Reply separately to two of my peer’s posts (See attached peer’s posts, post#1 and post#2). 

INSTRUCTIONS:

  1. Using the SWOT Analysis Resource, (https://www.clearpointstrategy.com/swot-analysis-examples/) review the two classmates’ posts. (See attached posts)
  2. Identify two items from each of the four components (S,W,O,T) that is relevant to the problem your classmate identified. Explain your reasoning for each.

To reply to the example in the initial post, you could select advantages of the proposition and financial reserves from the Strengths quadrant. Elaborate on the advantages of following the recommendations—for example, following professional standards of equal care, decreasing cost by not ordering unnecessary diagnostic tests, and increasing revenue from shorter visit times.

Items you might identify from the Weakness quadrant could include processes and systems, and morale commitment and leadership. These items are weaknesses because of the need to train providers on national recommendations and to create a system within the EMR to track PAP smears.

You should then choose two items from both the Opportunities quadrant and the Threats quadrant and include them in your reply posts.

Your responses should be in a well-developed paragraph (300-350 words) to each peer, and they should include evidence-based research to support your statements using proper citations and APA format!

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add new informative content regarding to their topic that is validated via citations. 

  • Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.
  • Minimum of 300 words per peer reply.

Background: I am a Registered Nurse, I work in a Psychiatric Hospital (Crisis & Stabilization).

POST # 1 AYME

Practical/ Clinical Issue

     Working with elderly /geriatric patients with a history of diagnosis of psychiatric illness presents one of the major quality issues in clinical practice in the form of falls and related injuries. When an elderly patient is diagnosed with a psychiatric illness, they became more vulnerable than others. Most of them become confused, disorganized, and need continuing redirection. The geriatric patient is a very sensitive and vulnerable population and will become aggressive with any psychiatric illness. When we work with old people, we must make sure that they get the best care because they decompensate easier than others. Within nursing homes such as our workstations or any place where I do my clinicals, we deal with a unique group of patients. The elderly population is recognized as the greatest consumers of healthcare services across the U.S as compared to any other age-matched group (Nunan et al., 2018). Most of the time they are very needed, and they request help easily compare with others. These high rates of consumption of healthcare services have been occasioned by two key factors. Firstly, the adoption of the Affordable Care Act has increased enrollment for Medicare especially among groups that were previously underserved such as the elderly. Thus, the healthcare system is now dealing with a larger volume of elderly patients due to increased access to care (Society for Healthcare Epidemiology of America, 2018). The second factor is related to the reality of multiple co-morbidities in a majority of the elderly population. These individuals present with cognitive and physical comorbidities that significantly impact their response to environmental stimuli. The prevalence of falls among elderly people is highest as compared to any other age-matched group. This high prevalence is linked to the multiple co-morbidities and their impact on decision-making, judgment, and actual response to stimuli (Nunan et al., 2018). After a human gets older most of the systems are starting to decrease in function and the person will need double attention compared with a younger population.

     At the facility, there has been a challenge in controlling the rates of falls. Fall is very common in all populations and after a fall a patient will get disabled compare with other populations. The organization has adopted universal fall precautions such as clear pathways, immediate wipe-up of spills, use of nonskid footwear, and access to call bells/alarms. However, these precautions do not indicate any significant change in the occurrence of falls. The facility is facing unprecedented times from a budget perspective considering the current regulations by the Center for Medicare and Medicaid Services (CMS) on hospital-acquired infections including falls and related injuries. The CMS identified that it would not reimburse for costs associated with any HAIs including falls and hea

POST # 2 Prudencia

After working as a nurse for several years and practicing as a mental health nurse practitioner during clinical, I believe staffing is one safety issue in my unit. The majority of hospitals face staffing issues that can be detrimental to their patient’s safety (Mensik, & Sigma 2017). A good example is working with geriatric psychiatric patients whose safety concerns are falls (Mensik, & Sigma 2017). In a unit of 20 beds with high fall risk patients with mental health issues as common as confusion needing constant redirection, the hospital will sometimes schedule two nurses and one safety attendant. Some of these patients are agitated and are prone to violence when trying to redirect them. This situation puts both the staff and patients at risk of potential injury.  

Without proper staffing, these patients have a high risk of falling, leading to other health problems such as physical injury. Poor staffing can also lead to work stress and dissatisfaction in nurses (Senek et al., 2020). I have seen nurses quit their jobs because of staffing issues. Nurses get burnt out during this period, which is also detrimental to the care they administer to their patients. With low staffing, most nurses fail to follow hospital guidelines while providing care, leading to medical errors.  

This issue can be resolved by ensuring that nurses take part in staffing their units. Patient census and acuity should also be considered when staffing for any unit (Clarke, & Donaldson, 2018). More nurses should be considered when we have an increased number in patients who are confused and are at a high risk of falling. Staffing issues can also be resolved by hiring more nurses, safety attendance, and clarifying job descriptions and expectations during interviewing and every quarter while at work (Clarke, & Donaldson, 2018).  

                                                                           References 

Clarke, S., P, Donaldson, N.E. (2018). Nurse Staffing and Patient Care Quality and Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US). Chapter 25. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2676/ 

Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., Taylor, B., & Tod, A. (2020). Determinants of nurse job dissatisfaction – findings from a cross-sectional survey analysis in the UK. BMC Nursing, 19(1), 1–10. https://doi.org/10.1186/s12912-020-00481-3 

Mensik, J., & Sigma. (2017). The Nurse Manager’s Guide to Innovative Staffing, Second Edition: Vol. Second edition. Sigma Theta Tau International.