Quality Improvement and Safety Initiatives Essay

Quality Improvement and Safety Initiatives Essay

Quality Improvement and Safety Initiatives Essay

This study focuses on the impact of inadequate mentorship and low retention on nurses that affect the quality and safety of patients in the hospital setting.The SWOT analysis done in hospital settings reveals strengths and weaknesses of hospitals limiting from attending to the problem of low retention and inadequatementorship in health care. Findings from selectedstudiosshow that low nurse retentionhas been a problem affecting the quality of service delivery and effective management of health care organizations. Gaps in nurse skills and knowledge limit the quality of care in health care organizations. Nurses deliver primary care in any health care organization. This implies that they need formal training and mentoring to ensure adequate health care delivery. Besides, the study proposed evidence-based practices like developing effective communication and nurse working environment as important in solving the cited clinical problem.

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Nurses in the hospital setting require constant mentoring programs to sharpen their skills. Mentoring programs enable nurses to offer better and improved care services in the hospital. However, this has not been the case because the mentors with the role of training the new nurses have increased workload limiting their time to attend to the mentees (Lai et al., 2018). These issues haveraised the problem of inadequate mentorship and low retention of the nurses. Low retention of the nurses has a negative impact on the healthcare facility because more funds are used in hiring and training new staff. These clinical issues need effective solutions to improve patient outcomes. The purpose of this paper is to compose a final presentation of your identified healthcare issue with support from evidence-based practice.

SWOT analysis


  • An adequate number of senior nurses take leading roles in mentoring novice staff.
  • A niche patient base.
  • Willingness to continuously invest in enhancing performance.


  • High staff turnover.
  • Lower ability to attract new patients.
  • Poor coordination of mentorship programs.


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  • The nurse leaders are willing to improve mentorship and improve staff retention.
  • Improved patient satisfaction and staff engagement.
  • Exploration and adoption of the better mentorship program.


  • Shortage of nurses nationwide.
  • Increased practice time demand on mentors.
  • Negative reviews from patients.

Literature Review

The study done by Alma et al. (2021) affirms that on-job mentorship programs enhance routine supervision among nurses that further improve nurse experience on compassionate care. The study suggests the implementation of competence, retention, and competence as mentorship programs that enhances care among nurses. The authors organized an intervention development study completed within one year. The study’s findings revealed that on-job mentorship positively impacts improving care and equipping the nurses with the effective skills that will enhance their work output. In addition, various findings were noted from the study. For example, mentoring nurses encompasses factors that affect social-economic, wellbeing, and environmental factors that should be implementedto solve the current problems discussed in this study effectively. These programs also had a positive impact on raising the retention levels of the nurses.

Marufu et al. (2021) further argue that recruiting and retaining the nursing staff is one of the leading workforce challenges that health care institutions face in the UK. These researchers focused on the huge nursing vacancy in the UK that stems from the limited programs that can aid in retaining and recruiting the retaining staff. The authors aimed at examining the factors affecting retention among the nursing staff in the UK. The study used five major online searches to sample 47 studies on retention among nurses in hospitals. From the accomplished analysis, the researchers noted that communication about health could alleviate health low staff retention as it acts as the main form of motivation. Besides, they also noted that poormotivation strategies among nurses are likely to affect low retention.Of importance, the study also revealed that increased turnover factors such as poor working environment and low motivation affect the nursing workforce in the UK.The study found that the turnover factors among nurses in the UK are long-standing, and evaluating the current workforce strategies needs to be a major priority.

Another study also focused on measures that can retain indigenous health professionals in Australia.According to Lai et al. (2018), retaining indigenous health professionals can be improved by developing culturally safe workplaces, clear documentation, and communication among nurses. The authors searched four major electronic databases in August 2017, where they found 15 articles that met the inclusion criterion. The researchers focused on indigenous nurses and their problems inthe healthcare industry due to cultural issues. The study found that important factors that affect nurse retention include low salary, heavy workloads, work environment, perception of disparity in salary, and poorly documented roles and responsibilities. Various solutions were found to be instrumental in addressing the problems. For example, peer-based mentorship and motivation can help address issues such as low work morale and poor job satisfaction.

Implementation Plan and Method for Initiation Change

Retaining experienced nurses is paramount, especially as the nursing profession ushers another shortage era. Cases of shortage of skilled nurses in a hospital would affect the quality of care and patient safety. The first-line managers in the health care setting need to devise effective strategies to enhance job satisfaction. The environment-related for the nursesimpacts their ability to unleash their full potential at the hospital. For instance, ensuring the utmost safety of the nurses increases the quality and safety of patients. Other studies show that a better working environment reduces job dissatisfactionexperiences by 28-32 percent. The nurse working environment is related to numerous outcomes to the service provider and the patient (Lai et al., 2018). This implies that implementing a better working environment for the nurses would solve the problem of low nurse retention by 38%. The effect of the nurses’ working environment across the globe was evident during the COVID-19 pandemic when nurses were ready to stop working because of the poor working condition. Clinics that started by offering effective protection to the nurses during the pandemic were able to retain their nurses. This EBP practice would empower nurses to meet their duties and responsibilities at the facility. A satisfied nurse would be more productive as compared to an unsatisfied nurse.

