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Policy Brief Part I to IV Nursing Assignment.

Policy Brief Part I to IV Nursing Assignment.Policy Brief Part I to IV Nursing Assignment.One PagerPolicy briefs create and initiate change through health care policy adoption. At times, policymakers require an even briefer summary version, or a one-pager, of the initial research so they can quickly grasp an issue. One-pagers provide at-a-glance information relating to the issue.Create a one-pager in which you synthesize the following components of your policy brief:Issue summaryRelevant background informationAlternative recommendations analysisAction requiredBe concise. Your one-pager should be no more than 350 words.Policy Brief Part I to IV Nursing Assignment.Cite at least four scholarly articles and relevant legal casesORDER A PLAGIARISM-FREE PAPER HEREContent     8 Points Points Points EarnedIssue summary 1.5 Policy Brief Part I to IV Nursing Assignment.Relevant background information 2  Alternative recommendations analysis 2  Action required 2  Should be no more than 350 words and one page 1  Comments    Total 8.5  Format2 points    Utilizes correct spelling, grammar, punctuation and APA format 1  include an APA-formatted reference page. .5  Comments: Policy Brief Part I to IV Nursing Assignment.  Total 1.5  Point Total 10   Policy Brief Part I: Nurse Safety in Psychiatric UnitAccording to the Occupational Safety and Health Administration(2013), the healthcare profession has the highest rate of illness and non-fatal injuries compared to other jobs. The nursing professions can be dangerous as nurses are consistently exposed to biological, chemical, and physical hazards in their workplace. Among nurses in various units, psychiatric nurses face an additional risk for physical injuries as they are susceptible to workplace violence related to dealing with a patient’s hostility, aggression, and assault. With increasing demands for behavioral healthcare services in the nation, the health and safety of mental health care nurses has become an issue of concern for all healthcare stakeholders. That is because “nurses’ sense of physical and emotional safety in the workplace translates into greater nurse satisfaction and better patient care” (Zolot, 2017, para 1). This policy brief examines the issue of nurse safety in the mental health unit, potential solutions to the problem, and impact of proposed solutions. Policy Brief Part I to IV Nursing Assignment.Describe the underlying issueOwing to its nature, the psychiatric department could cause nurses to feel unsafe, particularly as a result of the physically and mentally stressful working conditions. Psychiatric nurses’ safety in their workplace suffer from safety concerns that include physical and mental stress. Healthy nurses whose safety is guaranteed can offer vigorous advocacy, empathetic care for their patients, and vigilant monitoring (Kelly & Tazbir, 2013).Policy Brief Part I to IV Nursing Assignment.To be more precise, an environment that introduces long working hours in a shift, along with ineffective policies and safety procedures as well as insufficient de-escalation training exposes the nurses to occupational hazards. These stressors can have an influence on the nurses’ safety and result in impaired health that includes neoplastic, metabolic and cardiovascular ailments, mental health changes, infection, injuries, and musculoskeletal disorders. Once a nurse’s safety is compromised, he or she will be unable to provide the best possible care possible, resulting in patients receiving low-quality care (Kelly, 2011).Policy Brief Part I to IV Nursing Assignment.The working capacity of the injured nurses will be reduced resulting in more sick calls that places a strain on the facility and other nurses. Employers are also placed under financial strain to provide compensation to the injured nurses. Additionally, nurses placed in such stressful environments are likely to have low resilience and resign thereby, increasing turnover, particularly when it is considered that some psychiatry patients have a propensity for physical violence and could harm the nurses(Yoder-Wise, 2013).Policy Brief Part I to IV Nursing Assignment.A high turnover rate will imply that a significant number of nursing staff have opted to resign. For the most part, high turnover is the result of dissatisfaction. In this case, the employee is unhappy with the working conditions – such as long working hours – and opts to look for better working conditions elsewhere. Job characteristics could influence turnover decisions by failing to observe safety standards and creating an unsafe working environment. The intrinsic features of the job may either attract or repel the worker. For instance, dangerous jobs are typically unattractive and cause workers to resign when they find less dangerous jobs(Ulas, 2014).Policy Brief Part I to IV Nursing Assignment.Identify stakeholdersFour groups of stakeholders are affected by nurse safety in the psychiatric unit. The first group of stakeholders is the patients who end up receiving low-quality care when their nurses are injured. Injured nurses are unable to perform their nursing care at the highest level. The second group of stakeholders is the nurses who are injured when their safety is compromised resulting in their inability to perform at their best. Once a nurse is injured, his or her responsibilities will be transferred to other nursing personal thereby adding to their workload. The