Nursing Leadership Priorities

Nursing Leadership Priorities
Two nursing leadership priorities, nurse retention and increasing the education level of the registered nurse (RN) are crucial to the safety of the patients
and the stability and respectability of the nursing profession at Children's Hospital. In order to implement these leadership priorities, the objective is to
reinvent the organizational culture of nursing at Children's Hospital through the use of transformational leadership and innovation theory.
I.NURSE RETENTION
A.Nurse retention affects quality of care and costs to the organization.
1.The quality of patient care is enhanced by nurse retention. The National Database of Nursing Quality Indicators (NDNQI) indicates that years of
nursing experience is related to a decrease in patient ... Show more content on Helpwriting.net ...
Transformational leadership in nursing is positively related to job satisfaction, decreased burnout, and overall staff well–being, and nurse retention
(Weberg, 2010)
2.Transformational leaders who inspire, stimulate intellect, have charisma and provide individual consideration have a positive impact on nurse
retention (Huber, 2014)
3.Transformational leadership can inspire nurses to attain higher levels of education, including the BSN.
B.Organizational culture change related to nursing retention and increasing the educational level of the RN can be accomplished by using Innovation
Theory.
1.Innovation theory involves leadership being creative, abandoning the obsolete, and implementing new processes and ways of thinking (Huber, 2014).
2.Leaders who use Innovation Theory for change are charismatic, self–confident, and ambitious (Huber, 2014).
C.Analyze current data on nurse retention and the current BSN percentage of nurses on staff, set goals within the organization, implement leadership
strategies to achieve these goals, then measure outcomes in the next four years.
1.The organization should set a goal of retaining 80% of the nursing staff each year over the next four
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Quality Improvement Plan
Measures
"We will find our baseline measurement using nurse surveys, audits and observation timings. We will track what steps are covered and how long each
step takes and the number of occurrences of near misses due to inefficient handoffs relating to patient safety. We will also measure our patient baseline
data from current patient satisfaction surveys" N. Guyse (personal communication, February 22, 2014). Currently we are inefficient and unsafe with
handoff practices due to missing or incomplete information, multiple processes used between the nursing staff, and multiple report out processes being
practiced on the floor. Multiple processes are causing confusion and incidental overtime. With multiple processes, information is being missed between
nursing staff, which is a safety concern due to the increased errors. Our organization is working on the creation of one standardized process used
between all employees to ensure that all handoffs are efficient and safe. "We have implemented a group report out for nursing staff in conjunction with
the beside report outs" N. Guyse (personal communication, February 22, 2014).
Sample measures through patient and nurse satisfaction surveys and observations will be used to show if we are making improvements with the
change. Run charts will be used to show if improvements are taking place over time and will help with improvements by depicting how well the
handoff process is performing. They will help in determining when changes are

The Dangers Of Nurse Fatigue
Fatigue is defined as a feeling of weariness, tiredness, or lack of energy (Philips, 2013). Fatigue is a subjective feeling and has been described by
people as "feeling tired all the time" and "feeling weak" and it can be influenced by physiological, psychological, behavioral, and environmental factors
(Campbell, 2011). Nurse fatigue is an issue that has been a major concern for patient safety and the wellbeing of nurses. Nurse fatigue can be attributed
to working 12–hour shifts, working night shifts, working several back–to–back shifts and working overtime (Rogers, 2008). This paper will investigate
and analyze the dangers of nurse fatigue and will explore strategies for implementing changes to reduce nurse fatigue.
Situation Assessment ... Show more content on Helpwriting.net ...
Fatigue and sleepiness, tendency to fall asleep, go hand in hand as nurses struggle to stay awake during long, consecutive, day or night shifts. For
example, in the Staff Nurse Fatigue and Patient Safety Study, the number of nurses who reported an error or a near miss had less hours of sleep
than the nurses who did not report an error or a near miss, and it was determined that there is a 3.4 percent chance of a nursing error when nurses
get 6 hours of sleep or less in the prior 24 hours; another study found that the chances of making an error was three times higher when nurses
worked more than 12.5 hours per shift (Rogers, 2008). In the Staff Nurse Fatigue and Patient Safety Study, over two thirds of the participants
reported that they struggle to stay awake while working and 20 percent reported incidence of falling asleep during their shift (Rogers, 2008).
Nurses also do not get adequate breaks while working long shifts, according to the Agency of Healthcare Research and Quality (AHRQ) less than
50% of work breaks for are away from patient care, which means nurses never truly get a chance to relax (Phillips, 2014). Not only is the patient
safety at risk when nurses are fatigued, but the well being of nurses is at stake as well. While nurses are fatigued they are risking their

Electronic Health Care Case Study
The implementation of new information technology systems into existing organizations is not a new concept as the possible process improvements for
a business can be fairly obvious when compared to more traditional non–computer based processes. One sector, which for the most part is transitioning
into using information systems in an attempt to improve processes, is the health sector. This report observes and analyses multiple real life cases of
health care providers from the United States who have decided to upgrade from traditional paper based patient charts to computer based Electronic
Health Records (EHR). It should be noted that all of the case studies observed in this report were created by the Centre for Aging Services Technologies
who describe themselves as being "focused on development, evaluation and adoption of emerging technologies" in the medical sector. The Centre for
Aging Services Technologies is an international group made up of 400 technology companies research universities and government representatives. The
United States government describes Electronic Health Records as being "digital versions of a patients paper chart" (Healthit.gov, 2014). Electronic
health records typically include information on patients including the patient's medical history, medications the patient takes, treatment plans,
immunization dates, allergies, radiology images and test results. With this being said it would first seem that EHR's are simple data collection and
storage

Reducing Medication Errors In Nursing
Reducing Medication Errors In Hospitals
Patient centered care and patient safety are the most important roles in nursing. "Serious medication errors are common in hospitals and often occur
during order transcription or administration of medication" (Poon et al., 2010. p. 1). One important aspect of nursing is drug administration. It is a
multidisciplinary task including doctors, pharmacist and nurses. This paper will show evidence that using electronic medication systems instead of paper
based systems to administer medication will reduce medication errors.
Change Model Overview The John Hopkins Nursing Evidence–Based Practice change model used in this paper is, "Practice, the basic component of
all nursing activity, reflects the translation of what nurses know into that they do"(Dearholt, S. & Dang, D., 2012. p. 34). This model has steps to
incorporate evidence base research into the practice of nursing combined with their education and clinical skills.
Practice Question
Step 1: Recruit Interprofessional Team Interprofessional team members will include the triad team, pharmacist, staff nurses, chargenurse, nurse
manager, IT and physicians.
Step 2: Develop and Refine the EBP Question Does using Electronic Medication Systems With Barcodes Reduce ... Show more content on
Helpwriting.net ...
Medication errors may result in a decline in patient's health increasing their hospital stay and if they are on Medicare it will not pay for the extra days.
"A common economic evaluation of health care decision–making is a cost effective analysis, which compares costs of alternative interventions that
produce a common health outcome" (Dearholt, S. & Dang, D., 2012. p. 134). "To help prevent such errors, technology has been developed to verify
medications by incorporating bar–code verification technology within an electronic medication–administration system (bar–code eMAR)" (Poon et al.,
2010. p.

