Interprof Org & Sys Leadership

WK2 assignment due 3/13

 

Assignment: Analysis of a Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

  • Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
  • Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
  • Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

  • Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
  • Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
  • Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

Answer Rubric 

 Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

   Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations. 

   Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples. 

 Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. 

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation 

 Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 

Looking Ahead

The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.

Discussion wk3 due 3/17

 Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

  

Required Readings

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from
https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html  

Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

I will post for replies after classmates make their post for this discussion

  Student 1

Nursing shortages are at an all-time high, with a 17.1% turnover rate nationally (Vaughn, 2020). Companies are struggling to maintain nursing staff which leads to overworked nurses with high patient ratios. High patient ratios lead to unsafe situations, and nurses working long hours are more likely to make mistakes. Some nurses are leaving the profession altogether due to short staffing, lack of leadership, underpayment, career advancement, and overwhelming tasks per nurse (Suarez, n.d.).

In rural areas like where I live, there is already an inherent issue in recruiting nurses that want to live in this area. Furthermore, the health care agencies are competing to retain the nursing staff that they have. Nursing turnover costs nearly 300,000 annually for the average hospital (Suarez, n.d.). More creative ways other than simply posting a job vacancy needs to be done to recruit new nurses (Suarez, n.d.). Studies have also shown that sign-on bonuses are not effective in retaining nursing staff (Suarez, n.d.). They may initially draw in nurses, but after their contract is up, they most likely will leave the agency (Suarez, n.d.).

There are three nursing leadership models: transformational, transactional, and democratic (Laureate Education [Producer], 2018). Transformation leadership inspires others through effective communication, transactional leadership develops transparent chains of command, and democratic leadership likes to include ideas from staff before making final decisions (Laureate Education [Producer], 2018). Studies have indicated that management that is styled as transformational leadership has a higher staff rendition rate (Halter et al., 2017).

Nursing shortages specific to correctional setting has its inherent issues. Not only does correctional nursing face similar issues as a hospital setting, but it also has the dangers of prison life. Correctional nursing needs to address the growing shortage and make some changes to recruit and retain nursing staff. Studies have shown the preceptorships, internships, and mentorships have significantly increased nurse retention (Halter et al., 2017). Developing an academic-partnership with the local university would allow nursing students to complete a clinical rotation inside the prison to learn about it and have firsthand experience inside the facility. This is an excellent way for new nurses to have an opportunity to learn about correctional nursing.

Developing a mentorship program is an excellent way for new hires to feel comfortable that they will have the support and training they need while starting their new career as a correctional nurse. Another strategy to retain nurses is to have career advancement opportunities such as tuition reimbursements and offer to pay for RN to BSN program (Vaughn, 2020). The prison, at the moment, does not provide tuition reimbursement or tuition payments to further your education. Offering flexible hours is another strategy that has been linked to higher nurse retention (Vaughn, 2020). When nurses are required to work beyond 12-hour shifts and over 40-hour workweeks, they are more likely to leave the agency (Vaughn, 2020).

The prison is competing with the local hospitals to recruit and retain nursing staff. Although the prison has offered signing bonuses, it has not proven to keep nursing staff successful. The prison runs on transactional leadership, and nurses do not feel appreciated or heard. There are no internship or mentorship programs, so it is difficult for nurses to see the environment they will be working in until they are hired. Training only takes six weeks or less, and then you are on your own with little support from other staff leading to many frustrations. The prison is so short-staffed that nurses are working 16-hour shifts almost every day they are scheduled to work. Correctional nursing is a unique entity and requires the recruitment of the right people. An academic-partnership with the university would be an excellent way to recruit new nurses, and developing a mentorship program would be suitable for new employees.

Unfortunately, the health care business is a 24-hour, 7-days a week business. When nurses quit, that only compiles the workload onto the existing nurses creating dangerous situations. The company must continue with the staff that they have, and patients need to be taken care of, but that leaves the nurses overworked. Even when nurses are given an 8-hour shift or 12-hour shift, those often turn into 16-hour shifts. When nurses don’t feel valued or essential, they are also likely to leave an agency. It is imperative to recruit the right nurses for your business and then create a solid culture to support your staff to retain nurses. With the prison being ran strictly on policy and procedures, implementing change can be difficult, but something needs to be done to retain nurses to keep a safe environment for staff and patients.

References

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews. The Open Nursing Journal, 11, 108–123. https://doi-org.ezp.waldenulibrary.org/10.2174/1874434601711010108

Laureate Education (Producer). (2018). Moral Leadership [Video file]. Baltimore, MD: Author.

