Blog

Please read the discussion board post and complete a full 1-page peer review (response). Also, please elaborate on the discussion and follow the grading rubric. Please do not use the same words from the original order #121676I do not need a title page. I have attached the discussion board post and grading rubric as a file.

The essential data analysis techniques for the Doctor of Nursing Practice (DNP) leader provide an interesting perspective on using statistical techniques in ensuring accountability for the quality of health care and patient outcomes. According to Waxman (2018), the nurse leader is not required to be an expert in calculating statistical tests but must have a solid conceptual understanding of the quantitative statistical techniques and assumptions for their use (Waxman, 2018). The Essentials of Doctoral Education for Advanced Nursing Practice developed by the American Association of Colleges of Nursing (AACN) describe those competencies connected to financial data analysis (AACN, 2006). The competencies consist of using business, finance, economics, and health policy; developing and monitoring budgets; and analyzing the cost-effectiveness of practice initiatives (Waxman, 2018). Additional competencies include using analytical methods with other evidence to achieve evidence-based practice and design processes to determine variances in population shifts and practice outcomes.

The author emphasizes that transforming data from various sources into usable information is essential when making financial decisions. Therefore, nurse leaders need to acquire this skill. Waxman reflects on four generally accepted reasons for comprehending data analysis: interpretation of research, evaluation of research, consideration of empirical questions, and planning research (Waxman, 2018). The consideration of practical questions was thought to be critical to the success of financial decision-making.

Data analysis is essential in health care systems administration. It helps identify problems, reduce performance deficiencies, assess the effectiveness of problem solutions, and develop policies and procedures. Moreover, it assists leadership in making informed decisions that impact day-to-day operations and strategic planning (Waxman, 2018). The DNP-prepared nurse is positioned to conduct a scholarly analysis and make independent decisions using that information.

Multiple levels of measurement were reviewed in the readings for this assignment. However, the focus for the assigned questions will reference the correlation measure. According to Waxman (2018), correlation does not indicate cause and effect (Waxman, 2018). However, it is indicative of the strength and direction of a relationship. The Pearson product-moment correlation coefficient was the most common correlation calculation. Therefore, the measure of the association will be used in answering the following questions.

1. The oncology inpatient unit has experienced a great amount of nursing staff turnover. In the last 6 months, five of the 22 permanent RN staff have left. In addition, the number of medication errors for the unit has risen from an average of two per month to a high of 11 errors last month.

• How could you calculate whether there is a significant relationship between staffing and medication safety issues? (Chapter 9 #3)

Using the Pearson product-moment correlation coefficient to calculate the relationship between staffing and medication safety issues would be appropriate. This calculation uses ratio/interval data which requires meaningful numbers (Waxman, 2018). The correlation coefficient can be visually graphed on an x-y graph in this scenario. For example, the number of nursing staff is graphed on the y (vertical) axis, and the number of medication errors is graphed on the x (horizontal) axis. From the graph, one should see a relationship between the number of nurses on duty and the number of medication errors and whether it reflects a positive or negative correlation.

  You complete the calculation of the Pearson product-moment correlation coefficient to determine the relationship of the number of temporary RNs to the number of medication errors. Remember that correlation does not indicate cause and effect, but only that there is a quantifiable, directional relationship between these two variables. The calculated result is r = +0.47.

• How would you explain this result to your chief financial officer (CFO) to request additional money to hire more permanent staff RNs? (Chapter 9#4)

The correlation coefficient reflects a moderate relationship/association between the number of temporary nurses on duty and the increase in medication errors/safety issues. It would be more beneficial to hire and train permanent nursing staff to work on the unit to decrease the medication/safety issues. The hiring of permanent staff would be more cost-effective in this situation.

2. You are the chief nursing executive for a small rural clinic that provides contraception services to low-income individuals. An insurer, providing care under the Affordable Care Act (ACA), has rejected paying the claims, stating that they are a not-for-profit religious organization and are not obliged to cover these services. You check your records and find that nonpayment for contraception places a significant financial burden on the clinic. These individuals do not have access to any other health care services in the region. (Chapter 10 #3)

• What are your first, second, and third actions according to priority?
• How do you justify this action based on legal and ethical guidelines? 

