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How could you promote changes to ensure staffing becomes or remains adequate?

How could you promote changes to ensure staffing becomes or remains adequate?

How could you promote changes to ensure staffing becomes or remains adequate?

QUESTION
first installment

. Is your facility’s current staffing adequate? What is your reasoning?

How could you encourage changes to ensure adequate staffing is achieved or maintained?

Part 2

Examine the most common healthcare sentinel events. Transparency, Compassion, and Truth in Medical Errors: A TED Talk (This is a link to another website.)

The Most Common Sentinel Healthcare Events (2005-2016)

Wrong patient, wrong location, and wrong procedure

Unintentional foreign body retention

Treatment Delay

Suicide

Complications during/after surgery

Fall

Error in medication

Criminal occurrence

Perinatal mortality/injury

Concerning medical equipment

(According to the Joint Commission, 2018)

part 2 of questions

What could a risk manager do to prevent or reduce the likelihood of a repeat of this sentinel event?

What would you have done if you were the manager in charge of the shift during which this incident occurred?

How can you avoid or reduce the risk, and how would you react if the event occurred despite your efforts? What is the relationship between sentinel events and staffing?

Write in APA format, 7th edition, with two references.

within 14 hours

250-word essay
How could you promote changes to ensure staffing becomes or remains adequate?

ANSWER
Our health-care system is facing enormous challenges. Staff shortages caused by cost-cutting decisions, an aging population, increased patient complexity and need, and an aging workforce place stress on nurses’ working conditions, affecting patient care and overall outcomes. A growing body of evidence shows that adequate nurse staffing contributes to better patient outcomes and higher levels of satisfaction for both patients and staff. However, adequate staffing in all health care settings is still required. For more than two decades, the American Nurses Association (ANA) has worked to address unsafe nurse staffing levels in order to improve working conditions for nurses and achieve optimal patient outcomes.

Safe nurse staffing is critical to both the nursing profession and the health-care system as a whole. Staffing has an impact on all nurses’ ability to provide safe, high-quality care in all practice settings. We can improve health care for all by eliminating unsafe nurse staffing practices and policies.

The American Nurses Association is dedicated to providing evidence-based policy, practice, products, advocacy, and professional development to ensure safe staffing and to transform health and health care delivery.

Strategies for Contingency Capacity to Address Staffing Shortages
When staffing shortages are expected, healthcare facilities and employers should use contingency capacity strategies in collaboration with human resources and occupational health services to plan for and prepare for this problem. These are some examples:

Staff schedules are being adjusted, additional HCP are being hired, and HCP are being rotated to positions that support patient care activities.

Cancel all unnecessary procedures and visits. Shift HCPs who work in these areas to help with other patient care activities around the facility. Facilities must ensure that these HCP have received appropriate orientation and training to work in these unfamiliar areas.
Attempt to address social factors that may prevent HCP from reporting to work, such as a lack of transportation or housing that allows for physical separation, especially if HCP lives with people who have underlying medical conditions or elderly people.
Consider that some racial and ethnic groups are disproportionately affected by these social factors, which are also disproportionately affected by COVID-19 (e.g., African Americans, Hispanics and Latinos, and American Indians and Alaska Natives).
Find more HCPs to work in the facility. Be aware of any state-specific emergency waivers or changes to licensure requirements or renewals for specific HCP categories.
Request that HCP postpone elective time off from work as needed. However, the mental health benefits of time off should be considered, as well as the fact that care-taking responsibilities may differ significantly among employees.
Creating regional plans to identify designated healthcare facilities or alternate care sites with sufficient staffing to care for patients infected with SARS-CoV-2.

Allowing asymptomatic HCP who 1) had a higher-risk SARS-CoV-2 exposure, 2) are not known to be infected with SARS-CoV-2, and 3) are not up to date on all recommended COVID-19 vaccine doses to continue working onsite during their post-exposure period:

If asked to work, these HCP should be tested* one day after the exposure (the day of exposure is day 0), and if negative, again two, three, and seven days later. If testing supplies are limited, testing should be prioritized for 1-2 days after exposure and 5-7 days after exposure if negative.

*You can use either an antigen test or a nucleic acid amplification test (NAAT). Antigen tests have a faster turnaround time but are frequently less sensitive than NAAT. Testing contains more information about antigen tests and NAAT.

These HCPs should continue to report their temperature and the absence of symptoms each day before beginning work.
For the next ten days after their exposure:
They should always wear a respirator or a well-fitting facemask, even when they are in non-patient care areas like breakrooms.
If they need to remove their respirator or well-fitting facemask, for example, to eat or drink, they should do so separately from others.
To the greatest extent possible, they should maintain physical distance from others.
While interacting with these HCP, patients (if tolerated) should wear well-fitting source control.
If an HCP develops even mild COVID-19 symptoms, they should either not report to work or stop working and notify their supervisor or occupational health services before leaving. These people should be given top priority for testing.
If HCP are tested and found to be infected with SARS-CoV-2, they should be kept off the job until they meet all Return to Work Criteria. HCP with suspected SARS-CoV-2 infection should be prioritized for testing, as the results will influence when they can return to work and which patients they can care for.
Allowing SARS-CoV-2 infected HCP who are well enough and willing to work to return to work in the following ways:

HCP with mild to moderate illness who are not immunocompromised moderately to severely:

At least 5 days have passed since the onset of symptoms (day 0), at least 24 hours have elapsed since the last fever without the use of fever-reducing medications, and symptoms (e.g., cough, shortness of breath) have improved.
A negative antigen test or NAAT* may be used in healthcare facilities to confirm infection resolution.

