I . Organizational Structure

 

II. National Patient Safety Goal 15.01.01: Identify patients at risk for suicide

Video Previously recorded- fulfilling this portion of the project requirement.

III.  Professional Development: Nurse Competency

 

College of Central Florida

RN to BSN

NUR 4827 Leadership

RACI- Action Plan

 

 

Organization/Unit: Seven Rivers Regional Medical Center/ Telemetry

 Date Created: 8/3/2015

 

Strategy Title: /Nurse Competency- EKG Performance, Interpretation, and Documentation

 Last Modified: 08/03/2015

 

Student:      Chester Wheeler, RN toBSN

 

Description of the Strategy:_To develop a nurse competency  that  brings small group mentoring and education by a EKG competent nurse or clinical educate to enhances nursing staff’s current knowledge on performing an EKG, interpreting EKG rhythms ,and when to intervene or contact physicians in the presence of potentially life threatening cardiac arrhythmias. To reinforce and  reeducate on unit protocol for recording, documenting, and following through when an arrhythmia occurs.

 

TO:_Ensure that every telemetry floor nurse and hospital staff nurse is competent in performing an EKG, reading EKG rhythms, what channels of authority or communication to pursue when a patient has an arrhythmia, and how to document, record, and follow up on arrhythmias.

 

IN A WAY:_Enhances Telemetry nurse’s competency in caring for patients with potentially life threatening cardiac arrhythmias. Provides better standards of care and timeliness in seeking interventions for patients thereby creating a reputation for reliability and excellence in patient centered care.  Reaffirms established protocols/procedures for reporting arrhythmias and documentation in the electronic medical record.

 

Patients experience less negative outcomes related to lack of proficiency with EKG strips, and physician notification of arrhythmias.  Nursing staff has a more concrete and working knowledge of EKGs and that medical records are complete with relevant information.

 

 

 

STEP/ACTION	R	A	C	I	Resources	Deadline
Develop a RACI Team- implement EKG re-education	C.Wheeler	C.Wheeler/ Unit Manager	Clinical Educator, Cardiologists, Tele Monitor	Telemetry Nurses	Personnel	9/1/2015
Develop plan of implementing training	RACI Team Members	C.Wheeler/Clinical Educator, Unit Manger, Charge Nurses	Clinical Educator, Cardiologists, Tele Monitor	Telemetry Nurses	Evidence based Research, Personnel Time	9/15/2015
Presentation to Unit Manger, Education Director, Cardiologist, Tele Monitor	RACI Team	C.Wheeler/Unit Manager	Clinical Educator, Cardiologists, Tele Monitor	Telemetry Nurses	Technology/powerpoint	9/30/15
Presentation to Floor Nurses	C.Wheeler/ Charge Nurses/Tele monitor Tech	C.Wheeler/Unit Manager	Charge Nurses	Telemetry Nurses	Time/ Handouts/Equipment	10/10/15
Resources/Community Partners	RACI Team	C.Wheeler/Unit Manager/ Other Unit Managers	Other Unit Mangers	Floor Nurses from other units	All nursing Staff in Hospital	11/30/15
Measurements of success	RACI Team	C.Wheeler/Unit Manager	Risk Management/ Cardiologist	Telemetry Floor Nurses	Decreased incidents negative outcomes related to improper reporting of arrhythmias/ Cardiologist Survey/ Monitor Tech Feedback Tracking documentation	12/10/15

 

 

 

Nurse Competency: EKG Implementation, Interpretation, Reporting, and Documenting

            Even though Seven Rivers Regional Medical Center has dedicated 24 hour telemetry monitor techs that are specifically trained to observe telemetry changes, there has been a notable failure in nurses reporting telemetry changes and subsequently capturing 12-lead EKGs to validate these changes. This has also resulted in nurses failing to report to physicians and documenting in the electronic medical record relevant heart rate changes. Several near misses have been noted where patients were almost discharged with critical arrhythmias being unaddressed by physicians which could have lead to a sentinel event. Moreover, EKGs are routinely performed by the PCAs and this has lead to many nurses relying on PCAs to perform EKGs when patients are admitted, critical arrhythmias occur on telemetry monitoring or even during code situations, therefore RNs needs to have more accountability for implementing 12-lead EKGs. These facts highlight the need for continued education on EKG interpretation, reporting, and documenting.