third group of stakeholders is employers who may have to pay some compensation to nurses injured in the workplace and restructure staff assignments to cover for the injured nurses. The fourth group is nursing advocacy groups (such as American Nurses Association) who use injury incidences as opportunities to advocate for the safety of nurses, focusing on the underlying causes and how they can be mitigated (Finkelman, 2016).Policy Brief Part I to IV Nursing Assignment.Evaluate a resolution. The resolution to improve the safety of nurses should entail reviewing shift work and eliminating long work hours.A potential resolution to the identified problem is to replace12-hour shiftswith 8-hour shifts. The correlation between work schedules and safety is undeniable and influenced by a range of factors that include the work environment, rest breaks, length of the shifts, day off patterns, rotation speed and direction, and shift time. Also, the correlation is influenced by the nurse and job characteristics. Although long working hours and shift work are acknowledged to have negative effects, they also have some positive effects that include reduced work volume and incentive pay (Kaakinen et al., 2015).Policy Brief Part I to IV Nursing Assignment. Despite the positive effects, it is undeniable that shift work presents some safety issues that include disturbing sleep and circadian rhythms. Working for long hours reduces the amount of time available for sleep resulting in incomplete recovery after work, disturbed sleep, and sleep deprivation the leads to adverse immune, metabolic, cardiovascular and nervous functioning. Disturbing the circadian cycle reduces the sleep quality and length to cause sleepiness and fatigue as well as cardiovascular, psychological, and gastrointestinal symptoms. Long hours increase the exposure time to hazards in the workplace such as emotional, mental and physical demands, infectious agents and chemicals, as well as adding to work stress that may increase caffeine use, alcohol consumption, and smoking, while reducing the time available for nutritious meals and exercises (Porter-O’Grady & Malloch, 2016). In this respect, a resolution for the safety of nurses would entail designing new work schedules by reviewing shift work and having shorter working hours.Policy Brief Part I to IV Nursing Assignment.Assess specific alternative resolutions. Other than the presented solution, the issue can be resolved by implementing annualsafety training (de-escalation) workshops. The annual workshop isdesigned to provide superior de-escalation training through various activities and role-playing and would better prepare nurses for their work.Ultimately, the training allows the nurses to acquire safety knowledge that can be applied to increase safety standards and address safety concern (Ulas, 2014).A third alternative resolution would assign skill levels to nurses based on their experience and knowledge. This would then be used to assign responsibilities in the workplace, allowing for efficient management of the workforce even as the more vulnerable nurses are assigned less dangerous tasks (Ulas, 2014).Policy Brief Part I to IV Nursing Assignment.Identify the positive consequences of each resolution. The main resolution presents an administrative strategy. This strategy, offering 8-hour shifts, has the advantage of being applicable immediately since it only entails an administrative change to the present work schedule.Another advantage is that it presents a lower risk of hazards. Shortened work hours decrease nurse burnout and increase nurse resiliency and has a positive consequence on the nursing retention rate. Unlike the main resolution, the first alternate resolution presents behavioral strategy as it aims to increase the ability of nurses to handle work better through the safety training workshop. This solution shares similar advantages that include being easy to apply by including safety training sessions in the courseworkas well as improving nurse satisfaction levels since they are better prepared to handle the workplace hazards and increasing resiliency and retention rates(Porter-O’Grady & Malloch, 2016). Lastly, the second alternateresolution has the advantage of being less costly since it only makes use of the workforce already in place and improves its management (Ulas, 2014).It similarly improves nurse resiliency and retention since nurses are only assigned to tasks that they can complete as well as hazards that they can easily handle.Policy Brief Part I to IV Nursing Assignment.Identify the negative consequences of each resolution. The administrative strategy has the disadvantage of increasing administrative costs. That is because it requires that more nursing personnel be employed after work schedules are changed. By having nursing personnel work for shorter hours, more of them would be required to ensure that all the work is completed (Kaakinen et al., 2015). The first alternate resolutionhas two negative consequencesthat include cost and timefor health organizations to set up the annual workshop. Cost and time issues are attributed to the administrative and resources aspects of offeringyearly safety training workshop. Unlike other resolutions, the resolution of assigning skill levels has no remarkable negative consequences since it makes use of the personnel already in place, going on to apply better management strategies in ensuring that they are assigned to positions with acceptable hazard levels based on experience and knowledge.Policy Brief Part I to IV Nursing Assignment. Policy Brief II  Resolution 1: Changing 12-hr to 8-hr shifts Resolution 2: De-escalation training workshops Resolution 3: Labelling nurses’ skill levelsCost of each resolution –   This resolution requires health facilities to hire more nurses.