NHS FPX 6008 Assessment 4 Lobbying for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Lobbying for Change The Honourable Mr. Chris Governor of Upper Manhattan Region 622 W 168th St, New York, NY 10032, United States Dear Mr. Chris, I am writing to advocate for improved registered nurse (RN) staffing ratios at NewYork-Presbyterian Hospital. As a healthcare professional, I have witnessed firsthand that inadequate nurse staffing negatively impacts patient safety, healthcare outcomes, and workforce well-being. The current staffing levels create unsafe conditions, increasing patient mortality rates, nurse burnout, and financial strain on the hospital due to higher readmission rates and prolonged hospital stays (NewYork-Presbyterian Hospital, 2024). Addressing inadequate RN staffing ratios will benefit healthcare organizations and communities by improving patient outcomes, reducing medical errors, and enhancing nurse retention. Better nurse staffing helps patients live longer, leave the hospital sooner, and makes nurses happier, which improves care quality. According to Lasater et al. (2021), hospitals with safe staffing levels also experience cost savings due to decreased readmissions and fewer adverse events. Failing to address this issue presents significant disadvantages and negative impacts on patient safety and healthcare efficiency. NHS FPX 6008 Assessment 4 Lobbying for Change Overworked nurses are more prone to burnout, medical errors, and job turnover, which strains healthcare resources and reduces the quality of care. In underserved communities, staffing shortages worsen health disparities, leading to delayed treatments and preventable complications (Poku et al., 2025). Without intervention, hospitals will continue facing financial losses due to increased malpractice claims and avoidable hospital-acquired conditions. Legislative action is essential to ensure safer staffing ratios and better health outcomes for our communities. Studies show that the number of nurses affects patient health and safety. As of 2022, the United States employed approximately 3,072,670 registered nurses, equating to about 9.22 nurses per 1,000 people. In New York State, there were 190,470 registered nurses, resulting in approximately 9.68 nurses per 1,000 residents (Feeney, 2022). Twigg et al. (2021) found that when a nurse gets one more patient, the risk of patient death goes up by 7%. Lasater et al. (2021) revealed that better nurse staffing correlates with improved patient satisfaction and lower rates of hospital-acquired infections. NHS FPX 6008 Assessment 4 Lobbying for Change Furthermore, a study by McHugh et al. (2021) concluded that hospitals with higher RN staffing ratios experience reduced 30-day readmission rates, lowering healthcare costs. The American Nurses Association (ANA), (2022) supports these findings, advocating for safe staffing policies to improve patient care quality. Lastly, a recent study by Poku et al. (2025) emphasized that increasing nurse staffing reduces burnout and turnover, leading to a more sustainable workforce. Having enough nurses is key to keeping patients safe and making healthcare fair for everyone. Addressing inequities caused by structural racism requires policies that ensure fair nurse distribution, especially in underserved communities, to uphold social justice. I have worked in patient safety and risk management. This helped me understand planning resources and manage risks for low RN staffing. Not enough nurses cause more falls, mistakes with medicine, and burnout (Twigg et al., 2021). I learned to budget for more staff and use technology better. Risk analysis helped me find safety and money problems early. This way, I could fix issues before they got worse. My experience helps me use facts to improve staffing and keep patients safe. I urge you to support and advocate for legislation that mandates safe RN staffing ratios at NewYork-Presbyterian Hospital and across healthcare facilities. Investing in improved nurse staffing aligns with the goals of enhancing patient care, reducing healthcare costs, and ensuring a healthier workforce. Thank you for your consideration. I would love to discuss this important topic further. Please let me know if you have any questions. Sincerely, Angela References American Nurses Association (ANA). (2022). Nurse staffing advocacy. American Nurses Association. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/ Feeney, A. (2022). The U.S. nursing shortage: A state-by-state breakdown. NurseJournal.org. https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: An observational study. BMJ Open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899 NHS FPX 6008 Assessment 4 Lobbying for Change McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: A prospective study in a panel of hospitals. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6 NewYork-Presbyterian Hospital. (2024). Department of nursing – Overview. NewYork-Presbyterian. https://www.nyp.org/morganstanley/for-health-professionals/nursing-and-patient-care-services/department-of-nursing-overview Poku, C. A., Bayuo, J., Agyare, V. A., Sarkodie, N. K., & Bam, V. (2025). Work engagement, resilience and turnover intentions among nurses: A mediation analysis. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-025-12242-6 NHS FPX 6008 Assessment 4 Lobbying for Change Twigg, D. E., Whitehead, L., Doleman, G., & Zaemey, S. E. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12). https://doi.org/10.1111/jan.14909