            Drew, et.al. (2005) highlight the practice standards for EKG monitoring in a hospital setting. These standards along with other evidence based research will be used to create a nurse competency that addresses the current issues affecting quality of care. With the approval of administration, help of the clinical education director, and support from the managers, telemetry monitor techs and input from cardiologists, the competency will re-educate nursing staff on current standards of practice, interpretation of EKGs, chain of communication, and proper documentation in order to prevent negative patient outcomes and development of standardized procedures and protocols with EKGs.              

 

References:

American Association of Critical Care Nurses. (2013). Alarm Management Practice Alert. Retrieved From http://www.aacn.org/wd/practice/docs/practicealerts/alarm-management-practice-alert.pdf. 

Blakeman, J., Sarsfield, K., & Booker, K.(2015). Nurses' practices and lead selection in monitoring for myocardial ischemia: An evidence-based quality improvement project.  Dimensions of Critical Care Nursing. 34(4):189-195. Retrieved from doi: 10.1097/DCC.000000000000011

 

Drew  B.J., Califf  R.M., Funk  M., et al. (2005). Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young;110:2721-2746.Retrieved  from http://circ.ahajournals.org/content/110/17/2721.full

 

1. Recruitment and Hiring

Job Title:            Registered Nurse (Staff Position)

Department:       Telemetry

Agency:               Seven Rivers Regional Medical Center (CMH)

Job Announcement Number:   123456-KTY

SALARY RANGE:	$44,400 to $54,400 / Per Year
OPEN PERIOD:	Monday, August 3, 2015 to Monday, August 31, 2015
POSITION INFORMATION:	Full Time – 40 hours weekly
LOCATION:                           Crystal River, Fl
WHO MAY APPLY:	United States citizens or persons with a valid U.S. work visa
Licensing:	Valid Florida Registered Nursing License
SUPERVISORY STATUS:	No

ABOUT SRRMC:  Since 1978, Seven Rivers Regional Medical Center, a 128-bed general, medical/surgical acute care facility has been serving Citrus, Levy and South Marion Counties with a wide variety of Emergency, Surgical, Inpatient and Outpatient services. SRRMC is fully accredited by The Joint Commission and has earned the Gold Seal of Approval™ as a Certified Primary Stroke Center. The medical center has an innovative alliance with UF Health for stroke care, has earned the American Heart Association’s Get With The Guideline-Heart Failure Silver Plus.

OUR MISSION: Providing excellence in health care through caring, respect and integrity. In everything that we do for our patient's, their families, our visitors and fellow health care team members, our mission and values guide us along the way.

WHERE WE ARE LOCATED: Crystal River is known as “the gem” of Florida's beautiful Nature Coast. Located around  the breath taking King’s Bay, designated as an Outstanding Florida Waterway, Crystal River is famous for its boating, diving, swimming, fishing and  Manatee tours. Boasting a proud history, rich in archeological findings, and home to a wide variety of wildlife, there is something for everybody in the family. For more information on Crystal River, please visit http://www.crystalriverfl.org/ 

 

OUR MISSION: In everything that we do for our patient's, their families, our visitors and fellow health care team members, our mission and values guide us along the way.

quality achievement award, and is nationally recognized as a Blue Distinction Center+ in the areas of knee and hip replacement by the Blue Cross and Blue Shield companies.

Recruitment/Relocation Incentives: Incentives may be authorized for highly qualified candidates who possess unique skills and abilities.

Relocation Expenses: Relocation expenses may be covered as approved per by CNO on a case by case scenario.