–   The recruitment costs include orientation and training, sign-on bonus, and relocation, advertising, health screening costs, extraordinary turnover costs, and other minor costs. According to the KPMG Healthcare & Pharmaceutical Institute (2011), recruiting a full-time registered nurse costs $2,000.Policy Brief Part I to IV Nursing Assignment.–   The annual average cost of employing a full time registered nurse is $96,000 (The KPMG Healthcare & Pharmaceutical Institute, 2011). This cost included payroll (wages, taxes, shift differentials, overtime, holidays and paid time off, bonuses, pension contribution, and others), insurance (health insurance, workers’ compensation, disability and life insurance, malpractice, and others), and miscellanies (benefits administration, payroll services, continuing education, and other minor costs).Policy Brief Part I to IV Nursing Assignment. –      Training is associated with the costs of developing the training material, schedules, and hiring trainers. The cost of subjecting each nurse to de-escalation training could range from $20 to $250 per session (DeNisi & Grffin, 2015).–      Additionally, the facility would need to pay the nurses for the extra-time when attending the training, ranging from $20 to $60 per hour for each nurse (Finkelman & Kenner, 2016). –   This strategy could cost as low as $250. This is associated with the cost of acquiring software that matches the personal information in a database. The software uses algorithms to present the best matches for nurses’ responsibilities, knowledge, and experience (Phillips & Gully, 2013).Financial implications –   It reduces pay and benefit costs for individual nurses since it will still be based on 12-hour shifts (36 hours per week) and yet they will be working 8-hour shifts (40 hours per week). This decreases cost by approximately 12.5% for each nurse (Frehse, 2012).–   Despite individual salaries of each nurse decreasing by 12.5%, the overall salaries paid out will increase by 5% since approximately 10% more nurses will be employed (Feldstein, 2012).Policy Brief Part I to IV Nursing Assignment.–   Shorter work hours decrease nursing burnout, which is one of the major reasons for nursing turnover (The University of New Mexico, 2016).–   The average cost of turnover for a nurse ranges from $38,000 to $61,100 resulting in the average hospitals to lose $4.4 million to $7.0 million annually.  Each percent changes in RN turnover will cost/save the average hospital an additional $337,500 (Nursing Solution, 2018).Policy Brief Part I to IV Nursing Assignment. –   With de-escalation training, health facilities can reduce nurse injuries and save money on the nursing replacement. The estimated cost of replacing an injured nurse is $27,000 to $103,000 (OSHA, 2013).–   Stanford University Medical Center invested $800,000 on safety training and saved a five-year net saving of $2.2 million (OSHA, 2013).–   Additionally, stakeholders may have to spend between $300,000 to $1,000,000 on lobbying for legislative changes to include de-escalation training as part of standardized training in nursing education programs (DeNisi & Grffin, 2015). –   No significant financial loss for health facilities except one-time software fee which costs as little as $250.–   Increase of working experiences decrease incident rates (Hill, 2010).–   By allowing for efficient management of the workforce, health organizations would have various degree of financial gain from improved patient safety and health outcomes.–   Patient safety improvement in US Medicare hospitals estimated to save $28 billion between 2010 to 2015 (Slawomirski, Auraaen, & Klazinga, 2017).Economic implications –   It would require that more nursing personnel are employed since each nurse would only be able to handle fewer patients. This would improve the local economy by ensuring that the nurses have more to spend on local businesses (Frehse, 2012).Policy Brief Part I to IV Nursing Assignment.–   Increases in nurse commuters, as a result of increased nursing schedules, would improve revenues for local businesses such as gas stations, restaurants, etc. –   Employing de-escalation training personnel and acquiring equipment improves the local economy by ensuring that the training personnel had more to spend in local businesses (DeNisi & Grffin, 2015). –   This does not have any remarkable effect on the economy since it only makes the best use of the available nursing resources that have already been dedicated to medical services (Phillips & Gully, 2013).Resources –      There is a need for overtime and additional staff to cover increased shifts (Snell, Morris & Bohlander, 2015).Policy Brief Part I to IV Nursing Assignment.–      Nurse recruiters.Human resource staff for advertising, job fairs, interviewing, orienting, job training, and managing new employees.–      Advertisement materials to send out recruitment cards, letters, etc.–      Orientation materials including orientation room, policies, procedures, benefits, and other relevant information.Policy Brief Part I to IV Nursing Assignment.–      Health insurance agencies.–      Nursing staffing. –   Nursing staff as attendees.