive care units, and surgical units, where nurses perform cognitively demanding tasks persistently. However, other areas where medication administration is involved are prone to medical errors. The Agency for Healthcare Research and Quality (2023) highlights that medical errors can be experienced at any point in the healthcare system. Such points include clinics, hospitals, pharmacy units, and nursing homes. Since the prevalence is high and the impacts on care quality severe, medical errors should be addressed by problem-centered, organization-wide interventions. Such interventions require leaders and nursing professionals to collaborate in the quality improvement process through problem identification, implementation of interventions, evaluation, and other tasks.

Significance of Quality Improvement in Practice or Organization

Quality improvement in nursing should be a key objective for all professionals involved in direct patient care. Broadly, quality represents the extent to which patient care services achieve the desired health outcomes. As a result, quality improvement is centered on implementing interventions to improve care systematically by standardizing processes and structures (CMS.gov, 2021). An appropriate quality improvement initiative is mindfulness meditation training for nurses to overcome fatigue. A significant reduction in fatigue would lead to a proportional reduction in medical errors, hence better care quality. Improving care quality in areas where medical errors occur implies a commitment to achieving the goals of standardized processes and structures. These include reduced variations and improved outcomes for patients and healthcare facilities (CMS.gov, 2021). Quality improvement also leads to predictable results and helps healthcare organizations to reduce operational costs.

A critical evaluation of the impacts of medical errors further signifies the importance of quality improvement to reduce variations. As Ahsani-Estahbanati et al. (2022) observed, medical errors significantly burden the healthcare system since they undermine patient outcomes and impact nursing professionals’ mental health. Their occurrence also reduces people’s trust in the health system. Quality improvement through evidence-based interventions would prevent or mitigate these adverse impacts, hence improved patient outcomes. Nursing professionals would also be protected from mental health dangers, empowering them to provide comprehensive care timely and satisfactorily. Achieving these goals would also make nurses enjoy their work, which is pivotal for nurse retention in high-stressful work environments.

Demonstration of Support from Previous Research

Nursing research has extensively assessed the effectiveness of mindfulness meditation in stressful work environments and supports its implementation. In general, studies reveal that skills to practice mindfulness can caution nurses against the damaging effects of fatigue and work productively. Owens et al. (2020) found a 3-minute mindfulness intervention practice over four weeks crucial in reducing compassion fatigue among nurses. Burnout risk and secondary traumatic stress levels are reduced significantly among nurses practicing mindfulness. Sulosaari et al. (2022) also found that mindfulness interventions effectively improve nurses’ psychological well-being. Outcomes include reduced stress and depression and improved resilience and quality of life. In another study, Yıldırım and Çiriş Yıldız (2022) evaluated the impact of mindfulness breathing and music therapy on nurses during the COVID-19 pandemic. The primary finding was that these interventions decreased work-related strain and improved nurses’ psychological well-being. These studies show that mindfulness techniques can reduce fatigue among nurses, which is crucial in reducing medical errors.

Steps Necessary to Implement Quality Improvement Initiative

Quality improvement implementation is procedural and starts with basic processes before advancing to complex procedures. The first step is to assess the problem in terms of complexity and the scope of intervention required. When these dimensions are identified, the project leader should move into the next step- preparation. Here, nurses who should receive mindfulness meditation training should be prepared for the acquisition of skills and their implementation. De Kok et al. (2023) stressed the importance of preparing nurses for change since many resist change due to comfort in the status quo. Preparing them reduces potential resistance to change. Preparation also includes the organization of resources for comprehensive training. The next phase should be training to ensure nurses acquire the required skills to cope with workplace fatigue and execute them independently. This phase aligns with the most influential step of evidence-based practice, which involves integrating research findings into practice after evaluation and appraisal (Abu-Baker et al., 2021). Project leaders should also outline measures for quality improvement initiatives’ evaluation to assess whether they will achieve the desired outcomes.

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Evaluation of Quality Improvement

Quality improvement initiatives should be evaluated to provide a holistic view of their impacts. The proposed intervention will be proposed qualitatively and quantitatively to ensure all dimensions are assessed. Qualitative evaluation will be done using surveys of feasibility and satisfaction with the training. Here, participants in the training should describe their experiences with the training and its usefulness. Focus areas include benefits, readiness to implement the skills, and their perception of the training. Unlike qualitative evaluation, which focuses on collecting non-numerical data, quantitative analysis collects and evaluates numerical data to make predictions (Leavy, 2022). Appropriate data that can be evaluated quantitatively include the reported cases of medical errors and workplace fatigue before and after the initiative. This data can be collected at baseline and 4-6 months post-implementation. A reduction in medical errors and related issues by over 24% would be a reliable indicator of a successful initiative.