TRAVEL REQUIRED

• Live within a 25 mile radius of Main Hospital in Crystal River, Fl.
• KEY REQUIREMENTS

• New Hire and/or Random Drug Testing required.
• Level II Background check clearance
• Active/Unencumbered Florida Registered Nursing License
• American Heart Association BLS/ACLS/NIH Stroke Scale Competency Preferred
• Telemetry experience preferred
• Critical Thinking Skills DUTIES: Week One: Work Monday, Tuesday, Friday, Saturday  BASIC REQUIREMENTS:    
• QUALIFICATIONS Required: Applicants must meet all requirements by the closing date of this announcement: Monday, August, 31, 2015.
• Week two: Work Sunday, Wednesday, Thursday. 12 hours of overtime built into ever pay period.
• 
  Work Schedule: 0700- 1900 hours on an alternating schedule. For example:
• Are you looking to be a part of dynamic team of energetic health care professionals that are using innovative telemetry monitoring equipment in the assessment, planning, implementation, and evaluation of patients experiencing potentially life threatening cardiac arrhythmias? Telemetry RNs spcialize in technical nursing care to pediatric, adolescent, adult and geriatric patients admitted to the Intermediate Care Unit. Daily responsibilities include monitoring EKG strips, interpreting, and intervening on patients experiencing cardiac arrhythmias and other potential life threatening complications of their illnesses such as electrolyte imbalances, renal failure, respiratory distress, and organ failure. As an Intermediate Care Unit, a diverse patient population will be encountered including dialysis patients, med-surg patients, and downgraded ICU patients. Care provided will be individualized per patient needs. Tele RNs work collaboratively with a wide range of medical staff and specialist to help provide comfort and well being to patients. The nursing process of assessment, planning, implementation, and evaluation is used to meet the needs of the patients and optimizes the care delivered. Tele RNs are integral in providing bedside assistance to physicians during treatments, examinations, and medical explanations to patients. Under the guidance of a multidisciplinary team, age/developmentally appropriate care in accordance with the hospital’s policies and procedures are executed by Tele RNs. The day to day supervision and delegation to CNAs and LPNS in providing quality care to patients is important in the holistic care of patients. Day to day duties may also include care planning, wound care, ostomy care, IV starts, NG tube insertions, foley catheter insertions, and other basic general nursing skills as required to meet patients’ needs.
•  

         U.S. Citizenship. Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with CMHS policy.

         Education. Graduate of a school of professional nursing approved by a State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript.

         Licensure. Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

         English Language Proficiency. RNs appointed to direct patient care positions must be proficient in spoken and written English.

Experience: Minimum of one year in telemetry or similar work settings preferred; new graduates welcomed to apply.

Preferred Education: ADN, but BSN degree or above is preferred.

Certifications: Association(AHA) Basic Life Support (BLS) prior to beginning clinical duties. Advanced Cardiovascular Life Saving (ACLS) certification preferred. Basic cardiac arrhythmia course completion within 6 months of hire date.

Physical Requirements: Must be able to lift at least 50 pounds and use correct body mechanics in the transfer, ambulation, and turning of patients. Be able to walk the equivalent of 4 miles a day, stoop, bend, and squat as needed.

What Happens Next: After a Committee Review of resumes and qualifications, a Human Resources Representative will contact qualified applicants to set an interview with the unit manger. At that time of interview, an applicant's education and experience will be considered in the negotiation of pay.

BENEFITS:

• Health benefits through Blue Cross Blue Shield of Florida- HMO.
• Employee and Family life Insurance/Accidental Insurance
• Short and long Term disability
• Dental- Delta
• Eye- EPS
• Retirement/401K through Humana
• Free Continuing Education through Advanced learning Center

OTHER INFORMATION:

Probationary Period: A thirty day probationary period will be entered upon hire. Thirty calendar days after hire, full benefits will be granted.