–   Trainers who are proficient in de-escalation.–   Training material customized for the facility that includes literature and rooms (DeNisi & Grffin, 2015). –   Database and database manager to make sense of the staff experiences and knowledge.–   Access to personnel records that show the level of experience and knowledge (Phillips & Gully, 2013).Quality of care –       It improves quality of care since there are fewer instances of fatigue as the nurses work for fewer hours thereby reducing incidence of errors (Snell, Morris & Bohlander, 2015). –       It improves quality of care by increasing workplace safety and making staff more confident in the workplace so that they are more focused on the patients (DeNisi & Grffin, 2015). –   It improves quality of care by optimizing staff assignment since each nurse is assigned responsibilities that he or she can complete. This means that the best staff is assigned to each task (Phillips & Gully, 2013).Patient outcomes –      Nurses’ downtime means that fewer patients receive care by the end of the day.–      There are improved patient outcomes since the nurses are not fatigued and have fewer instances of errors (Snell, Morris & Bohlander, 2015). –   It improves patient outcomes by making the staff more confident and enables to focus on care delivery to the patients (DeNisi & Grffin, 2015). –   It improves patient outcomes by ensuring that each person is attended to by the most proficient staff member to improve patient outcomes (Phillips & Gully, 2013).Policy Brief Part I to IV Nursing Assignment. Policy Brief Part III: Ethical ConsiderationsThe issue that has been identified is the problem of nurse safety in a psychiatric unit. To address this issue, three contrasting resolutions have been presented for consideration. The first resolution is to implement a shift change from 12-hours to 8-hours. The second resolution is subjecting the nurses to de-escalation training workshops. The final resolution is labeling the nursing skill levels. While each of the three resolutions presents some possibility of success, they are similarly accompanied by unique ethical considerations and concerns. The present discussion explores these ethical considerations and concerns as well as proposed strategies for handling them.Policy Brief Part I to IV Nursing Assignment.Resolution 1: Changing 12-hour to 8-hour shiftsShift-change addresses ethical concerns about the facility’s obligation as the employer when they address the nurses’ welfare concerns as employees. This is not simply a question of working conditions or remuneration. Rather, it is about enduring and real concerns regarding the well-being for their nurses. By changing the shifts, the medical facility shows that the nurses’ welfare is their dominant consideration, demonstrating genuine concern even when costs could influence profitability. Implementing the decision would improve the facility’s reputation even as it has a psychological impact on the nurses. It is clear that the strategy conforms to the adage that employees are entitled to be treated with respect and fairly, with the facility having an obligation to improve the well-being of their personnel. The implication is that although self-interest can have compelling and powerful pressure on the facility, applying shift change shows that the basic ethical principles of caring and respect guide the facility when dealing with its nursing personnel (Cihon & Castagnera, 2014).Policy Brief Part I to IV Nursing Assignment.Secondly, there is an ethical concern that the shift-change could be considered breaching the employment contractual agreement. Although employment contracts are not intended to last indefinitely, the finite terms presented in the contract still are a guide for the employment relationship. The implication is that changing the finite terms could be considered a breach the contract. The same applies to the shift change that essentially changes the finite terms through revising the number of hours worked in each pay period. To address the potential breach of contract as an ethical concern, there is a need to present advanced notice to the nurses informing them that a shift change is expected at some defined time in the future, say at the end of three months or six months. This would also ensure that the nurses have time to change their expectations before the contract is revised to include the shift change (Miller & Hollowell, 2015).Policy Brief Part I to IV Nursing Assignment.Resolution 2: De-escalation training workshopsThere are two potential ethical concerns that present when de-escalation training is applied. Firstly, there could be concerns about the choice of activity for the training workshop since each activity could represent the behavioral and learning change the nurses are expected to achieve. This considers the fact that activity implementation is limited by time and resources. To address this concern, there is a need to identify how the potential unintended and intended consequences of an activity balance out (Wang, 2014). For instance, the focus should be on selecting activities that have sufficient resources and materials so that the nurses are presented with adequate tools that improve how they approach workplace hazards.Policy Brief Part I to IV Nursing Assignment.Secondly, there could be an ethical concern about the way in which the training activities are approached. For instance, how much information should be provided for each activity to ensure that the nurses attending the