Identification of Variables, Hypothesis Test, and Statistical Tests

Quality improvement should demonstrate a causal relationship between variables. In this initiative, mindfulness meditation training is the independent variable, while fatigue/workplace stress is the dependent variable. After the training, nurses’ stress levels would reduce, further reducing medical errors in the workplace. Accordingly, the hypothesis is that implementing mindfulness meditation training would reduce medical errors by reducing fatigue. As previous studies (Sulosaari et al., 2022; Owens et al., 2020) demonstrate, positive outcomes are achieved by properly implementing mindfulness techniques in stressful work environments. Similar outcomes should be achieved by implementing the proposed initiative. Statistical tests to prove the success of the initiative include the mean differences between incidents before and after the intervention and the frequency of occurrence. The mean is calculated by dividing the number of medication error incidents within a particular period by the number of days. The frequency of occurrence could be daily, weekly, or monthly. Comparing pre-intervention and post-intervention data can reliably demonstrate whether the project was successful.

Conclusion

To conclude HLT 362 Quality Improvement Proposal, issues that hamper care quality are widespread in nursing practice. Due to the need for high-quality care and optimal patient safety, nurses should evaluate issues hampering outcomes and address them accordingly. Regardless of the setting, medical errors are a common occurrence that poses a significant risk to patients, nursing professionals, and health systems. In response, nurses should design and implement practical interventions for preventing medical errors to improve care quality. As proposed in this paper, mindfulness meditation training can be implemented among nurses working in stressful work environments. The objective is to reduce fatigue, which would reduce medical errors proportionately.

References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1), 1-8. https://doi.org/10.1186/s12912-020-00522-x

Agency for Healthcare Research and Quality (2023). Topic: Medical errors. https://www.ahrq.gov/topics/medical-errors.html#:~:text=Medical%20errors%20can%20occur%20anywhere,%2C%20equipment%2C%20or%20lab%20reports.

Ahsani-Estahbanati, E., Sergeevich Gordeev, V., & Doshmangir, L. (2022). Interventions to reduce the incidence of medical error and its financial burden in health care systems: a systematic review of systematic reviews. Frontiers in Medicine, 9, 875426. https://doi.org/10.3389/fmed.2022.875426

Bell, T., Sprajcer, M., Flenady, T., & Sahay, A. (2023). Fatigue in nurses and medication administration errors: a scoping review. Journal of Clinical Nursing, 32(17-18), 5445–5460. https://doi.org/10.1111/jocn.16620

CMS.gov. (2021). Quality measurement and quality improvement. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Measure-and-Quality-Improvement-#:~:text=Quality%20improvement%20is%20the%20framework,%2C%20healthcare%20systems%2C%20and%20organizations.

De Kok, E., Schoonhoven, L., Lalleman, P., & Weggelaar, A. M. (2023). Understanding rebel nurse leadership‐as‐practice: Challenging and changing the status quo in hospitals. Nursing Inquiry, e12577. https://doi.org/10.1111/nin.12577

Leavy. (2022). Quantitative, qualitative, mixed methods, arts-based, and community-based participatory research approaches. Guilford Publications.

Owens, R. A., Alfes, C., Evans, S., Wyka, K., & Fitzpatrick, J. J. (2020). An exploratory study of a 3-minute mindfulness intervention on compassion fatigue in nurses. Holistic Nursing Practice, 34(5), 274-281. https://doi.org/10.1097/hnp.0000000000000402

Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: a qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. https://doi.org/10.1016/j.ijans.2020.100235

Sulosaari, V., Unal, E., & Cinar, F. I. (2022). The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: a systematic review. Applied Nursing Research, 64, 151565. https://doi.org/10.1016/j.apnr.2022.151565

Tansuwannarat, P., Vichiensanth, P., Sivarak, O., Tongpoo, A., Promrungsri, P., Sriapha, C., … & Trakulsrichai, S. (2022). Characteristics and consequences of medication errors in pediatric patients reported to ramathibodi poison center: a 10-year retrospective study. Therapeutics and Clinical Risk Management, 669-681. https://doi.org/10.2147/TCRM.S363638

