I HAVE TO Respond substantively to at least two other students. Comment on their identified safety concerns and the elements of healthcare finance applicable to their nursing practice issue. How do their responses compare to yours? Are there any similarities or differences that surprised you?

Answers must be evidence-based and include sources in APA format.


Safety Concern

Medication errors have been a significant health safety concern and are directly connected to a high patient-to-nurse ratio. Medication errors occur in almost all medication procedures, from registration, prescription, dispensing, and administration. Most of these errors result from physical and emotional disturbances of nurses when providing care. Bakhamis et al. (2019) present an unfavorable nurse-to-patient ratio as one of the leading causes of emotional and physical disorders. A high patient-to-nurse ratio leads to long working hours, fatigue, stress, and burnout, which increase the chances of nurses committing medication errors. Also, by working for long hours, nurses are left overwhelmed and unable to face the demand of their job. They may even develop a sense of cynical detachment from work, which leads to destructive feelings (Bakhamis et al., 2019). This may negatively affect the quality and effectiveness of the care provided to the patients. They become less attentive when administering medication, increasing the risk of committing errors.

Elements of Healthcare Finance

Inefficient healthcare financing adversely affects an organization’s ability to invest in appropriate nurse staffing. The healthcare system is in an escalating era where more pressure is being put on healthcare organizations to streamline their functioning while reducing the total cost of care. Most healthcare units consider value as a return on investment and achievement of desired regulatory requirements while optimizing payments, which increases the patient-to-nurse ratio. However, the value from the nursing perspective is considered as promoting positive health outcomes, preventing health risks, and maintaining professional and ethical concerns. This leaves a gap between the management and the nursing practice (Begley et al., 2020). Therefore, most units lack adequate evidence-based allocation of nursing resources since they consider having fewer nurse professionals as an initiative to cut costs and maximize their value. The available nurses, therefore, end up being overworked, leaving them overwhelmed and susceptible to committing medication errors. Best practices are needed to establish trust between nursing and finance by developing shared goals that will lead to enhanced quality while minimizing cost (Begley et al., 2020). New initiatives such as cost containment pressures, regulatory requirement, and changing payment models act as an avenue for enhancing the healthcare financing system so that more focus is put on improving patient experience in the care environment.


Bakhamis, L., Paul III, D. P., Smith, H., & Coustasse, A. (2019). Still an epidemic: the burnout syndrome in hospital registered nurses. The health care manager, 38(1), 3–10. https://doi.org/10.1097/HCM.0000000000000243

Begley, R., Cipriano, P. F., & Nelson, T. (2020). Common Ground:: AONL, ANA, and HFMA Outcomes-Based Staffing Report Provides Guidance, Insights. Nurse Leader, 18(3), 216-219. https://doi.org/10.1016/j.mnl.2020.04.007


Workplace violence (WPV), which can involve and affect employees, clients, customers, and visitors, impacts safety in the healthcare industry. WPV can range from threats and verbal abuse to physical assaults and even homicide. A greater than 13% increase in the number of such assaults reported in 2009 was reported in 2010, according to data from the Bureau of Labor Statistics (BLS) (Healthcare – Workplace Violence | Occupational Safety and Health Administration, n.d.). Almost 19% (i.e., 2,130) of these assaults occurred in nursing and residential care facilities alone. Unfortunately, many incidents are underreported (Healthcare – Workplace Violence | Occupational Safety and Health Administration, n.d.).

A well-known obstacle to the successful implementation of workplace violence (WPV) programs is the underreporting of workplace violence, which prevents easy identification of trends and problem areas within the hospital (Blando et al., 2014). According to one study, only 57% of physical violence and 40% of non-physical violence are reported, and 86% of these reports are just verbal complaints to supervisors (Blando et al., 2014). Underreporting occurs for a variety of reasons, such as the belief that violence is "just part of the job," that nothing will be done to address the issue, and that the person in a position of authority to whom the report would be sent is the offender (Blando et al., 2014). Underreporting affects workplace safety because it does not allow for the identification of problem areas in the hospital or a healthcare setting, causing delays in finding a solution.

Blando et al. (2014) published a study using focus groups to describe their perceptions and opinions of the obstacles to the successful implementation of WPV prevention in hospitals. One suggestion the focus group participants identified in this study that impacts workplace violence is that on several occasions, nurses and healthcare staff become default caretakers and managers of patients with broader social problems due to poorly funded or ineffective social services (Blando et al., 2014). According to participants, public policymakers need to recognize the flaws in the mental health system and provide resources to address this significant public health issue effectively. They also emphasized the need for the hospital to partner and collaborate with social service organizations and law enforcement agencies to manage these high-risk populations (Blando et al., 2014).

Another suggestion to help decrease WPV by Stand et al. (2021) is that leadership should invest in a "no tolerance" campaign reviewed during onboarding and orientation for all new staff. A review of the program should be included in ongoing training and education, and leaders must make it simple for victims to report workplace violence anonymously if they choose to do so (Stand et al., 2021).

Workplace violence is alarmingly prevalent in healthcare settings and has significant financial and human costs (Hutton, 2006). The cost of workplace violence is 4.2 billion dollars (about $13 per person in the US) annually (Hutton, 2006). In June 2020, the National Quality Forum released the results of a stakeholder action team to prevent healthcare workplace violence. The team reported that workplace violence can cause organizations to "face direct costs in the form of litigation expenses, medical expenses, and worker compensation, in addition to indirect costs related to low staff morale, employee absenteeism, training and re-training, and negative impacts to an organization’s reputation." (Stand et al., 2021, para. 2)


Blando, J. D., Ridenour, M., Hartley, D., & Casteel, C. H. (2014). Barriers to effective implementation of programs for the prevention of workplace violence in hospitals. Online Journal of Issues in Nursing, 20(1). https://doi.org/10.3912/ojin.vol20no01ppt01

Healthcare – Workplace Violence | Occupational Safety and Health Administration. (n.d.). https://www.osha.gov/healthcare/workplace-violence/

Hutton, S. A. (2006). Workplace incivility. JONA: The Journal of Nursing Administration, 36(1), 22–27. https://doi.org/10.1097/00005110-200601000-00006

Stand, L., Francis, R., Bickford, C. J., & Boston-Leary, K. (2021). Zero tolerance starts now: Making nurses’ safety a priority. Nursing Management. https://doi.org/10.1097/01.numa.0000795588.86737.9a





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