Evaluating the Solution to the Nurse Shortage Issue

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Background

The proposed solution to the problem of nurse shortage consists of three components, which include (1) altering the hospitals program to recognize the ability of short-term registered nurses and ensuring that nurse-related duties are easily transferable, (2) engaging in additional lobbying with the view to increasing funding, and (3) creating a suitable working environment to make the hospital more attractive and cause many short-term nurses to consider becoming residents. This section develops an effective evaluation plan aimed at assessing whether or not the proposed solution makes a difference.

Methods to Evaluate Effectiveness of Proposed Solution & Variables

A mixed-methods approach (quantitative and qualitative) will be used to evaluate the effectiveness of the proposed solution since the major purpose of the evaluation is to assess whether the solution has been able to achieve what it set out to accomplish. The Quantitative research methodology will utilize questionnaires that are supported by the positivist values of scientific inquiry (Walsh, Duke, Foureur, & Macdonald, 2007). The questionnaires will be targeted at nursing professionals in the hospital with the view to collecting numerical data intended to statistically demonstrate how the solution has been able to address the problem. As postulated by Walsh et al (2007), the quantitative methodology aims to generate findings that are objective, measurable and replicable (p. 138). The questionnaires will make use of the Lickert-type scale to achieve reliable and generalizable findings that demonstrate the capacity to surmount perceptions of bias and subjectivity (Jansson, Pilhammor-Anderson, & Forsberg, 2010). The arising data from the quantitative approach will be statistically analyzed using SPSS to come up with outcome-based findings for the solution.

The qualitative methodology will utilize interviews targeted at the hospitals management to, among other things, collect experiential data that enable the comprehension of the social, cultural, emotional, attitudinal, and behavioral responses of participants (Walsh et al., 2007). This method will not only acknowledge diverse viewpoints regarded as fundamental for effective evaluation in contemporary nurse settings but also afford a broader scope of inquiry from the early formative phases to the outcomes of the proposed solution. The arising data will be analyzed using content analysis with the view to develop themes that will serve to demonstrate if the proposed solution has been effective (Jansson et al., 2010).

Several variables will be evaluated using the two methodologies to determine if the project outcomes are effective in addressing the problem of nurse shortage. These variables include nurse turnover, nurse attraction and retention, duration of nurses in the hospital, ability of the hospital to meet its service obligations, reliance on temporary nurses, improved patient outcomes, level of burnout among nurses, and favorable working environment.

Poster Development to Educate Project Participants

Overview

This poster shares the knowledge of the causes of nurse shortage in the United States and what needs to be done to address the problem.

Causes of Nurse Shortage and Turnover

Nurse shortage and turnover are caused by a multiplicity of factors which include lack of job satisfaction, burnout, and stress occasioned by a heavy workload, lack of job security, aging of the population and workforce, low salaries, a small number of nurses from nursing faculties, poor working conditions, as well as insufficient governmental investments and monetary assistance in nursing (Elgie, 2007; Zarea, Negarandeh, Dehghan-Nayeri, & Razaei-Adaryani, 2009).

Solutions to Nursing Shortage and Turnover

Scholars and practitioners have identified several solutions to the problem of nursing shortage and turnover. These include introducing work-life programs, increasing salaries and other benefits, improving working conditions, attracting more students to nursing schools through funding and reimbursement, and ensuring that government investments and monetary assistance are allocated to hospitals through legislation (Elgie, 2007).

