Assignment: change implementation and management plan

It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose. 

To Prepare:

  • Review the Resources and identify one change that you believe is called for in your organization/workplace.
    • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
  • Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose. 

Your presentation should be 5–6 minutes in length and should include a video with you as presenter. 

Your Change Implementation and Management Plan should include the following:

  • An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
  • A description of the change being proposed
  • Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
  • Details about the type and scope of the proposed change
  • Identification of the stakeholders impacted by the change
  • Identification of a change management team (by title/role)
  • A plan for communicating the change you propose
  • A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

By Day 2 of Week 11

Submit your Change Implementation and Management Plan with audio and video.

Rubric:

Create a 5- or 6-slide narrated PowerPoint with video that presents a comprehensive plan to implement changes you propose. Your Change Implementation and Management Plan should include the following:

·  An executive summary of the issues that are currently affecting your organization/workplace (this can include the work you completed in your Workplace Environment Assessment).
·   A description of the changes being proposed.
·   Justifications for the changes, including why addressing them will have a positive impact on your organization/workplace.

Details about the type and scope of the proposed changes.
·   Identification of the stakeholders impacted by the changes.
·   Identification of a change management team (by title/role).
·   A plan for communicating the changes you propose.
·   A description of risk mitigation plans you would recommend to address the risks anticipated by the changes you propose.

Include an audio/video presentation that is 5–6 minutes in length with you as a presenter.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

This is from the previous work we did , we can address this issue , or what you think.

Work Environment Assessment- this is my discussion

Using the Clark Healthy Workplace Inventory (Clark, 2015) my workplace ranks 90, or very healthy.  Why it ranks as healthy or civil is that between units of the hospital there is great communication between units, to the extent that is a need on one unit as far as staffing, another unit will offer to help, this is the norm, and not the exception for our hospital. We also feel supported by management during times of crisis, I work in two distinct areas where things can escalate very quickly, both in inpatient psych, and Children pavilion for adolescent psych patients. We know we will always get backup from other building staff and security if things get escalated where there is danger to patients or staff. 

           Success in an organization comes from hardworking people who have a strong mission and vision with great strategies in place. This depends greatly on the leadership, management, and the team. To put things in perspective, the introduction of the workplace health status would give a broader picture. To be discussed below is a brief description of the results of the Work Environment Assessment at Chicago Lakeshore Hospital and based on the results, the explanation of how civil is this place with the reasons behind the claim. Also, this discussion includes a description of a situation where incivility in the workplace has happened and how was it addressed.

Workplace health is the status of the workplace concerning the workers, how civil is the place, and the overall environment safety for the employees. Lack of civility at the workplace contributes to poor employees’ job satisfaction, lack of courtesy and respect among peers, and it leads to poor patient outcomes (Tips to Improve Civility in the Workplace, 2017). Incivility at workplaces has the potential to emotional and physical distress to the workers and that can cause poor quality care and patient outcomes (Armstrong, 2017). To assess the civility of the workplaces, researchers have discovered tools to help assess the workplaces and the Work Environment Assessment is one of the tools. 

Using the Work Environment Assessment tool to assess Chicago Lakeshore Hospital revealed 90 which is a moderately healthy place. This means, in this organization, people live by the shared mission and vision, there is trust and respect among the workers, and communication at all levels is clear (Clark Healthy Workplace Inventory – americannursetoday.com. [n.d.]). The result assures the presence of teamwork and high levels of employees’ satisfaction. The workload is distributed equal and the organization offers competitive salaries. Based on my hospital workplace assessment results, the majority of the employees would recommend the place as a good place to work and overall there are high levels of employee satisfaction, therefore better outcomes (Clark Healthy Workplace Inventory – americannursetoday.com. [n.d.]).

Incivility incident at the workplace

         Courtesy and respect are not only meant for people of a certain rank within the organizations. These basic values and others are for everyone. Clark (2017), emphasizes all nurses have the obligation to foster healthy workplaces with an atmosphere of dignity, professionalism, and respect. Unfortunately, studies reveal incivility at workplaces, bullying, and lack of mutual respect (Armstrong, 2017). Incivility at the workplace has been linked to poor performance which impacts patient safety and the quality of patient outcomes (Armstrong, 2017). Marshall and Broome (2017) state that “workplace violence, incivility, and bullying are barriers to developing safe environments for providers and can occur in any setting” (p.261). The American Nurses Association (ANA; n.d.) defines incivility as “one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them” (para.2).  This brings back the memory of my former workplace. Doctors were very much valued and respected, but the nurses did not receive the same respect from the doctors. At times, nurses were hesitant to call the doctors for notification of patient condition change simply because of the fear of the expected response. There was no mutual respect. I am not sure how did this problem resolve after leaving the place but a few years down, the hospital was sold out to another company.

