understanding their care upon discharging from the hospital (U.S. Center for Medicare & Medicaid Services, n.d). Patient rounding by the assistant nurse managers is of great importance at KPSF. Patient rounding is one aspect of attaining higher HCAHP scores in sections of if the nurse is meeting
Essentials of Advanced Nursing Practice 9 the patient's needs promptly and if medications are being explained to the patient before administration. When the ANM rounds, they ask the patients these questions and intervene to ensure all complaints are addressed. KPSF refers to these complaints on patient rounding as service recoveries. Once these service recoveries are done, chances are, the patient will be more apt to give higher ratings on the survey. Evidence-based practice shows that purposeful rounding provides a structure to improve the patient care experience through proactive communication (Huang, 2019). Other initiatives KPSF implemented are the quiet at night, pain reassessments within 60 minutes of pain medicine administration, cleanliness of the patient’s room, hourly rounding, and nurse knowledge exchange at the bedside. Patient satisfaction is at the core of Kaiser’s mission. To tackle the quiet at night initiative, the assistant department manager explained that the alarms at the bedside were turned down to avoid awakening patients at night. Patients are also offered earplugs, face masks, and headphones to listen to soft music to promote relaxation. With the initiation of these steps, HCAHP scores have reportedly increased. A6. Organizational Change Recommendation Patient safety is on top of the priority list and the recommendation I suggest would be to go back to the prior way of staffing the units. The former way included a metric that was calculated based on the number of patients on the unit and the total acuity level. There were enough staff members to adequately and safely care for the patients, but since the implementation of the new system, there has been an increase in patient falls. Not in the critical care units, but the assistant department manager reported that they were all on the medical- surgical and medical telemetry floor. In addition to that, I recommend that when the cumulative acuity level is high, a campus support nurse be made available, to offset the extremely busy
Essentials of Advanced Nursing Practice 10 activities in the unit. This person would go around to help support the nurses and the patient care techs. I also recommend the use of more travel nurses in the interim of hiring new staff nurses. This will help buffer the shortage and increase the retention of current staff nurses, preventing them from possible burnout. According to the American Nurses Association (2012), there isn’t a proven staffing model that works for every patient care setting for all units. When considering staffing, all elements of patient care should be taken into account and patient safety and outcomes should be weighted heavily. When units are staffed appropriately, variables such as nurse burnout, medication errors, and the spread of infection decreases. Nurses are in turn able to
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