Suarez, L. (n.d.). 4 ways to recruit & retain engaged nurses who love their jobs. Healthcare Source. Retrieved from http://education.healthcaresource.com/recruit-retain-engaged-nurses/

Vaughn, N. (2020). Nurse turnover rates: how to reduce healthcare turnover. Retrieved from https://www.relias.com/blog/how-to-reduce-healthcare-turnover#:~:text=What%20is%20the%20Current%20Nurse,keep%20up%20with%20staffing%20ratios.

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Reply 2

Student 2

Top of Form

           To develop any policy to address nursing burnout, there are many factors that need to be considered. When staffing ratios are too high it effects the quality of patient care, and therefor affects patient satisfaction (Ezenwaji, Eseadi, Okide, Nwosu, Ololo, Oforka, & Oboegbulem, 2019). Lack of proper equipment, or even properly working equipment makes a nurse’s job more difficult, affects the quality of patient care, and increases nurses’ stress. After dealing with covid for the last year, a new concern causing nurse burnout is it quantity of acutely ill patients being given to undertrained nurses (Rosa, 2020). Cost is another big consideration because it costs a company tens of thousands of dollars to train new nurses when the old ones leave (Kelly, Gee & Butler, 2021). All these concerns are going to affect the development of any new policies.

           When attempting to develop a policy for burnout, all these items need to be addressed, and there are many more that can be added to this. As previously stated, in this last year, things have changed. A survey done recently of nurses that have been dealing with this pandemic, shows that as many as two-thirds of nurses are considering leaving their jobs (Rosa, 2020). Policy, or rather policies, need to address these topics if they are to be successful.

           A starting point would be a policy to address staffing and acuity levels. If a nurse has a patient that is critically ill, that nurse should not have six patients because there is no realistic way, they can give safe, appropriate care to all of them. Another policy could address how nurses are floated to other units. No nursing staff should be floated to higher level acuity floors if they do not have some sort of additional training. This is a safety issue for the nurse and the patient, it is also a cause for extra stress. For instance, floating med-surg nurses to covid units to care for patients that are on drips and ventilators is dangerous for both the nurses and the patients.  A personal experience where I work is that an entire unit quit, that is more than 30 staff members leaving because their staff kept being sent to units that they were not prepared to work in, at the same time, this was leaving their own unit very understaffed. If at the very least it costs roughly 11,000 dollars to train a new nurse or CNA, then that means the company is now looking at spending around 330,000 dollars to replace that staff (Kelly et al., 2021). No one policy will fix everything, but everything needs to be considered when management is planning a new policy.

References

Ezenwaji, I. O., Eseadi, C., Okide, C. C., Nwosu, N. C., Ugwoke, S. C., Ololo, K. O., Oforka, T. O., & Oboegbulem, A. I. (2019). Work-related stress, burnout, and related sociodemographic factors among nurses: Implications for administrators, research, and policy. Medicine, 98(3), e13889. https://doi-org.ezp.waldenulibrary.org/10.1097/MD.0000000000013889

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2020.06.008

Rosa, W. E. (2020). A blueprint for leadership during COVID-19: Minimizing burnout and moral distress among the nursing workforce. Nursing Management, 51(8), 28–34. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000688940.29231.6f

Module 2: wk3 assignment due 3/20

 Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

  • Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
  • Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
  • Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

  • Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
  • Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
  • Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
  • Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
  • Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

Rubric

 Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:
Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

  Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics. 

  Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations. 

  

WK4 Discussion due 3/23

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

By Day 6 of Week 4

Respond to at least two of your colleagues on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.

Note that from the total of 3 or 4 resources that you will provide at least 1 must be from the resources provided to you.

Replies for WK4

  

Student 1

Main Discussion Post

The Merriam-Webster Dictionary defines leadership as “a position as a leader of a group, the time a person holds in the position of a leader, and the power or ability to lead other people.” Leadership is multifaceted with many different dimensions but what is missing in these definitions are the words action, model, and inspiration, in my opinion. Although there are years and years of leadership research, “it is one of the most observed concepts, no universally accepted definition or theory of leadership actually exists” (Scully, pg. 439).

The two key insights I have learned through my research are that communication is key to a good leader and that leading by example and consistency helps great leaders grow leaders around themselves. The concept of leaders striving to develop solid and influential leaders around themselves is vital to the evolving healthcare system and an idea that makes many leaders very uncomfortable. 

