Title page: acute care nursing program

Table of contents

Introduction

Within the Australian healthcare system a change management strategy is an important

element in improving the delivery of care to meet the needs of the population. This proposal will
focus on the lack of workforce retention amongst acute care settings and the importance of
implementing an acute care program. Additionally, the proposal will critically discuss the need
for change, resource strategies, develop an implementation plan and an evaluation process.

Need for change

Nurse workforce sustainability is a major challenge which affects the quality and safety of
healthcare delivery. In Australia accessibility to healthcare has allowed the Australian population
to enjoy a higher life expectancy increasing the ageing population. This results in common
health challenges such as chronic diseases increasing acute care admission, in return straining
the nurse workforce (New South Wales Government, 2013).

The lack of workforce retention can threaten the quality and safety of care delivered.
A qualitative study undertaken by Sartori et al (2014), revealed nurse turnover in hospitals are
increasing due to lack of staff skill mix, heavy workload and unsafe nurse to patient ratio. Data
also retrieved the overall detrimental impact on the nursing workforce creating a domino effect
in burning out staff, furthermore raising patient safety and quality concerns (Sartori et al, 2014).

Additionally, pillar two of Australia’s national long term health goal is prioritising to better
support hospitals in the management of improving quality standards, efficiency and reducing
medical errors (Australian Government Department of Health, 2019). A study undertaken by
Roche et al. (2014), indicated an annual turnover of 15.1% of nursing staff. Additionally, further
evidence based data revealed 27% of clinical admissions were caused by medical errors due to
staff burn out and poor skill mix (Government of Western Australia Department of Health,
2020). As such, addressing workforce retention through implementing an acute care program
further discussed in the resourcing strategy section is vital in achieving workforce retention,
improving staff culture and quality of care.
Strategy for resource management

The Acute care program is a transition to practice program for registered nurses to smoothly
transition into an acute care setting. The program consists of supporting registered nurses to
develop their skills to become a proficient nurse within the acute care setting. The goal of the
program is to provide a supportive transitioning program which therefore leads to workforce
retention.

Recruitment is a vital element in resourcing the change (Australian Parliament House, 2020).
Without recruiting registered nurses the change cannot be implemented. A recruitment plan
attached to appendix 1.1 demonstrates the recruitment process. The recruitment plan can
ensure phases of recruitment,screening and hiring processes are carried out in a timely manner
to resource the acute care program. Hiring registered nurses specifically for an Acute Care
Program can increase the skill mix, reduce casual/ agency nurses on the floor which in return
reduce workload for permanent nursing staff. As a result, assist in reducing nurse burnout and
achieve Australia’s national health mission of delivering quality healthcare (Australian
Government Department of Health, 2019). Additionally, formulating budgets aligned with the
common health goal of improving workforce retention is an important tool that allows
stakeholders to visualise funding allocations (IHPA, 2019).

As such, resourcing the change is essential in smoothly facilitating the implementation of the
Acute Care Program.

Implementation plan

From an organisational point of view, the change can improve key areas of nursing culture,
patient safety and achieve Australia’s health goal of delivering quality healthcare (Dawood et
al., 2020). The implementation flow chart attached to appendix 1.2 demonstrates key
processes to execute a smooth implementation plan. The flow chart demonstrates critical
elements of designing and creating the foundations of the Nursing Acute Care program. The
strategic goal for the program is to implement a sustainable change to achieve workforce
retention for nurses in acute care. Through a solid resource foundation of infrastructure and
major resources readily accessible in the hospital this enhances the likelihood of a sustainable
program. Additionally, the flow chart’s core phases of recruitment, training and evaluation are
essential in delivering successful registered nurses focused on building their skills in acute care
and thus improve workforce retention rates amongst acute care.

