Developing an implementation plan

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Obtaining necessary approval(s) and securing support from leadership and staff

Health care organizations are critical research environments that important in advancing evidence-based practice. A research project encourages the researcher to find answers to questions of importance to clinical practice. When undertaking such activities, it is important to obtain approval from key stakeholders. The approval can be obtained before approaching participants or before data collection process. There are different ways by which both formal and informal approvals may be obtained. Formal approval will be obtained from Institutional Review Board. This can be carried out by filling out a project organizational feasibility form or a nursing research form. The forms are necessary for obtaining administrative approval for staff research. Signatures could also be obtained from Clinical operation director, nurse manager, DUHS chief nursing officer, Nursing research scientist or Chief nursing officer.

It will also be necessary to obtain support and participation of peers and leadership. The participation and support granted by leadership will be invaluable to the success of the study. Obtaining Leadership support will enhance buy-in and enthusiasm and serve to speed up the completion of the project. The first step to securing support from peers and leadership will involve the identification of key stakeholders. The key stakeholders include individuals who will be directly involved or affected by the study. Those directly involved include members of the organization who form part of the population from which data can be obtained from for the purpose of the study. Such may include staffing pool or patient population. Leadership forms part of the key stakeholder group as they have vested interest in the results of the study. The second step will involve getting feedback from the stakeholders early in the process through a commitment to participate and leadership buy-in. The level of commitment can vary among stakeholders (Weinberg & Creed).

Current problem, issue, or deficit requiring a change

Quality in healthcare is influenced by numerous factors. Factors of the patient, the provider of healthcare and factors linked to the healthcare organization and the broader health care system affect healthcare service quality. A critical factor in quality is healthcare staff.  With the current changes in policy, health care workers face mounting stress. For example, the Affordable Care Act has resulted in significant changes in healthcare organizations.  These changes have overburdened health professionals, resulting in increased burnout, dissatisfaction and the loss of care providers. While are expected to access services through Affordable Care arrangement, there has not been an increase in sizable workforce required to meet the heightened demand.

The health care staff is, therefore, facing a critical shortfall. These among other factors have increased burnout and stress among healthcare providers. Stress has a negative impact on the quality of healthcare in the fragile system.  Work stress remains important concerns in nursing affecting both staff and organizations. Regardless of how stress is perceived, it yields physiologic reactions that may, in the end, contribute to low quality in services and illness to the affected individual. It may contribute to absenteeism and turnover both of which impact the quality of care (Isikhan et al., 2004).

Detailed explanation of proposed solution

The most effective solution to reduce work stress among healthcare workforce includes organization strategies directed towards healthcare workforce. Healthcare staffs seem to be overexposed numerous psychosocial stressors including Long work hours, Lack of control,  Shift work, Insufficient resources, the Inadequate structure of communication flow, Interpersonal conflicts, Poor reward systems and other healthcare settings. Organizations can develop unique ways to reduce stress while reducing poor patient outcomes. Human resource strategies include optimal work scheduling, sufficient rewards, work control, adequate staffing, effective leadership and provision of advancement opportunities.  Healthcare organizations can keep staff energized and encourage staff them to take necessary breaks. Such programs can be implemented at low costs. Essentially, organizations can create environments that do not promote burnout or stress (Poissonnet & Véron, 2000).

Rationale for selecting proposed solution

Currently, a system overload is inevitable. In fact, policy changes may increase workloads. Such factors may not be within healthcare organization’s control. On the other hand, increased stress may further destabilize the health care system.  Solutions that stem out of the organization are the most significant to the current problem in the short run. In the long run, interventions that stem out from policies may be required to solve the problem. The concept of stress is highly relevant to the health care workforce in general and organizations. Currently, the American health care infrastructure is experiencing workforce shortages and is not adequately equipped to effectively or efficiently meet such a vast influx of patients.

Providing training to new health professionals may take a considerable amount of time. Without more individuals joining the healthcare organizations from institutions to share in roles and responsibilities, among existing staff, the system will be characterized by new frustrations with care delivery including longer wait times, shortened time with providers, greater difficulty having access to providers,  increased costs, and a general system overload. This will increase the exposure of healthcare professionals a myriad of stressors in their work. Thus, the most appropriate solution involves designing working conditions and influencing job characteristics that affect how tasks are designed (Shapiro et al.,  2005).

