AGEISM BETWEEN HEALTHCARE PROVIDERS

In this assignment, you will be writing a 6 -page paper identifying, comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective .
Reflect on your own decision-making practices and the implications this will have regarding differing approaches taken of nursing leaders and staff nurses/clinical practitioners in decision making within to issues in practice. To complete this assignment, do the following:

1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 3 different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC, HRSA, etc. Again, this need to be specifically applied with sufficient details

Sample Answer

Decision-Making Approaches in Nursing: Addressing the Issue of Nurse-to-Patient Ratio
Introduction
The issue of nurse-to-patient ratio is a significant concern that impacts nurses at all levels of practice, from bedside nurses to advanced practice nurses. The inadequate staffing levels and high patient-to-nurse ratios have been linked to negative patient outcomes, increased nurse burnout, and compromised quality of care. This paper aims to explore and compare three different decision-making approaches that nurse leaders, bedside nurses, and advanced practice nurses can utilize to address the issue of nurse-to-patient ratio.

Background and Significance
Nurse-to-patient ratio refers to the number of patients assigned to each nurse during a given shift. Numerous studies have established a clear association between nurse staffing levels and patient outcomes. Inadequate staffing, characterized by high patient-to-nurse ratios, has been linked to increased mortality rates, medication errors, patient falls, and healthcare-associated infections. Additionally, nurses working in high-stress environments with heavy workloads are at an increased risk of burnout, job dissatisfaction, and intention to leave the profession.

Addressing the issue of nurse-to-patient ratio is crucial to ensure patient safety, improve nurse job satisfaction, and retain experienced nurses. The literature suggests several strategies to address this problem, including the use of decision-making approaches that involve nurse leaders, bedside nurses, and advanced practice nurses.

Decision-Making Approaches
Shared Decision-Making (SDM): Shared decision-making involves collaboration and shared responsibility between nurses, nurse leaders, and other stakeholders in making decisions related to staffing and patient assignments. This approach empowers bedside nurses to actively participate in determining the appropriate nurse-to-patient ratio based on patient acuity, workload, and available resources. Nurse leaders facilitate this process by providing nurses with the necessary information, support, and resources to make informed decisions. Advanced practice nurses can contribute by leveraging their expertise to assess patient acuity and recommend appropriate staffing levels.

Evidence-Based Decision-Making (EBDM): Evidence-based decision-making involves using the best available evidence, combined with clinical expertise and patient preferences, to guide staffing decisions. This approach requires nurse leaders, bedside nurses, and advanced practice nurses to critically appraise research evidence on the relationship between nurse staffing and patient outcomes. By utilizing evidence-based staffing guidelines and tools, decisions regarding nurse-to-patient ratios can be based on objective data, ensuring that staffing assignments align with patient needs and safety requirements.

Transformational Leadership: Transformational leadership involves inspiring and motivating nurses to achieve shared goals and improve patient outcomes. Nurse leaders, as transformational leaders, can advocate for adequate staffing levels by engaging in open communication, fostering a positive work environment, and addressing the concerns of bedside nurses. Advanced practice nurses can also demonstrate transformational leadership by collaborating with nurse leaders and advocating for evidence-based staffing practices. By creating a culture of shared accountability and support, transformational leadership can facilitate decision-making processes that prioritize patient safety and optimal nurse-to-patient ratios.

Best Decision-Making Approach
After a thorough analysis of the three decision-making approaches, the best approach to address the issue of nurse-to-patient ratio is Shared Decision-Making (SDM). SDM empowers bedside nurses to actively participate in staffing decisions, taking into consideration patient acuity, workload, and available resources. By involving bedside nurses in decision-making, SDM enhances their engagement, satisfaction, and sense of ownership, which can ultimately improve patient outcomes.

SDM also aligns with the principles of patient-centered care, as it recognizes the importance of including patients and their families in decision-making processes. By considering patient perspectives and preferences, SDM ensures that staffing decisions are patient-centered and promote quality care.

Moreover, SDM fosters a collaborative and supportive work environment, where nurse leaders and advanced practice nurses act as facilitators and provide the necessary resources and information for informed decision-making. This approach promotes teamwork, trust, and open communication among all levels of nursing practice.

Funding Source
To support the implementation of SDM in addressing the issue of nurse-to-patient ratio, seeking funding from local nursing organizations such as Sigma Theta Tau International (STTI) can be a viable option. STTI offers research grants and project funding opportunities to support evidence-based practice initiatives and promote nursing excellence.

By applying for funding through STTI, nurse leaders, bedside nurses, and advanced practice nurses can access financial resources to conduct research studies or quality improvement projects that focus on implementing and evaluating SDM in staffing decisions. These projects can provide valuable insights into the effectiveness of SDM in improving nurse-to-patient ratios and patient outcomes, further contributing to the evidence base in this area.

Additionally, seeking funding from governmental organizations such as the Health Resources and Services Administration (HRSA) can also be explored. HRSA offers grants and funding opportunities to address healthcare workforce challenges, which can include initiatives aimed at improving nurse staffing and patient safety.

Conclusion
The issue of nurse-to-patient ratio is a significant concern that impacts nurses at all levels of practice. By utilizing decision-making approaches such as Shared Decision-Making (SDM), Evidence-Based Decision-Making (EBDM), and transformational leadership, nurse leaders, bedside nurses, and advanced practice nurses can address this issue effectively. Among these approaches, SDM is the most suitable, as it empowers bedside nurses and promotes collaboration, patient-centered care, and a supportive work environment. Seeking funding from organizations like Sigma Theta Tau International (STTI) and the Health Resources and Services Administration (HRSA) can provide the necessary resources to implement and evaluate SDM initiatives, further supporting evidence-based staffing decisions and improving patient outcomes.

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