Using the emergency room (ER) environment. As a nurse leader, how do you lead other nurses in the ER to manage their time effectively?
Allhospitals regardless of their size encounter time-management relatedpressures. Specifically, in the ER, the success of its operationsheavily relies on speed and efficiency. Therefore, it critical toensure time is well managed through the incorporation of numerousapproaches. As the person in charge of the nurses in the ER, first Ialways stay focused on my duties by avoiding any probabledistractions. Any free time is dedicated in anticipating for futureactivities, for instance, discharge orders and prescription writing.Consultation phone calls should be anticipated. This enableseffective treatment as the plan of action is outlined before all testresults are delivered back. This is useful in eliminating long waitsat the emergency department hence it’s important to createinterdepartmental rapport. I strictly focus on admitting patients whoapparently require admittance even before all the test results aredispatched. Further, I ensure that I am flexible in my operations tobe able to work extra fast. Patients with chronic conditions aretreated as referrals, and the patients should be reassured that noharm would occur while waiting for appointment.it is not mandatoryfor the charts to be taken in a particular especially when alone. Ifthere is stability among all the patients, the process can commencewith first handling the simpler cases before attending to the complexones (Huber, 2013). In preventing the delay in disposition,unnecessary tests should not be ordered. It is also critical to orderall the probable tests all at once. It is also important to have amemo book containing information about the patients and theirphysicians as this saves time in case they receive a call from thedoctor, they will not have to refer to the charts. Finally, nursesare encouraged to ensure they are efficient by having brief breaks inaddition to the intake of adequate nutrition.
Using your leadership skills, how can you improve the ER department budget to meet the company’s goal?
Forthe objectives of the company to be achieved, it is mandatory to cuton costs. As a leader, it is important to work towards ensuring thatreadmissions are significantly reduced as these have a negativeimpact on the operations of the ED. Besides being costly, they alsoattract scrutiny not only from private insurers, but also thepatients themselves. As a result, this ensures that the hospital as awhole does not risk losing government reimbursements (Buppert, 2014).Therefore, patients who have been discharged should routinely attendpost-acute hospital visits. Furthermore, patients must be educated onpractical measures to take following their release from the ER. Allnurses must be trained on the concept of preventive care to ensurethat general readmission rates are significantly lowered. Inachieving this, it is vital to ensure that all nurses in the ERconstructively engage the patients on how to be compliant with careplans accorded to them.
Deficienciesin the ER need to be appropriately addressed. For instance, the ERattends to scores of patients who lack any form of insurance. As aresult, this problem has contributed to the increased costs ofuncompensated care. As a result of close collaboration, all the ERnurses work to foresee that all uninsured patients who are eligiblefor public funding are provided with the much-needed assistance incompleting their applications. This enables prioritization ofpreventive care among patients thus eliminating the last minute rushto for treatment which is costly. This measure lowers uncompensatedcare and other negative debts.
What can you as a nurse leader do to improve staffing issues in the ER?
TheER should be staffed with highly trained personnel to ensure itoperates efficiently, attains patient satisfaction while cutting onthe costs of operation. As a nurse leader, I have to focus on boththe strategic and tactical drivers. The quality of care and servicein addition to patient safety are considered as strategic driverswhereas the tactical drivers comprise of the patient duration ofstay, capabilities of the physician, the number of non-physicians,admit holds, acuity and patient volumes (Welton, 2016). Given thatthe ER is operational throughout the year, I work towardsestablishing the reasonable workload which provides guidance onadding more staff once the workload is exceeded. The priority isgiven to staffing alternatives regarded to be less costly as would beindicated by the infection point in the event of double coverage. Theinfection point is attained when matching the capabilities of thestaff to demand (Huber, 2013). Additionally, I have to initiate abenchmarking process that compares the ER to other health facilitiesthat operate on a comparable acuity and volume. This results inpatient satisfaction and efficiency at ER.
Imagine yourself in a leadership meeting, what will be your contribution/s to the ER policy revision.
Nursesat the ER department face numerous difficulties on a daily basis.They handle critical conditions most of which are life-threatening.Therefore, the recommendations that I would make focus on the need toprevent loss through protecting both patients and the nurses. Recently employed nurses must undergo mandatory orientation tofamiliarize them with the hospital and departmental policies.Long-serving nurses must also be reoriented to improve theircomprehension on existent policies and the revisions that will beincorporated. The other recommendation would focus on preventing, andhandling of patient complaints. The policies would be agreed on byall stakeholders in the ER department on how to first avoid claimsand in case they occur, the policies would clearly outline how theyare to be handled. The disaster plan of the emergency departmentshould be streamlined with that of the hospital. Finally, I will alsorecommend a policy that will reduce frequent visits to the ER unlessit is mandatory (Soril etal.,2015).
How will you as a nurse leader enforce licensure and certification compliance among ER nurses?
Iwill ensure that all the nurses in the emergency room undergoperiodic competency testing. I will encourage them to pursue furthereducation which would provide them with broad perspectives regardingthe mutating healthcare requirements, the mounting knowledge andpolitical implications on health. It will be beneficial for allnurses to belong to a professional body as this will enable them tobe updated on the ongoing changes that might affect their profession.Furthermore, they will be required to undertake a compulsorycertification program provided by the American Nurses CredentialingCenter (ANCC). The outcome will be that their specialty expertisewill be well demonstrated to their patients and as their leader, Iwill be able to validate their knowledge. The nurses will be proudlyempowered and professionally satisfied as a result of the ANCCcertification.
Theywill also be required to partake Quality and Safety Education forNurses, which will equip them with the necessary competencies toprovide quality care and safety of patients. No nurse will be allowedto operate in the ER department without the necessary license ofoperation and certifications. They have to be registered with theNursing and Midwifery Council. Incompetent nurses will be required toupgrade their skills through continued education. It will be vitalfor them to ensure their registration is up to date.
How do you manage the patient work flow in the ER department as a nurse leader?
Thereare numerous ways through which the emergency room department caneffectively manage the workflow. One of the measures to incorporateis the use of data and metrics which allows for the efficientmonitoring and management of patients (Remus, 2016). As a result, thecyclical trends will be adequately identified, anticipated andmitigated. Besides, accountability is realized due to the existenceof clear goals and vision. Secondly, the boarding of patients in theemergency room is subjected to established objectives to guide themitigation and managing of the process. The quality of care andpatient safety is dependent on the clinical decision-making processwhich is regulated by established best practices and patient acuity. The nurses would undergo regular training and orientation to improvetheir interaction with patients who are regarded to have behavioralhealth emergencies. Communities are usually characterized by variouspractices and policies which are likely to confound the patient flowin this target group. Thus, I will give priority on closelycollaborating with behavioral health providers in the community. Theestablishment of new solutions will be synergized, and the ERservices would be appropriately utilized (Chan etal.,2014).
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Chan,H. Y., Lo, S. M., Lee, L. L. Y., Lo, W. Y. L., Yu, W. C., Wu, Y. F.,& Chan, J. T. S. (2014). Lean techniques for the improvement ofpatients’ flow in emergency department. Worldjournal of emergency medicine,5(1),24.
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Soril,L. J., Leggett, L. E., Lorenzetti, D. L., Noseworthy, T. W., &Clement, F. M. (2015). Reducing frequent visits to the emergencydepartment: a systematic review of interventions. PloSone,10(4),e0123660.
Welton,J. M. (2016). Nurse staffing and patient outcomes: Are we asking theright research question? InternationalJournal of Nursing Studies,63,A1-A2.