Secondly, the frontline nurse managers need to invest in effective communication (Vergara, 2017). The power of the nurse’s work relies on effective communication that would allow them to reduce human errors and meet the expectations of the patients. Positive communication between nurses and other health care professionals allows an effective flow of treatment on patients, thus raising the quality of the service delivery. The negative impact of low retention and inadequate mentorship is evident on the cost of health as hospitals spend more resources in hiring new staff. However, a proper communication system developed at the clinic would play an important in solving these clinical issues. Implementation of an effective communication system would imply that the interaction between nurses andnurse leaders would be perfect, thus limiting nurse errors that tend to affect the quality and safety of patients. The reduced mentorship limits hospitals from training many nurses to maintain the nurse-patient ratio. This lowers the standards of health care delivery. These clinical situations need an effective solution for better patient care. The health care delivery entire relies on the wellbeing of nurses. It is important to understand that there is a direct link between the quality of health care delivery, communication, and nurse low retention. The practice provides hospitals with measures to solve low retention inadequatementorship on nurses.

Strengths and Weakness (Barriers) in Promoting the Implementation Plan

The SWOT analysis shows that the hospital has an adequate number of senior nurses who can mentor novice staff. This is top-notch strength that hospitals could use in solving the problem of low retention and inadequate mentoring. Besides, hospitals are willing to enhance performance.Conversely, hospitals suffer the problem of poor coordination of the mentoring programs arising from the increased workload of the senior nurses reducing their time to mentor the young nurses (Vergara, 2017). The hospital management needs to devise better coordination for the mentoringprograms where the senior nurses would also be paid for the mentoringservices they offer to the novice nurses. This process acts as part of improved coordination of the mentoring programs. This implementation plan would effectively transform the cited weakness intostrengths in hospitals.

Both senior nurses and fresh nurses in the hospital need strong motivation from the management. A well-motivated nurse would tend to surpass their performance, increasing the positive patient outcome (Hoover et al., 2020). Solving employee retention problems requires the management to allow the nurses to develop a sense of belonging with the hospital. For instance, the management needs to revise the salaries and benefits of the nurses to ensure that efforts taken towards improving the quality of safety and delivery at the hospital pay in the long run. The shortage of nurses is a great threat to any health care institution. This implies that the existing nurses in any hospital need a reason to stay at the clinic while offering the required health care needs.

The Role of Informatics, Technology, and Interprofessional Collaboration on Improving Quality

The increase of application of modern technology at the hospital would as well be significant in solving the problem of low retention inadequate mentorship problems. The automation of health care services through the application of modern health software would reduce the workload of skilled nurses (Hoover et al., 2020). This would allocate more time to mentor the new nurses to meet the required health care quality.Modern technological skills are transforming nurse duties across the globe. The modern generation of nurse informatics is allowing the nursing disciplineto adopt a new shape regarding new interventions and carepractices that affect the quality and safety of patients.Besides, many hospitals across the globe are inclined towards employing nurse informatics because of the positive impact they have in creating technological changes. Therefore,training the nurses on the technological skills would also solve the problem of low retention as they would feel the ease of interacting with the new technology in the clinic.

Improved technology in a hospital allows nurses to have sensible workloads. Nurses need to have a practical workload and measures that lower nurse burnout to reduce low retention. For instance, longer working hours of the nurses in the emergency section have resulted in the high death of patients, as nurses cannot unleash their best performance (Van Camp & Chappy, 2017). It is for this reason the study contends some measures that look into the rectification of nurse fatigue that aids in solving low nurse retention. Many healthcare workforces would opt to resign when their clinic efforts do not equal the salaries and benefits they receive. Besides, creating an environment that allows the mentors and mentees to embrace self-develop can effectively address inadequate mentorship.

Interprofessional collaboration allows hospital staff to develop effective measures of improving safety and quality. This is by focusing on communication as a fundamental tool in the 21st century. A nurse leader should assist nurses in doing their best at work (Johnson & Sollecito, 2018). Setting vivid expectations and timelines to manage time effectively among nurses and make them perform their tasks on time. Besides, effectiveinterprofessional collaboration acts as a motivationaltoolfor nurses.This is because nurse leaders would develop a different cultural approach and celebrate the nurses who are surpassing their targetsin the hospitalgetting things done in the company. This motivation would aid in creating a culture of time management at the clinic,and each nurse would be creative in devising better ways of completing tasks within the stipulated time.


Clinical issues like inadequate mentorship and low retention of nurses result in various adverse clinical outcomes. Thequality improvement and safety initiatives at the hospital depending on the skills exhibited by the nurses. The nurses and nurse leaders have an imperative role to play in ensuring that experience and professionalism define health care delivery at a hospital.Mentoring new nurses by the existing skilled nurses is an activity managed by the hospital management. The accountability of the hospital stems from its ability to retain nurses. As a nurse, the significant role in the issue is to help coordinate mentorship programs and use various strategies to improve nurse retention. A SWOT analysis has been performed regarding the clinical issues, identifying strengths, weaknesses, opportunities, and threats. Therefore, to better address the problem, the weaknesses have to be addressed, the opportunities exploited, and threats neutralized.