Nurse Furthering Education
The Institute of Medicine (IOM) recommends that nurses further and obtain a degree in education at the baccalaureate level by 2020 to eighty
percent. The baccalaureate degree is achievable and is critical in changing workforce by allowing the expansion of nurse's skills and competencies in
all areas that affect the community, public health, leaderships and research. This author will obtain this level of baccalaureate degree before the
recommendation in 2015. There is a growing amount of nurses furthering education due to the organizations are now implementing that all staff is to
have a baccalaureate degree to be hired as a staff nurse. Hospitals that are Magnet status, this is a requirement now to hold a Magnet status. The
graduate degree... Show more content on Helpwriting.net ...
Bridge courses and learning paths between undergraduate and graduate programs are created to allow the learning progression of higher educational
levels. This author has obtained these steps throughout the career of nursing and is continuing to pursue the goals of lifelong learning. The changing
profession it is vital that continuation education credits (CEU) are maintained to hold a license as a nurse in individual states, unfortunately in Arizona
this is not the case. The CEU's should be mandatory in all states to promote advancement in skills and continue the recommended lifelong learning
commitment. Novice or experienced nurse must take critical improvements to keep up with the changing professions of health care delivery in a
multifaceted setting and furthering educational skills, also learning self–marketing skills. This writer is providing just this by promoting formal
education, remaining active in nursing professional associations, providing excellent communication and professional skills at every level. The
Associates Degree Nurse (ADN), only contains the clinical skills and knowledge. With the competitive market and advancements, these skills alone
won't carry any nurse over the nurses who have obtained a BSN or

Application Of The Nursing Staff At Dwu Virtual Hospital
In the nursing field change is a daily reality. The continuing improvements in health care mean that there are continually changing ways to provide
health care. Anyone who has been in the nursing field for any amount of time is sure to have uttered the words "Do you remember when we used
to...?" From a nursing point of view not all change is positive, and not all change is welcomed. Every change is however aimed at providing the best
care and achieving the best possible outcome for the patient. This project will outline the process that will be used to introduce the nursing staff here at
DWU Virtual Hospital to the change of implementing electronic medical records.
Change Model
Leaders have a selection of change theories to review ... Show more content on Helpwriting.net ...
This plan will begin with smaller unit meetings led by the unit manager. Next, training sessions in virtual patient records will be led first by managers
and then by peers. In the third and final stage the EMR will be implemented and all staff will be responsible for ensuring the proper use of the EMR.
Change Plan Design To initiate the plan we will begin with the first stage of Lewins Theory, unfreezing. The unfreezing process is the process of
creating a time frame for staff to become ready for the change (Huber, 2014). Management will need to inform staff of the upcoming change. This
should be done in a small unit meeting with only the nurses and unit manager present. Keeping the meeting small will help prevent any feelings of
being intimidated and will go along with the shared governance system recently instituted. In this meeting the manger will present researched facts
regarding EMR implementations. Among these facts would be the fact that having an EMR will save time. Nursing staff will have access to all
previous records and will no longer need to wait for other departments to obtain these records (Gagnon et al. 2010). Also having an EMR system
encourages teamwork between the healthcare and support personnel in a facility (Gagnon et al. 2010). For example, nursing will be able to look at the
radiology and lab schedule and coordinate with them on times for patient testing. During this meeting

The Importance Of Nursing Leadership
Nursing guidance is a complex but essential part of the nursing workforce. Guidance can come in the form of management and in the form of
leadership. The two terms are often used interchangeably, but do not always mean the same thing. The nurse manager is often someone who has
authority from the facility to be in management. The nursing leader may not have authority over other nurses, but may be a strong guide in the
workplace for other nurses and nursing staff. Nursing as a profession is ever–changing and increasingly challenging. Nurse managers are tasked with
an enormous variety of functions in their respective workplaces, budgeting, scheduling, hiring, disciplinary actions, implementing facility policies and
procedures, and the ... Show more content on Helpwriting.net ...
While patient care is at the center of what nurse leaders do as well, the help and support they give their fellow nurses is very important. Nurse
leaders are the background to the nursing care. Effective nurse leaders can promote a positive workforce and a healthy work place for other
nurses. Workplace dynamics is an essential part of how each nurse functions. Nurses, being mentally and physically stressed, need to have support
and guidance from a nurse leader to feel confident about performance. The impact of nursing leaders can be a positive and guiding force for the
younger or more inexperienced nurse. Having strong relationships with solid leaders can instill values in the beginning stages of a newer nurses'
career. Gaining insight and core concepts from a more experienced leader can make a world of difference in the way a new nurse performs, provides
patient care, and sets future goals for themselves. A newer nurse with a positive role model and nurse leader can model themselves to become a leader
for future nurses. Future nurses and the future of the nursing practice can positively benefit from having a revolving new nurse– nurse leader cycle.
With a profession as dynamic as nursing, the involvement of positive leaders and role models is essential for the practice to grow and inspire a nursing
force that not only adapts and changes with the profession, but leads and strives for promoting the improvement

Essay On Wound Care Nurse
Change Proposal Paper: Getting a Certified Wound Care Nurse
Abstract This paper is written from the perspective of a nurse–manager for a hospital floor and focuses on a proposed change to that floor: the addition
of a certified wound care nurse. It begins by describing the benefits of a specialized wound care nurse, the existing conditions on the hospital floor,
and how each of the stakeholders would be impacted by such a change. It utilizes Lippitt's phases of change theory to describe how those changes
would be implemented on the floor, outlining each of the phases in implementing such a change. Introduction Wound care nurses play a special role
in the hospital environment, and hospitals without those specialized nurses may not be able to offer the level of care as hospitals that have these
specialized professionals. "Wound care nurses, sometimes referred to as wound, ostomy, and continence (WOC) nurses, specialize in wound
management, the monitoring and treatment of wounds due to injury, disease or medical treatments. Their work promotes the safe and rapid healing
of a wide variety of wounds, from chronic bed sores or ulcers to abscesses, feeding tube sites and recent surgical openings" (Nursing Schools, 2012).
While it may seem as if any nurse should be qualified to perform these functions, it is critical to realize that it is a specialized field. "Their main
objectives are to assess the wounds, develop a treatment plan, clean wounds and monitor for signs of