Furthermore, a high level of communication between stakeholders is pivotal in facilitating a

smooth change (Reed & McDermott, 2020). The table attached to appendix 1.3 addresses
key stakeholders, communication methods, frequency and goal. This communication plan will
allow stakeholders to efficiently collaborate, eliminating threats of resistance to change and
achieving the intended goal for the Nursing Acute Care program (Reed & McDermott, 2020).

Evaluation Process-

Evaluation is a critical element in processing and measuring outcomes to improve the

effectiveness (Murdoch, 2016). The process of evaluation can further enhance the overall
project to better meet health goals through identifying limitations and threats (Murdoch, 2016).
There are three steps elements in an evaluation process which are process, impact and
outcome.

Process
Processing is important in assessing the appropriateness of the Acute Care program (Murdoch,
2016). As such, the Acute care program is sustainable and appropriate in not only improving
workforce retention, however meeting the needs of the population through delivering quality
care.

Impact
Measuring the impact of a change amongst the target population is critical in determining the
effectiveness (Murdoch, 2016). The proposed Acute care program targeted registered nurses.
Through measuring the impact it is gathered the change has improved workforce culture and
minimised nurse burn out. The change has also impacted nurses to reduce medical errors,
improving quality and safety of care. In addition, the implementation of the change contributed
to patient satisfaction, leading to a desired goal of workforce retention amongst Acute care.

Outcome
Overall, through comparing the impact of the intervention it has been demonstrated there has
been a positive outcome associated with the Nursing Acute Care program.
The change has substantially improved issues of depletion of workforce, patient safety concerns
and quality of care.

conclusion
In summary, Acute Care is an intense environment which requires a strong foundation of skilled
nursing staff. It is evident there is a need for change due to high staff turnover rates amongst
acute care sectors in Australia. As such, workforce retention can be addressed through
implementing a transition to practice nursing program for Acute Care. Through a strong
implementation plan and resourcing strategy it is anticipated the Nursing Acute care program
can achieve workforce retention and meet Australia’s national health goal of improving quality of
care.
Appendix

1.1 Recruitment process plan for the Acute Care Plan

1.2 Implementation flow chart

1.3 communication plan

References
Australian Government Department of Health.(2019). Australia’s long term national health plan.
Retrieved from https://www.health.gov.au/sites/default/files/australia-s-long-term-national-
health-plan_0.pdf

Australian Parliament House. (2020). Chapter 6 - Recruitment, retention and return to nursing.
Retrieved from
https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Compl
eted_inquiries/2002-04/nursing/report/c06

Dawood, A., Leodoro, L., Miner, A., Suja, K., & Alaa, A. (2020). Nursing Work
Environment, Turnover Intention, Job Burnout, and Quality of Care: The Moderating
Role of Job Satisfaction, Journal of nursing scholarships, 52 (1), 95-104.
DOI:10.1111/jnu.12528

IHPA. (2019). Activity Based Funding. Retrieved from

https://www.ihpa.gov.au/what-we-do/activity-based-funding

New South Wales Government. (2013). About our Region. Retrieved from
https://www.nbmlhd.health.nsw.gov.au/about-us/about-our-region

Dawson, A., Stasa, H., Roche, M., Homer, C., & Duffield., C. (2014). Nursing churn and
turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies,
Journal of BMC Nursing, 13(11). Doi: https://doi.org/10.1186/1472-6955-13-11

Reed, C., & McDermott, A. (2020). Reframing and reacting to employees’ responses to
change: a focus on resistance,BMJ Leader. DOI doi: 10.1136/leader-2020-000249

Sartori. R, Costantini, A, Ceshi. A, & Tommasi, F. (2018). How Do You Manage Change in
Organizations? Training, Development, Innovation, and Their Relationships. Frontiers in
Physcology, 9(3), p313. DOI 10.3389/fpsyg.2018.00313
Murdoch., J. (2016). Process evaluation for complex interventions in health services research:
analysing context, text trajectories and disruptions, Journal of BMC Health Services Research,
16(1), 406. Doi:10.1186/s12913-016-1651-8