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1.The main problem/issue which is facing by the organization where I am working on, is Nursing Shortage and the work overload. I find this as very critical issue which must be brought into higher consideration. There are so many senior nurses who are going to be retired soon, and of course that would be a challenging situation for the current nurses.

According to Martin (2015), poor nurse staffing affects both the patients as well as the employees. Workload intensifies, which leads to increase in job dissatisfaction, therefore causes employees to look for another place to jump for. It is stated that one in six nurses, plan to leave their job within a year due to insufficient staffing and adverse patient outcomes and increased nurse burnout and less payment. Working extra shifts or extended hours have substantial effects on so many silly mistakes as well as serious one like medication,documentation errors, which finally leads to poor resident care delivery and safety. According to Martin (2015), sufficient staffing saves lives. There have been many studies that proved that adequate staffing is directly related to patient mortality rate and better recovery. Therefore, sufficient staffing is a crucial element in order to deliver the best possible care and improve patient outcomes, patient and employee safety.

The direct implications would be staff’s own health status, as due to shortages there would be lack of man power for the lifting of the patient, helping aid due to inadequate aid for positioning of resident and treatment, especially in this unit where it consist of lack of mobility due to age and deterioratethe motor activity related age, diet and movement most of limb. Turning the patient for every 2 hours is said to be one of the main interventions for the prevention of ulcers, where we need enough hands to perform that. Nurse’s health is affected by this inadequate staffing which leads to severe neurological and musculoskeletal disorders.

Definitely, the other one will be the loss faced by leaving of experienced staffs, due to the better job opportunity, working hours, as well as nurse burnout. Nurses should be well experienced in their own field to keep the patient away from all the silly mistakes to be happened on them, to avoid documentation error and to give accurate care with correct findings on the resident.

2.One clinical issue my organization is facing is our documentation and ordering systems. We currently use 3 different systems. We have one application called EPIC for all of our outpatient needs. We have another application called Sorien for our inpatient needs. Also, we still use paper for medication orders and consults. It is extremely inefficient and time consuming to manage patients from 3 different systems. There is a greater risk for error. Practitioners, residents, fellows, and attending’s all use the paper charts and many of them have horrendous handwriting. This increases medication errors along with entries being incomplete.

Recently, our transitional care nurse navigation team has begun the steps to move the ordering system into EPIC for all of the discharge needs. Clinicians now have to manually enter in the request for appointments, labs, and imaging here. While the TCNN’s see it as a stepping stone for change and progressing into a more efficient way of communicating, many clinician’s see it as a hassle and rather than make it streamlined, would rather keep things as they are. This is mostly due to lack of time to learn the process and they find it annoying to be disrupted.

Nursing staff on the floor have understood the long term effects of this process and are willing to adjust to make the changes. However, much like the clinician’s, they felt as though it was a disruption. “When the systems fail to keep pace with the work speed, nurses need to adjust their workflow. In these situations, traditional paper-based health records are considered more flexible than EHRs” (Lippincott Solutions, 2016). They also felt frustrated that there was not enough time to learn the new system and were running into errors which held up the workflow. “During implementation of EHR information systems, healthcare staff might find themselves faced with difficulties because of heavy workloads and lack of time to learn how to use the new system” (Lippincott Solutions, 2016).

3.How does the focus of research and EBP differ? Discuss the application of research findings into evidence-based nursing practice.- minimum of 50 words with proper citation and references .

Peer Responses needed

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