Organizational Needs Assessment Essay
Organizations have different needs and issues that prevent them from achieving their goals. Organizational needs assessment determines the barriers to achieving organizational goals and objectives or identifies the needs gap between the current and desired outcomes. As DNP-prepared nurses, an organizational needs assessment is a must-have skill and competency for playing the project management role. The process of organizational needs assessment is an essential part of strategic planning since the needs assessment results clarify current problems and informs the development of the appropriate solution. Additionally, an organizational needs assessment helps an organization focus on accomplishing strategic goals by identifying potential areas of improvement. The purpose of this essay is to present a practice problem based on an organizational needs assessment conducted on a long-term care facility, identify a practice gap, and develop a practice question. The paper’s outline includes the practice problem, the practice gap, and the practice question.
Organizational Practice Problem
The healthcare organization of focus is a long-term care facility. The long-term care facility is a medium-sized facility that serves a total of 500 patients. The facility offers patients clinical care services and other social and physical services to facilitate daily living. A large proportion of the patients in the long-term care facility are geriatric patients with terminal and chronic illnesses, ranging from diabetes, cancer, liver, and kidney diseases to psychiatric disorders. The institution has integrated long-term care and skilled nursing services to ensure it serves a larger scope of patients, including those who do not need specialized clinical/medical services. The organization has skilled nurses, nurse aides, and other support staff to ensure it provides the best quality services to all patients.
The organizational needs assessment noted that pressure ulcers are one of the significant practice problems impacting the organization. According to Cowan et al. (2019), pressure ulcers, also known as bed sores, are an injury to the skin and other underlying tissues due to prolonged pressure on the skin. Pressure ulcers are mainly caused by the immobility of a patient and the inability to change from a current position. Cowen et al. (2019) note that long-term care facilities have a high prevalence of pressure ulcers since most of their patients have neurodegenerative conditions and paraplegias, which increase immobility and the risk of pressure ulcers.
Various stakeholders are also the decision-makers in the long-term care facility. These stakeholders’ decisions affect how the pressure ulcer practice problem is prevented, managed, controlled, and addressed. These stakeholders include the nursing unit leaders, general managers, nurses, physicians, nurse aides, and general institution leaders. Research shows that nurses play a huge role in preventing, managing, and controlling pressure ulcers (Kim &Lee, 2019). Additionally, nurses work with the nursing unit leaders, managers, and the institution leadership to develop and suggest interventions to address pressure ulcers.
The procure ulcers practice problem identified by the stakeholders is a patient safety and care quality issue that significantly impacts patient outcomes and quality f life for the patients. The problem is identified using the number of pressure ulcer cases reported in the organization and the cost used in treating and managing the reported pressure ulcer cases.
Practice Gap
A practice gap is an opportunity for improvement in practice or a deficit in existing skills, knowledge, and practice. From the assessment of the organizational needs, the practice gap identified in the organization is inadequacy in the methods used to prevent pressure ulcers. A high number of pressure ulcer cases are reported in the organization, mainly resulting from inadequate prevention interventions. Ideally, long-term care facilities are expected to have low cases of pressure ulcers by ensuring high standards of intervention of pressure ulcers prevention are put in place. However, a practice gap is seen when there is a deficit in these interventions, and the facility reports a high number of pressure ulcer cases. The factors contributing to the practice gap include potential issues with a lack of knowledge in pressure ulcer prevention and inadequate prevention measures in the organization. Evidence demonstrating the practice gap includes comments from the nurses in the facility, pressure ulcers cases report, and nurse practitioners’ report of the desire to be able to play their part and prevent pressure ulcers more effectively.
Practice Question
The population of focus includes male and female patients admitted to the long-term care facility for more than six months. The recommended intervention is the use of ripple mattresses as an intervention for preventing pressure ulcers. According to Shi et al. (2020), hospital bed and mattress interventions effectively prevent pressure ulcers in immobile patients. Research shows that ripple mattresses are one of the interventions that have tested effective in the treatment and prevention of pressure ulcers (Shi et al., 2021). The current practice that will be considered for comparison is routine care/ 2-hr repositioning. The outcome of the intervention is a reduction in the facility’s pressure ulcer cases. The project intervention will be implemented in 10 weeks.
The practice question developed to address the practice gap is as follows: For the patients hospitalized for more than six months, does the use of ripple mattresses, compared to routine care, reduce the number of new pressure ulcer cases as measured before and after the intervention in 10 weeks?