NHS FPX 6008 Assessment 3 Business Case for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Business Case for Change Hello, I am Pam, and today, I will be presenting on the business case for inadequate nurse staffing. Let’s get started with our discussion. Issue and Effect of Inadequate Nurse Staffing in Healthcare Economics In this presentation, we will examine the healthcare economic problem of inadequate nurse staffing and its impact on the analytics work that I do, my colleagues, and the organization for which I work. The US Bureau of Labor Statistics projects an average of 194,500 yearly job opportunities for registered nurses from 2020 to 2030, expecting a 9% increase in employment. In 2020, the unemployment rate among nurses was just 1%, according to a study by ANA, 2020. 17.1% of nurses held a master’s degree in 2018. The state that will be hardest hit by a nursing shortage in 2030 is California. 47% of military nurses are regularly working overtime. The largest age group of registered nurses in the US, 24.5%, are aged 50 or older. 15.3% of elderly adults at home filed neglect complaints (ANA, 2020). Inadequate nurse staffing is a formidable healthcare economic problem impacting patients, the sparse healthcare workforce, and organizational performance (Haegdorens et al., 2019). The shortfall of adequate nursing staff creates multiple sources of hardship for healthcare organizations, including low quality of care delivery, uneven treatment provision, and increased occurrences of adverse events such as medication errors and patient falls (Yoon et al., 2022). NHS FPX 6008 Assessment 3 Business Case for Change The inadequate nurse staffing disrupted my work routine, and affected my colleagues and organization. Inadequate nursing staff significantly increased my workload, and left me with minimal free time and increased work-related stress. Additionally, patient overcrowding led to cases of improper handling by nurses, which also placed patients at risk (Levins, 2023). In addition, I was involved in two near-miss events in which patients could have had adverse outcomes, although they did not, due to my work-related stress and heavy patient workload. This healthcare economic issue greatly affected my colleagues too, for instance, numerous experienced staff members suffered burnout, and a few left their positions due to work-related stress and dissatisfaction. My organization faced reputation issues. Insufficient nurse staffing in healthcare facilities compromises patient safety and satisfaction, leading to increased risks of medical errors, mortality, and nurse burnout. Addressing this issue requires creating supportive work environments, flexible schedules, and considering recommendations from the American Nurses Association to improve patient outcomes and organizational reputation. (Eastern Michigan University, 2019). In addition, the healthcare economic issue directly affects patients’ health and contributes to higher morbidity and mortality rates, making the community its primary victim (Loyd Miller Law, 2023). Considering Feasibility and Cost-Benefit Analysis When resolving the healthcare economic problem of insufficient nurse staffing, the feasibility and cost-benefit analyses must be taken into consideration. To properly address this issue, an organization has to carefully weigh the following cost-benefit and feasibility considerations. Feasibility Considerations Effective nurse staffing requires careful consideration of all relevant factors, including improved patient safety, higher-quality treatment, and favorable health outcomes (Yu et al., 2024). A balanced workload will also be maintained with enough nursing staff, reducing the risk of staff burnout and stress at work. Workload management can reduce nursing turnover rates, increase job satisfaction, and lower turnover-related expenses, all of which contribute to steady and effective organizational performance (Maghsoud et al., 2022). Cost-Benefit Considerations Adequate nurse staffing has potential cost benefits. Research by Griffiths et al., 2023 shows that registered nurse (RN) staffing in acute hospitals is associated with better patient outcomes. In hospitals with low baseline nurse staffing demands, it seems cost-effective to hire additional RNs. Evidence also supports investing in higher RN staffing because a reduced proportion of RNs is associated with poorer outcomes at higher costs. Challenging the argument that increased staffing would impose an unacceptable financial burden, a study by Griffiths et al., 2023 found that actually netted money for hospitals, as reduced hospital stays and readmissions saved more than twice the price of the additional labor required to fulfill required minimums ($923,832 cost for an additional RN at US hospitals for every 1000 surgery patients yielding a benefit of $1,646,190; $982,800/$589,680 cost for an additional RN per 1000 patients in medical and intensive care with benefits of $1,244,061/$1,479,933) (Griffiths et al., 