training workshop learn the intended lessons? This follows that although it is ethically right for the trainer to ask the attendees to complete an activity, it is wrong to provide too little information that hinders learning the activity. This can be seen in the case where participants are presented with a puzzle missing some crucial pieces and expected to provide a solution as a way of training them to how best to react to change. Such an approach deliberately misleads the trainees, thus presenting an ethical concern. As such, each activity in the de-escalation training workshops should allow for effective learning without complicating the learning process (Williams, 2014).Policy Brief Part I to IV Nursing Assignment.Resolution 3: Labeling nurses’ skill levels. This resolution presents an ethical concern in the form of workplace discrimination. That is because the labeling is a form of profiling that segregates nursing personnel into different classes on the basis of skills, with a determination about how each nurse would be treated in terms of salaries and responsibilities within the workplace. While this strategy appears ideal in making the best use of nursing personnel by matching responsibilities to skills, it can also act as the basis for discrimination when the system is abused. This would occur if particular skill levels are overlooked or the focus is excessive. To address this concern, there is a need to develop independent systems that match skills with responsibilities, such as using computer algorithms to identify the best nurse to undertake a particular task. Additionally, the information on each nurse’s skills should be kept confidential and only used for the pre-agreed intended purpose and not to target skill groups for discrimination (Mathis, Jackson & Valentine, 2013).Policy Brief Part I to IV Nursing Assignment.    Policy Brief Part IVLegal and regulation consideration of each resolutionResolution 1:Changing 12-hour to 8-hour shiftsThe law is clear that an employer must offer reasonable notice for any shift changes. In this case, reasonable notice is any period of time longer than one week. The implication is that there is no legal provision for the employer to guarantee a particular shift schedule. The only exception is when the employee is covered by a collective bargaining agreement in which case the agreement must be reviewed before the shift change can be implemented (Cihon & Castagnera, 2014).Policy Brief Part I to IV Nursing Assignment.The legal considerations concerning shift changes are intended to ensure that the affected individuals receive appropriate compensation. This occurs even as the considerations regulate minimum health protection levels, offer aid to personnel in fulfilling social and family obligations, and present opportunities for career development (Cihon & Castagnera, 2014). Other considerations include adequate consultation with nurses’ representatives on the shift changes, ensuring staffs have access to the appropriate social services, applying a compensation rate that matches the nature of work, and appropriate alternatives for female nurses when pregnant and in the period immediately after childbirth (Miller & Hollowell, 2015).Policy Brief Part I to IV Nursing Assignment.Resolution 2: De-escalation training workshopsCalifornia Occupational Safety and Health Administration (OSHA) had implemented a new regulation under section 3342, which titled Workplace Violence Prevention in Health Care, that tookeffect on April 1, 2017 (Occupational Safety & Health Standard Board, 2018). The regulations require health care facilities in California to comply with a variety of standard for violence prevention. For instance, the hospitals must have workplace violence prevention plan, review of the workplace violence prevention plan, and violence prevention training in place as of April 1, 2018 (Occupational Safety & Health Standard Board, 2018). Pursuant to the regulations and standards, the majority of healthcare facilities in California offer violence prevention training throughCrisis Prevention Intervention (CPI) training program or Management of Assaultive Behavior(MAB) course and require employees to maintain certification.Policy Brief Part I to IV Nursing Assignment.Training should consider the common standards applied. Training with a limited scope and grown out of the need of a single facility is likely not to impose any legal needs when compared to training with more comprehensive scopes covering different facilities or across state lines. That is because the state requirements for approval standards are likely to differ across state lines, particularly the conditions set by the nursing and education boards (Wang, 2014). In addition, access to the training workshops should be equitable and fair to conform to anti-discrimination legislation (Williams, 2014).Policy Brief Part I to IV Nursing Assignment.Resolution 3: Labeling nurses’ skill levelsNursing practice requires specialized skills and knowledge that are divergent since practice differs in terms of focus, setting, client type, disease type, and therapeutic approach. This presents some inherent risk of harm that is exponentially increased if nursing is practiced by incompetent or unprepared professionals. As such, it is only expected that the Nurse Practice Act come into being to set the Board of Nursing to offer the licensure requirements, types of licenses and titles, and nursing standards and scope. An extension of this expectation is that