HCP who were asymptomatic throughout their infection and are not immunocompromised in any way:

At least five days have passed since their first positive viral test (day 0).
A negative antigen test or NAAT* may be used in healthcare facilities to confirm infection resolution.

*When referencing the criteria above, either an antigen test or NAAT can be used. Some people may be past the expected period of infectiousness but remain NAAT positive for an extended period of time. Antigen tests have a faster turnaround time but are frequently less sensitive than NAAT. When testing asymptomatic HCP who have recovered from SARS-CoV-2 infection within the previous 90 days, antigen testing is preferred. Testing contains more information about antigen tests and NAAT.

Consider the following factors when deciding which HCP should be prioritized for this option:
The kinds of HCP shortages that must be addressed.
Where a specific HCP is in the course of their illness (e.g., viral shedding is likely higher earlier in the course of illness).
The kinds of symptoms they’re having (e.g., persistent fever, cough).
Their level of interaction with patients and other healthcare providers in the facility. For example, do they work in telemedicine services, direct patient care, or a satellite unit that reprocesses medical equipment?
The patients they look after (e.g., consider patient care only with patients known or suspected to have SARS-CoV-2 infection rather than patients who are immunocompromised).
If an HCP is asked to return to work before meeting all of the traditional Return to Work Criteria, they should still follow the recommendations outlined below.
If symptoms recur or worsen, they should self-monitor and seek re-evaluation from occupational health.
Until they meet the standard criteria for returning to work:
They should always wear a respirator or a well-fitting facemask, even when they are in non-patient care areas like breakrooms.
If they need to remove their respirator or well-fitting facemask, for example, to eat or drink, they should do so separately from others.
To the greatest extent possible, they should maintain physical distance from others.
While interacting with these HCP, patients (if tolerated) should wear well-fitting source control.
Strategies for Addressing Staffing Shortages in Times of Crisis
When staffing shortages occur, healthcare facilities and employers may need to implement crisis capacity strategies (in collaboration with human resources and occupational health services) to continue providing patient care. When there are insufficient personnel to provide safe patient care:

Implement regional plans to transfer COVID-19 patients to designated healthcare facilities or alternate care sites with sufficient staffing.

Allow asymptomatic HCP who 1) had a higher-risk SARS-CoV-2 exposure, 2) are not known to be infected with SARS-CoV-2, and 3) are not up to date with all recommended COVID-19 vaccine doses to continue working onsite without testing.

These HCPs should continue to report their temperature and the absence of symptoms each day before beginning work.
For the next ten days, they should wear a respirator or a well-fitting facemask at all times, even in non-patient care areas like breakrooms.
If they need to remove their respirator or well-fitting facemask, for example, to eat or drink, they should do so separately from others.
To the greatest extent possible, they should maintain physical distance from others.
While interacting with these HCP, patients (if tolerated) should wear well-fitting source control.
If an HCP develops even mild COVID-19 symptoms, they should either not report to work or stop working and notify their supervisor or occupational health services before leaving. These people should be given top priority for testing.
If HCP are tested and found to be infected with SARS-CoV-2, they should be kept off the job until they meet all Return to Work Criteria. HCP with suspected SARS-CoV-2 infection should be prioritized for testing, as the results will influence when they can return to work and which patients they can care for.
If shortages persist despite other mitigation strategies, consider allowing HCP to work even if they have suspected or confirmed SARS-CoV-2 infection, as long as they are well enough and willing to work, and even if they have not met all Return to Work Criteria.

Consider the following factors when deciding which HCP should be prioritized for this option:
The kinds of HCP shortages that must be addressed.
Where a specific HCP is in the course of their illness (e.g., viral shedding is likely to be higher earlier in the course of illness).
The kinds of symptoms they’re having (e.g., persistent fever, cough).
Their level of interaction with patients and other healthcare providers in the facility. For example, do they work in telemedicine services, direct patient care, or a satellite unit that reprocesses medical equipment?
The patients they look after (e.g., consider patient care only with patients known or suspected to have SARS-CoV-2 infection rather than patients who are immunocompromised).
If HCP are asked to work before meeting all criteria, they should avoid contact with immunocompromised patients (e.g., transplant, hematology-oncology), and facilities should consider prioritizing their duties in the following order:
Allow HCP with suspected or confirmed SARS-CoV-2 infection to work in jobs where they do not interact with others (e.g., patients or other HCP), such as telemedicine services, if this has not already been done.
Allow HCP with confirmed SARS-CoV-2 infection to provide direct care only to SARS-CoV-2 infected patients, preferably in a cohort setting.
Allow HCPs who have been diagnosed with SARS-CoV-2 to provide direct care only to patients who have been diagnosed with SARS-CoV-2.
Allow HCP with confirmed SARS-CoV-2 infection to provide direct care for patients who do not have suspected or confirmed SARS-CoV-2 infection as a last resort. If this is being considered, it should only be used as a bridge to longer-term strategies that do not involve potentially infectious HCP caring for uninfected patients. All other recommended infection prevention and control measures (e.g., use of respirator or well-fitting facemask for source control) must be strictly followed.
If an HCP is asked to return to work before meeting all of the Return to Work Criteria, they should still follow the recommendations outlined below.
If symptoms recur or worsen, they should self-monitor and seek re-evaluation from occupational health.
Until they meet the standard criteria for returning to work:
They should always wear a respirator or a well-fitting facemask, even when they are in non-patient care areas like breakrooms.
If they need to remove their respirator or well-fitting facemask, for example, to eat or drink, they should do so separately from others.
To the greatest extent possible, they should maintain physical distance from others.
While interacting with these HCP, patients (if tolerated) should wear well-fitting source control.

How could you promote changes to ensure staffing becomes or remains adequate?

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