Advancing evidence-based Nursing Care.
Please respond to the discussion Sharing an insight from readings
• and, synthesizing the information to provide new perspectives.
1 of the following references and 3 more APA 6th ed within 2 years. Thanks
1
Chlan, L., Tracy, M. F., & Grossbach, I. (2011). Pulmonary care. Achieving quality patient-ventilator management: Advancing evidence-based nursing care. Critical Care Nurse, 31(6), 46–50.
Practice Concern
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Mandatory overtime is a practice concern for nurses. The shortage for nurses began in the early nineties and had presented a staffing issue for hospitals (Trossman, 2005). The first solutions to render staffing issues were to mandate that nurses pick up over time shifts to fill in the holes (Trossman, 2005). Research supports that nurses that are forced to do overtime have more errors in judgment and medical care and this puts patients safety at risk (Trossman, 2005). Nurses that work greater than forty hours a week are more than three times likely to make a mistake (Trossman, 2005). Forced overtime is linked to poor health for the nurse, increased injury rates, more sick days, and ultimately an increased in mortality (Trossman, 2005).Advancing evidence-based Nursing Care. It is reported that on an average weekly, forty percent of nurses worked greater than forty hours (Sung-Heui, 2013). Mandatory overtime has proven to increase the nurse’s fatigue due to the lack of meaningful rest after each shift is completed (Sung-Heui, 2013). This sleep deprivation has shown to causes nurse to have delayed relation times in critical situations and attention to detail (Sung-Heui, 2013). Increased overtime has also shown to cause more needle sticks and musculoskeletal injuries among nurses (Sung-Heui, 2013). Sung-Heui, conducted a study on patient outcomes and how they related to nurses mandatory overtime requirements (2013). The study concluded that nurses who conservatively work greater than forty hours a week for six months were significantly related to increasing the patient\’s mortality (Sung-Heui, 2013).Advancing evidence-based Nursing Care. As a result of this practice issue, sixteen states have made laws to restrict the amount of mandatory overtime that is allowed (Sung-Heui, 2013). Several states have mandated laws into practice that state legally nurses are not required to private in mandatory overtime (Sung-Heui, 2013). In North Carolina, the board of nursing has guidelines that define safe staffing ratios and overtime (2018). The board of nursing states that the “Staffing and Patient/Client Safety” guideline need to be reviewed before agreeing to or assigning mandatory overtime (North Carolina Board of Nursing, 2018). The BON also points out that refusing to work mandatory overtime does not constitute patient abandonment (North Carolina Board of Nursing, 2018).However, it does state then if the overtime is accepted the assignment must be done and that if the nurse manager or nurse feels the nurses are sleep deprived or otherwise compromised then the overtime must be avoided (North Carolina Board of Nursing, 2018).Advancing evidence-based Nursing Care. The board’s position also states that work hours should be considered when staffing to protect the patient’s safety (North Carolina Board of Nursing, 2018). Several solutions are identified in which to render the overtime issues, but the main point boils down to the need to appropriately staff the organization. Staffing the organization with an increase in nurses instead of an increase in hours for nurses is the key concept being applied (North Carolina Board of Nursing, 2018). The Institute of Medicine (IOM) recognizes that in order to prevent overtime issues staffing issues need to be fixed and by doing this, they recommend using a float pool of nurses (Adams, Kaplow, Dominy, & Stroud, 2015). These float pools are made of nurses that work for the organization with the same education, orientation, and are familiar with policy and procedures (Adams et al., 2015). These nurses are not assigned a unit as a home but rather float to where the staffing issue is that day (Adams et al., 2015). The only drawback to this method is the nurses are not as familiar with the unit structure such as where supplies are located as they are if they are on one particular unit (Adams et al., 2015). Although not a catchall solution it does offer staffing without the requirement of overtime (Adams et al., 2015).Advancing evidence-based Nursing Care.
Use of information technology to locate sources regarding mandatory overtime
The information technology used when conducting this search was through professional online databases (McGonigle & Mastrian, 2018). These databases were through the Walden library. The library provided a search bar in which nursing journals were chosen and then a search engine was generated. The results showed several articles relating to the topic. Once an article was selected the Walden library connected to the database where full text articles can be seen. The databases that were utilized are MEDLINE and CINAHL (McGonigle & Mastrian, 2018). When conducting the research on the board of nursing for North Carolina the Google search engine was utilized (McGonigle & Mastrian, 2018). Then the board of nursing website was obtained and the information gained through this site was used as a source for the review.