nurses’ skill levels would be labeled to determine the work responsibility that each nurse can take on (Fitzpatrick & McCarthy, 2014).Policy Brief Part I to IV Nursing Assignment.Labeling nurses’ skill levels should ensure that no nurse is disadvantaged this conforming to equal opportunity legislation. The labeling should also protect the nurses against racial, gender and disability discrimination by providing support that is appropriate with needs. Besides that, there should be conformity to privacy and confidentiality legislation when handling personal information, through presenting guidelines on how information is collected, used and shared (Mathis, Jackson & Valentine, 2013).Global factors associated with each resolutionResolution 1: Changing 12-hour to 8-hour shiftsThere are regional directives on work time that present a rule on the maximum number of hours that personnel can work and rest. This rule is typically transposed into collective agreements. Any nation that violates this rule is likely to be blacklisted by foreign nurses. In addition, the shift must be presented as a collective agreement on working time between the nurses and their employers (Miller & Hollowell, 2015).Policy Brief Part I to IV Nursing Assignment.Resolution 2: De-escalation training workshopsThere are international standards in place on how training workshops should be conducted and implemented. Implementing the training using these standards ensures that the nurses can use the same qualifications even when out of the country. In addition, nurses from out of the country can use the same qualification when looking for work in the country (Wang, 2014).Resolution 3: Labeling nurses’ skill levelsLabeling skills is an accepted international practice that matches responsibilities to capabilities. Through this practice, competence is introduced in the workplace thereby making it easier to incorporate international workers who might have attended a different training program but have the same skills set (Mathis, Jackson & Valentine, 2013).Policy Brief Part I to IV Nursing Assignment. Final recommendations. Based on the consideration and factors discussed, it is recommended that resolution 3 be given priority followed by resolution 2 then finally resolution 1. That is because it applies an accepted international practice that is already implemented in some form such as when specifying requirements when hiring new personnel. De-escalation training workshop is considered second because it can be implemented at the local or facility level so that fewer impediments are faced. Implementing the training workshop on a larger scale would attract greater regulatory impediments. Shift change is considered last because it requires greater consideration, particularly with regards to changes in compensation rate and consultation with many stakeholders.Policy Brief Part I to IV Nursing Assignment.Implementation planCommunication strategy. The communication strategy applied focuses on the message that nurse safety in the workplace is a source of concern. Additionally, it will mention the three resolutions as well as their merits and demerits. The audience includes all healthcare organizations, healthcare professionals, medical staffs, professional nursing organizations, American Nurses Association, insurance companies, and government agencies. But, the target audience will be nurses and their employers as stakeholders in the health industry since they can influence safety outcomes for nurses. For instance, hospital administrators can decide whether or not to implement the first resolution. The supporting organization will be the health facility that employs nurses and offers an environment for them to engage patients.Policy Brief Part I to IV Nursing Assignment.The communication strategy will entail the use of mass media platforms since they present the best tool for reaching and educating these nurses and their employers. That is because mass media is an essential part of hazard management. In essence, a common hazard management aim would be to mediate at the level of the nurses and their employers. This aim allows mass media to facilitate the achievement of the change goal by acting as an effective tool to reach them and inform them of each resolution in detail. Through the mass media, the nurses and their employers can be empowered, educated, and informed thereby allowing them to experience lasting improvement as evidenced by short-term indicators (reduced incidents of accidents) immediately following the transmission of a message (Boje, Burnes & Hassard, 2012). Policy Brief Part I to IV Nursing Assignment.A second communication strategy would involve the use of social marketing. This draws on the concepts that are commonly applied in business marketing, using them to promote socially desirable health-related behaviors. In this case, social marketing uses approaches that are alternative to mass media. For instance, they can use peer-counseling among nurses to discuss the aspects of each resolution and what an ideal resolution entails. A prominent advantage of social marketing use in implementing community behavior change is that it introduces health promotion behaviors that do not rely on messages concerning disease risk, transmission modes, and severity, as is the case in mass media and other educational approaches applied to implement behavioral changes (Boje, Burnes & Hassard, 2012). In this respect, mass media and social marketing will be used to coalesce efforts