Conclusion
The organizational needs assessment of the long-term care facility helped identify pressure ulcers as a significant practice problem in the institution. The institution’s high number of pressure ulcer cases evidences the practice gap. The recommended intervention is the use of ripple mattresses. Effective communication is essential for the DNP-prepared nurse in performing the problem identification and identifying a practice gap since there is a need to collaborate with the entire interprofessional team.
References
Cowan, L. J., Ahn, H., Flores, M., Yarrow, J., Barks, L. S., Garvan, C., Weaver, M. T., & Stechmiller, J. (2019). Pressure Ulcer Prevalence by Level of Paralysis in Patients With Spinal Cord Injury in Long-term Care. Advances in Skin & Wound Care, 32(3), 122–130. https://doi.org/10.1097/01.ASW.0000553109.70752.bf
Kim, J. Y., & Lee, Y. J. (2019). A study on the nursing knowledge, attitude, and performance towards pressure ulcer prevention among nurses in Korea long‐term care facilities. International Wound Journal, 16, 29-35. https://doi.org/10.1111/iwj.13021
Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., & McInnes, E. (2020). Beds and mattresses for treating pressure ulcers. The Cochrane Database of Systematic Reviews, 2020(5), CD013624. https://doi.org/10.1002/14651858.CD013624
Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., McInnes, E., Goh, E. L., & Norman, G. (2021). Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta‐analysis. The Cochrane Database of Systematic Reviews, 2021(8). https://doi.org/10.1002%2F14651858.CD013761.pub2
Table 1: Organizational Needs Assessment
What is currently happening in the practicum site? |
What should be happening at the practicum site? |
What is the gap between what is currently happening and what should be happening (this is your practice gap)?
|
Why is there a gap in practice? What factors are contributing to the gap in practice? |
What evidence do you have to demonstrate there is a practice gap? |
There is a high number of new pressure ulcers cases reported in the long-term care facility. | Nurse Practitioners (NPs) should be using evidence-based pressure ulcers prevention strategies to reduce the number of new cases. | Approximately 35% of the patient population have reported pressure ulcers; however, there are no clear pressure ulcers prevention guidelines, apart from routine care.
|
Potential issue with lack of knowledge associated with pressure ulcers prevention
Inadequate prevention measures in the facility |
Comments provided by the Nurses.
NPs report they want to be able to better prevent pressure ulcers, especially among elderly patients.
|
Table 2: John Hopkins individual evidence summary tool
Practice Question: For the patients hospitalized for more than six months, does the use of ripple mattresses, compared to routine care, reduce the number of new pressure ulcers cases as measured before and after the intervention in 10 weeks?
Date: 16th March 2023
Article Number |
Author and Date |
Evidence Type |
Sample, Sample Size, Setting |
Findings That Help Answer the EBP Question |
Observable Measures |
Limitations |
Evidence Level, Quality |
2021 (8) | Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., McInnes, E., Goh, E. L., & Norman, G. (2021). | Review of Meta analyses | 4 reviews with 68 studies and 18174 participants | Bed overlays and mattresses were found effective in preventing pressure ulcers as compared to routine care | The article reviewed articles with bed overlays and mattresses pressure ulcer prevention interventions | Other prevention interventions were not considered in the comparisons | Shi et al. (2021) was appraised at Level I evidence with grade A quality. The study has generalizable results and the sample size is sufficient for the study design. |
32(3) | Cowan, L. J., Ahn, H., Flores, M., Yarrow, J., Barks, L. S., Garvan, C., Weaver, M. T., & Stechmiller, J. (2019). | Quasi-experimental study | 7,540 patients with quadriplegia, 11,614 patients with paraplegia, and 32,510 patients with hemiplegia in LTC facilities. | Patients with paraplegic issues are at a high risk of pressure ulcers, thus a need to implement prevention interventions | The study aimed to assess the prevalence of pressure ulcers in long-term care facilities | The study only focused n patients with paraplegic issues, leaving out other important factors such s neurodegenerative factors | Cowan et al. (2019) were appraised at Level II grade A Quality. The sample size is sufficient, and the results are generalizable. |
2020 (5) | Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., & McInnes, E. (2020) | Systematic review | 32 studies with 9038 participants from acute care settings | Alternating pressure in ripple mattresses reduced the proportion of participants developing new pressure ulcers | The observable measures included the prevalence of pressure ulcers and the number of new cases | The studies included in the review have an average of 80 participants, which is a small number. The methods used in these studies were also likely to produce errors | Shi et al. (2020) were appraised at level I grade B quality since the sample was inadequate |
16 | Kim, J. Y., & Lee, Y. J. (2019) | Experimental study | 282 registered nurses in long-term care facilities | Nurses were found to play a major role in the prevention of pressure ulcers using various nursing interventions | Registered demonstrated a positive attitude, knowledge and skills toward prevention of pressure ulcers | The study’s major limitation is the failure to include other factors of pressure ulcers prevention | Kim and Lee
(2019) were appraised at level II grade A quality The sample is adequate, and the results are generalizable to similar populations. |
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Organizational Needs Assessment
Assignment
Purpose
The purpose of this assignment is to identify a practice problem based on an organizational needs assessment, including the identification of the practice gap and formulation of the practice question. This assignment will allow for the assimilation of professional leadership competencies in project management as a DNP-prepared nurse. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.
