Feedback for 4 Milestone Two: Research and Support Please address Milestone two’s feedback and include these changes when working on your Milestone 3 assignment. 1)Proposal Care Support The data you cite in this section supports that there is a nursing shortage. However, I would have liked to see you add more insight into what research shows on the impact this shortage has on patient safety and quality care. What does the research say about the nursing shortage and its connection with quality care, thus leading you to believe a change was necessary? 2) Value-Based Support While you discussed financial impacts of your proposal, you did not touch on value based reimbursement. How does short staffing effect patient care and then ultimately reimbursement rates received by your institution?Top of Form Bottom of Form 3) Data Evidence You listed an example of a quality indicator that MAY be effected by the nrusing shortage. However, you need to include data that the nursing shortage itself is an issue. How many nurses is your facility short? What is the nurse to patient ratio? How many openings are there? etc. 4) Strategies While you gave great examples of strategies that could be used to help improve the nursing shortage, are there any interprofessional strategies currently in use that would also be helpful? 5) Strategy Defense So what nursing indicators will be affected with the implementation of your proposal? See http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html for a list of the Nursing Sensitive Indicators Additionally, while you wrote your own professional insight, I would have liked to see you utilize research to add support to these views and ideas. 6) Articulation of Response Submission has errors related to citations, grammar, spelling, or syntax Running head: RESEARCH & SUPPORT 1 Research and support 2 Nursing Shortage and the Need for More Nurses Research and Support Proposal Care Support Nurses are a very critical part of a health care facility. Nursing shortage is not just a problem experienced in the United States but globally. The shortage is as a result of high turnover, unavailability of potential educators and unfair distribution of the workforce. Healthcare organizations are therefore competing to acquire the scarce nurses in order to improve their delivery of quality care. According to the US Bureau of Labor Statistics, more than 1.1 million additional nurses are required to address the shortage problem (Haddad, 2019). For an organization to effectively compete for the scarce nurses, acquire top talent and reduce employee turnover, it must offer an enticing compensation and benefits package. Organizations that offer great wages and benefits easily attract applicant and maintain the nurses they already have. My proposal to offer a better compensation and benefits package would therefore lead to an i.

1. Feedback for 4 Milestone Two: Research and Support
Please address Milestone two’s feedback and include these
changes when working on your Milestone 3 assignment.
1)Proposal Care Support
The data you cite in this section supports that there is a nursing
shortage. However, I would have liked to see you add more
insight into what research shows on the impact this shortage has
on patient safety and quality care. What does the research say
about the nursing shortage and its connection with quality care,
thus leading you to believe a change was necessary?
2) Value-Based Support
While you discussed financial impacts of your proposal, you did
not touch on value based reimbursement. How does short
staffing effect patient care and then ultimately reimbursement
rates received by your institution?Top of Form
Bottom of Form
3) Data Evidence
You listed an example of a quality indicator that MAY be
effected by the nrusing shortage. However, you need to include
data that the nursing shortage itself is an issue. How many
nurses is your facility short? What is the nurse to patient ratio?
How many openings are there? etc.
4) Strategies
While you gave great examples of strategies that could be used
to help improve the nursing shortage, are there any
interprofessional strategies currently in use that would also be
helpful?

2. 5) Strategy Defense
So what nursing indicators will be affected with the
implementation of your proposal? See
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketp
lace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No
3Sept07/NursingQualityIndicators.html for a list of the Nursing
Sensitive Indicators Additionally, while you wrote your own
professional insight, I would have liked to see you utilize
research to add support to these views and ideas.
6) Articulation of Response
Submission has errors related to citations, grammar, spelling, or
syntax
Running head: RESEARCH & SUPPORT 1
Research and support 2
Nursing Shortage and the Need for More Nurses
Research and Support
Proposal Care Support

