Please complete the following questions in your reflective journal: (Meets Module SLOs 1, 2, 3, 4 & 5 ) Nursing leadership requires knowledge in fiscal management and budget evaluation. Time management, staffing and scheduling take a special skill to ensure you have adequate staffing within a planned budget to provide safe, quality patient care. You will use this assignment to practice your skills for determining nurse/patient ratios for staffing, patient assignments and time management through reflection and calculation. After completing the Sentinel U: Patient Management and Delegation Level 3- First while looking at the report sheets- what do you glean to know you have a low, medium, or high acuity patient? While looking at the report sheets, what tells you which nurse, an expert nurse or the nurse with a medium amount of experience needs to do something. While looking at the report, what criteria indicates that you must act right away as your first priority? What helpful suggestions can you as a charge nurse or nursing manager provide a new staff nurse to improve time management with a patient assignment? (Use your suggested reading for suggestions to improve time management: Leis, S. J., & Anderson, A. (2020). Time management strategies for new nurses. American Journal of Nursing, 120(12), 63. https://doi:10.1097/01.NAJ.0000724260.01363.a3 . Describe the workload tool used where you have practiced to efficiently meet the patient staffing needs. If you are not currently working as a nurse, find a tool online and describe it. (See Chapter 8 in your textbook). Calculate the nursing care hours per patient-day (NCH/PPD) based upon the same number of patients (10) staying for 24 hours and during the 0700-1500 shift, 3 RNs and 1 nursing assistant (NA); 1500-2300 shift, 3 RNs; 2300-0700 shift, 2 RNs, and 1NA. The formula is NCH/PPD = Nursing hours worked in 24 hours divided by Patient Census. Where nursing care hours per patient day is (NCH)/PPD. How does the nursing care hours per patient day formula compare to other workload measurement tools you discussed in question 2? Review the staffing and scheduling policy where you currently work and explain it in a short summary. If you are not currently working as a nurse, find a policy online and use it to answer the question. (See Chapter 8 in your textbook). Explore the American Nurses Association statement regarding nursing staffing advocacy, and determine if the policy you reviewed meets the state minimum staffing guidelines for the state you currently work- does your state have guidelines? Why or why not? Short case: The outpatient surgical unit is experiencing various unfinished nursing care, including patient teaching, review of current medications and reconciliation of the medications, and emotional support for the patient and family. There has been an increase in hospital-acquired infections and medication errors. The patient satisfaction scores have declined. Staff state they are feeling stressed and feel they don’t have enough time to complete everything that needs to be done in a timely manner. The facility is at the proper staffing ratios. There are some new nurses hired recently. In nursing management, what is a possible solution to improve the completion of needed nursing care and to improve the satisfaction of the patients? (Use your assigned reading articles to address the question: Bryant, S., & Yoder, L. (2021). Implementing the Lean Management System to Influence Unfinished Nursing Care. MEDSURG Nursing, 30(3), 181217. and Al-Abri, R. K., & Al-Hashmi, I. S. (2007). The learning organization and health care education. Sultan Qaboos University medical journal, 7(3), 207214). Describe the nursing budget model used at the facility where you currently work. What are the budget goals? What plans have been made to carry out the goals for the place you work in the budget? (If you are not currently working use the provided budget to discuss: El Camino Hospital FY 19 Budget-
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