Please note that this is the first part of a 3-part assignment submitted in Weeks 2, 5, and 7. You will receive corrective feedback from your course faculty on the Week 2 and Week 5 assignments that you will use to prepare the Week 7 assignment.
NOTE: All NR703 assignments and their requirements should be discussed in relation to your proposed or hypothetical DNP practicum project. **No DNP practicum project will be approved for implementation until the second practicum course, NR-705 Project & Practicum II
Instructions
Complete the Organizational Needs Assessment: Practice Gap Identification Table on a healthcare organization of your choice. This will be submitted as Table 1.
Link (Word doc): Organizational Needs Assessment: Practice Gap Identification TemplateLinks to an external site.
Include the following in your paper:
Introduction
Introduce the topic and establish the importance of an organizational needs assessment.
Present a clear purpose statement.
Create an organizing (outline) statement for the paper that matches the required level 1 headings (except for listing the conclusion).
Problem: Using the information that you gathered on the Organizational Needs Assessment: Practice Gap Identification (Table 1), describe the practice problem by explaining these elements:
Describe a specific location (hospital unit, community health clinic, surgical suite, primary care practice).
Identify the key stakeholders (decision-makers).
Explain the practice problem as would be identified by the stakeholders.
Practice Gap
In 1-2 organized paragraphs, summarize your findings in table 1, the Organizational Needs Assessment: Practice Gap Identification. Ensure the table is placed after the reference list starting on its own page with the heading Table 1.
Practice Question: Define and briefly explain the project’s intended population, evidence-based intervention, and measurable outcomes (PICOT):
Population: Describe the specific characteristics of the population that is the focus of the intervention.
Intervention: Citing evidence listed in the Johns Hopkins Individual Evidence Summary Tool (Table 2) which was initiated in NR-716, describe the evidence-based intervention. There should be a total of three (3) references listed in Table 2 for this assignment. If necessary, add one research study or systematic review to support your intervention unless one already exists on the table from your previous courses.
Comparison: State “compared to current practice” for the purposes of this assignment.
Outcome. Create and explain specific outcome measurements based on the current evidence you have collected in the Johns Hopkins Individual Evidence Summary Tool (attached as Table 2). If needed, add one research study or systematic review that supports your proposed outcome measurements. The source can be the same one that was used to support the intervention as long as it speaks to measurable outcomes. There should be a total of three (3) references listed in Table 2 for this assignment.
Time: Time frame for the project implementation. (Practicum projects are typically 8 – 10 weeks long).
State the Practice Question. Example: (P) For the critical care team in X hospital’s ICU, (I) does the implementation of the medical sepsis protocol (C) compared to the current practice (O) reduce the incidence of medical sepsis diagnoses in ICU patients as measured before and after the intervention (T) over a 10-week period?
Conclusion
Recap the paper’s purpose statement and organizing (outlining) statement of the three level 1 headings (not including the conclusion).
Draw major conclusions from the body of your paper.
Summarize the importance of effective communication for the DNP-prepared nurse in performing the practice gap and problem identification.
References
Create the reference page.
Ensure each reference has a matching citation.
Include a minimum of three (3) scholarly references (all three references on the Johns Hopkins Table should be included).
Tables
Add the completed Table 1 & Table 2 after the reference list. For directions on how to copy a table in Microsoft Word go to the following link:
Link (webpage): Move or Copy a TableLinks to an external site.