3. Nurses are a very critical part of a health care facility. Nursing
shortage is not just a problem experienced in the United States
but globally. The shortage is as a result of high turnover,
unavailability of potential educators and unfair distribution of
the workforce. Healthcare organizations are therefore competing
to acquire the scarce nurses in order to improve their delivery of
quality care. According to the US Bureau of Labor Statistics,
more than 1.1 million additional nurses are required to address
the shortage problem (Haddad, 2019). For an organization to
effectively compete for the scarce nurses, acquire top talent and
reduce employee turnover, it must offer an enticing
compensation and benefits package. Organizations that offer
great wages and benefits easily attract applicant and maintain
the nurses they already have. My proposal to offer a better
compensation and benefits package would therefore lead to an
increase of the pool of applicants and retain the existing nurses
thus addressing the nursing shortage problem that the
organization is experiencing. This would ultimately lead to
greater quality care.
Value Based Support
Value based reimbursement is a model that pays attention on
quality not quantity. The main aim of value based
reimbursement to reduce the significantly rising healthcare
costs. While at first glance, increasing the wages and benefits of
nurses might seem like an expensive affair, the organization
will cut down on its costs after a while. This is because with
enough nurses in the organization, patients will be effectively
cared for therefore reducing cases of readmission and infections
such as the Central line-associated bloodstream infections.
Offering a greater compensation and benefits package will lead
to an increase in the number of nurses therefore leading to
shorter patient stays and decreased hospital bills. According to
the American Nurses Association, optimal nurse staffing is
entirely necessary in order to achieve the objectives of value-
based care (Alghamdi, 2016).
Data Evidence

4. They’re very high rates of readmission in Mary Manning Walsh
home and this was the first indicator that there might be a
nursing shortage because patients are not receiving quality care.
In addition, coordination of activities within the facility is very
low. For instance, a patient who is about to get admitted takes
hours before being assigned to a ward and a bed. This is
because it is only two nurses handling the high number of
patients admitted each and every day. While talking to patients
in the organization, it was very evident that they are
dissatisfied. This is due to the fact that nurses are not spending
enough time with a single patient because of the high number of
patients who require care.
Strategies
Developing a new compensation and benefits package for an
organization is not just a walk in the park and various factors
must be considered. In this case, Mary Manning Walsh home’s
management needs to first analyze the current wages and
benefits that organizations within New York are offering to
their nurses. Through this, the organization will be able to
determine to what level it should increase its wages and benefits
to be competitive with those of other organizations. The
organization also needs to analyze the professional and personal
needs of nurses in order to determine the benefits it should
offer. Finally, the organization should engage nurses’ leaders
while developing the package in order to ensure that nurses
have a seat at the table in the decision making process. Through
this, nurses will have a chance to communicate the professional
and personal needs which are very important while developing
the package.
Strategy Defense
The recommended strategies are generally aimed at developing
a competitive compensation and benefits package. The final
package should be able to attract top talent and retain the
current nurses. For an organization to determine the wages and
salaries it should offer employees, it is always important to
evaluate other organizations in the region and engage

5. employees. Engaging nurses in the process is the most effective
way for the organization to ensure the final package meets their
personal and professional needs. Meeting the professional and
personal needs of nurses will improve their employee morale
and boost their productivity therefore they will offer greater
quality care.
Change Theory
The Lewin’s change theory informed my proposed initiative and
could be very helpful with implementation. The theory is based
on both driving and resistant forces. In this case, the driving
force is nursing shortage and the resistant forces are fear of
indicating the dissatisfaction that nurses have to the
management, fear that greater benefits and wages will be
accompanied by more work and fear of the organization to
increase its operating cost. The unfreezing, moving and
refreezing stages can be utilized in implementing the initiative
(Cummings, 2016).
Change Assessment
The Lewin’s change theory is very applicable to the intended
initiative and the entire organization. In the unfreeze stage, the
organization will determine the need for change and why the
current compensation and benefits package for the nurses is not
competitive. In the moving stage, the organization will
determine the adjustments that are required to make the package
competitive. In the refreezing stage, the organization will now
utilize the new package to attract more nurses, reduce turnover,
improve morale and productivity.