 Equal Employment Opportunity: SRRMC is an equal employment opportunity organization and selection of new hires will not be based on sex, race, color, national origin, lawful political affiliation, marital status, physical handicap, age, gender identity, sexual orientation, or expression, which are prohibited by law.

 Reasonable Accommodations: SRRMC strives to assist applicants and employees with disabilities. Reasonable accommodations for any part of the applicant and hiring process are decided on per situation. Questions should be directed to S. Cortez, Director of Human Resources, Telephone # 352-795-6560.

HOW TO APPLY:                    

The quickest way to apply is online by establishing an applicant account at http://www.sevenriversregional.com/about/careers/applicants

In person applications can be completed at SRRMC Main Hospital Campus:

Human Resources Dept. Located in Office Building across from Emergency Room, 2^nd Floor Room 209 6201 N. Suncoast Blvd.
Crystal River, FL 34428

http://maps.google.com/maps?q=6201 N Suncoast Blvd,+Crystal+River,+FL,+34428

If you have any questions or concerns please contact:

1. Cortez

Director of Human Resources

352-795-6560 

­­­­­­­­­­­­­­­

Interview Questions

INTERPERSONAL EFFECTIVNESS

1. Effective interpersonal communication is paramount to providing quality client care. Many times people misinterpret another’s words or communication failures occur. Describe a situation where you felt you had not communicated well or somebody did not communicate well to you. What were the outcomes of this miscommunication? How did you correct this?

FLEXIBILITY/ADAPTABILITY

1. Even though you are interviewing for a Tele position, being that this is a small rural hospital, we often time call upon our nurses from every department to float to another department when the need is there. Floating can be stressful because you are thrown into a new routine and expectations. How do you deal with stress? What coping mechanisms and self care behaviors do you utilize to deal with the stress?

10 questions:

1. Give a specific example of a time when you had to deal with an angry customer. What was the problem and what was the outcome? What was your role in diffusing the situation?
2. Tell about a situation at work where you realized a person needed help. How did you realize the person needed assistance and what did you do? What was the outcome of this situation?
3. Describe an instance when you had to think on your feet to extricate yourself from a difficult situation. What caused the situation? How did your solution work?
4. A part of this job is documenting your work. On a scale of 0 to 10 with 10 being excellent writing skills, how would you rate your writing ability? Give specific example of the types of documents you write routinely. What feedback do you get from your supervisor on your writing skills?
5. A part of this job is documenting your work. Give a specific example of something you had to write for your supervisor in the past three months. What feedback did you get from your supervisor?
6. Describe a time when you've had to work with strong-willed peers. What did you do? How did you handle them so you could influence their decisions?
7. What is your typical way of dealing with conflict? Give me an example. What have you learned from dealing with conflict?
8. Give two examples of things you've done in previous jobs that demonstrate your willingness to work hard.
9. List two characteristics that you feel you possess that make you a sensitive, effective leader. Give a specific example for each to show how you applied them to your work setting
10. Name three things you have done in the past two years to grow in your job.
11. Tell us how you keep your job knowledge current with ongoing changes.
12. Describe the day of patient who has you as his or hers nurse

 

1. Building Relationships

Name/Position	10	9	8	7	6	5	4		3	2	1
C,Schwartz- Telemetry Manager	x
C, Heitzman- CNO									x
T. Dourm- Clinical Educator		x
G. K. – ICU Manager									x
S,Stephens- Nursing Supervisor	x
G.Bare- Nursing Supervisor			x							x
K, Hotz- Director of Infection Control	x
V. Magurean CFO								x
J. Morgan- Director of Risk Management			x
M. Drake- Director of Case Management			x

It is no secret that the leaders, managers, directors, and higher authority members of teams are influential in ways that can promote one’s career. Who one spends time with and how relationships are developed makes the difference between employee A being chosen for advancement over employee B.  In my nascent nursing career of only one year on the floor, I have found the easiest way to develop relationships with people who are influential in the company by doing two things: 1) by being myself and striving for excellence, and 2) show genuine interest in other people’s positions, responsibilities, and lives.  By being myself which is synonymous with striving for excellence, I am being authentic and people observe that as true and feel that they can trust me. By showing interest in other people’s lives, I build trust through reciprocal self disclosure and rapport building.