Table 2, the Johns Hopkins Individual Evidence Summary Tool, is attached (after Table 1) & completely filled out with at least three (3) quantitative research studies at a minimum. (NOTE: a minimum of three [3] references should be included on the reference list, including those in Table 2).
Table 1: Organizational Needs Assessment: Practice Gap Identification
What is currently happening in the practicum site that causes the problem?
What should be happening in the practicum site based on current evidence*?
What do the stakeholders (decision-makers) identify as the gap between what is currently happening and what should be happening (this is your practice gap)?
Why is there a gap in practice?
What factors are contributing to the gap in practice?
What evidence* do you have to demonstrate there is a practice gap (e.g., NDNQI, AHRQ Quality Indicators, National Hospital Quality Measures, HCAHPS, Joint Commission ORYX®, etc.)?
*Reference & citation required.
[Add text] [Add text] [Add text] [Add text] [Add text]
[Add text] [Add text] [Add text] [Add text] [Add text]
PICOT Problem Statement:
P (Population – example: For critical care team in X hospital ICU…)
I (Intervention – example: Does the implementation of the medical sepsis protocol…)
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C (Comparison – example: Compared to current practice). NOTE: “C” is most commonly used for research projects, not DNP translation science projects. “C,” or Comparison intervention, is implied for DNP projects, although you will see instances where the C does not apply.
O (Outcome, measurable – example: Reduce the incidence of medical sepsis in patients as measured before and after…)
T (Time – Usually 8-10 weeks for a DNP practicum project)
Review the rubric below for the grading criteria.
APA Guidelines
Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing Professional Papers: Graduate Programs (located in the Canvas Resources menu under the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.
Use the standard APA Paper Template (located in the Canvas Resources: Writing Center) to format this assignment.
Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before constructing the assignment.)
Use the title, “Organizational Needs Assessment,” for your project and construct a title page using the APA paper template.
Use the following prescribed Level 1 headings for this paper (do not include the outline letters):
Problem
Practice Gap
Practice Question
Conclusion
Writing Requirements (APA format)
Length: 3-4 pages (not including title page, references page, or attachments)
1-inch margins
Double-spaced pages
12-point Times New Roman
Headings & subheadings
In-text citations
Title page
Reference page
Standard English usage and mechanics
CARE Plan paragraph development structure
Program Competencies
This assignment enables the student to meet the following program competences:
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Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)
Course Outcomes
This assignment enables the student to meet the following course outcomes:
Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)
Due Date
By 11:59 p.m. MT on Sunday
Late Assignment Policy applies
Rubric
W2 Assignment Grading Rubric
W2 Assignment Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction
Requirements:
1. Introduce the topic and establish the importance of an organizational needs assessment.
2. Present a clear purpose statement.
3. Create an organizing statement for the paper that matches the level 1 headings (except for listing the conclusion).
10 pts
Includes all requirements and provides an in-depth introduction.
9 pts
Includes 2 requirements and/or provides a sufficient introduction.
8 pts
Includes 1 requirement and/or provides a partial introduction.
0 pts
Provides an undeveloped introduction.
10 pts
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This criterion is linked to a Learning OutcomeProblem: Using the information that you gathered on the Organizational Needs Assessment: Practice Gap Identification (Table 1), describe the practice problem.
Requirements:
1. Describe a specific location (hospital unit, community health clinic, surgical suite, primary care practice).
2. Identify the key stakeholders (decision makers).
3. Relate the practice problem identified by the stakeholders.
30 pts
Includes all requirements and provides an in-depth description of the problem.
27 pts
Includes at least 2 requirements and/or provides a sufficient description of the problem.
24 pts
Includes at least 1 requirement and/or provides a partial description of the problem.
0 pts
Provides an undeveloped description of the problem.
30 pts
This criterion is linked to a Learning OutcomePractice Gap
Requirements:
1. In 1-2 organized paragraphs, summarize your findings in Table 1, the Organizational Needs Assessment: Practice Gap Identification
2. Include a thoroughly completed Organizational Needs Assessment: Practice Gap Identification Table as Table 1, placed after the reference list.
30 pts
Includes Table 1 and provides an in-depth summary of the Organizational Needs Assessment: Practice Gap Identification (Table 1).