Yıldırım, D., & Çiriş Yıldız, C. (2022). The effect of mindfulness-based breathing and music therapy practice on nurses’ stress, work-related strain, and psychological well-being during the COVID-19 pandemic: a randomized controlled trial. Holistic Nursing Practice, 36(3), 156–165. https://doi.org/10.1097/HNP.0000000000000511

Sample Answer 2 for HLT 362 Quality Improvement Proposal 

            Quality improvement (QI) is the systematic process by which healthcare organizations use data to enhance care services delivery concerning quality and safety. Healthcare organizations can use established principles and approaches to prevent challenges during quality improvement. One vital approach is the PDSA cycle, which entails planning, doing, studying, and acting. One of the problem areas in the healthcare organization that necessitate quality improvement is patient falls in the inpatient setting to improve health outcomes. This paper examines the patient falls issue in inpatient settings and offers actions that can be taken to enhance patient health and safety.

Problem Overview and Setting

            Despite a declining trend in hospital falls over recent times, there is still a significant issue. The problem is the most negative issue reported in the inpatient setting. For instance, it is reported that the United States records an estimated 700,000 to 1 million patient falls (LeLaurin & Shorr, 2019). The outcome is more than 250,000 injuries and 11,000 mortalities (LeLaurin & Shorr, 2019). The magnitude of the problem can be quantified by understanding that an estimated one in four patient falls result in injuries, and around 10% lead to grave injuries (LeLaurin & Shorr, 2019). The inpatient setting in the healthcare organization is no different and has a significant number of patient falls that necessitate urgent address.

Need for Quality Improvement Action and Expected Outcomes

            Patient falls are one of the most common safety incidents in the US inpatient setting. The implication is prolonged hospitalization, increased healthcare costs, and life-threatening issues (Boot et al., 2023). As a result, a quality improvement initiative is warranted. The objective of the QI initiative is to reduce patient falls in the inpatient setting. Such an initiative would involve determining the key drivers of the problem. These include establishing the patient at an increased fall risk and preventing these patients from falling. The QI initiative will be necessary to address the patient falls and, therefore, avert the problem of prolonged hospitalization, increased treatment expenses, and life-threatening issues resulting from patient falls. As a result, the outcome of the initiative will be to improve both process and outcome measures of quality improvement. The outcome measure expected from the initiative is a reduction in patient falls in the inpatient setting. The process measures will include accurate fall evaluations, weekly fall awareness programs, and the application of prevention interventions such as wristbands and tag-in/tag-out systems.

Evidence from Previous Research

            There are a myriad of studies that have sought to examine quality improvement initiatives concerning patient falls in the inpatient setting. For instance, Tricco et al. (2019) conducted a systematic review and meta-analysis to determine the QI initiatives necessary for preventing patient falls. The study established that effective fall interventions are multifaceted, involving a myriad of elements. For example, there are initiatives that focus on patients, including reminders and education. There are also those that focus on healthcare providers, such as staff education and team changes. Another study was conducted by Boot et al. (2023), seeking to minimize patient falls in acute settings. They sought a 5% minimization on falls for every 1000 bed days. These initiatives, which include change ideas, were evaluated using the Plan Do Study Act (PDSA) approach. The authors determined that the initiative recorded some success concerning process measures. Lastly, Lopez et al. (2023) conducted a study concerning the adoption of a quality improvement initiative to address the problem of fall reduction in an academic medical center. The intervention entailed the involvement of nurses in an e-learning module concerning fall safety. It was determined the implementation of the QI initiative led to an 8% reduction in falls for patients over 65 years (Lopez et al., 2023).

Steps to Adopt the Quality Improvement Action

            There is a need to adhere to various quality improvement steps in order to understand the root causes of the issue being investigated to establish the best approach to improve healthcare provision. These steps are critical, enabling the QI initiative team to collect the necessary data and develop appropriate interventions. The first step will involve understanding and categorizing improvement opportunities. In this case, there is an opportunity to reduce patient falls in the inpatient setting. The second step involves detailing the various improvement objectives. It will be followed by data collection to aid in decision-making to determine the most appropriate intervention. Lastly, there is implementation of the initiative to the selected patients and healthcare professionals. For instance, these steps are apparent in a study by Boot et al. (2023). The authors started by trying to understand the problem. It is followed by collecting data on the background of the problem, followed by measurement to determine the objectives of the initiative. An initiative was designed, and the strategy was implemented using the PDSA cycles.