My floor manger is probably the most influential person currently due to her being the most readily available on daily basis. She is the first resort contact for important issues and observes my worth ethic more so than the other listed people. I put the CNO next , even though I have spent little time with her and admittedly am not that comfortable around her yet, she ultimately decides who is retained, who is advanced, and is the key to influencing all the other party members. I put the clinical educator of third importance because she vital to facilitating my transition to ICU. The fourth person of importance to my career progression is the manager of ICU  because he is soon to be my manager and therefore will have the potential for great influence over my career. I do not have much a relationship with him, thus my comfort level is low. However, upon my transition I plan to establish a stronger relationship through developing trust, asking questions about his career and life, and by continuing to show interest in his life and career. Many of the other people I have listed have a strong comfort level due to the daily interaction that transpires in our activities on the floor and over the last year our relationships have become more familiar, informal, and trustworthy.

Reference:

Building collaborative relationships in healthcare (n.d). Retrieved from http://amnis.uk.com/sites/amnis.uk.com/files/downloads/BS11000%20Guide%20for%20Healthcare_0.pdf

 

1. HCAHPS Score Improvement

 

College of Central Florida

RN to BSN

NUR 4827 Leadership

RACI- Action Plan

 

 

Organization/Unit: Seven Rivers Regional Medical Center/Telemetry      

Date Created:08/03/2015

 

Strategy Title: Improving HCAHP Scores : Cleanliness and Noise Level          

Last Modified: 08/03/2015

 

Student: Chester Wheeler, RN to BSN

 

 

Description of the Strategy:  SRRMC has continually received HCAHPS scores in the 60-70 percentiles for cleanliness and noise level. An in-service to educate all staff members on cleanliness and reduction of noise will be implemented to help improve patient satisfaction levels.  A list of ideas on improving cleanliness will be presented to management for approval, ideas include post room cleaning inspections for thoroughness, leaving a  tent card on the bedside table to let the patient know that the room was cleaned and where to call if they have a cleaning need, retraining of environmental staff on proper cleaning of occupied rooms, more frequent trash emptying, and improving the conditions of rooms that have  deteriorating and flaking  paint or marked up walls.

Ideas to improve level of noise would be decentralizing nurses stations and setting up smaller more numerous stations throughout the floor, using noise meters to indicate decibel level, designating quiet times, providing patients with ear plugs or headphones, installing sound proofing barriers. Brainstorming with RACI team to find tangible ways to effectively and economically implement changes will be key in initiating these solutions.

TO: Increase patient satisfaction to 90^th percentile on HCAHPS scoring in the next business quarter for the area of cleanliness and noise level.

IN A WAY: Empowers nurses and all staff members to be more conscientious of their environments and noise levels thereby increasing satisfaction rates, , increasing reimbursements, and increasing overall quality of patient care.

 

SO THAT: The hospital HCAPHS scores in the area of cleanliness and noise level will meet or exceed patient satisfaction goals of 90^th percentile for the mutual benefit of patients, employees, and employer. So that hospital reimbursement may meet the maximum allowance.

 

 

 

 