Reducing Medication Errors During Long Term Care Facility...
Reducing Medication Errors in Long–Term Care Facility
One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they
stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered
medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication
errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis.
Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best
to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication
errors in this organization to ensure patient safety.
Background
The PCC is a Skilled Nursing Facility and is licensed for 99 beds. It provides specialized care services ranging from short–term, long–term, and hospice
care. The residents come from different racial background and were diagnosed with acute to chronic medical conditions. The majority of residents are
older adults and often taking numerous medications, which put them at risk for medication errors. As discussed by Lane, Troyer, Dienemann, Laditka,
and Blanchette (2014), older individuals

Violence Among Nurses
Evidence Gathering Researches have proven that continuing professional nursing training is essential in violence prevention amongst nurses. Tame
(2012), conducted a study on the relationship between horizontal violence in the operating room and continuing education found that the assess to
continuing professional education assist in strengthening nurse position and renegotiating the boundaries in practice. In addition, decrease oppression
of the operating room nurses. Similarly, Cvetic (2011) echoed that failure in communication in the perioperative setting is the main contributing factors
to errors. Refining communication among nurses heighten ability to render efficient and competent care to the patient. Castello, et al., (2011) found ...
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Constructing Alternatives Healthcare regulatory agencies agreed that the negative impact of lateral violence at work place directly affects nursing
care. There have been numerous suggestions on the guidelines on how to eradicate violence at the workplace. Unfortunately, the type of change
required for widespread adoption of new approaches to eradicate lateral violence is imperative (OSHA, 2015). Even though the OSHA (2015),
stipulated policy on workplace violence such as physical assaults which was termed as a workplace hazard, there are loop–holds in the policy. For
instance, lateral or horizontal violence was not mentioned, rather profound

Design For Change Proposal : Implementing Hourly Rounding
Design for Change Proposal: Implementing Hourly Rounding
Improving patient safety and increasing patient satisfaction while in the hospital is an ongoing issue in hospitals. Developing a plan to make changes
within hospitals is the first step in accomplishing this task. The design plan for change is to improve patient safety, decrease risk of falls and increase
patient satisfaction by implementing intentional hourly rounding for older adult patients (over the age of 65) admitted to a 40 bed telemetry unit at an
acute care hospital. For each hourly round preformed a preselected group of question will be asked by the nurse or nurse's assistant as well as informing
the patient when the next hourly round will be conducted.
Change Model Overview
The John Hopkins Nursing Evidence–Based Practice Model describes how practice, education and research are the foundation for professional nursing.
Practice is first, nurses need to question the basis of their practice and utilize an evidenced based approach to validate or change their current practice.
Next is education, nurses' education is basic in the beginning however with ongoing education nurses are able to gain new knowledge and skills
throughout their careers. Finally is research, research generates new information for the nursing profession and allows for improvement of practice
based on scientific evidence and research. (Dearholt & Dang 2012, p. 34–40).
Practice Question
Step 1: Recruit Interprofessional Team
An

EBP Research Essay
While many studies have examined the attitudes and barriers in implementing evidence–based practice (EBP), not many have examined which
variables lead to increased practice, knowledge, and attitudes. In a study described in the article "Use, Knowledge, and Attitudes Toward
Evidence–Based Practice Among Nursing Staff," by White–Williams et al. in 2013, these aspects were examined at a large Magnet hospital. A
questionnaire divided among three subscales (use, knowledge, and attitudes) was used as the method. The results of this study demonstrated how
these aspects of EBP were positively impacted by several variables among the staff and how awareness of EBP and implementation of educational
programs is necessary in the hospital's culture. These results can be used by hospitals to look at ways to improve evidence–based practices in the
clinical setting. The study done by White–Williams et al. (2013) recognized how certain variables among the nursing staff affected their use,
knowledge, and attitudes of EBP. These variables were correlated with a higher overall score on the... Show more content on Helpwriting.net ...
(2013) also examined if education, whether it was hands–on workshops, research days, classes, etc., had an impact on the use, knowledge, and attitudes
of EBP among nursing staff. The overall total score was greater for those that had some type of EBP education. Specifically, there was a significantly
increased total score in half (12/24) of the questions among those who had been previously educated compared to those who had not been. Because
those who had been educated about EBP had overall significantly higher scores on the attitudes subscale, it shows the importance of targeting attitude
toward the use of EBP in changing behavior. Also, the more educated staff found EBP fundamental to their practice. Gaining knowledge is crucial in
understanding the importance of the implementation of EBP. Knowledge is the second step in implementing EBP into the clinical

Peplau Nursing Theory Essay
The study which has been outlined earlier, if conducted can either support or refute if nurses will need increased education and training on Electronic
Health Records formerly known as EHR's. If this study is conducted, nurses will know whether or not the education and training they are receiving
traditionally on EHR's is sufficient for gaining interpersonal relationships with their patients. Interpersonal relationships include patient rapport,
effective nursing interventions, and patient safety. Nurses will know whether or not time is being sufficiently spent with the patient or if it is being
occupied with EHR input because of lack of education, understanding and training.
Nursing Theory Peplau's theory on interpersonal relationships defines four phases on how to gain a quality nurse–patient relationship. These four
phases include orientation, identification, exploitation, and resolution (Peplau, 1952). If this study is conducted and shows a need for an increase in
education and training in electronic charting to fulfill adequate care for patients, Peplau's nursing theory will reiterate the importance of gaining an
interpersonal relationship with patients. Peplau's theory will change by implementing the first phase, orientation in EHR use. The orientation phase is
coming to know your patient and being their major information source. The role of being a major information source will be done personally by the
nurse giving proper time to gain a relationship . The

The Factors Affecting The Work Environment On Health...
Literature Review In the recent years, there has been viable evidence that shows that other factors in the work environment may also be strong push
factors for retention (Burns, Bradley and Weiner, 2012, pg.445). The factors that contribute to forcing workers to leave the public sector include:
"workload and staff shortages are contributing to burnout, high absenteeism, stress, depression, low morale, and de–motivation" (Burns, Bradley and
Weiner, 2012, pg.445). It is also shown that poor working conditions also contributes to preventing staff morale and motivation and it also contributes
directly to recruitment and retention (Burns, Bradley and Weiner, 2012, pg445). According to Burns, Bradley and Weiner (2012), "one strategy being
used to alleviate health worker shortages and to improve access and quality of health services is task–shifting, or the delegation of tasks that would
traditionally fall within the scope of practice of doctors or nurses to other health who have undergone shorter periods of training" (Burns, Bradley and
Weiner, 2012, pg.445). In so by implementing task–shifting, the work load that all nurses have to handle on a daily basis is split up with easier duties
falling on other health professionals with less experience. Also another strategy of combating nursing retention is by offering nonfinancial incentives
instead of financial incentives which can help to motivate workers (Burns, Bradley and Weiner, 2012, pg.444). The offering on nonfinancial