by nurses and their employers to implement the project and bring about change characterized by reduced incidents of accidents.Policy Brief Part I to IV Nursing Assignment.Information dissemination process. The information dissemination will rely on five approaches. Firstly, the evidence from the project will be coalesced and published to ensure that they are available to other stakeholders other than the nurses and their employers. The publication will simplify and highlight the evidence base. Secondly, the project goals will be aligned with specific facility objectives with a view to convincing them to buy into the program through implementation (Brownson, Colditz & Proctor, 2012). Thirdly, nursing leaders will be integrated into the dissemination plan with their influence used as leverage to convince other stakeholders that the project is necessary and should be sled up. Fourthly, practical implementation tools will be applied that include information boards, demonstrations, and workshops that inform the targeted nurses (Jarman, 2015). Finally, monitoring and evaluation tools will be used to determine how well the implementation has worked in informing stakeholders about the project (Brownson, Colditz & Proctor, 2012).Policy Brief Part I to IV Nursing Assignment.Evaluation plan.Once the project resolutions have been implemented, an evaluation will be carried out to note if resolutions have affected on accidents incidence among nurses in the project. The outcome will be how often the nurses get hurt and if the accident figures differ from those reported before the project was implemented. This implies that the evaluation will apply a quantitative approach since it will be using empirical data. A qualitative approach will also be adopted by interviewing the nurses participating in the project. This will show whether their hazard knowledge levels have improved and if their opinions are well informed.Policy Brief Part I to IV Nursing Assignment. Both quantitative and qualitative approaches will be followed by statistics on accident incidence that note if the project reduced the rate of accidents and how much it has saved (in relation to the amount spent in the resolution) from avoiding accidents, compensations and missed work to monitor costs and determine the project sustainability. Joint Commission standards will be used as the basis of an objective evaluation process to measure and assess health facilities performance after implementation of each resolution. No ethical conflicts are anticipated since the project is only interested in de-personalized data. Still, participation in the project will be voluntary with participants signing informed consent forms at the beginning of the project. Also, ethical approval will be sought from the relevant institutional boards to show that the project has made adequate effort to protect participants from undue harm (Jarman, 2015).Policy Brief Part I to IV Nursing Assignment. ReferencesBoje, D., Burnes, B. & Hassard, J. (2012). The routledge companion to organizational change. New York, NY: Routledge.Brownson, R., Colditz, G. & Proctor, E. (2012). Dissemination and implementation research in health. New York, NY: Oxford University Press.Cihon, P. & Castagnera, J. (2014). Employment and labor law. Mason, OH: South-Western.DeNisi, A. & Griffin, R. (2015). HR 3. Boston, MA: Cengage Learning.Feldstein, P. (2012). Health care economics (7th ed.). Clifton Park, NY: Delmar.Fitzpatrick, J. & McCarthy, G. (2014). Theories guiding nursing research and practice: Making nursing knowledge development explicit. New York, NY: Springer Publishing Company, LLC.Finkelman, A. & Kenner, C. (2016). Professional nursing concepts (3rd ed.). Burlington, MA: Jones & Bartlett Learning.Frehse, J. (2012). The death of the 8-hour shift. Retrieved from http://www.industryweek.com/labor-employment-policy/death-8-hour-shiftFinkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care. London: Pearson Education.Policy Brief Part I to IV Nursing Assignment.Hill, K. S. (2010) Improving quality and patient safety by retaining nursing expertise. OJIN: TheOnline Journal of Issues in Nursing, 15(3). Retrieved from doi: 10.3912/OJIN.Vol15No03PPT03Jarman, K. (2015). Beyond Basic Statistics: Tips, tricks, and techniques every data analyst should know. Hoboken, NJ: John Wiley & Sons.Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A. & Hanson, S. (2015). Family health care nursing: Theory, practice, and research (5th ed.). Philadelphia, PA: F. A. Davis Company.Kelly, P. (2011). Nursing leadership & management (3rd ed.). Cliffton Park, NY: Delmar-Cengage Learning.Kelly, P. & Tazbir, J. (2013). Essentials of nursing leadership & management (3rd ed.). Boston, MA: Cengage Learning.Mathis, R., Jackson, J. & Valentine, S. (2013). Human resource management (14th ed.). Boston, MA: Cengage Learning.Miller, R. & Hollowell, W. (2015). Business law: Text and exercises (8th ed.). Mason, OH: Cengage Learning.Nursing Solutions. (2018). 