Discuss the information you would need as a nurse leader before you could approve a capital purchase.
When it comes to making purchases as a nurse leader, there are various things to take into consideration such as the necessity of the item being purchased and especially the impact it will have on the unit and the organization as a whole. Typically management will have a set amount of money assigned for purchases related to unit improvement and necessities and it is up to management to decide how to best allocate those funds. However, although there are designated funds that are available for nurse managers to use, it is their task to decide on what to spend the money, all while thinking on how to improve patient care (Naranjee et al., 2019). Things that are important to keep in mind are to prioritize what unit needs are depending on what needs are. As a nurse leader I would also make it a priority to note what my staff needs training on, or if I would need to make additional investments on training. By knowing if additional trainings are required, I would be able to have a better cost estimate as a nurse manager, on not only equipment I would spend the funds on, but also on how much it would cost for my entire staff to accurately learn utilization and procedure.
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Naranjee, N., Ngxongo, T. S. P., & Sibiya, M. N. (2019). Financial management roles of nurse managers in selected public hospitals in KwaZulu-Natal province, South Africa. African journal of primary health care & family medicine, 11(1), e1–e8. https://doi.org/10.4102/phcfm.v11i1.1981
As a nurse leader, having a vast knowledge of budgeting is important. “Understanding the budget process, engaging in conversations and data collection activities that inform the budget, teaching, and coaching staff to develop a better sense of the fiscal realities of care, and contributing to capital budgets through product and device evaluations are responsibilities of nurses in advanced roles” (DeNisco, 2021, p. 292). This working knowledge is essential to help maintain unit functionality within defined projected costs set by the organization. When considering a capital purchase, the nurse leader must assess the purchase’s necessity and provide additional details through a request process. According to Leger, capital assets include purchasing land, buildings, and patient care equipment (2023, p. 73). Capital assets are necessary purchases that every healthcare organization must make to provide care services. Equipment must be current and in good working condition, ready for use. When purchasing equipment or other high price items, the rationale must include the details outlining the necessity of the purchase. Purchase justification for equipment can consist of replacing or upgrading existing equipment or acquiring new equipment to improve efficiency. The nurse leader needs to consider not only the purchase of the equipment alone but the cost of training personnel on the operation of the equipment and maintenance costs. New equipment requires additional training so patients and staff remain safe. As a nurse leader looking at each purchase and assessing the necessity of the equipment itself and the maintenance, upkeep, and training needed is crucial to the overall budget.
DeNisco, S. M. (2021). Advanced Practice Nursing: Essential Knowledge for the Profession (4th ed.). Jones & Bartlett Learning.
Leger, M. (2023). Financial management for nurse managers: Merging the heart of the dollar (5th ed.). Jones and Bartlett. ISBN-13: 9781284230932
Before approving of a capital expenditure request, a nurse manager must first understand what the capital budget is and then what meets the requirements of a capital request for their particular organization. Budget capital requests are dependent upon the lifecycle of the product being purchased, it is considered a potential capital purchase if the useful service is beyond the year in which the purchase was made (Brown & Leger, 2021). The manager must also know the expenditure limits of the organization that define a capital expense.
Other information to consider includes the overall cost of the project or purchase (Holcomb & Smith, 2020) . The overall cost includes the purchase itself plus additional cost such as delivery, installation, and additional training. The total cost versus return of the item or project, considering the revenue impact of the purchase over the life of the item. This includes the analysis of the possibility of the loss of revenue or the compromise of safety due to not purchasing the product. Safety and patient satisfaction issues also cross into regulatory and compliance concerns, and the potential cost associated with risk. The purpose or justification of the purchase must also be considered, if the item replaces aging or unsafe equipment or whether it will be used to expand or create service lines. Is the product an upgrade that will save time, or will it serve to meet compliance?
Cost comparisons also need to made, including purchase price, process of introduction into the current system, and product replacement or maintenance costs. Depreciation of the product and expected time before needing capital investment to replace or repair need to be considered for all options. Financing options, if needed, and the overall long-term cost of each option also need to be figured in.
Brown, P., & Leger, J. M. (2021). Chapter 4, Healthcare finance: A view from 30,000 feet. In Leger, J. M. (Ed.) Financial management for nurse managers: Merging the heart with the dollar (5th ed) (pp. 71-79) https://bibliu.com/app/#/view/books/B1BPN02BMBJH1/epub/EPUB/xhtml/034_Ch04_03.html#page_71
Holcomb A. J., & Smith, D. G. (2020). Hospital capital budgeting during a public health crisis. Journal of Health Care Finance, 46 (4), 24-36. https://healthfinancejournal.com/index.php/johcf/article/download/217/219