Evaluation of the Initiative

            One of the key elements of a quality improvement initiative is the presence of a clear and concise goal. An evaluation plan needs to encompass the evaluation goals and how the process will link to them. The evaluation will have a testing phase to determine whether the initiative was effective or can be improved to provide the desired results. In this QI initiative, an intervention will be selected and implemented on patients in the inpatient setting. The main aim of the initiative is to reduce the number of patient falls. As a result, the evaluation will involve collecting data over a specified period after the implementation of the initiative. There will be a comparison of patient falls before and after the adoption of the initiative. Reduction in patient falls will be indicative of the success of the QI initiative in accomplishing its goal.

Statistical Testing

            It is critical to conduct statistical testing on an intervention to determine its effectiveness in addressing the problem. First, it is vital to determine the key variables in the quality improvement project, which includes dependent and independent variables. The dependent variable is the rate of patient falls, while the independent variable is the quality improvement initiative to be adopted in the healthcare organization. After the determination of the key variables, it is essential to ensure that hypothesis testing is conducted. Its objective would be to establish the presence of a significant statistical difference in patient falls before and after the adoption of the QI initiative. Therefore, the hypothesis test seeks to determine what will happen to the two variables. It will determine the relationship between the QI initiative and patient falls. The hypothesis is true if there is a relationship between the two variables. Lastly, a statistical test is necessary as it offers a way of quantitatively deciding on the initiative. The objective is to establish whether significant evidence exists to reject or support the initiative. In this QI project, a chi-square statistical test will be used. A positive hypothesis means there is a relationship between the variables, and the initiative is a success, while a null hypothesis rejects a correlation between the variables.

Conclusion

            The quality improvement initiative involves adopting a strategy whose objective is reducing patient falls in the inpatient setting, thereby improving patient outcomes. As a result, the initiative seeks to understand the problem and its main drivers. It will followed by the design of an initiative that involves all the key stakeholders, such as patients and healthcare practitioners. Patient falls cause patient injuries, fatalities, and increased treatment costs. It is one of the most common patient incidents in the US. Therefore, a quality improvement initiative is necessary. The success of such an initiative will be determined through an evaluation plan that compares data on patient falls before and after its implementation.

References

Boot, M., Allison, J., Maguire, J., & O’Driscoll, G. (2023). Qi initiative to reduce the number of inpatient falls in an acute hospital trust. BMJ Open Quality, 12(1). https://doi.org/10.1136/bmjoq-2022-002102  

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients. Clinics in Geriatric Medicine, 35(2), 273–283. https://doi.org/10.1016/j.cger.2019.01.007  

Lopez, M., Ma, C., Aavik, L., & Cortes, T. A. (2023). Implementing a quality improvement program to reduce falls and increase patient medication satisfaction in an academic medical center. Geriatric Nursing, 49, 207–211. https://doi.org/10.1016/j.gerinurse.2022.09.002   

Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., Khan, P. A., Sibley, K. M., Robson, R., MacDonald, H., Riva, J. J., Thavorn, K., Wilson, C., Holroyd-Leduc, J., Kerr, G. D., Feldman, F., Majumdar, S. R., Jaglal, S. B., Hui, W., & Straus, S. E. (2019). Quality Improvement Strategies to prevent falls in older adults: A systematic review and network meta-analysis. Age and Ageing, 48(3), 337–346. https://doi.org/10.1093/ageing/afy219  

