Effective Approaches in Leadership and Management

All aspects of health care share a common goal: to provide respectful, responsive, safe, and patient-centered care. Nurse staffing ratios have long been debated, with data indicating a significant relationship between higher nurse staffing ratios and lower mortality (Aiken et al., 2018). Staffing ratios cannot be approached solely by assigning a ratio, such as 1 (nurse): 6 (employees) (patients). According to the American Nurses Association (ANA), “appropriate nursing resources must account for human factors such as a nurse’s years of experience, knowledge, education, skill set, and patient mix, acuity, and intensity” (McClendon & Hurwitz, 2019). This paper aims to address how safe, appropriate nurse-to-patient ratios affect the quality and safety of care and how to approach this critical issue from a leadership and management perspective.

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Patient Safety and Quality of Care

Improving the nurse-patient ratio provides the opportunity to provide the safe, high-quality, patient-centered care that every nurse, provider, and organization strives for and that every patient deserves. The additional cost of increasing nursing staff is offset by a reduction in readmissions due to a lack of discharge planning and patient education, as well as costly adverse outcomes such as falls, medication errors, catheter-associated urinary tract infections (CAUTI), and pressure sores (Aiken et al., 2018). According to studies, improved nurse staffing correlates with “30 percent fewer hospital-acquired infections” as well as the potentially avoidable cost of “hospital readmissions within 30 days of discharge” (Aiken et al., 2018). According to the findings, “every additional patient added to nurses’ workloads is associated with a 6-9 percent increase in readmissions for patients with pneumonia, heart failure, and acute myocardial infarction (18); an 8 percent increase in readmissions after hip and knee replacement (19); a 3 percent increase in readmissions after general surgery (20); and an 11 percent increase in readmissions for hospitalized children (21).” (Aiken et al., 2018). Furthermore, the demands placed on the nursing profession in the absence of improved ratios increase the likelihood of nurse burnout, which leads to high turnover, exacerbating the shortage of nurses. This, combined with an aging population, puts healthcare in jeopardy shortly. Safe staffing is a great place to start when it comes to retaining experienced nurses, attracting new potential students to the profession, and achieving the improved patient outcomes each organization strives for. However, cost-cutting decisions, an aging population and workforce, and increased patient understanding contribute to a work environment where providing safe, high-quality care becomes increasingly difficult.

Professional Practice Guidelines

The American Nurses Association (ANA) has created and updated nursing practice standards that establish and promote the highest levels of ethics, effectiveness, and accountability. The American Nurses Association recognizes that safe nurse staffing is critical to the nursing profession and the overall healthcare system. The ability of a nurse to provide safe, high-quality care is directly related to improved patient outcomes (McClendon & Hurwitz, 2019). When applying these standards and principles to nurse staffing, the emphasis should be on accountability, leadership, and management. The flexible approach to staffing advocated by the ANA is ideal. There is no simple, one-size-fits-all approach to staffing any unit. The ANA’s recommendations aim to improve patient outcomes by lowering mortality rates and lengths of hospital stays (Brusie, 2019).

Nursing Supervisors and Managers

The roles of nurse leaders and nurse managers differ in many ways; however, they should share common goals. Although a nurse leader may not have formal power within the organization, there is often a sense of power through influence. As a leader positively motivates and encourages team members with a vested interest in providing quality patient care, followers are generally willing and feel supported. A nurse manager has complete control and authority. They are in charge of organizational goals such as time, money, resources, and results, as well as decision-making. Managers are in charge of hiring and scheduling adequate personnel. The manager is critical in ensuring that safe patient ratios can be achieved. Charge nurses are frequently nurse leaders. These nurses are in charge of assessing and adapting to the changing dynamics of the unit throughout the shift. Leaders should report staffing and safety issues to the manager so that the manager can make necessary changes. Leading and managing have an impact on more than just staff members; they also have the potential to affect every patient cared for by staff. Failure can be defined as one without the other (Whitney, 2018).

