NHS FPX 6008 Assessment 2 Needs Analysis for Change

Name

Capella university

NHS-FPX 6008 Economics and Decision Making in Health Care

Prof. Name

Date

Needs Analysis for Change

Systematic evaluation, also known as needs analysis, is a crucial process for healthcare organizations to identify areas for improvement and implement effective changes. This paper will analyze the economic issue of nursing shortages at Riverside Community Hospital, a pressing concern within the healthcare system. We will explore the impact of these shortages on the hospital, staff, and the community while identifying causes and proposing solutions to ensure better patient care and financial stability. 

Summary of the Economic Issues of Nurse Shortages

Nursing shortages at Riverside Community Hospital pose a significant financial strain. Alarmingly, the nursing workforce shrunk by over 100,000 registered nurses between 2020 and 2021, a considerable portion being young (under 35) (Lucy et al., 2024). At Riverside Community Hospital (RCH), the nursing workforce shortage has been highlighted since the COVID-19 pandemic, and since then, the issues associated with nursing shortages have not been resolved (Seiu121rn.org, 2023). This shortage burdens my colleagues’ work, increasing workloads, and leading to burnout and job dissatisfaction. Further, high turnover rates due to understaffing and overtime compromise the quality of care and potentially lead to safety risks. Data shows that the average nurse-to-patient ratio is nine-to-thousand, which contributes to medical errors and adverse events (Lucy et al., 2024).

The RCH can have financial strain due to turnover, decreased patient satisfaction, damaging reputation, and discourage new hires.  Moreover, it impacts the community negatively, as patients experience longer wait times and potentially lower quality of care due to understaffing. This can have a disproportionate impact on vulnerable populations who already face limited access to healthcare. Among the ten states with the most significant expected nursing shortages include California (18%) in 2035 (Rosseter, 2024).

Addressing this issue is critical to ensure both quality patient care and financial stability for the hospital. A key contributing factor to the shortage is the high turnover rates among the nurses, often caused by job dissatisfaction and heavy workloads. The data shows that in the US, 58% of the nurses leave the workforce in the first two years of their job from hospital settings. Generally, the reasons recorded show burnout 45.1%, fatigue 49.7%, and emotional exhaustion 50.8%. But this percentage of leaving in the first two years extends to 62% at RCH (Zippia, 2022).

Socioeconomic or Diversity Disparities

The nursing shortages at RCH can disproportionately impact specific patient populations seeking care services due to socio-economic disparities in healthcare access. For instance, low-income and uninsured patients often rely on public hospitals like RCH for essential medical care. Now, RCH is a 517-bed hospital that caters to acute care patients and actively engages in the emergency department. With fewer nurses on staff, these patients might face longer wait times and lower-quality care due to rushed interactions or limited time for thorough assessments (Udina et al., 2020). Moreover, Riverside County is part of the Inland Empire and has the highest diverse population, with Hispanics/Latinos the largest, followed by Whites and other races. This means, a significant population speaks languages other than English, prominently Spanish. A lack of sufficient bilingual nurses can create communication challenges, hindering effective care for non-English speaking patients.

A study by Qi et al. (2023), explicitly discusses that demographic characteristics such as race, age, and ethnicity caused disparities in healthcare access. It also discusses that socio-economic conditions, including poverty level, educational level, and insurance type, play a role in healthcare access. This study significantly discusses that private insurance, high educational attainment, and being White bring in better healthcare services like better diabetic medications and better vaccination options. Low education attainment, gender differences, and other factors hinder access to high-quality care, damaging the principles of equity that demand the division of resources based on needs. Another study highlights that limited access to healthcare services disproportionately affects racial and ethnic minorities, low-income populations, and rural residents. These disparities are often exacerbated by a shortage of healthcare professionals in underserved communities, demanding a strategic plan to fill this gap (Mohajer, 2023)

Evidence-Based Sources

The nursing shortages at RCH necessitate immediate attention due to the detrimental impact on patient care, staff well-being, and financial stability. Research offers evidence-based solutions that RCH can implement. Firstly, the work environment and retention strategies should be improved. A study by Gil et al. (2022), found a positive correlation between nurse-to-patient ratios and burnout. Hospitals with lower nurse-to-patient ratios reported decreased burnout and higher job satisfaction among nurses. Implementing safe staffing ratios at RCH can significantly improve nurse wellbeing and reduce turnover. Another study by Pressley and Garside (2023), talks about the importance of retention strategies, for instance, investing in professional development programs, mentorship opportunities, and competitive compensation packages, which all add to job satisfaction. It can incentivize nurses to stay at RCH, reducing the financial burden of recruitment and temporary staffing.

