Feb 23, 2024 NURS 8100 Discussion Agenda Setting
A Sample Answer For the Assignment: NURS 8100 Discussion Agenda Setting
Identify the clinical practice issue you would like to see on your organization’s systematic agenda.
Clinical Practice Issue: Frequent Admissions due to Poor Discharge Nursing Education. Reducing hospital readmissions is a national focus for healthcare reform. Consequently, patient discharge education is increasingly important for improving clinical outcomes and reducing hospital costs (Polster, 2015). According to the Centers for Medicare and Medicaid Services (CMS), nearly 20% of all Medicare patients are readmitted to the hospital within 30 days of discharge; 34% are readmitted within 90 days of discharge (Polster, 2015)
The quality of discharge teaching is statistically linked to decreased readmission rates. Nursing most often bears the major responsibility of patient and caregiver teaching (Luther, et al., 2019). Currently, discharge teaching is complicated by problems including time constraints, patient and caregiver overload, and coexisting comorbidities that add complexity to the patient’s care needs at home. (Luther, et al., 2019). A structured discharge process with tools to help healthcare organizations improve their discharge process to decrease readmission rates need to be considered (Luther, et al., 2019).
The CMS expects nurses and other healthcare team members to address modifiable factors that can increase the chance of rehospitalization, such as (1) unplanned and early discharge or insufficient post-discharge support, (2) inadequate follow-up, (3) therapeutic mistakes, (4) adverse drug events, and (5) failed handoffs (Polster, 2015). The policy of interest will focus on failed handoffs or poor discharge education.
NURS 8100 Discussion Agenda Setting
Ineffective discharge is related to factors at the level of the individual care provider, the patient, the relationship between providers, and the organizational and technical support for care providers. Providers can reduce hospital readmission rates and adverse events by focusing on high-quality discharge information, well-coordinated care, and direct and timely communication with their counterpart colleagues (Hesselink, et al., 2015)
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What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?
There are several strategies that can be used to inform stakeholders while persuading them on the importance of a new policy (Hydera, et al., 2010). For example, the policy of interest must be established and stakeholders to be included. The stakeholders will entail clinical nursing, physicians, patient experiences, pharmacy, quality and safety, nursing managers and directors. Once a policy of interest and stakeholders have been established, accepting of the stakeholder’s perspective on the issue would be first taken into consideration.
Expectations related to interventions can predict the likelihood of successful intervention implementation through intervention refinement and incorporation of innovative ideas, sharing perspectives with key stakeholders will enhance solidarity around interventions for improving discharge education and reduction of frequent admits (Hydera, et al., 2010). Stakeholder engagement throughout research generation and policymaking becomes critical to strengthening the research–policy interface.
Fostering such linkages between mediators, individuals or institutions with different stakeholders will encourage strong research-policy linkages (Hydera, et al., 2010). Another strategy that can be used to persuade stakeholders on the importance of improving discharge education to decrease frequent admissions is to use policy briefing, a new approach to packaging research evidence for policymakers (Lavis, et al., 2009). The first step in a policy brief is to prioritize a policy issue, followed by use of systematic reviews to mobilize full range research evidence to the various features of the issue.
Hesselink, G., Zegers, M., MyVernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., Ön, G., Olsson, M., Bergenbrant, S., Orrego, C., Suñol, R., Toccafondi, G., Venneri, F., Dudzik-Urbaniak, E., Kutryba, B., Schoonhoven, L., & Wollersheim, H. (2014). Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC Health Services Research. 14: 389.
Hydera, A., Syeda, S., Puvanachandraa, P., Bloomb, G., Sundarama, S., Mahmoodc, S., Iqbalc, M., Hongwend, A., Ravichandrane, N., Oladepof, O., Pariyog, D., & Petersa, D. (2010). Stakeholder analysis for health research: Case studies from low- and middle-income countries. Public Health, 124(3): 159-166
Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy & Systems, 71–79.
Luther, B., Wilson, R. D., Kranz, C., & Krahulec, M. (2019). Discharge processes: what evidence tells us I most effective. Review Orthopedic Nurse; 38(5): 328-333.
Polster, D. (2015). Preventing readmissions with discharge education. Nursing Management, 46(10): 30-37.
A work environment is made up of a range of factors, organizational culture, management styles, hierarchies, and human resources policies. Employee satisfaction refers to how satisfied employees are with their jobs on a personal level. Employee satisfaction in the workplace is an important part of any organization that wants to keep their employees and cut down on work-related costs (Miller-Jones, 2020). It has been three years since I’ve worked for the organization. I’m one of a few people who have kept their jobs. I have witnessed employees come and leave during this time. Prior employees have often said “this people don’t know what they are doing.” This has been a common reason for leaving the organization. This should be on the organization’s long-term plan because it is taking a lot of time and money to train, as well as costing the agency money.
It comes as no surprise that poor leadership can result in higher employee turnover. Employees who aren’t motivated and are burned out from a poor culture begin looking for other jobs. Organizations struggle when they lose top performers and experienced employees and must replace them with new hires. The management of the organization lacks leadership skills and do not have a medical background, making it very difficult to communicate key issues that may arise. Dr. Kathleen discussed the importance of taking certain steps to get a policy adopted while taking into consideration feasibility, cost, and involvement of stakeholders prior to implementation (Executive Producer, 2011). Malik et al. (2017), found that engaging in leadership development, building organizational trust and commitment, and promoting job satisfaction are some of the modern human resource management functions in organizations.