The Role Of Electronic And The Media
section barriers are discussed. In the context of this model, the role of electronic and media in promoting awareness, willingness of nursing staff and
review committee to revise policies and curriculum, and cost and feasibility of infrastructural changes are discussed in detail.
Role of electronic and print media in promoting awareness: Any policy to gain momentum must have public support. The public must be convinced of
its importance through repeated exposure and explained the repercussions of not implementing the policy. The role of print and electronic media lacks
in certain areas creating little value to any event or program that highlights the importance of implementing fall–prevention programs through formal
training of nursing staff.
Revision in current policies: Previous policies must be evaluated to assess the need and room for revision before policy implementation. This is agenda
entrance level of policy formulation model of Cobb and Elder (1983). Current policies would be reviewed thoroughly to minimize conflicting policy
by the review board by the graduate student. The education departments are task with the duties to write policies and implement all nursing related
education at ARMC. The review board will be established by a nursing committee and would be a time–consuming task. This critical task of the review
entails consistency, commitment, and motivation and is vulnerable to inadvertent changes created by the institution.
Revision in current courses to

St. Vincent Medical Center
St. Vincent Medical Center is located in the Bridgeport, Connecticut, in Fairfield County. It is a 520–bed, faith–based community teaching hospital that
is a member of Ascension Health, the largest Catholic, non–profit healthcare system in the country. The organization is an integrated community health
system provides a full range of inpatient and outpatient services. St. Vincent's has a very strong commitment to patient safety and has several
mandatory programs for employees that include: relationship–based care and high reliability. As a Magnet designated organization, the nursing
professional practice model is well defined, and facilitated through shared governance councils (St. Vincent's Medical Center, 2012).
The nursing leadership model is traditional with the exceptions of the (CNO) who also act as the chief operating officer (COO). There are NVP that
are assigned to each service line, as well as a nurse director level. Nurse managers are assigned at the patient unit level, and there is also a clinical nurse
leader on each patient unit. Since St. Vincent's is part of a larger organization there are both local and corporate nursing priority's and initiatives.
Combine this will the rapid changes in health care the ability to lead change and effectively communicate are of the utmost importance.
Due to the organization structure of the medical center, there are many layers and dotted lines of reporting responsibility. This can cause conflicts due
to competing

Effective Approaches in Leadership and Management...
NRS 451Nursing Management and Leadership
Effective Approaches in Leadership and Management Nurses demonstrate the core values of professionally caring for others in two different
prospects. Huber (2014), notes that "nurses have two basic roles: care providers and care coordinators" (p. 3). Most significantly nurses are valued in
the setting of patient care, while the coordinator role revolves around management and organizing care, using thinking skills to coordinate complex
activities. Nursing is multifaceted, although direct quality patient care is of significance, a positive leader or manager is also essential to support the
recent changes to healthcare requirements. Having the right blend of qualities is vital to becoming a ... Show more content on Helpwriting.net ...
A roll out date with 'super users' available to troubleshoot and maintain staff productivity and compliance would be beneficial. The last aspect of
strategic management is evaluating the effectiveness of strategies used. Huber (2014), describes "analysis needs to review four areas: strengths,
weaknesses, opportunities, and threats (SWOT)" (p. 334). Through prioritization, the threats are avoided, weakness are lessened and strengths are
empowered to increase patient safety with medication administration, by insuring patients receive "the right drug at the right time to the right patient"
(Weston & Roberts, 2013. para. 11). Most importunately, applying shared governance or allowing decision making amongst the staff, allows leaders to
inforce equality in the nursing workforce. Shared governance is an important current focus in nursing practice, as the desire for increased autonomy
and accountability is encouraged with voicing of nursing opinions to assist in better quality healthcare. Huber (2014) mentions that shared governance
"is a partnership between management and clinical staff. Research suggests that registered nurses who are empowered to make decisions through
shared governance have higher nurse autonomy and increased confidence in decision making " (p. 249). As discussed, positive personality qualities,
use of strategic management and including the partnership of shared governance all directly facilitates a leader or mangers

Grand Nursing Theory Essay
Applying Theory to a Practice Problem October 3, 2012 Introduction Our first class in the masters in nursing program, has been focused on nursing
theorists. We have learned about Grand Theories, which are theories that are very broad and difficult to test and Middle Range Theories, which are
also broad theories but narrow enough to be testable. We have learned how to study the different theories, looking at how we can utilize theories to
evaluate practice. I have been in a nursing leadership role for many years. Approximately 8 years ago, I lead a group of nurses to develop a shared
governance nursing model in our organization. Shared governance is having staff involved with making decisions related to unit... Show more content
on Helpwriting.net ...
4) Resolution phase (Evaluation) – problem resolved, relationship is terminated. This theory was applied to a client that had a diagnosis of
intervertebral disc prolapse. The client was in severe pain. 1) Orientation phase; the client was initially reluctant to talk due to her pain. 2)
Identification phase; the client expresses the need to get relief from pain. The nurse educates the client on the pain scale to measure pain. 3)
Exploitation phase; client informs nurse that there is relief from pain when she is in the supine position. 4) Resolution phase – client's pain was
reduced and tolerable. To apply this theory to managing in a shared governance organization, I will define the nurse as the manager, and the client as
the unit staff. The organization has asked all managers to improve their patient satisfaction scores in the next fiscal year. The manager will use the unit
council (shared governance structure) to assist with this goal. 1) Orientation phase – the manager shares the organization goal of improving patient
satisfaction scores and shares current patient satisfaction scores and patient comments with the unit council. The unit staff asks questions, share past
experiences, and seek resources to assist with gathering data. The manager and unit staff discuss bias and limitations of the unit council. Roles of the
unit council and the manager are defined. 2) Identification phase – the manager and unit