Another strategy is to enhance the support system and recognition program. A study by Nurmeksela et al. (2021), states that there is a link between hospital leadership, particularly the nurse manager’s approach, and nurse retention. Nurse managers who actively engage with nurses, fostering a supportive and collaborative work environment, can increase job satisfaction and decrease turnover. Nurses complain of burnout and selfless commitment to the healthcare system, impacting their emotional, physical, and psychological well-being. Evidence highlights the positive impact of recognition programs in both monetary and non-monetary ways. Programs that acknowledge and reward nurses for their contributions can boost morale and create a more positive work culture, benefiting the system with a satisfied workforce (Alahiane et al., 2023). 

NHS FPX 6008 Assessment 2 Needs Analysis for Change

Moreover, there is a need for strategies to retain and engage younger nurses; at RCH, 47% of the employees are within the range of 20 to 30 years (Zippia, 2022). A study by Mitra et al. (2024), emphasizes the need for work-life balance for nurses. Offering flexible hours, childcare options, and loan repayment programs for younger nursing staff has several benefits, including reduced stress, increased productivity, and enhanced physical health. RCH should incorporate a preceptorship program within the healthcare system to help novice nursing staff adjust to clinical settings. This program eases the transition for new nurses from the educational to the practical world, as demonstrated in the study (Hong & Yoon, 2021). Pairing experienced nurses with new hires can provide valuable mentorship and support, leading to higher job satisfaction and retention among younger nurses.

Predicted Outcomes and Opportunities

Addressing the nursing shortages at RCH through proposed solutions can lead to significant economic benefits for both patients and the organization. Following are some predicted outcomes and opportunities for reduced costs. Firstly, the retention strategies would improve patient care and reduce costs associated with it, as adequate staffing allows for more comprehensive education and discharge planning, potentially leading to fewer complications and readmissions. In the surgical unit, ideally, four-to-one would prevent 1595 and save $117 million (Lasater et al., 2021).

This lowers health costs for both the patient and the hospital. Further, with more time for proper hygiene protocols and patient monitoring with adequate nursing staff, the risk of Hospital-Acquired Infections (HAIs) decreases. This translates to cost savings for RCH as HAIs are expensive to treat (Abalkhail & Alslamah, 2022). Moreover, shorter wait times, improved communication, and more personalized care due to adequate staffing can lead to higher patient satisfaction (Yoon, 2022). This, in turn, can positively impact RCH’s reputation and potentially attract more patients, raising revenue. 

The strategies are targeted to increase staff retention, hence reducing costs at RCH. By retaining existing nurses through improved work environments and incentives, the hospital can ease the financial burden of constant recruitment and training for new staff. A happier and less stressed nursing staff leads to increased productivity and efficiency (Hong & Yoon, 2021). This translates to better patient care and allows RCH to handle a larger patient volume without compromising quality. Moreover, more robust support systems and recognition programs can foster collaboration among nurses. This leads to an efficient and cost-effective healthcare delivery system (Alahiane et al., 2023). By addressing the nursing shortage, RCH can achieve significant cost savings through improved patient outcomes and productivity, as well as reduced expenses. This translates to a more financially stable organization, allowing for further investment in patient care and infrastructure and potentially attracting new talent. 

Conclusion

In conclusion, the nursing shortage at RCH has significant economic consequences. By implementing evidence-based solutions focused on improved work environments, staff retention, and attracting younger nurses, the hospital can achieve better patient care, reduced costs, and improved financial stability. This will allow RCH better to serve the community and its diverse patient population.