A consequence of poor leadership is failing to inspire employees to deliver their best results and meet their potential. To achieve the best results, employees at every level need to be committed to the organization and to the accomplishment of goals, both financial and otherwise. Without a supportive culture or encouraging manager, financial goals are likely to be missed (Miller-Jones, 2020). Stakeholders include patients, caregivers, clinicians, employees, and healthcare facility representatives who are impacted by quality measures. Engaging stakeholders will involve identifying who the stakeholders are, and what my goals are for engaging with them. The more widely I spread my net at this stage, the more robust my plans will be bearing in mind how to influence each stakeholder to achieve the results I want.
References
Miller-Jones, G. (2020). Ineffective leadership and the devastating individual and organizational
consequences. Retrieved from
https://www.forbes.com/sites/forbescoachescouncil/2020/02/25/ineffective-leadership-and-the-devastating-individual-and-organizational-consequences/?sh=7d7c8fc51f2c
Malik, W. U., Javed, M., & Hassan, S. T. (2017). Influence of transformational leadership components on
job satisfaction and organizational commitment. Pakistan Journal of Commerce & Social Sciences, 11(1), 146–165.
Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda setting and
the policy process. Baltimore: Author.
A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level.
This is insightful Erin, employee satisfaction is a critical factor in the success or failure of any healthcare system. Happy, satisfied employees are more likely to provide quality care than those who are disgruntled and unhappy (Lins et al., 2021). A recent study by the Commonwealth Fund found that employee satisfaction is a key ingredient in high-performing health systems. The study looked at six countries – Australia, Canada, France, Germany, Sweden, and the United Kingdom – and found that those with the most satisfied employees also had the best results in terms of quality of care and patient outcomes (Popa et al., 2018).
Most organizations consider flexibility scheduling as one of the major factors that can ensure employee satisfaction within the healthcare institutions. Flexible scheduling is an important part of ensuring the wellbeing of nurse’s roles in healthcare (Gomez et al., 2020). It can help to reduce stress levels and improve work-life balance. Additionally, it can allow nurses to better care for their patients by providing them with the time they need to perform their duties effectively. Informing the stakeholder about flexibility scheduling requires constant communication through different platforms such as workshops.
References
Gomez, S., Anderson, B. J., Yu, H., Gutsche, J., Jablonski, J., Martin, N., … & Mikkelsen, M. E. (2020). Benchmarking critical care well-being: before and after the coronavirus disease 2019 pandemic. Critical care explorations, 2(10). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587602/
Lins, M. G., Zotes, L. P., & Caiado, R. (2021). Critical factors for lean and innovation in services: from a systematic review to an empirical investigation. Total Quality Management & Business Excellence, 32(5-6), 606-631. https://doi.org/10.1080/14783363.2019.1624518
Popa, I., Ştefan, S. C., Morărescu, C., & Cicea, C. (2018). Research regarding the influence of knowledge management practices on employee satisfaction in the Romanian healthcare system. Amfiteatru Economic, 20(49), 553-566. https://www.ceeol.com/search/article-detail?id=686828
To prepare:Review this week’s media presentation, focusing on the insights shared by Dr. White and Dr. Stanley on agenda setting and identification of stakeholders.Brainstorm clinical practice issues that you believe are worthy of being on your organization’s systematic agenda.Who are the stakeholders who would be interested in this clinical practice issue?
By Day 3
Post a cohesive response that addresses the following:
In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues providing additional strategies for informing and persuading stakeholders. Include additional research evidence that supports the importance of their identified clinical practice issue.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Submission and Grading InformationGrading Criteria
To access your rubric:
Week 3 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 3 Discussion
Name: NURS_8100_Week3_Discussion_RubricGrid ViewList View
Excellent Good Fair Poor
RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements:
*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts.
NURS 8100 Discussion Agenda Setting
Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.
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NURS 8100 Discussion Agenda Setting
Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE
Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION
Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.
Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.
Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING
Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
Points Range: 5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.
Points Range: 4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.
Hello
This is an outstanding post on the issue of frequent admissions due to poor discharge nursing education. Minimization of hospital readmission is currently a national focus for the health care system. Many hospital readmissions are preventable and emanate directly from uncoordinated care. As such, patient discharge education is essential in enhancing clinical outcomes and lowering hospital costs (Oh et al., 2021). Patient education during discharge matters because the current discharge process is intricate, inefficient, and time-consuming (Gülşen & Akansel, 2020).
Patients are often overwhelmed and rushed at discharge. The discharge information they are given through verbal instructions or a pile of aftercare guidelines they are handed on discharge are often infective. Ideally, the weakest link to hospital readmissions entails discharge procedures including inadequate post-discharge support, failed handoffs, premature discharge, and poor follow-up (Sharma & Rani, 2020). Therefore, proper education of patients both after discharge and at home and providing them with the appropriate tools they deserve to care for themselves or their families is essential in a significant reduction of the readmission rates in hospitals.
References
Gülşen, M., & Akansel, N. (2020). Effects of discharge education and telephone follow-up on cataract Patients’ activities according to the model of living. Journal of perianesthesia nursing, 35(1), 67-74. https://doi.org/10.1016/j.jopan.2019.04.010
Oh, E. G., Lee, H. J., Yang, Y. L., & Kim, Y. M. (2021). Effectiveness of discharge education with the teach-back method on 30-day readmission: a systematic review. Journal of patient safety, 17(4), 305-310. doi: 10.1097/PTS.0000000000000596
Sharma, S. K., & Rani, R. (2020). Nurse-to-patient ratio and nurse staffing norms for hospitals in India: a critical analysis of national benchmarks. Journal of family medicine and primary care, 9(6), 2631. Doi: 10.4103/jfmpc.jfmpc_248_20
Discussion – Week 3
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