Skin Assessment Paper

An ineffective healthcare policy that I experienced in my practice is skin assessment sign-off at shift change. Although an excellent policy, this was unsuccessful due to inadequate staffing and working long hours. In the Intensive Care Unit (ICU), some patients are high acuity and the nurse-to-patient ratio needs to be one-on-one. Other times an ICU nurse can have three patients due to low staffing. Jooste and Prinsloo (2013) stated that when a hospital is low on staffing, the aftermath can affect the patient’s quality of care as well as their safety. Further research stated that the American Nurses’ Association have guidelines for making decisions on staffing, which “suggest that the number and acuity of the patients, the level of staff working

After a 12 hour shift, nurses are tired and just wants to give report and go home. According to Horrigan, Lightfoot, Larivière, and Jacklin (2013), working long hours can cause nurse illness and injury, fatigue and safety problems, feelings of burnout, and depression. This causes the nurses to get discouraged from having to say longer than necessary checking the same patients at the end of each shift. The result of this is neglecting to comply with the policy and a failure in the skin assessment sign-off. Using incrementalism as a policy making mode, skin assessment sign-off at shift change can be successful. One way of accomplishing the skin assessment sign-off compliance is to assign all the off-going nurse’s patients to the same nurse, when feasibly. This can decrease the amount of time spent giving report and conducting the skin assessment sign-off at shift change. Another way of using incrementalism to enhance compliance with the skin assessment sign-off is to conduct it every 24 hours instead of doing so at each shift change. A skin assessment team, with the charge nurse as the leader, could also be implemented to perform this