Conclusion

Civility at the workplace is not only important for the workers’ feelings it also influences overall performance, productivity, and patient outcomes. The consequences of incivility at workplaces “can result in life-threatening mistakes, preventable complications, and harm or even death of a patient” (Clark, 2017). It is with that intensity that the workplace health assessment should be one of our priorities. Despite the individual differences, we must find a way to improve civility at our workplaces. The first step towards improvement is to assess the current status and the Work Environment Assessment is a great tool.

References

Armstrong, N. E. (2017). A Quality Improvement Project Measuring the Effect of an Evidence-

Based Civility Training Program on Nursing Workplace Incivility in a Rural Hospital Using Quantitative Methods. Online Journal of Rural Nursing & Health Care, 17(1), 100–137. https://doi-org.ezp.waldenulibrary.org/10.14574/ojrnhc.v17i1.438

Clark, C. M. (2017). An Evidence-Based Approach to Integrate Civility, Professionalism, and 

Ethical Practice Into Nursing Curricula. NURSE EDUCATOR, 42(3), 120–126. https://doi-org.ezp.waldenulibrary.org/10.1097/NNE.0000000000000331

Clark Healthy Workplace Inventory – americannursetoday.com. (n.d.). Retrieved from 

https://americannursetoday.com/wp-content/uploads/2015/11/Clark-Healthy-Workplace-Inventory.pdf.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New Tork, NY: Springer.

Tips to Improve Civility in the Workplace. (2017). AACN Bold Voices, (1), 18. Retrieved from 

https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsovi&AN=edsovi.01436852.201701000.00025&site=eds-live&scope=sit

References:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

  • Chapter 8, “Practice Model Design, Implementation, and Evaluation” (pp. 195–246)

https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf

https://wdhb.org.nz/contented/clientfiles/whanganui-district-health-board/files/rttc_leading-change-by-j-kotter-harvard-business-review.pdf

http://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf

Assessment 1 instructions: locating credible databases and research

Create a 1-2-page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.

Evidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.     
    • Explain why the sources selected should provide the best evidence for the chosen diagnosis.
  • Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.     
    • Describe the best places to complete research and what types of resources one would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
  • Competency 4: Plan care based on the best available evidence.     
    • Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
  • Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.     
    • Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
    • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.

Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario. Choose something you would find interesting to research or that applies to a clinical problem you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.

You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.

Instructions

The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

  • Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
  • Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
  • Describe where you might go in the clinical setting to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

  • Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
  • Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
  • Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
  • Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis.
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.

Submission Requirements

Your assessment should meet the following requirements:

  • Length of submission: 1–2 pages (not including the reference page) description of communication, collaboration, and evidence location process, including a list of databases or other sources with description of why they are appropriate for clinical scenario diagnosis (that is, something that would be useable in professional practice for other nurses). Be sure to include an APA-formatted reference page at the end of your submission.
  • Number of references: Cite a minimum of three sources of scholarly or professional evidence that supports your findings and considerations. Resources should be no more than five years old.
  • APA formatting: References and citations are formatted according to current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

Homework # 5 | Nursing homework help

 

Read Chapter 6 & 7

1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

2. What similarities and differences can you identify among the above interactions?

3. Explain the concept of congruence between verbal and nonverbal communication.

4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective?

5. How have you seen ISBAR used during your clinical experiences?

6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports.

7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond?

8-Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?

9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

10. Discuss the differences between direct delegation and indirect delegation.

1. You have to observe delegation procedures in your assigned unit:

A-What considerations does the RN take into account when delegating patient care?

2-You have to look at the unit census and prioritize the patient care:

A- Give the rationale foryour choices.

3.Answer the following questions during your clinical experiences:

a. What specific tasks did your patients require that you might have been able to delegate?

b. How effective was your nurse/preceptor in delegating tasks to others?

c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?