Transformational leadership is a style of leadership that is exemplified daily in my place of work. Transformational leadership “inspires supporters to perform at the maximum capacity after some time, by providing adjustment in recognition, and a sense of guidance” (Alloubani et al.). Transformational leadership is supportive, encouraging, engaging, yet upholds accountability and expects the best while promoting learning and growth. Evidence-based practice, just as in medicine, is essential in leadership. According to the article “Implementing administrative evidence-based practice: lessons from the field in six local health departments across the United States,” decision-making needs to be a collaborative effort between all staff, including non-managerial, to gather and distribute ideas. This is achieved by forward-thinking and acting leaders who stay educated, like attending academic classes to ensure staff they lead are being given best practice information.

I have the privilege to work with a fantastic leader. A leader who leads with integrity and compassion. A transformational leader while taking the time to connect and grow leaders through conversations and providing leadership opportunities within the department. Our department’s current leadership team has been outspoken about how they want to develop leaders and give options to employees to grow their careers when possible. They are open to ideas and are collaborative. My manager is insightful and knowledgeable about leadership and how to share leadership theories and styles. I am very fortunate with the current leadership team I work with because not many leadership teams support staff, base decisions, and action off evidence-based practice while being patient-centered as this team.

References

Alloubani, Aladeen, et al. “Leadership Styles’ Influence on the Quality of Nursing Care.” International Journal of Health Care Quality Assurance, vol. 32, no. 6, 2019, pp. 1022–1033., doi:10.1108/ijhcqa-06-2018-0138.

Duggan, Kathleen, et al. “Implementing Administrative Evidence-Based Practices: Lessons from the Field in Six Local Health Departments across the United States.” BMC Health Services Research, vol. 15, no. 1, 2015, doi:10.1186/s12913-015-0891-3.

“Leadership.” Merriam-Webster, Merriam-Webster, 2021, www.merriam-webster.com/dictionary/leadership.

Scully, Natashia Josephine. “Leadership in Nursing: The Importance of Recognising Inherent Values and Attributes to Secure a Positive Future for the Profession.” Collegian, vol. 22, no. 4, 2015, pp. 439–444., doi:10.1016/j.colegn.2014.09.004.

  

Student 2

A person with good leadership skills can make the workplace a positive place. I am going to focus on transformational and authentic leadership for the purpose of this discussion. Broome and Marshall describe transformational leadership as “a process through which leaders influence others by changing the understanding of others of what is important” (2021, pg.15). Authentic leadership focuses on the relationships of self and others (Broome & Marshall, 2021, pg. 184). I think it is very important to create healthy work environments by demonstrating good leadership qualities. I have researched two articles that discuss the impact of leadership styles on the workplace.

In the first article, written by Kaiser (2017), the impact of leadership styles on nurse hostility is measured in a quantitative study. A survey was given to 237 staff nurses participants that measured “perceived levels of incivility and the leadership styles experienced” and data was reported numerically (Kaiser, 2017). The study concluded that transformational leadership is the most effective leadership style to reduce nurse hostility and a laissez-faire leadership style leads to bullying. Kaiser (2017) concluded, “Leadership style is not a definitive factor of incivility, but leader behaviours impact the level of incivility between staff nurses.” Broome and Marshall (2021) describe transformational leaders as leaders who focus on “self, others, the situation, and the larger context”.

In the second article written by Shirley (2009), a qualitative study was conducted on 21 nurse managers from three different facilities to determine the effectiveness of authentic leadership and a healthy work environment. Organizational culture was also considered when determining the effect of leadership on the environment of the workplace. It was determined that the organizational culture does affect the environment. Managers reported they felt happy in the workplace when a positive organizational culture was reported with good leadership styles exhibited. Comparatively, nurse managers felt unheard or unhappy within a negative organizational culture with poor leadership styles. The article concluded that leadership does affect the work environment. The more involved a leader is, the better the outcome.

There are many great leadership styles to display with transformational leadership being the most beneficial. Authentic leadership is genuine, but may not be the best leadership style in all situations. Transformational leaders change to better suit the needs of others in order to help them better themselves.  In my opinion, a transformational leader is the most adaptable and resourceful. 

I have had experience with both types of leadership styles in the workplace. The authentic leader was honest, optimistic, and genuine. He empowered others by talking problems through and giving honest feedback. The transformational leader I encountered pushed me to see things more clearly and made me a better nurse. He always has my back and looks out for my best interest. He encourages me to change so that I can thrive in life. The transformational leader has been the most beneficial to me in the workplace.

References

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Kaiser, J. A. (2017). The relationship between leadership style and nurse-to-nurse incivility: turning the lens inward. Journal of Nursing Management (John Wiley & Sons, Inc.), 25(2), 110–118.

Shirey, M. R. (2009). Authentic leadership, organizational culture, and hea