2023). Mitigating Risks to Financial Security The following three practical steps can be taken to solve the shortage of nurses and reduce threats to healthcare organizations’ financial stability: These approaches aim to reduce the financial risks for healthcare organizations while tackling insufficient nurse staffing by striking a balance between delivering high-quality care, fostering a manageable work environment for nurses, and safeguarding the hospital’s financial stability and security. Evidence-Based Research Strategies The risk mitigation strategies outlined above for bolstering the financial security of healthcare organizations are rooted in evidence and have been extensively researched. A study aimed to evaluate the attitudes of nurses toward the culture for the safety of patients. A survey conducted for this received responses from 184 nurses, or 45.7% of the total. The results showed that only cooperation secured a score higher than 75%. The percentage score fell short of the Agency for Healthcare Research and Quality’s (AHRQ) criteria, indicating that workable solutions have not yet been put into place (Fuseini et al., 2023). So, healthcare organizations are encouraged to hire nurses as it enhances outcomes while also reducing the occurrence of adverse and near-miss events. This provides nurses with valuable frontline experience and opportunities for career advancement in nursing practice. Offering additional benefits to nurses may help boost nurse retention and lower turnover rates (ANA, 2023). In addition, optimizing nurse productivity through the use of technology, staffing tactics, and interdisciplinary cooperation can improve job satisfaction, work output, and reduce nurse attrition, a factor that can jeopardize financial stability because of inadequate nurse staffing (Health Carousel, 2023). Addressing Insufficient Nurse Staffing: Proposed Changes and Solutions In this section, we will discuss several adjustments that can be made
NHS FPX 6008 Assessment 2 Needs Analysis for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Needs Analysis for Change An organization must conduct a change analysis to bring about management changes and improve productivity and outcomes. Similarly, healthcare organizations must periodically oversee and adjust their systems to ensure the delivery of high-quality care. At Valley Hospital, the identified health care economic issue for the ICU wards of hospitals is insufficient staffing, notably a shortage of nursing staff. Therefore, the primary goal of this assessment is to investigate the impact of inadequate nursing staff on the healthcare organization and its operations. Economic Issues and Low Nurse Staffing Inadequate nurse staffing in ICU presents a significant challenge for healthcare organizations, with major health and economic implications for patients and system functionality. This transpires when there are not enough nurses to meet the treatment demands and needs of the patients within a healthcare organization, which diminishes the quality of care provided. Consequently, there is an uptick in adverse events, such as medication errors and patient falls, ultimately increasing the length of hospital stays and the likelihood of acquiring hospital-acquired infections (Nantsupawat et al., 2021). These happen because the staff nurses have to work longer, become tired, and feel less engaged and burned out, diminishing quality care delivery in ICU. Patients, the organization, and the workers all fall victim to this issue (News Medical, 2023). NHS FPX 6008 Assessment 2 Needs Analysis for Change The shortage of nurses directly impacted me as I cared for numerous patients in ICU without breaks and became fatigued. There were also extra costs to the organization as there has been an increase in adverse events and medication errors, especially across different healthcare settings in these conditions. Severe nursing burnout led to nurses on the brink of giving up, with some leaving their jobs due to job dissatisfaction and increased stress, creating even greater nurse turnover rates (Acdis, 2022). The community also suffered, as the few nursing staff were unable to provide sufficient high-quality care. It greatly affected the elderly who needed long-term care for chronic conditions, particularly during periods of exacerbation. Thus, the insufficient nurse staffing negatively affected all stakeholders concerned, including my workplace, organization, colleagues and community members (Levins, 2023). The aim of addressing the shortage of nurse staffing issue is because nurses are partners in caring for patients and are the key health professionals for medication administration, patient education, and counseling. Their role in ICU is paramount, due to continuous care provision for patients with critical condition.They are the ones supervising, managing, and monitoring the patient’s conditions. When they are not provided the resources to do this, like carrying out nursing tasks, the patient’s condition deteriorates and both their morbidity and mortality risks increase (Abdullah et al., 2020). Socioeconomic or Diversity Disparities The issue of inadequate nurse staffing in ICU, exacerbates socioeconomic and diversity inequities in healthcare. The