Professionalism in a Variety of Health Care Settings

Language is only one aspect of diversity in the healthcare setting. Culture, religion, race, socioeconomic status, education, and gender are all factors. Diversity fosters an environment of tolerance and teamwork by welcoming new ideas and innovation (Edwards, 2018). Addressing the issues raised in this paper would allow nurses to devote more time to providing high-quality care to patients. If the nurse is constantly challenged to find time to care for the physical body, caring for the important, nonphysical aspects is unfortunately overlooked. Nurse managers and leaders are in a unique position of responsibility to their organization and subordinates and the patients and families. Creating an open environment of respect, acceptance, and understanding with clear expectations outlines the organization’s goals to fit a diverse healthcare setting that includes staff and patients. Identifying, creating, and maintaining professionalism in a diverse healthcare setting is critical. In this situation, developing and maintaining appropriate nursing ratios that are situationally flexible will ensure the quality and safety of patients under the care of nurses.

Style of Leadership

Different situations necessitate various management styles. To be extremely effective and successful as a leader and manager, you must adapt to the situation at hand. Because of the complexities of nurse-patient ratios and the ANA’s flexible approach to staffing, having a manager and leader who employs the situational leadership style is essential. Situational leaders are adaptable and possess strong analytical and critical thinking abilities (MAS, 2019). This is necessary to assess the complex nature of the patients on the unit, their understanding, and the strength and experience of the available staff. Patient acuity can change anytime, making it critical for the manager to respond quickly. Continuously assessing and potentially changing assignments on the fly to accommodate changing acuity levels. A situational leader or manager will effectively bring about positive change in the issue of nurse-patient ratios. They are improving patient outcomes staff satisfaction, and retention rates.

Conclusion

Health care is constantly evolving. The shortage of qualified nurses to care for an aging population with increasingly complex health conditions is critical. Nurses are sacrificing quality patient care to meet the demands and expectations of current regulations. However, establishing and maintaining safe nurse staffing ratios is critical. This will ensure that patients receive safe, high-quality care that meets the expectations of patients, family members, and the organization. This will also increase employee satisfaction while decreasing burnout and turnover.

References

Aiken, L., Cerón, C., Simonetti, M., Lake, E., Galiano, A., Garbarini, A., . . . Smith, H. (2018, June 07). Hospital Nurse Staffing and Patient Outcomes. Retrieved January 18, 2021, from https://www.sciencedirect.com/science/article/pii/S0716864018300609

Barrows, K. (2019, April 15). Safe Staffing: Critical for Patients and Nurses – Department for Professional Employees, AFL. Retrieved January 18, 2021, from https://www.dpeaflcio.org/factsheets/safe-staffing-critical-for-patients-and-nurses

Brusie, C. (2019). ANA Updates Nurse Staffing Guidelines to Support Flexibility. Retrieved January 18, 2021, from https://nurse.org/articles/nurse-staffing-ana-guidelines/

Edwards, S. (2018, February 20). The Benefits of a Diverse Workforce for a Healthcare Facility. Retrieved January 18, 2021, from https://www.medprostaffing.com/benefits-diverse- workforce-healthcare-facility/

MAS. (2019, January 25). 7 Types of Leadership Styles in Nursing (Which One Are You?). Retrieved January 05, 2021, from https://www.masmedicalstaffing.com/2018/02/08/types- of-leadership-styles-in-nursing/

Pape, T. (2019). Nursing and Patient Safety. Retrieved January 18, 2021, from https://psnet.ahrq.gov/primer/nursing-and-patient-safety

Whitney, S. (2018). Roles and Responsibilities in Leadership and Management. Retrieved January 12, 2021, from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and- management-leading-and-serving/v1.1/#/chapter/2

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Question

What nurse leader strengths and competencies position nurse executives and nurse managers as essential to strategic planning and development?

Effective Approaches in Leadership and Management

I made your response with a minimum of three paragraphs with three sentences each. The response should have references and citations.

Effective Approaches in Leadership and Management