Clinical Activity

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Nursing is a very delicate practice that requires proper implementations of various aspects in the practice. These includes aspects such as the performance appraisal process, succession planning as well as the needs assessment of the organization. Others include compliance with the state, federal and accreditation regulations, emergency preparedness plans and staffing. Appropriate facilitation of these activities ensures that a nursing organization effectively discharges their services in a manner that conforms to the nursing regulations. This essay comprises of journal entries regarding these nursing aspects, which were developed through interactions with a staff member of Doylestown Hospital.

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Annual Performance Appraisal Processes, Succession Planning and Needs Assessment

Performance Appraisal Process

The nursing leader of the hospital employs a five-step approach when conducting the annual performance appraisal. The first step is the consultation of the resources. This is performed on various policies and contracts to identify policy procedures specific to the different nursing departments. The next step is to prepare for the performance appraisal by developing objective for that particular performance period. Afterward, the third step is to pen down a preliminary draft of the performance appraisal according to the departments model. This is followed by the fourth step, which is the actual conduction of the appraisal meeting. Finally, the last step entails producing the final draft of the appraisal and giving the employees copies of the document.

Succession Planning

The hospitals succession planning also employs a five-step model. First, they identify, through research, the critical positions that will serve as the focus of the succession efforts. Secondly, the hospital identifies the competencies required for the successful execution of the roles of these positions and then sets the performance expectation. Third, the hospital looks for the appropriate succession management strategies such as the internal pool development and recruitment. These are the strategies that are best suited for filling the positions. This is followed by the documentation of the identified strategies in an action plan for implementation. The last step entails the evaluation of the plans effectiveness by monitoring the staffs data and making necessary adjustments.

Needs Assessment

The meeting with the clinical educator revealed that the hospital mainly carries out its needs assessment through the performance of gap analysis. This is mainly done through the identification of gaps in knowledge and skills in the nursing practice. Once the best practices have been identified, the hospital develops learning objectives through course development so as to close these gaps. When the activity has been implemented, its effectiveness in the nursing practice is evaluated to ascertain that it contributes to more positive patient outcomes. This process ascertains that the hospital can live up to its mission and vision, and also achieve its goals in the nursing practice.

Policy, Procedure and Preparedness Plan

Policy and Procedure of Ensuring Compliance

The interview revealed that the hospital has employed the use of modern technology to manage their policies and procedures for compliance with the federal, state and accreditation regulations. The hospital realized that the use of pen and paper to educate their employees was unsustainable. The use of automated technology is, therefore, necessary to push out new policies due to the rapid change of regulation in the nursing practice. The hospital uses a web-based system that notifies the employees of all new policy updates through individual email. This helps employees to access these policies when and wherever they may need them (Hughes, 2008).

The Hospitals Preparedness Plan

In addition, the interview provided information regarding the hospitals emergency preparedness plan. The plan contains comprehensive information that is quite useful during an emergency. It contains the contact information of local and state emergency managers as well as the buildings blueprints and life safety systems information. It also contains the names of all the facility personnel and their contact information. This organizational chart is similarly included in the plan. Most importantly, the plan contains information regarding the characteristics as well as the needs of the persons for whom care is to be provided. In addition, the responsibilities of the staff, the emergency communication channels and the safety and security procedures are also included in the emergency preparedness plan.

Comparison of Emergency Preparedness Plan

There were significant differences when I compared the emergency preparedness plan of Doylestown Hospital with the current plan of my organization. The observable differences were mainly because of the additional information within my organizations plan. This additional information comprised of the safety and security procedures that provided for different types of possible hazards such as floods, hurricanes and fire. This is contrary to the Doylestown Hospitals plan, which only provided general safety and security procedure that would be followed regardless of the type of emergency.

Care Delivery Models and Human Resource Staffing

Care Delivery Models and Implications On Staffing Strategies

The hospitals ICU unit director revealed that the unit used the primary nursing care model. This model employs the same nurse to provide a complete care for each patient throughout the period of health care provision (Dunphy, 2007). This has had significant implications on the staffing strategy. This is because it proves difficult and also takes longer to identify these type of dedicated nurses. On the other hand, the director of the telemetry unit revealed that the unit uses the progressive patient care model. This is where the degree of illness determines patients needs rather than on the basis of medical specialty. This also affects the staffing strategy as it facilitates a mix up in determining the specific roles of the nurses in this unit.

Challenges to Effective Staffing

One of the barriers identified by the director of the ICU unit was the high cost of staffing unit. He suggested that the low retention of employees in this unit highly contributes to the costs incurred in staffing the unit. The director of the telemetry unit also emphasized on the high costs of staffing the unit as well. He also reiterated on the fact that most of the nurses are reluctant to join the telemetry unit due to the long working hours and utter commitment required from them when joining the unit. In this case, coupled with the limited number of staffs in the hospital, they pose a huge barrier to the effective staffing of this unit.

Evidence-Based Plan for Meeting Staffing Goals

An evidence-based plan is one that ensures all the staffing goals are met. It is one that is designed to execute policies, which touches all the hospitals departments, the staff, their leaders as well as the applicants (Buerhaus et al., 2009). First, a range of human resource data from various sources is collected, managed and analyzed. The hospital then develops a cohesive structure to integrate this data across the departments with the help of medical external partners. This is mainly aimed at optimizing the human resource policy design and practice. Further, this integration enriches the data that is used to support human resource development and facilitate further rigorous research. Using this data, the hospital is capable of identifying the correct persons for each department considering the competencies that will have been identified during the research.


In light of the above, it is evident that these aspects of nursing are important to any medical facility and should, therefore, be handled appropriately. They include appropriate conduction of the organizations performance appraisal, succession planning and adopting the appropriate means of performing a needs assessment for the organization. There should also be appropriate policies and procedures that have been adopted by the organization to ensure improved compliance with the state, federal and accreditation regulations involved in the nursing practice. In addition, the organization should establish emergency preparedness plans and evidence-based staffing strategies, which will ensure the continuity of the organization and improved quality of service to its patients.


Buerhaus, P., Staiger, D., & Auerbach, D. (2009). The future of the nursing workforce in the United States. Boston: Jones and Bartlett Publishers.

Dunphy, L. (2007). Primary care. Philadelphia, PA: F.A. Davis.

Hughes, R. (2008). Patient safety and quality. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.

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