STEP/ACTION	R	A	C	I	Resources	Deadline
Develop a RACI Team	C. Wheeler	CNO Nurse Manager Clinical Educator Environmental Services Charge Nurses	Environmental Services Operations Clinical Education Managers	CNO Charge RNs Managers All staff Employees	Personnel	08/30/15
Develop steps necessary to make changes, create an inservice, seek approval from administration	RACI Team Members	CNO, Managers, Clinical Educator	Environmental Services Operations Clinical Education Managers	CNO Charge RNs Managers All staff Employees	Evidence based Research Brain storming on ideas to enhance cleanliness and reduce noise reduction	09/10/15
Presentation to Unit Manger, Education Director, Cardiologist, Tele Monitor	RACI Team	C.Wheeler/Clincal Educator	Clinical Educator, CNO, Managers, Charge Nurses	All employees	Technology/powerpoint	9/15/15
Presentation to Floor Nurses	C.Wheeler/ Charge Nurses	C.Wheeler M anagers Clinical Educator	Charge Nurses	All employees	Time/ Handouts	9/20/15
Hourly Rounding Patient Inquiry	Charge Nurses, Managers, CNO	CNO, Clinical educator, Managers	Charge Nurses	All employees	Time from Management	09/23/15
Scripting	Nurses   Clinical Educator   Nurse Managers   Nurse Techs   CNO	Nurse Manager   CNO	Education Department   Nurse Manager	Nurse Manager	Scripting education (class or computer learning)	09/23/15
Evaluation of intervention effectiveness	CNO   Nurse Manager	CNO   Nurse Manager	HCAHP Survey Results Website @ medicare.gov	Hospital Executives   Nurses	HCAHP Survey Results Website @ medicare.gov	12/30/15
Modification of Action Plan PRN	CNO   Nurse Manager Nurses	CNO   Nurse Manager	Nurses   Clinical Coordinator Education Department	Nurses	What worked and what didn’t? New ideas if scores do not increase.	1/15/16

 

 

Hospitals are always looking for ways to earn more profit from the services they are providing patients. No organization wants to be penalized or have their reimbursements withheld due to patient satisfaction surveys. Hospitals that service patient population primarily insured by Medicaid/Medicare are particularly keen on assuring that they do everything possible to make sure that patients are answering always on their HCAHPS questionnaires to achieve scores that ensure maximum reimbursements. Even though Seven Rivers has done well in most categories and scoring above or near the national  rankings in communication, medication side effects, and discharge education, the hospital still struggles with getting higher scores on cleanliness and noise level. My approach to help remedy these scores would be to utilize my RACI team to brainstorm concrete and applicable ideas/solutions to provide

One great organizational structure that I discovered is the Plantree Patient-Centered approach to provide a patient-centered care. The main components of this approach are compassionate human interactions, access to meaningful information , support and  participation of family, friends; healing environment, and support for body, mind & spirit. Organizations that have adopted the Plantree approach  has proven improvement in HCAHPS scores , patient satisfaction , and patient outcomes internationally (http://planetree.org/). This is something that would be a complete orgranizational overhaul in order to implement , so not necessarily appropriate for this project, but I felt it was worth mentioning nonetheless.

 

References:

 

Doucette, J.,  Zimbro, K., & Woolwine, D. (2015). Making an impact: Can a training program for leaders improve HCAHPS scores?.Nursing Management.  46(3). doi: 10.1097/01.NUMA.0000459093.40988.78

McCaughey, D., Stalley, S., & Williams, E. (2013). Examining the effect of EVS spending on HCAHPS scores: a value optimization matrix for expense management. Journal of Healthcare Management, 58(5), 320+. Retrieved from http://db04.linccweb.org/login?url=http://go.galegroup.com.db04.linccweb.org/ps/i.do?id=GALE%7CA384340830&v=2.1&u=lincclin_cfcc&it=r&p=AONE&sw=w&asid=56cd7f7bdcd104b2e5c20426538c238f

Plantree: Your leader in patient centered care. (n.d.). Retrieved from: http://planetree.org/

Solomon, C. (2012). HCAHPS: Ways to improve on environment question. Retrieved from http://healthcare-executive-insight.advanceweb.com/Features/Articles/HCAHPS-Ways-to-Improve-On-the-Environment-Question.aspx

 

 

 

VII. Leadership Theory

 

