NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEK 1 PRACTICUM

What is the difference between leadership activities and management activities:

Leadership can be described as the conduct of a person when guiding the activities of a given group towards a common goal. The main concept of roles of leadership is based on impacting group activities and adjusting to change Sullivan, E. J. (2013. There is a challenge when considering leadership in the healthcare context because most theories are not formed within the healthcare framework for they were normally established for business contexts and later applied to the healthcare. Management can simply be defined as the process that managers utilize to realize organizational goals. It’s the process of achieving organizational set goals through the available resources.

How do management and leadership activities contribute to the success of change initiatives:

The activities involved in this process include planning, staffing, organizing, directing, controlling, and making decisions in the operations of the system to attain anticipated result and improve its entire performance. Management involves a combination of steps to follow to achieve the set requirements. Leaders look for suitable ways of doing things for instance they will establish the goals and purposes for the people (American Nurses Association, 2010; Sullivan, 2013). Anyone can be a leader without necessarily being in an authority position.

Transformational leadership is necessary along with good management of staff and resources. This entails committing individuals to action, converting those under you into leaders and converting the leaders themselves into change agents. It has less to do with use of power to pressure and suppress others in order to achieve result. Instead, it involves empowering them to understand and own the vision of the organization and trusting them to work towards the goals that profit not just themselves but the organization in general (Sullivan, 2013). In nursing empowerment would result to enhanced patient care, reduced sick days, and less attrition.

Through this, the staff will have higher job satisfaction and there will be higher retention of staff amongst there nursing functions.

What change projects are needed in your agency at this time?

Among the changes required is to ensure nurses practice to the full capacity of their education and training and programs to be formed to ensure nurses attain higher training to much the growing demands in the sector. These can only be achieved through good leadership and proper management. The Company that I work for currently is an insurance company and as a registered nurse case management, there is always area of change especially in reaching patients who had just been discharge in a timely manner so that gap in their discharge instructions, medications reconciliation and other issues can be address to avoid readmission.

Which project will I select for my practicum change project:

I will select the benefit of reaching patient within 2 days of hospital discharge in reducing chance of readmission

References

American Nurses Association (2010).Nursing: Scope & standards of practice. Silver Spring, MD: American Nurses Association. Retrieved from the Walden Library databases

Sullivan, E. J. (2013). Effective leadership and management in nursing. (8th ed.). Upper Saddle River: Pearson Prentice Hall

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NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEK 2 PRACTICUM

Change Implementation 2

Change is inevitable in any sphere of life. In the healthcare sector, change is even more critical. The dynamic nature of technologies, the healthcare sector, and health care requirements necessitate for any healthcare institution review its practice and adopt the best available. This paper addresses change in a hospital setup.

Several change theories exist, which help implement varying nature of changes in hospitals (Sullivan, 2012). The most useful theory of change applied to my place of practice, The United Healthcare Group, is the Roger’s theory. The Roger’s Theory, also referred to as the Diffusion of Innovation Theory, was advanced by Rogers and entails a description of the process by which people in any setup respond to change (Sullivan, 2012). The Theory describes five steps towards the adoption of a change, which comprise the creation of awareness stage, interest creation, evaluation of effectiveness, implementation and the adoption stages (Sullivan, 2012).

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My project entails the introduction of post-discharge calls to monitor the patients and help prevent hospital readmissions. The Roger’s Change Theory allows a stepwise evaluation of the project progress. This helps the change process to be modified as necessary during the implementation process.

The United Healthcare Group’s mission is to provide people with healthier lives and make convenient the health care system cost effectively. The Group seeks to uphold integrity, compassion, relationships, performance and innovation as its core values. The vision to provide a high value of service to their clients and become the medical center of choice guides the group. The change aims to improve the patients’ health while reducing incidences of re-hospitalization. This is in line with hospitals mission and values. Moreover, the follow-up leads to an improved quality life, which is in line with the institution’s vision.

References

Sullivan, E. J. (2012). Effective leadership and management in nursing (8th ed.). Boston: Pearson

NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEK 3 PRACTICUM

Collaborative and Strategies

Change in an integral process for any organization aiming to continually the quality of its service delivery. This paper presents how effective communication and collaboration with other stakeholders are critical to the implementation of a change at the United Healthcare Group, which entails the introduction of post-discharge calls aimed at preventing further patient readmissions.