Questionnaire and Interview to Evaluate Project Outcomes

Questionnaire Development

The questionnaire will utilize a Ticket-type scale to ensure that the evaluation can objectively measure the nursing professionals attitudes, feelings, and opinions relating to the implemented solution (Walsh et al., 2007). The 10-item questionnaire will include the following questions (ranking: 1= strongly agree; 2=agree; 3=neither agree nor disagree; 4=disagree; 5=strongly disagree)

No. Statement 1 2 3 4 5
1. Altering the hospitals program to recognize the ability of short-term registered nurses has reduced nurse turnover?
2. Ensuring that nurse-related activities are easily transferable has increased nurse attraction and retention?
3. Engaging in additional lobbying has enabled the hospital to employ more nurses for longer periods due to the availability of funds?
4. Creating a suitable working environment within the hospital has reduced nurse turnover?
5. Increasing the number of nurses and retaining them improves patient healthcare outcomes?
6. Creating a suitable working environment within the hospital has reduced the reliance on temporary nurses?
7. Ensuring that nurse-related activities are easily transferable has reduced nurse burnout and stress?
8. Engaging in additional lobbying for extra funds has enhanced the hospitals capability to meet its service obligations?
9. A favorable working environment developed within the hospital has resulted in more nurses requesting permanent positions?
10. Altering the hospitals program to recognize the ability of short-term registered nurses to serve its needs adequately has resulted in improved nurse retention rates for permanent members of staff?

Interview Development

The interview will be unstructured and will be guided by the following questions which will be directed at the senior management of the health institution:

  1. How has altering the hospitals program to recognize the ability of short-term nurses and to ensure transferability of nursing duties impacted the issue of nursing shortage in the institution?
  2. Have additional lobbying efforts led to more nurses being attracted and retained in the workforce?
  3. Has the creation of a suitable work environment addressed the problem of nurse shortage in the hospital?

Strategy for the Dissemination of Results

Available literature demonstrates that dissemination is an active approach of spreading evidence-based information to the target audience via determined channels using planned strategies (Brownson, Jacobs, Tabak, Hoehner, & Stamatakis, 2013, p. 1693). Although research findings can be disseminated using methods such as conference presentations, journal articles, and company reports (Drury & Hart, 2013), this paper uses a novel bottom-up approach intended to generate a climate of ownership and ensure that the key stakeholders, as well as the greater nursing community, benefit from the findings. The strategy adopted in this paper is known as a poster presentation. Available literature demonstrates that poster presentation is an innovative and novel approach to dissemination not only due to its capacity to meet the needs of a diverse group of people but also because of its potential to provide a two-way process of exchanging knowledge between the research team and the intended audience (Drury & Hart, 2013).

The posters will use graphs as an acceptable visual representation of findings and also encourage stakeholders and the greater nursing community to stop and read them due to their visual appeal. The intended audience will find them easy to read due to the use of minimal amounts of text, thus encouraging the adoption of ownership of the project (Drury & Hart, 2013). The posters will be placed in visible locations to encourage the uptake of information and understanding of the research findings. The posters will also break down the research findings into summaries that will be easily understood by the intended audience and contacts will be provided for any queries or feedback. This strategy is a relatively cheaper, practical approach to disseminating research findings.

References

Brownson, R.C., Jacobs, J.A., Tabak, R.G., Hoehner, C.M., & Stamatakis, K.A. (2013). Designing for dissemination among public health researchers: Findings from a national survey in the United States. Journal of Public Health, 103(9), 1693-1699.

Drury, V., & Hart, K. (2013). Getting the message out  disseminating research findings to employees in large rural mining organizations. Australian Journal of Advanced Nursing, 30(4), 19-22.

Elgie, R. (2007). Politics, economics, and nursing shortages: A critical look at United States government policies. Nursing Economic$, 25(5), 285-292.

Jansson, I., Pilhammor-Andersson, E., & Forsberg, A. (2010). Evaluation of documented care plans by the use of nursing-sensitive outcome indicators. Journal of Evaluation in Clinical Practice, 16(3), 611-618.

Walsh, K., Duke, J., Foureur, M., & Macdonald, L. (2007). Designing an effective evaluation plan: A tool for understanding and planning evaluations for complex nursing contexts. Contemporary Nurse, 25(1-2), 136-145.

Zarea, K., Negarandeh, R., Dehghan-Nayeri, N., & Razaei-Adaryani, M. (2009). Nursing staff shortages and job satisfaction in Iran: Issues and Challenges. Nursing & Health Sciences, 11(3), 326-331.

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