According to Waxman (2018), ethics alludes to standards of right and wrong that prescribe what humans ought to do (Waxman, 2018). The DNP-prepared nurse is educated and licensed to protect patients from harm. Therefore, the DNP nurse should become a strong advocate versed in the ethics that guide individuals to stand up to the potential harm toward vulnerable individuals.

The first priority would be to verify whether the insurer falls under the religious exemption clause of the ACA. Entities invoking religious exemption should be required to provide notice about what is excluded and alternate means of accessing coverage. Secondly, establish whether an insurer or third-party administrator will make separate payments for contraceptive services that you use. Individuals should still be able to acquire coverage for contraception through alternate means.

The ethical analysis described by Buppert (2021) would also be a good approach to consider in resolving the ethical dilemma presented in this scenario (Buppert, 2021). The author emphasizes approaching a situation with ethical considerations in the following manner: gather information about the situation, who is benefitting or being hurt by the situation, structure a plan, and consult with business partners involved or executive leadership of the company involved. In structuring a plan to handle an ethical situation, one should identify the course of action to take, identify alternative approaches, and identify pros and cons of the preferred course of action, as well as alternative approaches (Buppert, 2021).

Waxman (2018) emphasizes that the leadership of any given organization influences the ethics of its mission and enforces the legality of its operation (Waxman, 2018). Therefore, it is the responsibility of the DNP leader to be involved in the shaping and refinancing of health care policy on the fair and equal distribution of health care dollars.

References

AACN. (2006). The essentials of doctoral education for advanced nursing practice. Washington.

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide, 7th edition. Burlington: Jones and Bartlett Learning.

Waxman, K. (2018). Financial and business management for the doctor of nursing practice, 2nd ed. New York: Springer Publishing.

DNPs: Response to Discussion

Organizational management needs can sometimes be overwhelming for leaders of healthcare organizations. They usually expose major gaps in leadership, especially on issues that require close analysis of data. Nurse leaders are charged with the responsibility of identifying and addressing gaps in management that might affect patient outcomes and financial performance (Wymer et al., 2021). Doctorally-prepared nurses must be in a position to interpret statistical data collected in relation to issues that are affecting their organizations to develop appropriate preparedness and response plans. An example of a healthcare-related issue that requires comprehensive data collection, analysis, and interpretation is high rates of nursing staff turnover. You have clearly explained in your discussion that the nurse leader is not required to be an expert in calculating statistical tests but must have a solid conceptual understanding of the quantitative statistical techniques and assumptions for their use (Waxman, 2018).  In the given scenario, the nurse leader should direct the collection, analysis, and interpretation of statistical data to explain the relationship between nurse turnover and patient safety issues.

Nurse leaders work in an environment where numerous issues occur and in which conflicting data related to the same problem is likely to be generated. Most of the time, they have to utilize this data to make decisions. Other leaders of the organization assume that doctorally-prepared nurses possess relevant competencies that they can utilize to analyze conflicting data and generate meaningful information from it to influence decision-making. It is important to remember that Essential IV of the Doctoral Education for Advanced Nursing Practice expects doctorally-prepared graduates to be in a position to analyze biostatistical, epidemiological, and environmental data and utilize the information to direct interventions that promote clinical prevention and improve population health (AACN, 2006). Since nursing staff turnover is an issue that has a direct impact on patient outcomes, it is highly imperative that Doctor of Nursing Practice (DNP) graduates be able to analyze statistical data and utilize the information to guide legal and ethical interventions that promote patient outcomes and improve financial performance.

References

AACN. (2006). The essentials of doctoral education for advanced nursing practice. Washington.

Waxman, K. (2018). Financial and business management for the doctor of nursing practice, 2nd ed. New York: Springer Publishing.

Wymer, J. A., Stucky, C. H., & De Jong, M. J. (2021). Nursing leadership and COVID-19: Defining the shadows and leading ahead of the data. Nurse Leader, 19(5), 483–488. https://doi.org/10.1016/j.mnl.2021.06.004.