Teamstepps Analysis Nursing
Teamwork is central to supporting plans of implementing any modifications in practice. The purpose of this paper is to determine organizational
readiness and define transformation opportunities on 2 east post–surgical nursing unit to assume a TeamSTEPPS initiative based on the results of the
TeamSTEPPS AHRQ's Organizational Readiness Assessment Checklist and Hospital Survey on Patient Safety. Additionally, a brief description of the
organization and post–surgical unit along with staff's perceptions and attitudes of the unit, barriers in implementing change, implications for the nurse
executive to consider utilizing the TeamSTEPPS tools.
Nursing unit and organizational structure
Southside Regional Medical Center (SRMC) is a 300–licensed bed ... Show more content on Helpwriting.net ...
It is vital that you begin by evaluating your unit's readiness using the tools offered by the Agency for Healthcare Research and Quality (AHRQs)
TeamSTEPPS initiative (Team Strategies and Tools to Enhance Performance and Patient Safety) (AHRQ, 2011).
A checklist assessment was performed with assistance on the 2 East Post–Surgical unit by the Nurse Manager (NM) and Charge Nurse (CN) to assess
unit's structure and willingness to apply an improvement opportunity utilizing the TeamSTEPPS initiative. The responses from the checklist reflected
"YES" to all questions asked, which is conducive in implementing a TeamSTEPPS initiative. Increased levels of staff engagement and performance are
considered work environments in which people are motivated to do their best that will be beneficial for both the patient and the success of the
organization (Evans & Lindsay,

Adopting New Technologies in Nursing
Adopting New Technologies into Nursing Lisa M. Ehret
Walden University
Transforming Nursing and Healthcare through Information Technology
NURS 6051N–20
July 10, 2015
Adopting New Technologies into Nursing The healthcare system is a continuously evolving spectrum. Nurses must take great strides in learning and
adapting to new technologies to meet the standards of the health care system. One significant change that has occurred throughout the last few years is
the transition from paper charting to utilizing electronic health record (EHR) systems. This technological change is a major development that has the
potential to significantly impact the nursing role and overall ... Show more content on Helpwriting.net ...
15). Thus, if possible, emphasizing the simple aspects of the chosen EHR while avoiding excessive complexity during design will be an important
aspect to avoid obstacles in the adoption of the new practice. As the nurse facilitator, realization that the older generation may be confronted with
difficulty regarding technological innovation is crucial. Providing constructive, and tolerant instruction will help with successful adaption of the new
EHR for these individuals. Adequate training and instruction, while ensuring user–friendly technology was the base of the design for the new EHR
will help ensure simplicity and encourage positive outlook from staff and increase rates of adaptation. Thus, emphasizing simplicity of use while
avoiding complexity will give health care workers a positive stance on their capabilities regarding the utilization of a new EHR.
Trialability
The fourth aspect of successful implementation is trialability. As described by Rogers (2003), "Trialability is the degree to which an innovation may
be experimented with on a limited basis". An easy way to interpret this aspect is that the more practice, the easier a concept becomes or "practice
makes perfect". As the nurse facilitator, one must recognize and understand that adequate training and available resources are the basis for trialability
and success. Thus, the more the nurses who utilize the new EHR, the faster a successful adaptation occurs. It is during this part of the

Nt1330 Unit 3 Paper
The hospital will establish policies and standards that protect patient privacy of the health care information. These policies should determine levels
of access to the EHR. The CernerВ® system will provide many layers of protection. A major piece of maintaining patient privacy is managing
access to the EHR. This is accomplished through password management. The system will require case sensitive passwords with mandated password
change every 90 days. There is employee badge swipe access that automatically enters the user log in ID but requires the password be entered. If a
user has not accessed the system in a designated time period, which will be determined by the hospital (typically 90 days) then the system will
automatically drop the... Show more content on Helpwriting.net ...
An error can cost the hospital hundreds of thousands of dollars. Utilizing technology to prevent errors will result in cost savings to the hospital.
Implementing CPOE will not only save in prevention of medication errors but also in the decreased time spent in order verification due to illegible
handwriting. Elimination of paper documents except as backup for downtime events will provide cost savings to the organization. Savings will come
from decreased printing cost as well as decreased cost of storage of paper charts, decreased cost of scanning paper documents into the EHR, decreased
printing and decrease cost of document destruction. Another measure that implementation of EHR may affect will be patient satisfaction. Its impact on
patient satisfaction will be difficult to quantify. It is anticipated that staff will be more knowledge about the patient and will have more time to spend
with the patient both factors are known to improve patient satisfaction. Patient satisfaction is reported publicly so scores can affect selection of the
hospital as a place for treatment and patient's willingness to recommend or return. Active Nursing

Implementing Fixed Patient For Nurse Ratios
Implementing Fixed Patient–to–Nurse Ratios in High–Volume High–Acuity Settings
Striving for excellent patient care is the cornerstone of nursing. However, delivery of innovative care requires nurses to take initiative in finding issues
and concerns in current clinical practices to promote change that leads to optimal patient outcomes. One current issue in clinical practice is the varying
patient–to–nurse ratios (PNRs) amongst different hospitals (Aiken et al., 2012). Having high PNRs may lead to nurse burnout, medical errors, and
ineffective nursing care (Aiken et al., 2012; Karavasiliadou & Athanasakis, 2014). The solution would be to regulate PNRs, especially in areas such as
the emergency room. To initiate this change, a task force would have to be established to use current data and research as evidence to propose the
change, implement the change and evaluate its effectiveness.
Change Model Overview
The Johns Hopkins Nursing Evidence–Based Practice (JHNEBP) process can be used to facilitate change. This process serves as a guideline to
access, combine, and implement research into nursing practice. According to Dearholt and Dang (2012), the JHNEBP is an 18–step process that
occurs in three phases. Phase one of the JHNEBP contains steps 1 through 5 and can be summarized as the practice question phase where the issue is
identified (Dearholt & Dang, 2012). Phase two is the evidence phase containing steps 6 through 10 and is where search for evidence pertaining to the
issue

Nursing Dress Codes
Abstract The purpose of this paper is to offer a summary and synthesis of some of the more recent research regarding implementing mandatory dress
codes. The tradition of nursing attire has changed over the years. The history of nursing uniforms includes wearing solid white skirts, shoes, and white
cap. These white garments typically signified nursing roles and differentiated nurses from other staff members. Common questions that arise within
medical institutions includes: what are the advantages of implementing mandatory dress codes? Should nurses be required to wear traditional white
uniforms? Should personal individuality be preserved? How will patient care be impacted? Regardless of the point of view, most positions tend to
agree that... Show more content on Helpwriting.net ...
Is this self–expression beneficial to our patients and our nurses? Personal self–expression has lead to the assortment of styles seen in the nursing
wardrobe; moreover, LaSala & Nelson (2005) states that dress can reflect the individual's personality, but should not be distracting or too casual for the
work setting. In association with personal expression within the workplace, Spragley & Francis (2006) argue that nurses often say they want to be
recognized for their knowledge, competence, and experience, not for what they are wearing. To consider the creative of nursing apparel, the department
or work environment would be the best indicator of suitability. Perhaps, colors and patterns can be considered appropriate in certain departments of
nursing, such as pediatrics. According to Matziou et al. (2009), studies report that the nurses' uniform influences the children's mood and that of their
parents, especially in pediatric hospitals; furthermore, the uniform of the nurses should be specially designed to be functional and representative of
their role. Multicolored nurses' uniforms are those most preferred by both the children and their parents. For instance, cartoon characters worn on scrub
attire may be considered distracting, and inappropriate in medical units such as oncology. Albert et al. (2009) adds that patients and visitors may
perceive nurses as

