Comment on the posts of two peers. APA citations are required only for the original post.
Peer 1 (JS):
Using my experience as a long-term care nurse, there have been many clinical practice issues that create barriers to care. Some of the biggest issues when it comes to providing high-quality, evidence-based practice care are time constraints and staffing ratios. In long-term care in Indiana, there are no set minimum nurse-to-patient ratios. In the facility that I worked at, the ratios varied from 18-30 residents for one nurse on day shift and up to 50 residents to one nurse on nightshift. This makes it extremely challenging to monitor and provide good nursing care, especially personalized care. When nurses are running around trying to get medications administered and treatments completed, as well as help the nursing assistants, assist with meals, and all of the required documentation completed, it does not leave much time to interact and build relationships with the residents or to notice a change of condition.
There are a couple of the key principles that would be beneficial in solving these issues. The first one is to furnish appropriate, valid, and ongoing resources to utilize the staff successfully. If nurses have all the supplies they require and need for their medication pass and treatments, then less time will be spent searching for those items and that time can be utilized for monitoring patients. If other departments stay staffed and are able to do their jobs effectively with good training, then nurses would also spend less of their time assisting in those areas and could redirect the time to their patients. Another principle that would be helpful in this case is requiring staff members to be accountable within the process (Boswell & Cannon, 2023, p89). It is everyone’s responsibility to care for the patients in the facility but often times you will have employees that will use the excuse “that is not my resident” just because they are on a different assignment and there is often a lack of teamwork. If more accountability was required, then teamwork would improve and therefor lighten the workload and improve the quality of care that the patients receive.
I believe qualitative research could improve these issues as it will give opinions and base if off of personal experience versus numerical data. It is hard to measure these constraints in an exact way. Interviews, surveys, and other similar data collection methods could be beneficial in evaluating if reducing staffing ratios improve patient care and outcomes. Reducing the nurse-to-patient ratio will also free up more time for resident monitoring and involvement. Qualitative research can use the residents experience and personal opinions on how they feel they are being cared for and how their needs are met. You can also incorporate how their outcomes are improved based on infection rates or improvement in other health areas due to closer monitoring.
Peer 2 (HW):
Becoming a school nurse after working in an acute care inpatient setting has been a challenging transition. As a nurse, working in a hospital setting allows for many resources to be at your disposal. Hospitals have the funds and resources to provide staff with education and training, and make education and training a priority. As a nurse, working in the school setting where a majority of the focus is on the education rather than health of the individual, healthcare resources are limited. I feel the biggest barrier to providing high quality, evidence based care is the lack of resources and training/ mentorship available to the school nurse. There is a need to be motivated to self educate and seek out the resources needed. However due to demanding workload there is not often time to seek out evidence based practice when a situation arises.
The principle for guiding quality improvement that would be beneficial in resolving this barrier would be improvement in patient care and safety. Essentially the barrier to quality care identified can have the most impact on patient care and safety. If school nurses are not trained and do not have the resources needed to adequately do their job effective care and safety can not be achieved.
Qualitative research would be beneficial to addressing this issue because it can provide insight to the opinions and experiences of school nurses (Chalmers & Cowdell, 2021).I think qualitative research methodology would be best because it is the narrative of experiences and opinions that would be most beneficial to determine what training and resources are needed to provide high quality care.