27 pts
Includes Table 1 and provides a sufficient summary of the Organizational Needs Assessment: Practice Gap Identification (Table 1).
24 pts
Includes no Table 1 and/or provides a partial summary of the Organizational Needs Assessment: Practice Gap Identification (Table 1).
0 pts
Provides no Table 1 and/or an undeveloped summary of the Organizational Needs Assessment: Practice Gap Identification (Table 1).
30 pts
This criterion is linked to a Learning OutcomePractice Question: Define and briefly explain the project’s intended population, evidence-based intervention, and measurable outcomes (PICO).
Requirements:
1. Population. Describe the specific characteristics of the population that is the focus of the intervention.
2. Intervention. Citing evidence listed in the Johns Hopkins Individual Evidence Summary Tool (Table 2), which was initiated in NR-716, describe the evidence-based intervention.
3. Comparison: State “compared to current practice” for the purposes of this assignment.
4. Outcome. Create and explain specific outcome measurements based on the current evidence collected in the Johns Hopkins Individual Evidence Summary Tool (attached as Table 2, placed after Table 1).
5. Time. State the time length for the project (i.e., 8-10 weeks).
6. State the Practice Question.
7. Table 2, the Johns Hopkins Individual Evidence Summary Tool, is attached & completely filled out with at least three (3) quantitative research studies at a minimum. (NOTE: all three [3] references should be included on the reference list).
40 pts
Includes Table 2 and all data requirements and provides an in-depth summary of the practice question.
36 pts
Includes Table 2, no fewer than 5 of the requirements, and provides a sufficient summary of the practice question.
32 pts
Includes Table 2, no fewer than 4 of the requirements, and provides a partial summary of the practice question.
0 pts
Includes no attached Table 2, fewer than 4 of the requirements, and/or provides an undeveloped summary of the practice question.
40 pts
This criterion is linked to a Learning OutcomeConclusion
Requirements:
1. Recap the paper’s purpose and organizing (outline) criteria that revisit the three level 1 headings (not including the conclusion).
2. Draw major conclusions from the body of your paper.
3. Summarize the importance of effective communication competencies for the DNP-prepared nurse in performing the practice gap and problem identification.
10 pts
Includes all requirements and provides an in-depth summary in the conclusion.
9 pts
Includes at least 2 requirements and/or provides a sufficient summary in the conclusion.
8 pts
Includes at least 1 requirement and/or provides a partial summary in the conclusion.
0 pts
Provides an undeveloped summary in the conclusion.
10 pts
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This criterion is linked to a Learning OutcomeReferences
Requirements:
1. Create the reference page using the APA template and the Chamberlain Guidelines for Writing Professional Papers.
2. Ensure each reference has a matching citation that follows the formatting guidelines in the APA manual/Chamberlain Guidelines for Writing Professional Papers.
3. Include at least three (3) scholarly references at a minimum (including those from the Johns Hopkins Table)
10 pts
Includes all requirements of the reference section, at least three scholarly references with matching citations, and the reference page is formatted without errors.
9 pts
Includes at least 2 requirements for the reference section, and/or the reference page is formatted with 1-2 errors.
8 pts
Includes 2 requirements for the references, and/or the reference page is formatted with several errors.
0 pts
Includes fewer than 1 requirement for the reference section, and/or the reference page is formatted with multiple errors.
10 pts
This criterion is linked to a Learning OutcomeAPA Style and Organization for Scholarly Papers
Requirements:
1. Use prescribed level I headings for section organization.
2. Format the paper using APA formatting conventions.
3. Length of APA formatted paper is 3-4 pages (excluding title page, reference page, and tables).
10 pts
Includes all requirements of APA style and standards.
9 pts
Includes 2 requirements of APA style and standards.
8 pts
Includes 1 requirement of APA style and standards
0 pts
Includes no requirement of APA style and standards that conforms to APA style.
10 pts
This criterion is linked to a Learning OutcomeClarity of Writing
Requirements:
1. Use of standard English grammar and sentence structure.
2. No spelling errors or typographical errors.
3. Organized and logical presentation of ideas in paragraphs (CARE Plan), sentences, and phrases
10 pts
Includes all requirements of clarity of writing.
9 pts
Includes 2 requirements of clarity of writing.
8 pts
Includes 1 requirement of clarity of writing.
0 pts
Includes no clarity of writing requirements that conform to standard English (APA) style.
10 pts
Total Points: 150