Case Study : Patient Safety And The Knowledge Of Santiago...
Background/Facts :
Patient safety is one of the main concerns in many hospitals. The present case study deals with medication use and the knowledge of Santiago's health
leaders to solve safety and billing problems. Santiago health system comprises of one large hospital campus and two small satellite hospitals which
includes 556 bed hospital, cardiac care center, cancer center, and outpatient surgery center.Dr Trubelli is a warm hearted pediatrician and former chief
of staff of the SCC and now hold the position of Medical director of Information systems. Throughout his career he has addressed many medical errors
and wants to implement the new system of administration i.e. bar code medications. This system helps nurses to verify all the drugs along the bedside
using electronic verification and to prevent medical errors. The pharmacy department at SCC wants to adopt bar code system to ensure safety using
codes on medications but their main concern is that all the medications don't come with bar codes. All the drugs should be packed, compounded and
delivered with printed bar codes to implement this system. Changes should be made to the pharmacy technician work flow as implementing the bar
code system results in billing changes, dose charging at administration and they are not aware of the responsibilities and roles of the IS staff. Changes
are also necessary in the nursing department as most of the nurses face the difficulty in using bar codes at the point of care. In SCC the

Evidence Based Practice
According to CLPNA (2005), "nurses should ddemonstrate knowledge of the elements and impact of nursing research and evidence–based practice
such as improved quality of practice and changes to practice based on new data. This competency is crucial for the professionalism in nursing
practice". So being in the nursing profession, we should participate in continuous quality improvement and evidence based changes to nursing practice.
According to Mccrae (2012), "The legitimacy of any profession is built on its ability to generate and apply theory" (p. 222). Evidence–based practice
promotes using best evidence to make decisions to improve quality of care for individuals, groups, communities, and systems (Schaffer, Sandau, &
Diedrick, 2013, p.1206).

Transformational Leadership Within A Health Care Setting
Using transformational leadership in nursing practice can increase morale, motivation, and enhance job performance, which can ultimately improve
patient outcomes and quality of care. The purpose of this paper is to explain what exactly transformational leadership is, and how it can be used by
nurse leaders within a health care setting to inspire positive change within the working environment to improve patient quality of patient care and
improve job performance.
Introduction
As we know the healthcare system is constantly changing, therefore requiring effective leadership among nurses. With that said leadership that
promotes positive change is necessary in a health care setting. Transformational leadership was developed by leadership expert James MacGregor
Burns in the late 1970's. Transformational leadership is considered a contemporary leadership theory. Contemporary theories of leadership place
emphasis on teamwork and collaboration, and is built around the premise of change. "Transformational leadership is a process that motivates
followers by appealing to the higher ideas and moral values where the leader has a deep set of internal values and ideas and is persuasive at
motivating followers to act in a way that sustains the greater good rather than their own interests" (Burns, 1978 as cited in Owen Doody & Catriona
Doody, 2012, p.1212). Therefore, when it comes to implementing transformational leadership in a healthcare setting the nurse leader must takes on
various

Priority Quality Improvement Of A High Performing Health...
Priority Quality Improvement Need Identified The advancement of a high–performing health care system that accomplishes improved access,
enhanced quality, and more effectiveness, for the susceptible, vulnerable, the uninsured, minority, children, and elderly adult, remain vital
(Commonwealth Fund, 2016). The expectations to meet this standard has been adopted by hospitals as they are in continuous review of modalities to
provide safe, effective, and efficient care for their community. Consequently, the priority Quality Improvement area identified in the Medsurg
/Orthopedic unit of riverside hospital is "Point of Care Documentation". Members of the Healthcare Team Involved with priority need Members that
will be affected by the priority Quality Improvement as identified in the Medsurg/Orthopedic unit, include clinical and direct care nurses, nurse leaders
and administrators, Patient Support Assistants, the multidisciplinary team, comprising of the physicians, the physical therapists, occupational
therapists, Nutritionists, Phlebotomies, Respiratory therapists, environmentalists, and the social workers, and the hospital in general. Complete Review
of Minutes Regarding Priority NeedMeanwhile, the minute of the need as identified was reviewed. In attendance was the hospital improvement
committee, Clinical Nurse managers, Administrative nurse managers, staff nurse leadership representatives, and representatives from the unit's joint
Commission. During the proceedings, the focus

Certified Medical Assistant Dissemination Plan
Dissemination Plan The staff will be will be notified of the new pilot project to hire and only have Certified Nursing Assistant and Medical Assistant
administer medication, this program will begin April 1, 2016. The current MEDT Techs that are not Certified Nursing Assistance or Medical
Assistance will have 1 year to obtain their certification for either field. The purpose of the program is to ensure adequate learning skills and to have
someone with foundational knowledge of skills such as vital signs, basic knowledge of recognizing medical concerns and being able to make
notification to the appropriate person and then completing the directed tasks. The purpose of this objective is to utilize this new research or evidence
based information... Show more content on Helpwriting.net ...
The ideal situation is to introduce the team to program and have someone in from a practicing group someone on the staff's level of understanding that
can share their thought about the program that has already been practiced at a like facility, the group who is practicing will be able to explain the
program and can explain on their staff's level of understating (Melnyk & Fineout–Overholt, 2005). Individual barriers can vary based on the audience,
some staff members may be less than forth coming do to their skill sets, their lack of confidence and their complaints of doing more for less pay. It
can be a challenge yet having them be a part of the decision making will validate their concerns and verify where we should begin (Thompson, Bell &
Prevost, 1999). Just keep the EBP positive and be willing to share the results (Melnyk and Fineout–Overholt,

A Nurse Residency Program For New Nursing
Introduction The publication from the institute of medicine has garnered much interest since its publication in 2010 focusing on the future of nursing
and the implementation of this with in the nursing community. The nursing profession has over 3 million members and is the largest segment of the
nation's health care workforce. Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the
2010 IOM (Institute of Medicine). One of the recommendations is that of a nurse residency program for new nurses or nurses transitioning into new
clinical practice areas. The area I work in is home health and this is a growth area the need for a residency program cannot be over stated home... Show
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He theorized a three–stage model of change known as unfreezing–change–refreeze model that requires prior learning to be rejected and replaced. Lewin
's definition of behavior in this model is "a dynamic balance of forces working in opposing directions." Implementing a change in practice within these
environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz,
Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a
change of this nature. The use of Lewin's Change Management theory can support nurses through the transitions and identify areas of strengths and
resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track. As the demand for home visits from
nurses increases its necessities a need to prevent avoidable hospitalizations, it is critical to attract and prepare more nurses for roles in home care. The
residency program would have input from the California Association for Health Services Home and the Infusion Nurse Society. Providing newly
graduate registered nurses support and experiences to become competent home care nurses Providing current Option care nurses opportunities to
increase their skills in clinical teaching and become preceptors for residency nurses Providing resources