Sample Answer 3 for HLT 362 Quality Improvement Proposal 

Nurses are a critical component of an effective and efficient healthcare system because of the irreplaceable role that they play in care delivery. However, with estimates showing that nurse shortage is a growing problem and requires an urgent intervention, healthcare organizations and policymakers must devise innovative ways to fill the gap without lowering quality standards that may affect patients’ safety, primarily emanating from medication errors. In their study, Haddad and colleagues (2020) observe that while the U.S. healthcare system has close to 4 million nurses, the country faces a growing shortage of these critical healthcare providers to meet the increasing need for access to healthcare, primarily due to the transformation in the sector and need to handle medical emergencies and pandemics like the current coronavirus pandemic. Further, statistics from federal agencies like the Bureau of Statistics as well as professional associations like the American Nurses Association (ANA) project that over 11 million nurses are needed to prevent a further shortage. In addition, the project that employment opportunities for nurse professionals will rise at a higher rate of about 15% compared to all other jobs through 2026. Imperatively, healthcare organizations need to fill the current gaps using different approaches. Based on the PICOT question, this paper assesses the use of support healthcare workers as an intervention aimed at addressing the current shortage. The essay explores the level of quality care that support workers like nursing aides or assistants will offer if used to fill the gap in healthcare delivery through a comprehensive review of the literature.

Literature Review

Nurse shortage is a critical problem that has continued to increase in severity in recent years. The effects of the shortage include frequent and well-documented nurse burnout, a lack of work-life balance for these healthcare providers, as well as constant turnover and switching of careers due to the increased workload. Concerns about the shortage are exacerbated by an aging population that will require more care in long-term facilities and nursing homes as well as a retiring workforce among the senior nurses. Statistics show that currently, an estimated 1 million registered nurses are aged above fifty years, implying that a third of the workforce could attain their retirement age in the coming 10 to 15 years (Bureau of Labor Statistics, 2019). In addition, the nursing faculty is facing a shortage, and this implies that enrollment is limited due to the small number of instructors (Haddad et al., 2020). The implication is that the number of nurses going through nursing school also reduces. Studies show that a decrease and limitation in the amount of faculty can lead to not only fewer students but also lower the overall quality of programs as well as a decline in classes. These factors demonstrate that nurse shortage is a severe problem in the country that requires active and long-term interventions for increased accessibility and quality care provision. 

The PICOT question identified the need for healthcare facilities, especially nursing homes and long-term care organizations, to use health support workers like nursing aides or assistants to fill the shortage and gap due to the low numbers of nurses in the sector. Different research studies have indicated that healthcare facilities like nursing homes can replenish the small nurse numbers by employing lower-qualified professionals like nurse aides. In a survey by Sarre and colleagues (2017) about the use of support workers in acute care facilities in England, the researchers discovered that the increasing demand in the care system led to a proportionate rise in the reliance on healthcare support workers. The study asserts that while these workers play critical roles in care delivery in these facilities, healthcare organizations in the country do not provide essential care for them to ensure that they deliver quality patient outcomes. Further, their training programs are varied, implying that there is no standardized approach to their training. The study suggests that these workers can play a critical and help the National Health Services (NHS) in Britain to bridge the shortage if their training, support, and evaluation become a priority for policymakers in the country. As demonstrated in this study, the challenges associated with the use of support workers in care provision and mitigation of the current nurse shortage include lack of support, standardized training, and sufficient assessment to improve quality delivery, especially in acute care facilities.

The shortage of nursing professionals means that acute care hospital ward nurses have increased workload, which has the potential to lower quality service delivery due to potential burnouts. In a study by Twigg and colleagues (2016), the researchers sought to establish the effect of increasing assistants in acute care settings on bad patient results. The study findings suggest mixed results where the assistants mediated positive changes while in other adverse areas, they registered negative outcomes. Using a logistic regression model that was linked to administrative health data, the study examined the link between several adverse patient results and the utilization of assistant in wards. The results showed that having assistants in nursing wards increased the prediction for urinary tract infections as well as pneumonia. In each 10%, more time patients had with an assistant in wards, and they registered a one percent increase in having urinary tract infections and a two percent rise in the chances of having pneumonia. The implication is that the use of support health workers like nurse assistants has an additive role in decreasing the quality of care delivery. However, the study also noted that there was a decrease in odds for a patient to die when using assistants in nursing wards. The use of support workers in wards also led to adverse outcomes that include the inability to mitigate urinary tract infections and dangerous falls. The implication is that the use of support health workers does not lead to quality improvement despite the need to use these personnel to address the nursing shortage. However, the study observes that the introduction of assistants in such settings in an additive role must be carried out based on a protocol that defines their purpose, working relationship with registered nurses, and scope of practice as well as monitoring its impact on patient care. 

