Question

A nurse is assigned to care for six patients at the beginning of the night shift. The nurse learns that the floor will be short by one registered nurse (RN) as a result of a call-in. A patient care technician from another area is coming to the nursing unit to assist. Because the unit requires hourly rounds on all patients, the nurse begins to make rounds on a patient who recently asked for a pain medication. The nurse is interrupted by another registered nurse who asks about another patient. Which factors in this nurse's unit environment will affect the ability to set priorities? (Select all that apply.) a. Policy for conducting hourly rounds b. Staffing level c. Interruption by staff nurse colleague d. Type of hospital unit e. Competency of patient care technician

Short answer

The factors that will affect the nurse's ability to set priorities are: a. Policy for conducting hourly rounds, b. Staffing level, c. Interruption by staff nurse colleague, and e. Competency of patient care technician.

Step-by-step solution

Identify Prioritization Factors

The ability to set priorities can be influenced by various factors in the nursing unit. These factors include policies and procedures that guide nursing activities, the level of available staffing, interruptions that could divert the nurse's attention from current tasks, the particular demands of the assigned hospital unit, and the competency of the staff available, particularly when receiving assistance. In this situation, considering those factors will help identify which will affect the nurse's ability to set priorities regarding patient care.

Evaluate Specific Factors

In this scenario, the nurse is dealing with limited staffing which is automatically a priority consideration. The interruption by another nurse impacts the nurse's work process and time management, making it another factor. The policy for conducting hourly rounds creates a structured routine and requirement that influences how the nurse allocates time to each patient. Furthermore, the competency of the patient care technician who is assisting will affect the delegation and efficiency of patient care, which is also a priority setting factor.

Select Relevant Options

Based on the analysis, the following factors will affect the ability to set priorities: Policy for conducting hourly rounds, staffing level, interruptions by staff nurse colleague, and the competency of the patient care technician. The type of hospital unit is not explicitly mentioned as causing any additional and specific prioritization issue in this scenario.

Key concepts

Staffing Levels in Healthcare

Understanding the impact of staffing levels in healthcare is crucial for effective nursing unit management. When staffing levels are insufficient, nurses may face an increased workload, which can lead to challenges in providing quality patient care.

For example, in the scenario provided, the absence of one registered nurse (RN) places additional pressure on the existing nursing staff. The workload intensity and the nurse-to-patient ratio are directly affected, which can compromise patient safety and the well-being of the nurses. A high nurse-to-patient ratio is associated with increased stress, potential errors, and overall burnout, which further emphasizes the importance of adequate staffing.

Nursing leaders must anticipate staffing needs and implement strategies, such as adjusting shift schedules or utilizing float pool nurses, to maintain a balance that ensures patient safety and a manageable workload for staff. Additionally, healthcare facilities often use nursing policies and procedures to guide staff during understaffed shifts, supporting both the quality of care and the prioritization of tasks.

Nursing Policies and Procedures

Nursing policies and procedures serve as the backbone of clinical decision-making and patient care. They provide a framework that helps nurses manage their duties and supports the prioritization of care especially in complex and dynamic environments like healthcare facilities.

In the context of the original scenario, the policy for conducting hourly rounds stands out as a significant factor in prioritization. This policy dictates a minimum standard of care that must be adhered to, regardless of staffing levels. It ensures that all patients are monitored regularly for any changes in their condition and that their needs are met in a timely manner.

Adherence to these policies and procedures is also important for legal and regulatory compliance. When exceptions occur, such as a short-staffed shift, the policies may offer guidance on how to adjust priorities and make critical decisions. This can involve the reevaluation of patient acuity levels, the delegation of tasks to available personnel, and the strategic postponement of non-critical activities. Implementing these policies effectively greatly assists nurses in providing safe and efficient patient care under challenging circumstances.

Nursing Unit Management

Nursing unit management is essential to the smooth operation of healthcare services. It includes factors such as staff leadership, patient flow management, and resource allocation. Effective management ensures that a unit's day-to-day activities align with overall health system goals of providing high-quality patient care.

In the exercise, the nurse's ability to manage the unit effectively is challenged by unexpected staff shortages and the interruption from a colleague. These disruptions require the nurse to be adept in prioritizing tasks while considering both unit needs and available resources. This often includes crucial decisions regarding delegation, as seen with the assignment of the patient care technician from another area.

Good nursing unit management also involves fostering a supportive environment that can adapt to the varying competency levels of staff members. By understanding their strengths and weaknesses, a nurse manager can better allocate duties to ensure all patients receive appropriate care. Additionally, effective communication strategies such as briefings and debriefings can mitigate the impacts of sudden staffing changes or unexpected interruptions and maintain a functional and safe patient care environment.