The Patient Education Program Will Increase Patient Safety
The patient education program will increase patient safety and will improve HCAHPS medication communication scores . A patient's understanding of
medications is very important to a satisfactory patient experience and it also improves safety and quality. A recent study shows that only 35% of
patients knew the side effects of their medication (Hays, Ron D., et al. "Physician Communication When Prescribing New Medications.") Archives of
Internal Medicine 166, no. 17 (2006): 1855–62 Many health care organizations have used Lewin's theory to recognize human behavior as it relates to
change and patterns of resistance to change, the model encompasses three distinct phases known as unfreezing, moving and freezing or refreezing
(Bozak, 2003). The purpose of the model is to distinguish factors that can impede change from happening; forces that are in opposition to change
often called restraining or 'static forces' and forces that promote change, referred to as 'driving forces'. When health care organizations fully understand
what behaviors drive or oppose change, then work to reinforce the positive driving forces, change can happen successfully (Bozak, 2003).
Unfreezing Stage In Lewin's 'unfreezing' stage, an understanding of the difficulties related to the recognized problem is sought and "strategies are
developed to reinforce the driving forces and weaken or reduce the restraining forces" (Bozak, 2003, p. 81). Unfreezing involves identifying key players

Novice to Expert Nurse Leader
NOVICE TO EXPERT NURSE LEADER
By
Gwen Travis
Gonzaga University
NURS 553
The path to nursing leadership most often progresses from novice to expert nurse and then onto a novice nurse manager. The novice nurse manager
is asked to lead and rarely given the tools or knowledge to be successful in this new role. The Dreyfus Model of Skill Acquisition discussed by
Patricia Benner includes the following five levels of competency in the clinical nurse (Benner, 1982): * Level I – NOVICE – beginners with no
experience with practice situations and an inability to use discretionary judgment. * Level II – ADVANCED BEGINNER– actions/decisions are based
on prior experience in actual situations. * Level III – COMPETENT – actions ... Show more content on Helpwriting.net ...
If the use of the latest, high–quality research is vital to optimal patient outcomes it can also transfer over to the development of staff and nursing
leaders. Better trained nurses and leaders are more able to perform their jobs which should lead to the goals of improved patient care and expert staff
retention. As research shows, there are several key factors involved in the

Planned Change Of Maternal Child Health
Planned Change in Maternal Child Health For many years organizations have faced challenges in trying to promote interdisciplinary team collaboration
and shared governance. Many have attempted the trial and error method with the use of different nursing care delivery systems to meet the concerns of
our ever–changing healthcare world. A shared–governance model is one professional practice model used to improve nursing practice through
collaboration of nurses, patients, and other care providers. This model encourages professionals to have a voice and represents an avenue where staff
can get involved in how nursing care is delivered, and furthermore promotes collaboration between professionals. The Maternal Child Health (MCH)
unit at... Show more content on Helpwriting.net ...
The professional nurse is an asset simply because much of what drives success within an organization is the fruit of labor. In order for this continued
performance to strive it is necessary that an organization be designed to allow professionals to participate in the practice and help shape the
environment in which patient care occurs which ultimately brings us back to this notion of shared governance.
The goal for SLMC is to have a unit based interdisciplinary design with the use of a Collaborative Care Committee (CCC) as a vehicle in
implementing shared governance, and increase interdisciplinary team collaboration. According to Suby (2012), "shared governance models create
decentralized systems in which decision making lies with bedside staff nurses whose role becomes the source of innovative solutions; the managers
role is one of facilitation and support to assist staff nurses in changing practice to better care for the needs of the patient". This CCC will allow for
staff nurses and nursing management as well as providers to work together to promote autonomy, accountability, leadership and empowerment, all of
which are elements of shared governance and also important factors to address when trying to improve quality of care.
Alignment with the Organization's Values
Having the Collaborative Care Committee at SLMC would positively impact the organization by promoting working conditions where employees
would be motivated and satisfied

Best Practice To Implementation Essay
For this written assignment, I will imagine that I am on a team in my workplace and have identified a new best practice to implement. I will
describe the steps of implementing this practice and research about how change comes about in the workplace. I will check policies and procedures
in my workplace and may need to speak to a supervisor who has experience in this area. I will provide literature and support on why this change
needs to occur. I will provide references on this material and a conclusion. Best Practice to Implement For my best practice to implement, I have
chosen betadine nasal swab in pre–operative patients. Prior to this new practice being implemented, the hospital where I work would test patients prior
to surgery... Show more content on Helpwriting.net ...
Knowledge–focused triggers come from staff when they read research, attend research conferences, or experience evidence–based practice guidelines
that is published by federal or specialty organizations (LoBiondo–Wood & Haber, 2014). You must form a team that is responsible for establishing,
implementing, and evaluating the evidence–based practice topic. Research and literature on the topic must be retrieved. The evidence on the new
practice must be graded to justify the effectiveness of the body of evidence. Within my workplace, the first step to implementing a new practice is a
needs assessment, whether it be metric or a process based on data or outcome. After this has been completed a research path is the next step. This is
based on research team or a governing body that gives approval or not for implementation of a new practice. Process or procedural change goes
through several different councils. Literature to Support New Practice When trying to implement a new practice, there are several tools that must be
considered to use. First, you must ask a focused clinical question, searching literature is another important component, screening your findings,
appraising each article's findings, and applying the findings. There are many different types of articles, such as: diagnosis articles, prognosis articles,
harm articles, and meta–analysis articles. Having the appropriate literature to support your new practice

Nur/598 Essay
Implementation of SBAR Training Program Sandeep Bains NUR/598 February 18th, 2013 Margaret L. Colucciello
Section D: Implementation Plan 1. Proposed Solution Implementation Plan The first step in implementing this project will be for the author of this
evidence–based practice SBAR (situation, background, assessment, and recommendation) program to approach the Director of ... Show more content on
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The staff attending the educational session will receive the guide to take home and brochures on SBAR (Joint Commission, 2006). The author will set
up the flyers to sent the information about the educational sessions, including venue, dates, class size, contact phone numbers, and program times to
physician's offices, local bulletin boards, and to all nursing departments. The advertisement will be placed in the local newspaper with the same
information listing in the flyers. The SBAR educational program will develop by the author with the assistance of nursing director, and
multidisciplinary team and will be presented by the multidisciplinary team appointed by the project director. Nutritious snacks, drinks, and lunch will
provide by the Brampton Civic Hospital. 2. Resources Needed for Solution Implementation The multidisciplinary team consists of managers, nursing
educators, and physicians are salaried employees and will prepare and provide these educational sessions during non– patient care hours and with no
extra pay. The team will not only teach the SBAR tool and also provide educational sessions that provides information on communication styles, and
strategies for collaborative communication. To keep the cost down, the author will present the majority of the education sessions and only one day for
physicians in the series of classes. Brampton Civic Hospital is a teaching facility, has the auditorium,