2018 National health care retention & RN staffing report. Retrieved from http://www.nsinursingsolutions.com/Files/assets/library/retention-institute/NationalHealthcareRNRetentionReport2018.pdfOccupational Safety and Health Administration (OSHA). (2013). Facts about hospital workersafety. Retrieved from https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdfOccupational Safety and Health Administration (OSHA). (2013). Worker safety in your hospital: Know the facts. Retrieved from https://www.osha.gov/dsg/hospitals/documents/1.1_Data_highlights_508.pdfOccupational Safety & Health Standards Board. (2018). Rulemaking: Workplace violence prevention in health care. Retrieved from https://www.dir.ca.gov/oshsb/Workplace-Violence-Prevention-in-Health-Care.htmlPolicy Brief Part I to IV Nursing Assignment.Phillips, J. & Gully, S. (2013). Human resource management. Mason, OH: South-Western.Porter-O’Grady, T. & Malloch, K. (2016). Leadership in nursing practice: Changing the landscape of healthcare (2nd ed.). Burlington, MA: Jones & Bartlett Learning.Snell, S., Morris, S. & Bohlander, G. (2015). Managing human resources. Boston, MA: Cengage Learning.Slawomirski, L., Auraaen, A. & Klazinga, N. (2017). The economics of patient safety. Retrievedfrom http://oecd.org/els/health-systems/The-economics-of-patient-safety-March-2017.pdfThe KPMG healthcare & pharmaceutical institute. (2011). KPMG’s 2011 U.S. hospital nursinglabor costs study. Retrieved from http://www.natho.org/pdfs/KPMG_2011_Nursing_LaborCostStudy.pdfThe University of New Mexico. (2016). The high cost of nurse turnover. Retrieved fromhttps://rnbsnonline.unm.edu/articles/high-cost-of-nurse-turnover.aspxUlas, A. (2014). Handbook of research on developing sustainable value in economics, finance, and marketing. Hershey, PA: IGI Global.Wang, J. (2014). Encyclopaedia of business analytics and optimization. Hershey, PA: Business Science Reference.Williams, S. (2014). Introducing employment relations: A critical approach (3rd ed.). Oxford: Oxford University Press.Yoder-Wise, P. S. (2013). Leading and managing in nursing (5th ed.). Amsterdam: Elsevier Health Sciences.Zolot, J. (2017, February). Nurse perception of workplace safety affects patient care. TheAmerican Journal of Nursing, 127(2), 14. doi: 10.1097/01.NAJ.0000512286.71113.23  Policy BriefIssue summaryThe issue under review is nurses’ safety in a psychiatric unit. This follows the awareness that the health profession is suffused with risks resulting in the highest illness and non-fatal injury rates when compared to other professions (Occupational Safety and Health Administration, 2013). The risks are more apparent in the psychiatric unit where nurses face the additional risk of physical injury from hostile and aggressive mental health patients (Zolot, 2017). Based on this awareness, there is a need to develop strategies for ensuring the nurses’ safety while in the workplace.Policy Brief Part I to IV Nursing Assignment.Relevant background informationAlthough there are inherent risks in the psychiatric unit, particularly the hazards linked to the patients, there are mutable risks that can be addressed through a change in strategy. This is particularly true when it is considered that energetic and alert nurses are more environmentally aware and capable of identifying risks and mitigating them before they occur. This is particularly true when nurses attend long shift-hours that cause them to remain at work even when fatigued so that their probability of overlooking workplace risks increases. The risks could be compounded by ineffective policies and safety procedures as well as insufficient de-escalation training exposes the nurses to occupational hazards (Kelly, 2011).Policy Brief Part I to IV Nursing Assignment.Alternative recommendations analysisTo address the concern of nurses’ safety in the psychiatric unit, three alternative actions have been recommended. The first resolution is to review shift work and eliminating long work hours through replacing 12-hour shifts with 8-hour shifts. This would allow the nurses to remain at work when alert and leave work when fatigue starts to set in so that opportunities for risk occurrence are reduced (Kaakinen et al., 2015). The second resolution is to subject the nurses to regally scheduled de-escalation training that primes the nurses to handle the more common risk occurrences. The final resolution would entail assigning skill levels to nurses based on their experience and knowledge, and using this to assign responsibilities in the workplace so that each nurse is exposed to risks that he or she can handle (Ulas, 2014).Policy Brief Part I to IV Nursing Assignment.Action requiredBased on the three resolutions, it is recommended that the issue is best handled by applying the third resolution as a priority. That is because assigning skill levels to nurses based on their experience and knowledge is an accepted international practice that is already implemented in some form such as when specifying requirements when hiring new personnel.As such, its application would not require significant policy changes.Policy Brief Part I to IV Nursing Assignment.  ReferencesKaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A. & Hanson, S. (2015). Family health care nursing: Theory, practice, and research (5thed.). Philadelphia, PA: F. A. Davis Company.Kelly, P. (2011). Nursing leadership & management (3rded.). Cliffton Park, NY: Delmar-Cengage Learning.Occupational Safety and Health Administration (2013). Facts about hospital worker safety. Retrieved from https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdfUlas, A. (2014). Handbook of research on developing sustainable value in economics, finance, and marketing. Hershey, PA: IGI Global.Zolot, J. (2017, February). Nurse perception of workplace safety affects patient care. The American Journal of Nursing, 127(2), 14.doi: 10.1097/01.NAJ.0000512286.71113.23. Policy Brief Part I to IV Nursing Assignment.

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