Exceptional Leadership can have many meanings. I believe that being and exceptional leader starts with open communication. By open I am referring to the “open door” policy where followers can come to you at any time and express their personal feelings, concerns, and needs. This open communication means that the leader is available, approachable, willing to hear followers and be able to assist them find a solution to their needs. Through open communication can an exceptional leader display their propensity for emotional intelligence or the ability to perceive other’s emotions, utilize these emotions to accomplish tasks, understand the diversity of emotional variations, and manage these emotions to achieve a goal. By utilizing emotional intelligence and open communication, an exceptional leader develops a reciprocal trust with his or her followers. Trustworthiness is the glue to hold leader-follower relationships together. Without trust then communication fails, self disclosure is stymied, and emotional intelligence is goes unutilized. Through trusting relationships, an exceptional leader can be an authentic role model. By being transparent and true to oneself and others, an exceptional leader can  be a role model for followers. Lastly, an exceptional leader is transformative. They are a catalyst for change and innovation and they inspire followers to be the best they can be, achieve great goals, and help create new leaders and standards of quality. An exceptional leader can only be transformative if she or he has open communication with followers, has a strong emotional intelligence, builds trusting relationships with followers, and is true to who they are personally and professionally  thereby being an authentic role model for the followers.

References:

Laschinger, S., Heather., K. PhD.; Fida, R., (2015).   Linking nurses' perceptions of patient care quality to job satisfaction: The role of authentic leadership and empowering professional practice environments. PhDJournal of Nursing Administration. 45(5):276-283.

doi number

:10.1097/NNA.0000000000000198

McGregor Burns, J. (n.d.) Transformational leadership. Retrieved from

http://www.langston.edu/sites/default/files/basic-content-files/TransformationalLeadership.pdf 

Shapira-Lishchinsky, O. (2014). Simulations in nursing practice: toward authentic leadership. Journal Of Nursing Management, 22(1), 60-69. doi:10.1111/j.1365-2834.2012.01426.x  

Sherman, R.  (2008).  Becoming a transformational nursing leader.

Retrieved from: http://www.emergingrnleader.com/transformational-nurse-leader/ 

Taft, S. (2007) Emotional Intelligence in the Nursing Profession.

http://www.asrn.org/journal-nursing/202-emotional-intelligence-in-the-nursing-profession.html 

 

 

 

 

VIII. Star Competency

 

 

 

Dementia/Alzheimer’s patients residing in skilled nursing facilities are often housed in memory care or locked units for their own safety and to promote consistency in surroundings and routine. Often times these patients present with complex levels of care due to their cognitive impairments and comorbid health conditions. Health care workers are routinely consumed with assisting residents with basic ADL’s that there is little extra time to promote cognitive and physical stimulation. Creating safe outlets for cognitive and physical stimulation are important in enhancing the quality of life for this population of elderly residents in accordance with the 2020 Healthy People Goals. Utilizing the existing white retention wall approximately 50 ft x 4 ft located in the adjacent gated courtyard accessible by memory care residents,  a large art mural will be created to provide visual and cognitive stimulation. Additionally, concrete flower boxes will be secured on the top of the retention wall to provide a location for growing flowers and vegetables, and an outlet for physical, visual, and cognitive stimulation to residents. A flagpole will also be installed in the courtyard so that raising and lower of the flag daily will provide additionally stimulation. Other ideas to create an environment that is conducive to providing stimulation and enhancing quality of life would be: creating colorful spinners that can hang from the roof or sheppard’s hooks outside of the residents’ bedroom windows and in the general courtyard.  Local Artists/High Schools will be contacted and encourage to volunteer their time for the mural projects. A local mason will be recruited to design and secure the concrete planter boxes. And a local nursery will be recruited to donate plants for the flower boxes. The goal of this project also has a secondary aim at providing the staff members with role models to emulate in their daily interactions with patients. Evaluating this will be based on the frequency of activity incorporation of the aforementioned stimulating outlets, resident willingness to participate in activities, and community participation.