Alma Arshad Hookmani, Naureen Lalani, Noureen Sultan, Aly Zubairi, Ayesha Hussain, Babar S. Hasan, & Muneera A. Rasheed. (2021). Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care. BMC Nursing, 20(1), 1–18. https://doi.org/10.1186/s12912-021-00682-4

Eckerson, C. M. (2018). The impact of nurse residency programs in the United States on improving retention and satisfaction of new nurse hires: an evidence-based literature review. Nurse education today71, 84-90. https://doi.org/10.1016/j.nedt.2018.09.003

Hoover, J., Koon, A. D., Rosser, E. N., & Rao, K. D. (2020). Mentoring the working nurse: a scoping review. Human resources for health18(1), 1-10. https://doi.org/10.1186/s12960-020-00491-x

Johnson, J. K., & Sollecito, W. A. (2018). McLaughlin & Kaluzny’s Continuous Quality Improvement in Health Care. Jones & Bartlett Learning.https://catalog.nlm.nih.gov/discovery/search?vid=01NLM_INST:01NLM_INST&query=lds04,exact,101556953

Lai, G. C., Taylor, E. V., Haigh, M. M., & Thompson, S. C. (2018). Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review. International Journal of Environmental Research and Public Health, 15(5). https://doi.org/10.3390/ijerph15050914

Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: systematic review. British Journal of Nursing, 30(5), 302–308. https://doi.org/10.12968/bjon.2021.30.5.302

Van Camp, J., & Chappy, S. (2017). The effectiveness of nurse residency programs on retention: a systematic review. AORN journal106(2), 128-144. https://doi.org/10.1016/j.aorn.2017.06.003

Vergara, J. Y. (2017). Implementation of a mentorship program to increase staff satisfaction and retention in critical care. Nurse Leader15(3), 207-212. https://doi.org/10.1016/j.mnl.2017.02.003

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Assignment Overview
The purpose of this paper is to compose a final presentation of your identified healthcare issue with support from evidence-based practice. Portions of the prior assignments will be utilized within the final paper. Provide any revisions as identified from your instructor in your previous assignments. Assignment: Final Paper This last assignment will serve as your final paper (6-8 pages). You will need to incorporate the following previous week’s assignments into this final paper: 1. SWOT analysis 2. Literature Review 3. Quality Improvement Initiatives
The paper will need to include the following elements:
1. An abstract
2. A table of contents
3. Using your SWOT analysis write an introduction to the problem identifying the strengths, weaknesses opportunities and threats to initiating a change.
4. Provide an analysis and synthesis of the 3 selected evidence-based articles.
5. Select a change theory and describe how you would change this situation.
6. Include in your discussion the role that quality and safety initiatives (including informatics, technology, and interprofessional collaboration) would play in implementing this change.
7. Identify the strengths of your change and the barriers you may confront when attempting to create the change. Provide a discussion on how the strengths can be utilized to promote the change and how as a nurse leader the barriers can be overcome.
8. Support your ideas with current literature and evidence-based healthcare practice. At least 3 peer-reviewed references are required.
9. Paper is to be written in APA format. (6-8 pages).

Please make sure to address the following 10 sections sub-headings: Additional Assignment Instructions: Below is a list of the 10 sections to include in your submission:
1. Abstract: The submission provides an APA-formatted abstract of 150-250 words.
2. Table Contents: Include a table of contents page that outlines the sections of the paper and includes accurate page numbers.
3. Introduction: The submission provides a thorough introduction of the healthcare issue and provides a full overview of the topics to be discussed in the paper.
4. SWOT Analysis: A detailed narrative discussion outlines the 4 components of the SWOT Analysis (strengths, weakness, opportunities, and threats) with 2-3 examples from each component.
5. Literature Review: The 3 peer-reviewed articles are integrated and includes the synthesis from the previous unit’s work with the inclusion of in-text citations.
6. Implementation Plan and Method for Initiation Change- Provide a discussion with 2-3 examples of evidence-based practices that apply to the identified healthcare issue in relationship to quality improvement and safety initiatives. The discussion includes the identification of a change theory that can be utilized to implement the proposed SWOT Analysis. At least 1 scholarly source is provided to support the change theory selection.
7. Strengths and Weakness (Barriers) in Promoting the Implementation Plan: Provide a discussion that identifies 2-3 strengths and weakness of the implementation plan. Provide a discussion on how the strengths can be utilized to promote the change and how the role of the nurse leader can impact the identified barriers.
8. The Role of Informatics, Technology, and Interprofessional Collaboration on Improving Quality: Provide a discussion with 2-3 examples of how informatics, technology, and interprofessional collaboration could improve the identified healthcare issue. At least 1 scholarly source is provided.
9. Conclusion: Provide a discussion that summaries all components of the paper. The discussion provides conclusive comments regarding how the implementation plan will improve upon the identified healthcare issue. No new topics are provided in the conclusion.
10. Reference page: APA: The paper is submitted in proper APA format and within the 6-8-page limit.

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