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At the multidisciplinary meeting to evaluate the hospital how the institution could improve the inpatients’ experience at the hospital teamwork. The institution’s medical director acted as the meeting coordinator, who employed a democratic leadership style. The leader allowed the input of every participant in the discussion. Conflicts in the form of disagreements were solved through compromise (Losa Iglesias & Bengoa Vallejo, 2012). The decision and counterarguments were based on the principles of nursing. At the end, the group proposed a plan to improve the patient experience at the institution.

The interview with the director of the pharmacy division of the institution proved much insightful. The director describes himself as a servant leader, who is focused on the achievement of the hospital goals and upholding of its values (Sullivan, 2012). The leader argued that communication is critical to influencing the workforce, which is why he endeavors to pass important messages through face-to-face communication. The leader believes in the uniqueness of every member of his department and works towards harnessing their different strengths.

The proposed change at the institution calls for the involvement of every stakeholder; from the top-level management, nursing staff to the patients. The Rogers Theory will help implement the change in phases, which will enable its evaluation and modification (Sullivan, 2012). The theory enables the change to be tried, and its benefits realized which would influence its adoption (Sullivan, 2012). The multidisciplinary team will help refine the change to make it compatible with every department, which will help in its swift adoption. The best way to communicate the project is through the multidisciplinary team meetings. The leaders will then relay the change to their staff after the discussions, which will facilitate its support by the staff.

References

Losa Iglesias, M., & Becerro De Bengoa Vallejo, R. (2012). Conflict resolution styles in the nursing profession. Contemporary Nurse: A Journal For The Australian Nursing Profession, 43(1), 73-80. doi:10.5172/conu.2012.43.1.73.

Sullivan, E. J. (2012). Effective leadership and management in nursing (8th ed.). Boston: Pearson.

NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEK 4 PRACTICUM

Change Project Resources Budget

Implementing a change that improves the way an organization performs work may sometimes come with the requirement of heavy resource inputs. Without the proper checks and balances, the change may counterproductive in terms of economy. In the light of this, this paper evaluates the budgetary estimates for the proposed change at the United Healthcare Group.

In a bid to reduce the readmission rates in the United Healthcare Group, it is imperative that follow-up calls are made to the released patients. The successful implementation of the change calls for additional resources in a number of areas. The resources have to be allocated their respective amounts, which should reflect in their different budgets, such as capital budgeting, salary budget, and the operating budget (Sullivan, 2012).

The change project involves the implementation of post-discharge calls to monitor patients, hence prevent readmissions. Thus, the hospital needs resources that include personnel, equipment, technology, and travel in some instances. Additionally, Sullivan (2012) argues that employee motivation and continual development helps improve the job performance. As such, the hospital will be required to put additional resources for the purposes of employee motivation and education.

Telephone calls will require the installation of an additional four telephone lines in the hospital, specifically for the follow-up calls. The hospital will incur the purchase cost of $500 for the phones. The installation cost will amount to $100. The maintenance and the subscription fees for the phones will be about $300 per year. Thus, the hospital will incur a capital budget of $600 for the telephone lines, acquisition, and $300 operating budget for the telephones.

The change involves keeping in touch with discharge patients through telephone calls. As such, the hospital will need to employ additional staff, in the form of nurses, who will supplement the existing body nurses in assessing the patients to be put on the follow-up program and making the calls. In this area, the hospital will need to add an additional two nurses. These will reinforce the existing workforce, who will be used to make the required follow-up calls and offer the necessary instructions. Additional tasks require the addition of staff (Sullivan, 2012). The salaries of the staff will be about $8400 for the additional staff. Thus, the hospital will incur an additional $8400 salary budget for the program.

Education for the nursing staff will be required so as they are acquainted with communicating with the patients, assessing their condition remotely, making critical decisions and offering the necessary instructions to the patients. Thus, a seminar to educate the nurses on phone etiquette, the questions to ask and the kind of information to guide on will be held. This exercise will cost the hospital about $1000, for a week’s education of the nurses at the hospital premises. The change entails the introduction of tasks that the nurses were not accustomed to, which requires the enrichment of their knowledge (Sullivan, 2012).