References:

Vance, D. E. (2012). Potential factors that may promote successful cognitive aging. Nursing: Research and Reviews, 2, 27+. Retrieved from http://db04.linccweb.org/login?url=http://go.galegroup.com.db04.linccweb.org/ps/i.do?id=GALE%7CA345989349&v=2.1&u=lincclin_cfcc&it=r&p=AONE&sw=w&asid=c7c6484ddd203a0e6ebc94a23b1bdb61

Yi-Xuan, N., Ji-Ping, T., Jin-Qun, G., Zeng-Qiang, Z., & Lu-Ning, W. (2010). Cognitive stimulation therapy in the treatment of neuropsychiatric symptoms in Alzheimer’s disease: a randomized controlled trial. Clinical Rehabilitation, 24(12), 1102-1111. doi:10.1177/0269215510376004

 

 

 

 

 

 

 

 

 

References:

American Association of Critical Care Nurses. Alarm Management Practice Alert. 2013. http://www.aacn.org/wd/practice/docs/practicealerts/alarm-management-practice-alert.pdf.

Blakeman, J., Sarsfield, K., & Booker, K.(2015). Nurses' practices and lead selection in monitoring for myocardial ischemia: An evidence-based quality improvement project. Dimensions of Critical Care Nursing. 34(4):189-195. Retrieved from doi: 10.1097/DCC.000000000000011

Building collaborative relationships in healthcare (n.d). Retrieved from http://amnis.uk.com/sites/amnis.uk.com/files/downloads/BS11000%20Guide%20for%20Healthcare_0.pdf

Clyne, Mary Ellen, "Connective Leadership: The Chief Nursing Officers' Relationship with Staff Nurses" (2011).Seton Hall University Dissertations and Theses (ETDs).Paper 1775.

Cooper, J. (2015, May). Nurses as leaders--creating nurses with drive and passion. Australian Nursing & Midwifery Journal, 22(10), 38. Retrieved from http://db04.linccweb.org/login?url=http://go.galegroup.com.db04.linccweb.org/ps/i.do?id=GALE%7CA414426968&v=2.1&u=lincclin_cfcc&it=r&p=AONE&sw=w&asid=88468878ca50fc1d7fe83d63318aa2d8

Daniel Goleman's Emotional Intelligence Theory(2009). Retrieved from http://www.sonoma.edu/users/s/swijtink/teaching/philosophy_101/paper1/goleman.htm )

Drew  B.J., Califf  R.M., Funk  M., et al. (2005). Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on

           Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young;110:2721-2746.Retrieved from http://circ.ahajournals.org/content/110/17/2721.full

Help End Alzheimer's. (2015). Retrieved from http://www.alz.org/

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Leadership & Management Reflection Paper

This course has taught me a great deal about myself and the world around me. Prior to taking this course, my knowledge was limited at best on organizational structures and how they operated I was always trying to deduce how my hospital was organized, why people were in the positions they were, and how reimbursements for services worked. However, now I am much more informed on why and how organizations are structured and have a greater sense of clarity over the daily hospital operations.

This class has allowed me to understand the nature of leadership and what it takes to be an exceptional leader and inspire exceptional followers. I believe that as nurses, we are all inherently leaders. Whether you are a transformative, servant, connective, or a knowledge driven leader, you are a leader. As nurses, we have always been taught the importance of introspection and learning to understand our strengths and weaknesses. I think this is of utmost importance when trying to be a leader that inspires others. Being true to yourself, being authentic about who you are to others, and embracing your weaknesses and strengths for their limitations is key on being that leader that inspires others. We are all flawed, but it is those that acknowledge their flaws and champion them that real people can relate to. I have felt inspired by this class to be a better leader in my own work environment by setting a good role model for my coworkers and helping to inspire them to be better as well.

I really enjoyed reading about the history of nursing leadership and management. I am always fascinating and illuminating by the development of the nursing field in general and am excited and hopeful for where it is going. It makes me feel fortunate to be a member of such an accomplished group of hardworking professionals.