NR531 2022 June Discussions Latest (Full)

NR531 Nursing Leadership in Healthcare Organizations

Week 1 Discussion

Organizational Structures

Discuss the organizational structure that you, as the nurse administrator for SLMC, believe would be most appropriate. Use a specific organizational theory to support your decision and discuss how this structure may impact the organization’s outcomes.   

There is no word count for threaded discussions and there is only one discussion per week. This is different from what you are used to in your core courses.  Please see discussion guidelines and rubric below.

 

NR531 Nursing Leadership in Healthcare Organizations

Week 2 Discussion

Care Delivery Models and Effective Nurse Administrators

You are the nurse administrator at SLMC. Your Human Resources Director informed you that SLMC is having difficulty recruiting registered nurses for your facility. It was decided by the Chief Executive Officer (CEO) to hire more nursing assistants to assist during this shortage. Discuss the impact this new strategy/model may have on the organization and how an effective leader can assist with implementing this change.

 

NR531 Nursing Leadership in Healthcare Organizations

Week 3 Discussion

Shared Governance and the Magnet Model

Describe the nursing care delivery model used at your current or previous employer. Would you utilize this model at SLMC? Discuss current interprofessional collaboration and how you would encourage collaborative efforts. Does the model support the person-centred nursing framework by McCormack and McCance (2017)? Explain your rationale for choosing to use or not use the person-centred nursing framework.

Please refer back to the 2017 PCNF overview presented below.

Patient-Centered Care: A Person-Centred Care Model Revisited

Caring continues to be a central concept in nursing; however, the context for caring is transforming, resulting in conceptual and theoretical advancements related to the evolving healthcare practice settings. McCormack and McCance originally developed a Person-Centred Nursing (PCN) Framework in 2006 and updated it in 2010 that can be applied to practice in complex healthcare systems (McCormack & McCance, 2006; McCormack & McCance, 2017). The PCN Framework provides a standard of care for practice and is a multidimensional process that places emphasis on the person as the center of care delivery (McCance, McCormack, & Dewing, 2011). The PCN Framework fosters outcomes related to therapeutic relationships through respecting individuals as persons and partners in care. The Person-Centred Care Nursing Framework consists of four constructs: prerequisites, the care environment, person-centred processes, and outcomes (McCance et al., 2011). To deliver effective care, one must work from the outer circle first to the core. McCormack, B. & McCance, T. (2017)Prerequisites focus on the attributes of the nurses and include being professionally competent, having developed interpersonal skills, being committed to the job, being able to demonstrate clarity of beliefs and values, and knowing self. The care environment focuses on the context in which care is delivered and includes appropriate skill mix, systems that facilitate shared decision making, effective staff relationships, organizational systems that are supportive, the sharing of power, the potential for innovation and risk taking, and the physical environment. Person-centred processes focus on delivering care through a range of activities and include working with a patient’s beliefs and values to overcome this gap between the concept and the reality of person-centred care we have developed the Person-Centred Nursing Framework…engagement, having sympathetic presence, sharing decision making, and providing holistic care. Outcomes, the central component of the Framework, are the results of effective, person-centred nursing and include: satisfaction with care, involvement in care, feeling of well-being, and creating a therapeutic environment. (McCance, McCormack, & Dewing, 2011).

NR531 PCCN model jpg

McCormack, B. & McCance, T. (2017)

 

NR531 Nursing Leadership in Healthcare Organizations

Week 4 Discussion

Vision and the Organizational Structure

As the nurse executive, discuss your vision that you would like to implement for the organizational structure at SLMC. Share your rationale. How would you incorporate aspects of the person-centred nursing framework into your vision? Using motivational theory, discuss your strategies, as the nurse executive, for creating a motivating climate and atmosphere that supports a more positive work environment.

 

NR531 Nursing Leadership in Healthcare Organizations

Week 5 Discussion

Management of Influence, Power, Conflict, and Decision Making

As the nurse executive at SLMC, you are trying to increase communication and empower decision making among your team members. In the past, it has been difficult for some of the various shift workers to attend scheduled, mandatory meetings that involve Magnet™ designation preparation. Share your specific strategies (examples) for enhancing communication and empowering all members of your team.