problems make it difficult for individuals from low-socioeconomic and minority backgrounds to get the basic healthcare services. Thus, those from low-socioeconomic backgrounds are likely to experience difficulty obtaining medical services and are the ones most negatively affected by a lack of nurse staffing. They also suffer disproportionately when they must face longer wait times for care, diagnoses are delayed and health outcomes are worse (Togioka et al., 2023). Furthermore, it sets up potential communication barriers for patients from minority racial and ethnic backgrounds who do not speak English as their first language and who may need a skilled nurse to understand their specific needs (MD Newsline, 2023). The healthcare economic issue exacerbates disparities in these socioeconomic and diversity areas, highlighting the need for strategic plans that will recruit nurses in healthcare organizations to help address the gap of communication in health care access that has been identified. It is responsibility upon healthcare organizations to give people of all socioeconomic backgrounds with culturally diverse environments the same access to essential healthcare facilities as individuals of non-diverse cultural backgrounds (Zakaria et al., 2021). Evidence-Based Sources The global healthcare issue of inadequate nursing staff has been highlighted in various research studies, advocating for the need to address this issue and recommending actions to overcome it. Nurse shortages cost hospitals an estimated $16.7 billion in 2020 in overtime and temporary staff, the American Association of Critical-Care Nurses (AACN) said (Zhavoronkova et al., 2022). One study suggests the development of nurse education infrastructure in clinical settings to improve the supply of nurses and attract and retain registered nurses through opportunities for clinical education, attractive salary scales, and auxiliary benefits (Järvinen et al., 2022). In order to lessen burnout and increase nurse retention in ICU, another study addresses nurses’ burnout as a result of insufficient staffing. It places a strong emphasis on mindfulness-based programs, emotional regulation skills, resilience, and coping mechanisms (Veigh et al., 2021). Another study suggests a cultural transformation toolbox to lower nursing turnover and burnout rates, foster a healthy work environment, and encourage shared decision-making to keep nurses in healthcare organizations (Nassif, 2022). It is advised to use competency-based training and enhanced pedagogy as strategies for policy creation and implementation to address the nursing shortage and enhance nurses’ abilities to stay with the organization (Chen et al., 2022). Predicted Outcomes and Opportunities Many advantages, such as improved patient care, fewer adverse events, shorter hospital stays, and decreased rates of hospital acquired infections, have been linked to appropriate nursing staffing. Reducing health inequities, it may also improve access to care for patients from a range of socioeconomic backgrounds. Appropriate staffing numbers in ICU can also serve to enhance the wellbeing of nurses, address issues of workload and burnout, boost job satisfaction, lower turnover, and establish a more stable workforce. This has significant potential benefits that extend far beyond safer working conditions, better patient experiences, and more possibilities for women and people of color to pursue professional careers (Bourgault, 2023). Greater operational efficiency, increased productivity, greater care coordination, and cost savings from lower attrition and better patient outcomes could all
NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Prof. Name Date Identification of an Economic Issue Related to HealthCare A review by Griffiths et al., 2023 included 23 observational studies from multiple countries, including the U.S., indicating that staffing more nurses in general ICU/surgical ward staffing in the U.S. would represent a highly cost-effective policy. Conversely, policies that reduce the number of nurses might lead to increased healthcare costs (Griffiths et al., 2023). Another study found that lower staffing levels are linked to higher levels of missed care (Cho et al., 2019). Nearby communities or populations are susceptible to being affected by this issue. It is essential to resolve this issue to improve patient outcomes. Objectives of the Identified Healthcare Economic Issue The choice of insufficient nurse staffing as a healthcare economic issue is derived from the findings of a systematic review (Twigg et al., 2021). In low- and middle-income groups of people, low nurse-to-patient ratios or excessive nursing workloads cause hospital-acquired infections, prescription mistakes, and treatment abandonment. In addition, inadequate staffing results in adverse nurse workforce outcomes, such as burnout, intent to leave, and absenteeism. The economic effect of insufficient nurse staffing is realized in increased healthcare costs due to extended hospital stays (Assaye et al., 2020). Addressing this issue is necessary to optimize healthcare delivery and control healthcare spending (Bae, 2021). In my experience, I observed ICU patients are more likely to experience death due to prolonged