leadership in nursing

Promoting Quality through Fiscal Responsibility

Nursing turnover is extremely costly for healthcare organizations. According to the 2019 National Healthcare Retention & RN Staffing Report, it costs between $40,300 and $64,000 to replace one clinical nurse, costing the average hospital a $4.4 million to $6.9 million loss each year. The nurse leader must employ strategies to retain nursing staff. This involves using (savvy) leadership skills and implementing cost-efficient yet effective retention practices.

Five practices have been identified as important in decreasing turnover:

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• *Onboarding*
• Employee Rounding
• Social Networking
• *Employee Recognition*
• Developmental

please do the two with stars

Consider your current organization or one that you have been affiliated with in the past. What specific activities in any of these five practices are occurring (or have occurred) in that organization? Choose two of these areas and identify at least two activities that the nurse leader could employ. Remember that these must be consistent with the organization’s vision, mission, values, and culture.

Leading and Influencing Change: Part II

In this second part of your Leading and Influencing Change Paper, you will complete both a SWOT and Stakeholder Analysis. Please see the following template for your assignment: 

Section A: SWOT Analysis

Conduct a SWOT analysis and identify existing strengths, weaknesses, opportunities, and threats that could impact your proposed change. Fill in the table using the template provided. You should include 3 – 5 elements in each of the four components.

Strengths: The organization’s resources and capabilities that are used as a basis for implementing proposed change.

Weaknesses: Limitations of the organization to implement the proposed change.

Opportunities: External conditions and new opportunities that will support proposed change.

Threats: Factors or changes in the external environment that may present threats to the proposed change.

Section B: Stakeholder Analysis

Identify 4 – 5 key stakeholders (internal and external) essential to planning and implementing your proposed solution.

Section C: Discussion

In one to two pages, discuss the following:

•  
  • The process that could be used to identify stakeholders.
  • Two or three strategies to engage key stakeholders in the planning and implementation phases.
  • Overall reflection on the advantages and disadvantages of completing a SWOT and Stakeholder Analysis when planning change.

The mission  of the  School of Nursing  is to prepare nurses  at the associate, baccalaureate, and master’s levels to achieve professional goals through a seamless transition along the educational continuum.

Your Reflection

This reflection involves considering how accountability, safety, and quality align with the mission and values of your organization.

1. First, consider the core values, mission, and values of your organization. Also, look at the mission of the School of Nursing above. How do these align with your personal values, mission, and vision?
2.  
3. Second, in a few sentences, outline whether or not these values, mission, and vision drive how the organization is run. Cite at least one policy, a new program, or strategy that supports your point of view.
4.  
5. Finally, where can you find evidence of accountability, safety, and quality within the values, mission, and vision?

Your team has been given the task of designing a post COVID-19 Quality Improvement (QI) Program for an acute care facility that is part of a large metropolitan healthcare system. Each acute care center in the system will “pitch” a QI program to the Board of the large metropolitan healthcare system. QI program proposals must include THREE potential QI projects that drive Plan Do Study Act cycles. The Board has requested that all teams follow the Model for Improvement. (Links to an external site.)

Your Conversation

Over the course of this week, your team must decide on three COVID-19 related QI projects that have the potential to positively impact patient health outcomes and/or nursing care. The goal is to design projects with the potential for the most impact.

The answers to the following questions for each one of the three COVID-19 related QI projects will be submitted to the Board by the Nurse Administrator:

1. What is the group trying to accomplish (AIM)?

The aim should be time-specific and measurable; it should also define the specific population of patients that will be affected.

2. How will the group know the change is an improvement?

Decide what your structure, process, or outcome measures will be. Describe which measures you selected for studying processes and outcomes of the intervention/change(s), including the rationale for choosing them. Identify who will be involved in the data collection.

3. What changes can the group make that will result in the improvements that are sought? 

Identify at least two relevant change concepts and change ideas that will result in the improvement that the group is seeking. Please use the following document for reference: Using Change Concepts to Come Up with Ideas 

Download Using Change Concepts to Come Up with Ideas from the Institute for Healthcare Improvement.

Example

AIM

Reduce patient waiting time in the Emergency Room by 25% by January 25, 2021. (You should provide at least one source of evidence to support your planned change idea.)

MEASURES

1. Current wait time will be measured and documented so there is a baseline from which to work. Measuring the wait time after implementation will allow the team to determine if there was a decrease in the wait time after the change.
2. Wait time will be measured by the time of patient registration at the ER until the time a patient is evaluated by a provider, Doctor of Medicine (MD), Doctor of Osteopathy (DO), Physician Assistant (PA), or Advanced Registered Nurse Practitioner (ARNP).
3. Workflow forms will be developed to collect information related to waiting times. The ER charge nurse will be responsible for completing the forms and submitting them to the QI project lead.

CHANGE

Change Concept: Smooth workflow Change Idea: Implement direct bedding protocols. When there are four or more beds available in the ER, patients will not be triaged. Instead, they will be taken directly to a room for evaluation and treatment. When there are two or fewer beds available, a triage system will be in place. Direct bedding will resume when there are no patients waiting and there are 4 or more beds available.

Omar Cruz, RN, is the discharge planning coordinator on the geriatric diabetic services team. He is also chair of the service’s Practice Council. Because of the changes stimulated by healthcare reform, the unit leadership has begun working on developing a continuum of care geriatric diabetic services model to ensure adequate services are available to these patients across their continuum of need.

Focusing on this population’s continuing healthcare needs requires Omar and his colleagues to reflect on which model of service might integrate the disciplines and link a variety of geriatric services in a model that would support geriatric diabetic patient care needs along the health continuum. The task appears complex and challenging, but Omar and his colleagues sense that it is the right priority to address.

Your Conversation

1. Because this task will require interdisciplinary team deliberation and decision making, who should be at the table? How do those individuals reflect the continuum of care for this patient population?
2. Because Omar and his team are building a continuum of care service structure for a specific patient population, which services will be provided for that population? How do they reflect the continuum of care for this population?
3. What is the role of the nurse both in the development of this continuum of care model and its integration?