QuestionResponses (minimum of two):Critique classmates’ evidence-based practice solution including:Opinion if the proposed practice change was relevant and supported by the literatureDiscussion of the feasibility of a plan to implement, evaluate and sustain practice changeAt least one suggestion for how to improve the proposal for an evidence-base practice solution.Response: Tyree WashingtonIn one of my clinical sites, a potential practice problem that I witnessed was the under staffing, in a long-term care facility nursing home. The nurse to patio ratio was freakishly senseless and can put the nurse in many situations that could be avoidable. On top of that, the patients are so under kept, or the care provided was given to the best of their ability. The patients that were mobile and who could care for themselves made the time of the nurse and the CNA’s a lot smoother because the amount of those who could not made it time consuming when providing care.An evidence-based question could simply be, if adequate staffing in a long-term care facility would the quality of care be better?In research, study’s link the quality of care attributed by nurses and staff to adequate staffing (Clarke, 2008). Nurses are a critical part of healthcare as they make up the largest section within the healthcare profession. Nursing shortages are due to the lack of high turnovers, inequitable workforce distribution, aging within the work force, violence, and nursing burnout which has an effect on the patient outcomes and the cared that is able to be delivered. Nursing shortages or healthcare professional shortages lead to errors, higher morbidity, and mortality rates as appropriate staffing levels will decrease errors, increase patient satisfaction, and improve nurse retention rates. When inadequate staffing occurs, ratios go up to meet the need which can cause potential issue (Haddad, 2020).Evidence – based practice for solution building with implementations, evaluations, and a plan to sustain the change begins with the restricting of the hospital. Hospitals redesigning their system of care, scheduled practices, as well as their approach to the care of hospitalized patients, making the correct accommodations can decrease a lot of potential declinations. Restructuring the staffing to provide safe, effective, and therapeutic patient care is a challenge for nurse administrators under any circumstances, and substantial changes are occurring in the organization and delivery of hospital care. It is important to restructuring of hospital inpatient services is but one part of the larger restructuring efforts of the care delivery system related in large part to managed care and the development of integrated delivery systems. Along with those changing roles and responsibilities to maximize the efficiency of each profession and their strong points. In order to accomplish the work of care teams effectively and efficiently, this system of organizing care relies on this manager to integrate in-depth clinical knowledge, community resources, and financial and organizational requirements with patient needs and the institutional goals of providing high-quality, cost-effective care (Institute of Medicine, 1996).?esponses (minimum of two):Critique classmates’ evidence-based practice solution including:Opinion if the proposed practice change was relevant and supported by the literatureDiscussion of the feasibility of a plan to implement, evaluate and sustain practice changeAt least one suggestion for how to improve the proposal for an evidence-base practice solutionResponse to DanielThere are many issues that still need to be solved in nursing. It is important for us to be aware of these problems so that we can spark change. I believe that many of these changes will need long-term solution plans, but there are things we can do now to help relieve some of the stress. One potential problem that medical staff is faced with when working is workplace violence. This can happen at any time with no reason behind the start of it. I was able to observe this firsthand at the clinical site when I was working in the Pediatric ED. There were situations that were very hostile and could have resulted in a workplace injury. Thankfully it did not happen this time. However, homicide is the fourth leading cause of fatal occupational injury and the leading cause of death for women in the workplace (Mennella, 2018).?n research, these articles look at patient violence. They look at the risks and how to use strategies that minimize the risk of causing injury or even occurring in the first place. Nurses have to be almost hyper-aware of their surroundings especially in high-risk environments such as the emergency department. Many times violence in the workplace is under-reported because of the headache and nurses thinking that it is just part of the job (Mennella, 2018).?artindell, (2012) performed a study that looks at what we know about workplace violence that can help minimize the risk. A few of these ideas include: following hospital policy, aggression predicting factors, verbal techniques to diffuse the situation, self-defense training, ETC. This study was done in Pennsylvania where only 36 % of respondents reported they had proper training. One thing that was brought up in the study was the need to have sound security systems in facilities so that we could stop potentially dangerous situations from occurring. The study also includes the type of violent act that was committed.Types & Percentage of workplace violence committed.verbal threat: 75 %,Physical assault: 21 %A confrontation outside of the workplace: 5 %Stalking: 2 %?n the study done by Lu, D Et al. (2021) they state that nursing students were at the highest risk for workplace violence. This is because of their inexperience, constant clinical rotation, and challenges of building relationships quickly with staff and patients. This study looks at different instruments as well that can evaluate the nurse’s ability to deescalate a situation. This study also found that workplace violence has a long-term negative effect on the physical and psychological health of nursing students. The main assessment tool that was used to help gather data was the 4R crisis management theory. It consists of reduction of violence, readiness for violence, response to violence, and recovery from violence. Ensuring that nurses know how to handle situations like this is essential to their safety.?y implementation plan to ensure nurses were prepared for WPV would be to educate them. It would be required to attend sessions that educated nurses on what to do in these types of scenarios. I would evaluate them by using instrumental tools developed by organizations that can predict the likeliness that a nurse can maintain safety in dangerous situations. If they did not score high enough then further education would be required. The plan to sustain this change would mean that the hospital would have to incorporate this in their policy so that it was required by nurses to do.?n conclusion, it is so important that medical professionals are educated on how to deal with WPV. Safety is the top priority for our staff and patients. There is no clear-cut solution to this issue and continues to happen. We as nurses have to ensure that this problem is made known to the hospitals so they can make changes to the facility and policy to promote a safer work environment.?ealth ScienceScienceNursingNURISNG NUR3643
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