Assignment: Developing Organizational Policies and Practices

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Developing organizational policies and practices

The health care issue of concern has been identified as hospital-acquired pneumonia (HAP), the second leading hospital-acquire infection and cause of death among critically sick patients (Torres-García et al., 2019). As a preventable issue, the concern is that the facility is not doing enough to address HAP incidences.

  • Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

There are three competing needs that…

 

Assignment: Developing Organizational Policies and Practices
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected. NOTE: The healthcare issue/stressor is HOSPITAL ACQUIRED PNEUMONIA
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (4-pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

Required Readings
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html

Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

Required Media
Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2009b). Working with Individuals [Video file]. Baltimore, MD: Author.

 

Developing organizational policies and practices

The health care issue of concern has been identified as hospital-acquired pneumonia (HAP), the second leading hospital-acquire infection and cause of death among critically sick patients (Torres-García et al., 2019). As a preventable issue, the concern is that the facility is not doing enough to address HAP incidences.

  • Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

There are three competing needs that impact HAP. Firstly, time demands whereby time acts as an obstacle that prevents medical personnel from completing patient care duties. In this case, the care duties compete with the time needed to engage in other activities such as hand washing. With time being a limitation owing to limited availability of hygiene stations, nurse-patient ratios and patient acuity demands, there is a need to explore strategies that would improve care delivery. Secondly, patient overcrowding and low nurse staffing levels are a concern since they lead to poor management that are associated with high adverse outcome rates for HAP. In acute care settings, understaffing among medical personnel can facilitate HAP occurrence through relaxed attention to basic infection control measures and care delivery. This occurs because the number of assigned personnel are fewer than the number of staff members necessitated by the workload. Thirdly, the use of medical equipment, such as endotracheal incubation and mechanically assisted ventilation, that are necessary to help the patient maintain life bit present opportunities for HAP incidences. The three competing needs that have been identified have an influence on HAP incidence (Black, 2013).

  • Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

The organization applies infection control practices related to the use of medical equipment in crucial care, and this has implications for HAP. In this case, the face has presented protocols that identify the best strategies for disinfecting and sterilizing equipment and maintaining instruments thus ensuring that patients do not come into contact with new pathogens that cause HAP. Firstly, the organization has a strategy for managing mechanical ventilators to reduce the risk of HAP. It stresses that ‘single-use’ devices should not be reused since this has implications for their effectiveness, performance and safety, while exposing patients to unnecessary risks. Also, the facility stresses that reusing a device intended for single use has legal implications. As such, the facility recommends that devices marked for single use must not be reused under any circumstance. Besides that, all medical equipment should be maintained, disinfected and sterilized as instructed by the manufacturers (Cherry & Jacob, 2016).

Secondly, the organization presents a strategy for managing ventilator circuits whereby it instructs that they should be changed every week (7 days), unless they are damaged or spoiled in which case they should be changed sooner. Each patient should use a new ventilator circuit tubing. In addition, contamination should be prevention should having medical personnel wear facial protection when closed breathing circuits are disconnected, especially when dealing with highly communicable infections. Also, breathing circuit concentrate should be periodically drained away from the patient and discarded. Fourthly, nebulizers can become contaminated and act as HAP source. The organization recommends that new nebulizers should be used for single patients, and must be disinfected and cleaned using sterile water between use. Fifthly, reusable resuscitation equipment should be decontaminated according to the manufacturer instruction between each use to minimize HAP risk. Finally, it recommends that all other equipment not listed in the policy should be managed using basic hygienic measures that include single patient use and sterilization between uses. The policies applied at the organization to manage equipment help with reducing HAP opportunities through eliminating pathogens and preventing cross-contamination (Cherry & Jacob, 2016).

  • Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.

The equipment management strategies that have been described entail decontaminating and sterilizing the equipment through chemical and physical means by inactivating and removing pathogens to a point where they become incapable of transmitting infection. In fact, the management renders the equipment safe for use and handling. Strict adherence to the strategies is considered critical, and failure to comply with the practices is perceived to have serious consequences in terms of increasing incidence of HAP. The policy is in line with the ethical responsibility and duty of medical personnel to provide competence and safe care while protecting the patients right and being accountable to the relevant professional governing bodies (Cherry & Jacob, 2016). To be more precise, medical personnel have the unique responsibility of being the advocates of the health care system and patients, and this implies using their unique complement of skills, competencies and knowledge to ensure that medical equipment is safe for use and opportunities for HAP are minimized. With the availability of a wider range of more complex medical equipment and an increasing focus on how the equipment can be sterilized for reuse and cost saving, it becomes incumbent upon medical personnel to perform their due diligence and practice ethically by ensuring that they do not intentionally expose patients to harm. Through following the protocols for disinfecting and sterilizing medical equipment, medical personnel actively ensure that they proactively reduce opportunities for HAP (Cherry & Jacob, 2016).

Kadivar et al. (2017) adds to the discussion by explaining that medical personnel must adhere to the principle of non-maleficence through ensuring the safety of patients and preventing harm as a priority. From a moral perspective, the use of decontamination and sterilization strategies that ensure that medical equipment are free from pathogens serves two purposes. The first is a practical purpose whereby the benefit is to reduce incidence of HAP. The second is moral value by focusing of protecting human dignity and promoting humanity (Kadivar et al., 2017). Overall, it becomes clear that the protocol is a structured process that fosters safety settings that reduce opportunities for HAP.

  • Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

There are two practice changes that can be applied to help with balancing the competing needs. The first strategy is surveillance that establishes mechanisms to provide medical personnel with appropriate tests for diagnosing HAP incidences. Also, the surveillance would help in maintaining a high index of suspicion for the diagnosis among high risk patient groups, while routinely culturing air, water and equipment systems for HAP pathogens. Secondly, there is a need for personnel education to heighten their suspicion for cases of HAP, and to use appropriate diagnostic methods (Brett et al., 2019).

 

 

References

Black, B. (2013). Professional nursing: concepts & challenges (7th ed.). New York, NY: Elsevier.

Brett, M., Russo, P., Cheng, A., Andrew, S., Rosebrock, H., Curtis, S., Robinsion, S. & Kiernan, M. (2019). Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review. Infection, Disease & Health, 24(4), 229-239.

Cherry, B. & Jacob, S. (2016). Contemporary nursing: issues, trends, & management. Amsterdam: Elsevier Health Sciences.

Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical and legal aspects of patient’s safety: a clinical case report. Journal of medical ethics and history of medicine, 10, 15.

Torres-García, M., Pérez Méndez, B. B., Sánchez Huerta, J. L., Villa Guillén, M., Rementería Vazquez, V., Castro Diaz, A. D., López Martinez, B., Laris González, A., Jiménez-Juárez, R. N., & de la Rosa-Zamboni, D. (2019). Healthcare-Associated Pneumonia: Don’t Forget About Respiratory Viruses. Frontiers in pediatrics, 16(7), 168. DOI: 10.3389/fped.2019.00168