Review of Literature

The problem of stress has been assessed in nursing by various researchers. Some of the commonly identified causes of stress include work design, job characteristics, and elements of patient care, responsibility, decision making and change. Healthcare staffs’ role has long been viewed to be stress-filled based upon human suffering, physical labor, staffing, work hours and interpersonal relationships that are primary to the work staff do. Despite the relevance, the effects of stress on quality care, patient outcomes, and patient safety are not well defined by evidence. However, the link has been explored in various investigations only a few suggestions have been made on how to alleviate the problem.Compassion fatigue and Moral distress have been identified as some of the consequences of nursing stress. The two factors have received exceptional attention from researchers in recent times.  Stress is often largely attributed to shift-work, emotional demands, interpersonal relationships, physical labor, suffering and work hours and other pressures that are primary work (Ruotsalainen et al., 2008).

Other factors that have increased stress include increasing workload, budget cuts, the increasing utilization of sophisticated innovations and constant organizational changes. Studies have firmly identified that increasing exposure to stressors generates sizeable job stress, resulting in a range of problematic long and short-term results. Stress has also been associated with a decrease in job satisfaction, absenteeism, turnover and physical complaints. Other studies have documented that increased levels of stress add to feelings of self-doubt, inadequacy, irritability, lower self-esteem, and somatic disturbance. Another study shows that nurses tend to have disproportionately higher rates of psychiatric outpatient consultation, mortality, general illness, psychiatric admissions and stress-related diseases.  Research findings show that multiple pressures related to healthcare setting and nursing responsibilities translate into considerable stress levels among healthcare professionals. Findings also show that nurses consistently report the significantly high levels of stress among all healthcare staff. Management styles particularly the relationships between managers and healthcare staff has been found to be an important factor examining stress. They also identify stress as one of their top concerns. Unfortunately, only a few studies have been conducted on organizational interventions (Tennant, 2001).

Description of implementation logistics

Organizational as well as Person-directed interventions can be used in the process of reducing stress. Any changes need to be integrated into organizational structure, workflow and culture.   Leadership and staff have responsibilities to ensure that the changes are successfully implemented.  For example, work scheduling requires the involvement of all affected staff by managers. The involvement encourages feedback and staff commitment to the program. The implementation of interrupted or shorter work schedules would reduce stress levels. While organizational interventions are considered effective, it would be great if leaders establish and implement measures that have a real tangible stress-reducing effect. The programs must also be incorporated into organization’s culture. The integration into organization culture encourages the long-term commitment to the implementation of the program. Incorporation into organization culture is important as healthcare organizations are involved in taking care of other peoples’ lives.  Thus, human errors or mistakes that may result from stressors may be expensive and sometimes irreversible. The healthcare organization’s leadership and staff will be responsible for initiating the change overseeing the implementation process.

Resources required for implementation

There are different resources that will be required for implementation. The first critical resource involves funds necessary to conduct research activities. Funds will be used to ensure that assessment tools reach participants and the printing resources necessary in the collection of data. Surveys will be used for the research work. Questionnaires will be used as the assessment tools during the survey process.  The research study will involve the compilation of data from individuals.  Given that ethnographic thoughts will be necessary for the study, the researcher will be resolved to get individual’s account of reality, as compared to taking up one general version of reality.

Thus, the survey approach will be the most appropriate for the study. Questionnaires will be utilized as the instrument for data collection.  The questionnaires will be open-ended questions to allow the researcher to discover the answers of the respondents. The researcher will first develop a letter of beginning created for this study and send it through the mail to all of the study participants. The requirements of the study will be discussed in advance with the respondents. The questions will be categorized thematically in order to ease the process of analysis. The questionnaires will be distributed online in the form of online surveys. The approach will allow the researcher to reach a large number of participants. It will also allow participants more freedom to express their views in their own terms. With the kind of data collection instrument, it will be more likely to obtain as much related data as possible due to the in detail answers likely to be gathered from the study participants. The questionnaires will also produce rich, dependable and proportional qualitative data. The data collected will then be investigated in a range of ways to create findings.


Weinberg, A., & Creed, F. (2000). Stress in healthcare professionals and hospital staff. The Lancet, 355(9203), 533-537.

Isikhan, V., Danis, M. Z. & Comez, T. (2004). Job stress and coping strategies in health care professionals. European Journal of Oncology Nursing, 8(3), 234-244.

Ruotsalainen, J., Marine, A., Serra, C., & Verbeek, J. (2008). Interventions for reducing occupational stress in health care workers. Scandinavian journal of work, environment & health, 169-178.

Tennant, C. (2001). Work-related stress and depressive disorders. Journal of psychosomatic research, 51(5), 697-704.

Shapiro, S. L.,  Bishop, S. R., Astin, J. A. & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management, 12(2), 164.

Poissonnet, C. M., & Véron, M. (2000). Health effects of work schedule in healthcare professions. Journal of clinical nursing, 9(1), 13-23.

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