Essay On Nursing Leadership Competency
Nursing leadership competency is a very important to me as an employee, it can mean the difference between having a chaotic or smooth workday. It
is the responsibility of the manager to put forth a plan on how and what needs to be done. Communication, vision, trust, adaptability is essential for a
leader when implementing changes and dealing with subordinates working toward a group goal (Huber, 2014). In this discussion board, I will explain
why understanding and effectively managing change and innovation is an essential leadership competency is important in the workplace. In additions to
providing two examples from my own nursing experiences and applying the change theory elements as it applies to the nursing process.
The nursing field ... Show more content on Helpwriting.net ...
The need for the EMR was to help with becoming compliant with physician order entry and increasing patient safety relating to meaningful use. As an
ER staff nurse, I was approached by my manager to be a super user and part of the team for the new EMR. It was a long process over several months
of planning and collaborating with the builders of the system and receiving input from the staff on what would be useful. All the ER staff received
appropriate in class training in addition to online access to practice. Physicians were also given scribes to assist with a smooth transition. I have to
say the implementation and evaluation process went very smooth with minimal disruptions to the ER flow. I continued to teach the EMR class to
new arrivals and remained a super user in the department until I transferred to another facility. This was by far one of my favorite experiences as a
nurse. Here is an example of a failed roll–out project that was chosen for. As a nurse working in vascular assess area during a monthly staff meeting,
a group of us were delegated with specific instructions to start a project to place small chlorhexidine gluconate (CHG) patch on ultrasound peripheral
intravenous catheters (PIVs) in patients in the intensive care unit (ICU). This project was to last a month or more, no specific time was given. There
was no planning in place or input from the staff that was requested during the implementation of this project. The purpose was to see if this would
decrease the chances of infection, phlebitis, infiltrates, and increasing its longevity of the PIV. This sounded good but there was no information or
evidence of a problem in our facility on how often PIVs were discontinued due to these symptoms. During the evaluation process, we assessed each
patient's PIV insertion site daily. We were instructed tell the floor nurses to

The Importance Of Evidence Based Practice In Nursing
The focal point of this discussion is to create an organized method to bring evidence base practice (EBP) awareness to the forefront, increase
knowledge to health care nursing in prevention and management as they are confronted daily with clinical problems, lack of up–to– date EBP research.
Nurses will develop the skills for early detection by exploiting the four–stage framework model in their organization and validating the need for
implementation of accessible current evidence base research to bring about optimal patient care and safety.
The plan is to establish multiple educational workshops for all nursing staff of various specialties, to include chief nurse officers, managers and risk
management. This ensures uniformity of education to maximize optimal patient care in bridging the gap from the bedside to benchmark. The
education department, alongside with organizational learning coordinators will have the task of constructing computer basic learning (CBL) modules
with the input of experts from all specialties to obtain an interprofessional insight. Special budget is allocated as the organization recognizes the
benefits of teaching and implementing evidence based practice which outweighs standardize outdated information, in view of up keeping the
institution's core measures. Upper management, nurse educators will attend a specialize training to become familiar with the tools and accessing
material on their respective floor. They will schedule nurses in groups for a series of training,skill competencies and provide an incentive for
attendance, may be earning CEU's, recognition and/or opportunity of clinical ladder. The National Database of Nursing Quality Indicators (NDNQI)
collects nursing–unit level data on healthcare safety and quality measures. This database can be used as a tool to compare the institution's performance
with the national benchmark.
Do
Establish a pilot study to promote translational science and evaluate its impact in clinical nursing in one department before implementing it within the
hospital. Allocate special budget to establish multiple educational workshops, such as an "In–Service" training for staff in different specialties.
Educators and specialists will collaborate to develop

Critical Information About A Patient 's Plan Of Care
Specific problem requiring change and Situation description: The shift report between the off–going and oncoming nurses must include all of the
critical information about a patient's plan of care. This information must be communicated. The change of shift report that is done incorrectly can be a
result of missed information and poor communication between nurses, affecting their ability to deliver safe and efficient care for the patients. This
problem occurs not just at one but at most hospitals, where inter–shift report still continues to take place at the nursing station without inclusion or a
visual of the patient until the report is done. As I witnessed shift report in the hallways or at the nursing stations of SCVMC of the 33 bed mother and
baby unit, I noticed that at times unnecessary information is received and critical information may not be communicated. On the other hand, at
Redwood City Kaiser neuroscience unit bedside inter–shift nursing report works well and I have witnessed better nurse–patient relationship, lower
incidents of falls, strong teamwork, as well as improved nurse accountability and prioritization at the beginning of the shift. As evidence shows in the
article "Improving Client and Nurse Satisfaction Through the Utilization of Bedside Report", there is a direct correlation between the bedside report
and both client and nurse satisfaction in care settings, validating the importance of changing to bedside report (Vines, Dupler, Guido, 2014). I

Root Cause Analysis : Root Causes Analysis
ROOT CAUSE ANALYSIS
Root cause analysis process will utilize a systematic step–by–step approach to help identify all causative factors leading to this sentinel event. The main
purpose of the Root Cause Analysis is to understand how the event happened, why did it happen, and what can be done to prevent an event from
happening again. The first step, collect all necessary data associated with this event such as: current policy and procedures, incident report, Mr. B's
health history, environmental flowcharts, dispensed medications, equipment and staffing factors relevant to the event. The process of identifying
causative factors can begin once all the data is collected. The goal, of a Root Cause Analysis, is to identify interventions to prevent an event from
reoccurring. Scenario: Mr. B, a 67–year–old–man, came to the ER complaining of severe pain to his left hip and leg after falling over his dog at
home. Left leg appears shortened with swelling in his calf, bruised, and limited range of motion.Mr. B has a history of impaired glucose tolerance
and prostate cancer. Home medications include atorvastatin and oxycodone for chronic back pain. Mr. B's labs, taken during a previous visit with
his primary care doctor, revealed elevated cholesterol and lipids. Several errors and hazards can be identified as possible factors leading to the
sentinel event. The ER appeared to be terribly understaffed that day with only one ER physician, one RN, one LPN, and a secretary.

Nursing Leadership Priorities

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