Information technology supports evidence-based practice
The use of information technology makes it easier to access evidence-based practice research (Hynes, Weddle, Smith, Whittier, Atkins & Francis, 2010). Information technology provides professional online databases and electronic library catalogs (Hynes et al., 2010). Having exposure to these resources makes it simple to access and implement evidence-based practice (Hynes et al., 2010).Advancing evidence-based Nursing Care. Having access to online databases through information technology reduces the time it takes for research to reach the clinical arena (Hynes et al., 2010). This can seriously affect patient outcomes (Hynes et al., 2010). Computers are utilized in all areas of research (McGonigle & Mastrian, 2018). The National Institute of Health recognizes the importance of technology when conducting interdisciplinary research (McGonigle & Mastrian, 2018). The NIH stresses the use of translation informatics to help facilitate the gap between evidence-based research and the bedside (McGonigle & Mastrian, 2018). The National Guideline Clearinghouse is a database has been developed that has evidence-based clinical practice guidelines (McGonigle & Mastrian, 2018).Advancing evidence-based Nursing Care. It is available through the databases and through electronic mailing lists that subscribers can obtain (McGonigle & Mastrian, 2018). This database allows users to look at current clinical guidelines, view full-text links, and download the clinical guidelines lines to all devices such as computers, tablets, and phones (McGonigle & Mastrian, 2018). Lastly, there are a large number of electronic resources available now for anyone to access that have databases full of evidence-based practice (McGonigle & Mastrian, 2018). Some of these include CINAH, PUBMED, and World Views on Evidence-Based Practice Nursing (McGonigle & Mastrian, 2018). Having access to these resources through information technology promotes the use of evidence based practice at the bedside (McGonigle & Mastrian, 2018).Advancing evidence-based Nursing Care.
References
Adams, J., Kaplow, R., Dominy, J., & Stroud, B. (2015). Beyond a Band-Aid® Approach: An Internal Agency Solution to Nurse Staffing. Nursing Economic$, 33(1), 51–58. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=100927404&site=eds-live&scope=site
Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2010). Use of health information technology to advance evidence-based care: Lessons from the VA QUERI program. Journal of General Internal Medicine, 25(Suppl. 1), S44–S49.
Retrieved from the Walden Library databases.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett Learning
North Carolina Board of Nursing (2018). Joint position statement on nursing work environments. Retrieved from https://www.ncbon.com/vdownloads/position-statements-decision-trees/nursing-work-environments.pdf
Sung-Heui, B. (2013). Presence of Nurse Mandatory Overtime Regulations and Nurse and Patient Outcomes. Nursing Economic$, (2), 59. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsovi&AN=edsovi.00006073.201303000.00003&site=eds-live&scope=site
Trossman S. (2005). Issues update. Beyond mandatory overtime: the ANA and nurse leaders take aim at RN fatigue and workplace practices. AJN American Journal of Nursing, 105(10), 73–77. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=106536528&site=eds-live&scope=site
Mandatory overtime
The posting identifies mandatory overtime a nursing mandatory overtime as a management strategy for addressing staffing shortages in medical facilities. Although it has addressed the issue of staffing shortage, mandatory overtime introduces new problems that are linked to the resultant fatigue.Advancing evidence-based Nursing Care. This concern gains traction when it is considered that nurses are concerned with delivering healthcare, and the fatigue they experience from being overworked as a result of overtime could cause them to make mistakes with serious consequences for the patients and medical personnel to include death. Yoder-Wise (2013) expresses similar sentiments but notes that mandatory overtime is simply a short-term solution that would be detrimental for all stakeholders if used for the long terms. For nursing personnel, mandatory overtime causes them to be overworked and experience fatigue that makes them disillusioned with the profession. In addition, the fatigue causes them to make care mistakes that could threaten them, patients and other medical personnel. For instance, an overworked and fatigued nurse could end up overdosing a patient and causing death simply because he or she did not pay attention to how medicine was constituted and delivered. For patients, mandatory overtime reduces their wait time (since there are more nursing personnel to address their needs) but it does not offer them the expected quality of care. In essence, it sacrifices care quality for quantity (Chlan, Tracy &Grossbach, 2011). Politand Beck (2017) puts the issue of mandatory overtime into perspective by recommending that it should only be v short-term solution that should be abandoned once new nursing personnel are hired to address the staffing shortage. In this respect, mandatory overtime is a management strategy for addressing staff shortage in the short-term with the long-term solution being hiring new personnel to address the shortage.Advancing evidence-based Nursing Care.