The major objective of the project is to reduce the instances of hospital readmissions for the patients. As such, the nurses may be called to task by visiting some of the patients in their homes, depending on their conditions. Such cases are expected to be very few. As such, the hospital will set aside $1000 per year for such visits as the need arise.

Budget Summary

Category

Budget type

Cost

Telephone acquisition and installation

Capital Budget

$600

Phone maintenance and subscription

Operating budget

$400/year

Staff education

Capital budget

$1000

Salary for additional staff

Salary budget

$8400/month

Travel

Operating budget

$1000/year

Total

$11,400

This project is very interesting to me because as nurses, we face are faced with the challenge preventing skin tear and breakdown with incontinent patients. Continuous exposure to urine and feces is one of the most common causes of skin breakdown. The chemical present in these waste products have an effect on the skin making it fragile and causing it to break and injure easily, so changing patient’s position and keeping them dry is very crucial in preventing this problem. But because of cost, proper method are not utilize. Even though the chux are less expensive but the frequent use of barrier ointment or moisture sealants available in the market which are helpful for they form a protective barrier on the skin can become expensive, retraining staff members and new employees on skincare and prevention of decubs can also incur some expenses.

References

Sullivan, E. J. (2012). Effective leadership and management in nursing (8th ed.). Boston: Pearson.

NURS 4021 WEEKLY PRACTICUM ASSIGNMENTS

NURS 4021 WEEK 5 PRACTICUM

QUALITY OR SAFETY ISSUE IN UNITED HEALTHCARE SYSTEM 2

Safety Issue

The lack of knowledge of managing certain conditions reported by patients in a health care institution can pose greater safety hazard to both the affected and unaffected patients. This also compromises the quality of the services offered by an institution (Sullivan,2013).

One of the safety issues faced by United Health Care system is that practicing nurses lacked knowledge on Skin and wound care management. Because of this, they also did not know how to operate wound care equipment.

What Data did you use to Identify the Safety Issue?

Collection of data is important in the process of identifying a safety issue. Once data have been collected; evaluation is done so as to identify a safety issue and thereafter come up with ways of addressing the safety issue.

In this case, the data used to identify the safety issue was the number of nursing staff that participated in the educational activities involving skin care issues and wound care management. In addition, nurses filled questionnaires in the on skin and wound care management processes; skin and wound care management systems and equipments. Results from the evaluation of these questionnaires informed the conclusion that lack of proper knowledge of skin and wound care management was indeed a safety issue.

How will the Practicum Change Project Address the Safety Issue?

The Practicum Change Project will address this safety issue firstly by procurement of hospital equipment to be used for skin care and wound management. The institution’s procurement system would also be adjusted to involve the top management more in the process.

Secondly, setting up a system through which all nurses and their managers will report skin care and wound management cases accurately and on time. This will assist in the close monitoring and evaluation of these cases (Sullivan, 2013). Because of the knowledge gap that exists in this safety issue, the hospital management, through the change project will allocate resources to source for qualified staff. The qualified staff will train the nurses and their managers on the reporting system for some time and then exit after the knowledge gap has been bridged.

Conclusion

Finally, clear and constant communication will be maintained as this will be the most important step in addressing the safety matter. This will ensure that the management keeps abreast on matters of skin care and wound management. Thus, the nurses will be constantly reminded and sensitized on the requirements and importance of the issue to the success of the change project. Current wound care expertise encompasses numerous dressing-related skills including, treating the cause of the wound and addressing patient centered concerns to set the stage for local wound care, Properly assessing the wound and identifying the dressing requirements, selecting dressings based on their form and function for an individual wound’s need, and meeting setting-specific requirements for dressing change frequency and maintenance. There is always a safety risk if the nurse is not able to follow the above step, when wrong dressing changing material is used; when wound is not properly staged and poor wound information is provided to the patient. Dressings alone will not promote wound healing, unless the underlying cause(s) for the wound are also addressed (e.g. treatment of the wound cause, blood supply, nutrition, patient centered concerns, local wound care etc.). As the wound changes, the plan of care must change and dressing products may have to be changed and this is where effective communication

References

Course Text: Guide to the Code of Ethics for Nurses: Interpretation and Application Retrieved from the Walden Library databases.

Sullivan, E. J. (2013). Effective leadership and management in nursing. (8th ed.). Upper Saddle River: Pearson Prentice Hall