Change Proposal for Nursing Shortage in Geriatrics Care Settings

This report presents a change proposal aimed at addressing the nursing shortage within geriatrics care settings. The paper begins with a background on the growing concern of nursing shortages, particularly in geriatrics, and the negative impacts on patient outcomes and safety. The proposal focuses on implementing a nursing preceptor program to provide support and training for new nurses. The report includes a PICOT framework, outlining the population, intervention, comparison, outcome, and timeline. A literature search strategy is detailed, including relevant databases and keywords. The report reviews studies supporting the effectiveness of preceptor programs in increasing job satisfaction, retention rates, and improving patient care. The proposed implementation plan addresses potential barriers like productivity demands and time constraints. The report concludes with references to the cited sources.

Running head: NURING SHORTAGE
Change Proposal for Nursing Shortage in Health Care
Name of the Student
Name of the University
Author Note

NURING SHORTAGE
Background
The nursing shortage is a growing concern in the health care sector, with several
health care institutions facing the issue. Poor management and administration are recognized
to be on the major factors leading to nursing burnout, forcing the nurses to leave the
profession and create a nursing shortage. The nursing shortage in the geriatrics care
department can lead to severe consequences and is one of the most significant issues in the
broad category of the nursing shortage. The geriatrics department requires the highest
standards of accountability on behalf of health care providers and the adequate availability of
nursing professionals. According to Flaherty & Bartels (2019), nursing professionals are
essential stakeholders that strengthen the health care provisions within the continuum of care.
The authors state that by the year 2025, the demand for geriatricians will increase by 45%,
which can potentially create a geriatrician workforce shortage of over 27,000 professionals.
Problem Statement
Nursing workforce shortage in geriatrics care settings can increase the risk of negative
health outcomes and patient safety. As the primary subjects in the ward are old, they require
extensive support to follow their medication prescription and perform activities of daily
living. In the absence of an adequate workforce, an increase in the incidence of medication
errors or misuse falls and other health consequences such as the incidence of pressure ulcers
(Holveck & Wick, 2018). With a higher prevalence of nursing shortage, there is an increase
in the burden amongst the remaining workforce, which leads to quick burnout and refraining
the nursing professionals from properly attend the older patients in the geriatrics ward.
Purpose of the Change Proposal
The primary objective of the project is to propose solutions and interventions that can
effectively address the problem of nursing shortage in the geriatrics department. The paper

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will critically analyze the proposed interventions and check their efficacy in the suggested
health care settings.
PICOT
Population
The target population for this research project is the adult patient groups in the
geriatrics ward requiring immediate assistance from health care professionals. The chosen
population requires the highest standards of assistance and aid from the nurses to restore their
health, and the nursing shortage can highly influence the health outcome and safety of adult
patients.
Intervention
The practice of integration of nursing preceptor program in the geriatrics department
of the health care institution. A nursing preceptor is a competent and experiences nurse,
serving as a role model for the new graduate nurses, student nurses or newly employed
nursing staff. The program will provide the experienced registered nurses with tools to help
the new members experience and develop as a competent registered nurse.
Comparison
To evaluate the efficacy of the intervention, a comparison will be drawn among the
patients who are attended by nursing professionals enrolled in the nursing preceptor program
and patients attended by nurses not participating in the nursing preceptor program.
Outcome
Patients attended by nursing professionals enrolled in a nursing preceptor program
show better health outcomes with increased satisfaction towards the health care services
provided to them. The retention rate of nurses from the health care settings increasing post-
intervention of the nursing preceptor program.

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Timeline
The timeline for the aforementioned intervention is one year. Post one year of
integration of nursing preceptor programs, changes observed in the health care settings, the
retention rate of the nurses, patient’s health outcome, safety and satisfaction along with the
improved quality of health care delivery.
Literature Search Strategy
To search for past conducted literature relevant to this project, a basic search protocol
will be followed. The databases that will be searched include PubMed, CINAHL, MEDLINE
and BioMed Central. Keywords used for search is a nursing shortage, geriatrics, health
outcomes, nursing preceptor program, registered nurse, retention rate, and patient
satisfaction. These keywords will be used along with Boolean operators ‘AND’ and ‘OR’ in
the advanced search option available in the databases. Peer-reviewed journal articles
published between 2014-2019 and in the English language will be eligible to be included for
further review.
Evaluation of Literature
A study conducted by Bontrager, Hart & Mareno (2016) aimed at determining the role
of preceptorship on the intent to stay and satisfaction in clinical settings of the newly
employed registered nurse. According to the authors, over 13% of the newly employed
registered nurse leave their first job post completion of one year and around 37% of the
population state they are ready for a job change. The researchers conducted a prospective
study and findings conclude that new employees report the role of the preceptor as highly
significant and critical in increasing their job satisfaction, increasing group cohesion, and
bring a moderate change in the levels of intention to stay.
Another study conducted by Watkins, Hart & Mareno (2016), aimed at analyzing the
role of preceptor on professional autonomy and psychological empowerment as perceived

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newly employed registered nurse. The researchers conducted a survey for data collection and
concluded the findings from it. According to the findings from the research, a significant
relationship between psychological empowerment and professional autonomy and preceptors
increase their effectiveness to help the new professionals have a smoother transition in
clinical settings.
Nursing Theory
Nursing preceptor programs is an effective initiative to help the ‘preceptees’ or new
professionals get access to better resources and knowledge from the experienced and
competent set of nursing professionals. This program can lead to significant development of
competency in the preceptees, improve their abilities of problem solving, critical thinking,
and clinical reasoning and help them to ensure implementation evidence-based practices in
clinical settings (Lippincottsolutions.lww.com., 2017).
Proposed Implementation Plan
Considering the target population consisting of adult patients, the intervention, that is,
the introduction of the nursing preceptor program for new nursing professionals will be
continued for one year. The plan is effective in providing necessary training to the new
professionals, increase their cohesion towards other professionals and have higher job
satisfaction.
Potentials Barriers and Solutions
The primary barriers to the implementation of the proposed plan of the nursing
preceptor program are productivity demands and time constraints (Miller & Kennedy, 2016).
To address the productivity demand issue barrier, improved collaboration between the
existing and newly employed nursing professionals is required. To address the issue of time
constraints, all the newly employed nurses will dedicate one day per week for the preceptor
and will be funded for it.

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References
Bontrager, S., Hart, P. L., & Mareno, N. (2016). The role of preceptorship and group
cohesion on newly licensed registered nurses' satisfaction and intent to stay. The
Journal of Continuing Education in Nursing, 47(3), 132-139.
Flaherty, E., & Bartels, S. J. (2019). Addressing the community‐based geriatric healthcare
workforce shortage by leveraging the potential of interprofessional teams. Journal of
the American Geriatrics Society, 67(S2), S400-S408.
Holveck, C. A., & Wick, J. Y. (2018). Addressing the Shortage of Geriatric Specialists. The
Consultant Pharmacist®, 33(3), 130-138.
Lippincottsolutions.lww.com. (2017). Nurse Preceptor Best Practices. [online] Retrieved 1
February 2020, from
http://lippincottsolutions.lww.com/blog.entry.html/2017/09/06/nurse_preceptor_best-
HNnZ.html
Miller, J., & Kennedy, O. (2016). Barriers and incentives to precepting nurse practitioner
students in a pediatric facility. Journal of Pediatric Health Care, 30(4), 302-303.
Watkins, C., Hart, P. L., & Mareno, N. (2016). The effect of preceptor role effectiveness on
newly licensed registered nurses' perceived psychological empowerment and
professional autonomy. Nurse education in practice, 17, 36-42.