In their study, Duffield and colleagues (2018) sought to evaluate the impact of adding unregulated nursing support employees to staff in acute care facilities. The researchers posit that adding nursing support workers can be an intervention to mitigating the nursing workload and enhance outcomes. The study notes that while the response has been identified as one way of solving the current nurse shortage, its impacts on nursing staff, patients, and system outcomes have not been studied or documented. Therefore, by conducting a trial use of the support workers to ward in health care facilities, the authors sought to assess the effects in a natural practical world situation. In their study, the researchers found that nursing leadership, staffing as well as resources and experience of the nurse had a link to the outcomes in wards. However, they noted that the instability of the nursing support workers led to reduced care quality. It also increased the turnover intention in areas where the support workers were used. 

The implication is that using these workers to mitigate staffing problem does not lead to quality care improvement. Further, the researchers assert that staffing wards is a complicated activity, and using simple interventions like adding support, workers may not be successful and offer positive outcomes in both short and long-term. Besides, the decrease in quality delivery is evident as these workers were highly unstable in their jobs and created an increased rate of staff turnover in such settings (Singh, 2015). The study recommends that it is essential to consider ward-linked factors when making choices in staffing and skills-mix to reduce instability and prevent adverse outcomes to patients, staff, and the entire system. The researchers assert policymakers and administrators should consider the context of the ward, as well as effective delegation procedures and integration of the support workers into the multidisciplinary team when using them to nursing staff to alleviate the shortage in such facilities. 

Support workers in healthcare service providers are critical players in their own right. They possess a host of qualifications specific to their roles and make an essential contribution to the healthcare system. In their research study in 2016, Duffield and others assessed the effect of utilizing support workers in wards to ease the workload that registered nurses have in the healthcare system. The study acknowledges that the utilization of unregulated workers as an option for improving the number of registered nurses. However, they note that hospitals and care facilities should develop a protocol on how to implement such decisions to reduce adverse events and medication errors (Duffield et al., 2016). In their conclusion, the researchers contend that adding nursing support workers is a not tested but potentially cost-effective remedy to reduce the cost of care and alleviate the current shortage. The implication is that if such additions have a better effect on job satisfaction and decision to be employed, then healthcare systems could have significant benefits due to the cost of replacing a registered nurse. Conversely, while such a staff replacement approach may prevent the workload of nurses, this approach may have adverse effects due to the possible rise in adverse outcomes as a result of an increase in sensitive nurse indicators (Singh, 2015). Further, anecdotal evidence exists to suggest that the addition of support workers will increase a nurse’s workload since they will be needed to have more time in supervising and monitoring the support workers in such settings.

Nurse assistants or aides are essential in care delivery and a valuable resource that should be tapped to alleviate the nurse shortage that exists today in the healthcare systems, not just in the U.S. but across different developed nations like Australia, the UK, and the Netherlands. These personnel work in assisted living care facilities, hospice care settings, and community-based long-term care institutions as well as hospitals. While they help patients of different ages to execute or carry out the most basic daily duties and tasks, the quality of services in patient outcomes working alone has never been documented, and they may not be an effective intervention (Singh, 2015). The quality of service provision and result is critical in addressing the present nurse shortage. Imperatively, studies demonstrate that while these workers can be tapped to ease the biting shortage and enhance care delivery, the quality care outcomes remain unknown and undocumented.

Again, a study by Buljac-Samardzic and Van Woerkom (2018) reveals that quality and safety improvement in nursing homes requires team support where nurse assistants work under the supervision of registered nurses in such settings. The authors use a regression analysis model to predict the occurrence of adverse events if support workers are not adequately integrated into the healthcare team at these facilities. Therefore, nursing support workers may play a critical role in filling the nurse shortage, but no evidence exists to show if such addition leads to quality outcomes for patients.

Conclusion

The review of the literature illustrates that nurse shortage will continue to rise if effective interventions are not implemented. However, such interventions must be founded on the need to increase quality results for patients, the nursing workers, and the entire system. As observed in the literature, several studies show that support workers play a critical role in service provision and quality outcomes. However, their stability and ability to prevent the occurrence of adverse occurrences remain unknown or not studied and, therefore, no evidence to indicate that they will not compromise care delivery. 

References

Buljac-Samardžić M, van Woerkom M (2018) Improving quality and safety of care in nursing

homes by team support for strengths use: A survey study. PLoS ONE 13(7): e0200065. https://doi.org/10.1371/journal.pone.0200065

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