waiting because of low nurse staffing. Intent to leave and turnover rates in nursing have surged in 2021, resulting in an RN loss of about 2.5 percent in 2021. A Health Affairs study confirmed the loss of mid-tenure nurses aged 35–49 (Berlin, 2023). Impact of Inadequate Nurse Staffing on Diverse Groups Insufficient nurse staffing has far-reaching impacts, affecting patient care, nurses’ well-being, colleagues, and the wider community. The relationship between dropping nursing care and modifications to hospital work conditions, nurse staffing, and other factors was investigated in a study by Lake et al., 2020. According to findings, staffing can effectively reduce care compromises and economic burdens, and nurse managers must evaluate work settings for areas needing change (Lake et al., 2020). At the individual nurse level, short staffing in nursing has significant effects in two main areas: Patient care and the nurses themselves. On the one hand, high demands and increased workload due to short staffing can have a high cost for patients. The increased stress and demands can, in turn, lead to high levels of burnout. These factors can significantly affect nurse morale and job satisfaction because feeling unable to provide quality patient care can discourage nurses. Besides, this situation can decrease job satisfaction, result in negative long hours, and cause relentless work pressure for nurses. (Study Smarter, 2024 and Levins, 2023). Inadequate nurse staffing significantly impacts many areas in healthcare organizations and communities. An insufficiency in the number of nursing staff increased my colleagues’ workloads, overtime work, and stress. The functionality and workflow of the overall organization were also affected, which increased turnover rates and created a more significant financial burden in recruiting new nurses (Griffiths et al., 2023). My coworkers left primarily due to nursing burnout and lack of job satisfaction, which exacerbated our hospital’s functionality. Insufficient nurse staffing also has a profound effect on the community. Our community includes diverse and low-socioeconomic groups struggling to access healthcare services. This is because of prolonged hospital stays due to low staffing, which exacerbates their illness, ultimately causing a financial crisis (Assaye et al., 2020). Gap Contributing to the Inadequate Nurse Staffing Evidence from a review by Tamata & Mohammadnezhad, 2022 highlights the importance of undergraduate nurse education in addressing inadequate nurse staffing and its impact on nurse retention. However, the study also emphasizes the necessity of adequately preparing nurses for practical difficulties, such as managing workload and emotional strain. One strategy to lessen the adverse effects of low staffing on nurse retention could be to improve undergraduate nursing education to foster resilience and confidence in students. Also improving the work environment to attract students to choose nursing professions. Ultimately, healthcare institutions must address this to value nurses and promote their well-being. (Collard et al., 2020). Moreover, the challenges in undergraduate nurses’ education need to be addressed. These challenges may be pandemics and financial crises in lower-class people (Dewart et al., 2020). Due to lower staffing, the little time nurses are often left which affects their skill development or career progression opportunities. Hence, the inability to learn and hone the vast array of skills that the profession requires is another area where short staffing can have a significant impact on individual nurses (Study Smarter, 2024 and Levins, 2023). Conclusion The selection of the healthcare economic issue was based on a correlation between lower staffing levels and high rates of patient care deficiencies, which can impact treatment quality and patient safety, increasing the cost of treatment in ICU/surgical units. Adverse outcomes for the nursing workforce include burnout and inadequate staffing. Despite the staffing data, this issue has not received enough attention overall, particularly in undergraduate nursing education. Knowledge and comprehension of efficient staffing techniques are among the gaps in this issue that need to be filled to minimize the effects of understaffing and maximize care provision. It is critical to address this issue to maintain healthcare professionals’ health and control healthcare expenses. References Assaye, A. M., Wiechula, R., Schultz, T. J., & Feo, R. (2020). The impact of nurse staffing on patient and nurse workforce outcomes in acute care settings in low- and middle-income countries. JBI Evidence Synthesis, Publish Ahead of Print(4). https://doi.org/10.11124/jbisrir-d-19-00426 Bae, S. (2021). Intensive care nurse staffing and nurse outcomes: A systematic review. Nursing in Critical Care, 26(6), 457–466. https://doi.org/10.1111/nicc.12588 Berlin, G. (2023, May 5). How hospitals are confronting the nursing shortage | McKinsey. Www.mckinsey.com. https://www.mckinsey.com/industries/healthcare/our-insights/nursing-in-2023 NHS-FPX 6008 Economics and Decision Making in Health Care Cho, S., Lee, J., You, S. J., Song, K. J., & Hong, K. J. (2019). Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse