Running head: NURSING LEADERSHIP PRACTICUM JOURNAL

Nursing Leadership Practicum Journal

Student’s Name

Institution of Affiliation

Course Name

Date
NURSING LEADERSHIP PRACTICUM JOURNAL

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Week 7 Journal

Issue

The issue which I identified at Cleveland Clinic was that the ratio of patients to nurses in

the emergency department evidently compromised their ability to deliver high quality care. The

huge workloads contributed to inconsistencies in the documentation of patient care and little or

no time for nurses to connect with patients’ hence poor inter-personal therapeutic relations

(Ramsey, et al., 2018). As a result, the clinic has failed to meet the standards set by the

Accreditation Association for Ambulatory Healthcare. There is still the urgent need of promoting

high quality emergency medical care provided to patients as stipulated in the mission, vision and

goals set out by the clinic. However, inadequacy of the nursing workforce to actively interact

with patients at individual level and promote accurate documentation of patient care results to

poor quality of care in terms of: longer patient stay in the emergency department, medication

errors and inability to effectively address patient’s needs.

Analysis of the Action using Literature

The Standards set by the Emergency Nurses Association binds the provision of high

quality emergency care to staffing and clearly stipulates that the ability to provide high quality

care is compromised by huge workloads and inadequate staffing. It further emphasizes on the

need of maintaining the equilibrium and relationship between nurse to bed ratio to sustain the

provision of high quality emergency care as the hospital did (Rochefort, Buckeridge &

Abrahamowicz, 2015). The key purpose of taking a patient centered approach in emergency care

was to ensure that patients’ needs were adequately and efficiently addressed. This was however

affected by the availability of nursing personnel and therefore, achieving high quality emergency

care was similar to maintaining the required nurse to bed ratio.

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Alternative Evidence Based Approach

The issue can be addressed by incorporating the use of EHRs system in the

documentation of patient care to make work easier for the already limited nursing staff. As

suggested by Recio-Saucedo, et al., (2015), it would be necessary to revise nursing retirement

and schemes to change the process and address the deficits to achieve high quality care.

References

Ramsey, Z., Palter, J. S., Hardwick, J., Moskoff, J., Christian, E. L., & Bailitz, J. (2018).

Decreased Nursing Staffing Adversely Affects Emergency Department Throughput

Metrics. Western Journal of Emergency Medicine, 19(3), 496. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942016/.

Rochefort, C. M., Buckeridge, D. L., & Abrahamowicz, M. (2015). Improving patient safety by

optimizing the use of nursing human resources. Implementation Science, 10(1), 89.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26071752.

Recio-Saucedo, A., Pope, C., Dall'Ora, C., Griffiths, P., Jones, J., Crouch, R., & Drennan, J.

(2015). Safe staffing for nursing in emergency departments: evidence review. Emerg Med

J, 32(11), 888-894. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26273096.

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Week 11 Journal

Issue

Most of the patients who presented in the inpatient or outpatient clinical settings had

complex healthcare needs that generally required more than a single discipline to adequately

address healthcare issues. However, inter-professional collaboration continued to be a significant

challenge in clinical care due to the attitudes and beliefs of healthcare providers which hindered

its adoption. Most nurses, physicians, pharmacists, radiologists, cardiac specialists, renal

specialists and laboratory technicians had trouble working with one another in addressing the

healthcare needs of patients due to varying scopes of practice, belief systems and attitudes. As

highlighted by Green & Johnson (2015), interprofessional collaboration is an essential practice in

the healthcare field that promotes: patient centered care, knowledge pooling to tackle complex

healthcare problems, learning opportunities that are beyond traditional systems of thinking,

reduced medical costs, reduction of medication errors and adverse drug reactions, reduction of

workloads and increased job satisfaction.

Analysis of the Action using Literature

Faye Abdellah’s patient-centered theory to care was used to educate healthcare providers

how inter-professional collaboration helps to address the social, physical, and emotional needs of

a patient resulting to good health outcomes. This theory also highlights the transformation of care

within the clinical setting. Clinical providers have established that transition to collaborative

practice is challenging but exciting. The entire process includes effective communication

between healthcare providers, highly effective healthcare teams, respect, trust, discipline and

participatory leadership (Gonzalo, et al., 2016). Healthcare providers should learn how to:
NURSING LEADERSHIP PRACTICUM JOURNAL

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accommodate each other’s ideas, practice turn-taking during conversations, adhere to time

guidelines, embrace diversity, speak openly and freely to provide patient-centric care.

Alternative Evidence Based Approach

Patients who present with complex healthcare needs can be difficult to diagnose and

manage due to high chances of their healthcare needs not being adequately addressed. As

suggested by van Dongen, et al., (2016), embracing inter-professional education during the

period of training is also needful. It helps to nurture the culture of inter-professional

collaboration that is likely to be embraced in the entire period of clinical practice to provide

patient-centered care.

References

Green, B. N., & Johnson, C. D. (2015). Interprofessional collaboration in research, education,

and clinical practice: working together for a better future. Journal of Chiropractic

Education, 29(1), 1-10. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360764/.

Gonzalo, J. D., Himes, J., McGillen, B., Shifflet, V., & Lehman, E. (2016). Interprofessional

collaborative care characteristics and the occurrence of bedside interprofessional rounds:

a cross-sectional analysis. BMC health services research, 16(1), 459. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061365/.

van Dongen, J. J. J., Lenzen, S. A., van Bokhoven, M. A., Daniëls, R., van der Weijden, T., &

Beurskens, A. (2016). Interprofessional collaboration regarding patients’ care plans in

primary care: a focus group study into influential factors. BMC family practice, 17(1), 58.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884411/.