6. References
Alghamdi, M. G. (2016). Nursing workload: a concept analysis.
Journal of nursing management, 24(4), 449-457.
Cummings, S., Bridgman, T., & Brown, K. G. (2016).
Unfreezing change as three steps: Rethinking Kurt Lewin’s
legacy for change management. Human relations, 69(1), 33-60.
Haddad, L. M., & Toney-Butler, T. J. (2019). Nursing shortage.
In StatPearls [Internet]. StatPearls Publishing.
NUR 400 Milestone Three Guidelines and Rubric
In this milestone, you will now write specifically on your
chosen initiative. So far, you have introduced the topic and
completed a literature review. Did your
literature review convince you of the merits of your proposal?
In this section, please provide at least three evidence-based
sources to support your initiative or
proposal. APA format is required. You may use the areas below
as subheadings for your paper. Remember, the final project is
an executive summary, so write
persuasively and convincingly about your proposal. As noted in

7. prior milestone overviews, all faculty feedback should be
incorporated into the final executive
summary.
Prompt: In your milestone, make sure to address the following
topics:
1. Quality Outcomes: What are the desired quality outcomes you
hope to achieve through implementation of your initiative? Your
outcomes should be
reasonable, measurable, and time-considerate to help monitor
progress.
2. Communication: Analyze the organizational processes for
communicating change initiatives to determine the most
effective paths/methods for
promoting the proposed initiative.
3. Data Flow: Discuss how the existing organizational processes
will allow for improved or maintained flow of survey-required
quality data that may be
valuable for tracking your initiative.
4. Needed Leadership: Describe the behaviors of leadership and
the role of leadership in implementing these strategies for
change within the organization.
In other words, what responsibilities do leaders within your
organization hold to ensure the implementation of the initiative?
Guidelines for Submission: This paper should be 2–3 pages, not
including the cover page or reference page. APA format is to be
used for the reference list and all
internal citations (at least three evidence-based sources are

8. required).
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Quality Outcomes Meets “Proficient” criteria and
offers keen insights about the
desired quality outcomes to be
achieved through
implementation of the initiative
Accurately articulates the
desired quality outcomes to be
achieved through
implementation of the initiative
Articulates the desired quality
outcomes to be achieved
through implementation of the
initiative, but with gaps in
accuracy
Does not accurately articulate
the desired quality outcomes to
be achieved through
implementation of the initiative
20
Communication Meets “Proficient” criteria and
offers professional insights
about the organizational
process for communicating
change within the organization

9. Accurately analyzes the
organizational process for
communicating change within
the organization
Analyzes the organizational
process for communicating
change within the organization,
but with gaps in accuracy and
detail
Does not accurately analyze the
organizational process for
communicating change within
the organization
20
Data Flow Meets “Proficient” criteria and
offers critical insights about
how organizational processes
allow for flow of quality data
that will facilitate tracking the
initiative in the organization
Articulates accurately how
organizational processes allow
for flow of quality data that
facilitates tracking the initiative
in the organization
Articulates how organizational

10. processes allow for flow of
quality data that facilitates
tracking the initiative in the
organization
Does not articulate accurately
how organizational processes
allow for flow of quality data
that facilitates tracking the
initiative in the organization
30
Needed Leadership Meets “Proficient” criteria and
offers professional insights
about the role and behaviors of
leadership in implementing the
proposed changes
Accurately details the role and
behaviors of leadership in
implementing the proposed
changes
Accurately details the role and
behaviors of leadership in
implementing the proposed
changes, but with gaps in
accuracy of explanations
Does not accurately detail the
role and behaviors of
leadership in implementing the
proposed changes
20

11. Articulation of
Response
Submission is free of errors
related to citations, grammar,
spelling, and syntax and is
presented in a professional and
easy-to-read format
Submission has no major errors
related to citations, grammar,
spelling, or syntax
Submission has major errors
related to citations, grammar,
spelling, or syntax that
negatively impact readability
and articulation of main ideas
Submission has critical errors
related to citations, grammar,
spelling, or syntax that prevent
understanding of ideas
10
Earned Total 100%