 

NR531 Nursing Leadership in Healthcare Organizations

Week 6 Discussion

Communication

As the nurse administrator for SLMC, you must communicate to your team the disappointing news that your organization is discontinuing tuition reimbursement benefits. Discuss how you will communicate this message to your direct reports and to the rest of the organization. Be specific and state your rationale for your communication plan.     

 

 

 

NR531 Nursing Leadership in Healthcare Organizations

Week 7 Discussion

Quality Management and Control

Zanderville Healthcare Systems, a regional, acute care facility in the foothills of the Appalachians is committed to delivering quality healthcare to its local and neighboring communities. The population it serves is diverse by gender and ethnicity. The primary payer for healthcare services is CMS. Over the past six months the acute care facility has experienced a 25 % increase in readmissions from this payer group within the first 30 days of discharge. The economic impact on the health system has been negative and patients’ satisfaction with their hospital experience has declined. Senior leadership has charged you, the nurse executive, to convene an ad-hoc task force to perform an outcomes audit and propose an intervention. Currently patients receive a follow-up telephone call about 7 days following discharge. You decide to use an evidence-based practice approach and have the following information for the “working” PICOT:

P: CMS patients readmitted within 30 days of discharge

I: What will we do differently to impact the improved outcome

(State what this is)

C: Follow-up phone call 7 days after discharge

O: Reduce readmission rate of CMS patients from ____ to ____…..

T: Over next six months

If this were happening in your organization, discuss:

Whom will you include in your task force?

What outcomes measures will you audit?

Where will you obtain the data to determine your baseline and goal regarding the percentage of readmissions within 30 days of discharge?

What specific outcome do you want to achieve?

What standard or benchmark will you use for the outcome? What does your organization use as a benchmark for readmissions within 30 days of discharge?

Describe the intervention you will use to achieve your goal?

Then, restate the completed PICOT using the information you have collected related to the intervention and outcomes.

*For a review of writing PICOT, see the following example. There is also an instructional webinar in the Course Announcements: CGE Prep Academy Part II: PICOT*

PICOT Writing Review

Situation:

Sunnybrook Health System has started the process for acquiring Magnet status. They have scheduled multiple planning and process meetings over the next year that require attendance of all staff. Staff must attend at least 70% of the meetings live. After three meetings, live attendance of night shift staff has been about 5%. There is concern that with the small amount of interest shown from this group, the benchmark of 70% for live attendance may be jeopardized. Currently, the meeting schedule is communicated to all staff via email and posted announcements. Suzie thinks an incentive of a free meal for live attendance might improve attendance of the night shift crew.

How could a PICOT be developed with this information?

P = Population – Describes the group upon which the intervention will have an effect.

   Ex: night shift staff

I = Intervention – What we want to do that is different from what we currently do; the thing that is going

to impact the population identified

   Ex. coupons for a free meal in the cafeteria

C = Comparison – Here the comparison is a before and after the intervention (incentive in this case)

   Ex: communication of scheduled meetings via email and posted announcements

O = Outcome – What we want to see happen as a result of the intervention. The outcome should meet three criteria: direction (increase, decrease, etc), a baseline, and a goal.

   Ex: increased mandatory meeting live attendance from 5% to 50%

T = Timing or Timeframe – When we expect to see the outcomes.

   Ex: over the next 4 meetings

Now you can create the PICOT:

Among night shift staff(P), will offering a coupon for a free meal in the cafeteria(I), as opposed to only email invitations and posted announcements(C), increase mandatory meeting live attendance from 5% to 50% (O) over the next 4 meetings(T)?

 

NR531 Nursing Leadership in Healthcare Organizations

Week 8 Discussion

Reflection

What specific knowledge of the healthcare environment and leadership skills that you gained through this experience will be most important as you take on your future nurse-executive role? Describe a concrete way in which you anticipate using these skills and knowledge.

How will you use the concepts in this course to identify, guide and evaluate your final MSN practicum project?

Please review the American Nursing Credentialing Center (ANCC) nurse executive competencies (refer to the Week 1 lesson) and the American Nurses Association (ANA) Nursing Administration Standards of Professional Performance (refer to the Week 7 required reading: Marquis, B.L. & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia: Lippincott Williams & Wilkins). Share how these will influence you as a nurse leader.

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