References

Abalkhail, A., & Alslamah, T. (2022). Institutional factors associated with infection prevention and control practices globally during the infectious pandemics in resource-limited settings. Vaccines, 10(11), 1811. https://doi.org/10.3390/vaccines10111811 

Alahiane, L., Zaam, Y., Abouqal, R., & Belayachi, J. (2023). Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: A single-centre, cross-sectional study in Morocco. National Library of Medicine, 13(5), e051933–e051933. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193074/ 

California100. (2023). Inland Empire region a California 100 report. California100.org https://california100.org/wp-content/uploads/2023/11/Inland-Empire-Region_FINAL-1.pdf 

Gil, M. F. H., Hernández, J. A. R., López, F. J. I., Llor, A. M. S., Valcárcel, M. D. R., Mikla, M., & Montesinos, M. J. L. (2022). Relationship between job satisfaction and workload of nurses in adult inpatient units. International Journal of Environmental Research and Public Health, 19(18), 11701. https://doi.org/10.3390/ijerph191811701 

NHS FPX 6008 Assessment 2 Needs Analysis for Change

Hong, K. J., & Yoon, H.-J. (2021). Effect of nurses’ preceptorship experience in educating new graduate nurses and preceptor training courses on clinical teaching behavior. International Journal of Environmental Research and Public Health, 18(3), 975. https://doi.org/10.3390/ijerph18030975 

Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: An observational study. BMJ Open, 11(12). https://doi.org/10.1136/bmjopen-2021-052899 

Lucy, I., Mahoney, K., & Hoover, M. (2024, January 29). Data deep dive: A national nursing crisis. Www.uschamber.com. https://www.uschamber.com/workforce/nursing-workforce-data-center-a-national-nursing-crisis 

Mitra, L. G., Sharma, J., & Walia, H. S. (2024). Improving work-life balance and satisfaction to improve patient care. Indian Journal of Critical Care Medicine/Indian Journal of Critical Care Medicine, 28(4), 326–328. https://doi.org/10.5005/jp-journals-10071-24689 

Mohajer, M. A. (2023). Understanding the gap between nursing workforce in the United States and population needs—a policy brief. Avicenna Journal of Medicine, 13(04), 206–214. https://doi.org/10.1055/s-0043-1775724

NHS FPX 6008 Assessment 2 Needs Analysis for Change

Nurmeksela, A., Mikkonen, S., Kinnunen, J., & Kvist, T. (2021). Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: A correlational study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06288-5 

Pressley, C., & Garside, J. (2023). Safeguarding the retention of nurses: A systematic review on determinants of nurse’s intentions to stay. Nursing Open, 10(5). https://doi.org/10.1002/nop2.1588 

Qi, M., Santos, H., Pinheiro, P., McGuinness, D. L., & Bennett, K. P. (2023). Demographic and socioeconomic determinants of access to care: A subgroup disparity analysis using new equity-focused measurements. PLOS ONE, 18(11), e0290692–e0290692. https://doi.org/10.1371/journal.pone.0290692 

Rosseter, R. (2024, May). Nursing shortage fact sheet. Www.aacnnursing.org. https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage#:~:text=According%20to%20a%20Health%20Workforce 

Seiu121rn.org. (2023, August 29). Riverside community hospital nurses stage picket over unsafe staffing, working conditions. Seiu121rn.org. https://www.seiu121rn.org/2023/08/29/riverside-community-hospital-nurses-stage-picket-over-unsafe-staffing-working-conditions/ 

Udina, M. J., Samartino, M. G., Jiménez, M. M. L., Canals, M. P., Fernández, H. R., Duelt, I. J. B., Pérez, M. T., Prat, M. P., Martínez, E. J., Llorca, M. À. B., Flores, S. A., Morelló, C. B., Pérez, E. Z., Hito, P. D., Luque, Ó. R., Zabalegui, A., Fabrellas, N., & Adamuz, J. (2020). Acuity, nurse staffing and workforce, missed care and patient outcomes. A cluster‐unit‐level descriptive comparison. Journal of Nursing Management, 28(8). https://doi.org/10.1111/jonm.13040 

NHS FPX 6008 Assessment 2 Needs Analysis for Change

Yoon, H.-J. (2022). The effect of nurse staffing on patient outcomes in acute care hospitals in Korea. International Journal of Environmental Research and Public Health, 19(23), 15566. https://doi.org/10.3390/ijerph192315566 

Zippia. (2022, March 25). Riverside Community Hospital number of employees, statistics, diversity, demographics, and facts – Zippia. Www.zippia.com. https://www.zippia.com/riverside-community-hospital-careers-36822/demographics/