...Organizational Change Plan -Part 1 Kristine Vyers HCS/587 August 20, 2013 Organizational Change Plan -Part 1 Abstract Rapidly changing patient care environments result in significant ramifications for nursing team members caring for patients. These recent changes have refocused the current workflow views back onto inter-disciplinary teams, and collaborative working environments, and lead to a reexamination of nursing roles in the Long-Term Acute Care (LTAC) arena. Using action research methodology allows for the identification of areas of change, clarification of core and specialty skills, which in turn assist in the redefinition of nursing roles and eventually the adaption of a new nursing model. The new nursing model requires ongoing, detailed, and process driven education to establish and clarify the change objectives and new nursing roles. Quantitative and qualitative data collected from numerous sources, in conjunction with unit-based round tables, individual patients, nurse managers, and administrative interviews allows for consideration of multiple stakeholders. When patients vocalize a positive experience with services provided, this information helps to shape the new roles and responsibilities for the nursing teams. Proposed Change After the second California Medicare Services survey in 2013 major nursing deficiencies were highlighted between K Hospital’s patient acuities and the current staffing mix. In response to these specific deficiencies...
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...Organizational Change Plan HCS/587 9/15/14 Organizational Change Plan In assessing the needs of the organization, the education department realized that the systems current methodology of validating nursing competencies was out dated and very inefficient and non cost effective. In March of 2012, the education department embarked upon collaboration with a well-known national speaker to come speak to our leaders and clinicians regarding nursing competencies. This was the initial step taken to start changing forever how we assessed and validated nursing competencies across the system. Unit Based Competency Business Case As we examined the dynamics in healthcare, we pursued the introduction of a new unit based competency model. This shifted the paradigm from yearly skills labs that were non productive to the UBC model as it was the right thing to do. The ability of the nurses at the point of service is constantly plagued by intricate innovations in the areas of equipment’s, staffing, requirements from regulatory bodies, on-line documentations, and the like. The current trend in healthcare is highly motivated by a well-educated clientele of the community, hence an escalating expectation from the nurses is inevitable, most specifically the competency. Competency assessment as required by external and internal standards is a must for every healthcare facility. The controversy...
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...Translational Research for Practice and Populations Linda Parson Western Governors University February 20, 2016 Translational Research for Practice and Populations A. Identify a current nursing practice within your healthcare setting that requires change. Patients having procedures considered invasive require interaction with a medical device and a patient's mucous membranes. One major hazard of these procedures is the induction of pathogenic microorganisms that could lead to infection. Malfunction of utilizing the correct processes in accurately reprocessing or sterilizing reusable medical devices bears a risk connected with break of the host barriers. Spaulding’s classification is utilized to determine the stage of reprocessing/disinfection a medical device should be exposed to (CDC, 2008). Also, Spaulding’s classification also determines the level of sterilization for a medical device. The classification is as follows (CDC, 2008) • Critical items (such as surgical instruments, which contact sterile tissue • Semicritical items (such as endoscopes, which contact mucous membranes), • Noncritical items (such as stethoscopes, which contact only intact skin) Based on the classification of the device determines whether the device requires sterilization, high-level disinfection, or low-level disinfection, correspondingly. Pre-cleaning must be the most important thing to perform prior to high-level disinfection and sterilization (FDA, 2009) ...
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...for continued patient confidentiality and charting accuracy. In addition, it is a necessary step in the direction of Electronic Patient Records. The goal of the implementation of the EPR is to enhance health care delivery from the nursing spectrum and allow for improved charting accuracy, decrease errors, and provide thorough documentation. Nurses are an essential part of today’s health care system. Pt care is the core of all health care organizations. Many institutions have moved focus to electronic charting. One of the most important aspects of this is patient focused charting. It is necessary for the organization to implement this change and move forward with a proposal for this change as we focus on the information technology vital today for our health care system. In addition, we recognize that there will be organizational and individual barriers that will occur. We will look at proposed factors and a proposed theory model that influence the change to EPR and show how it will benefit this institution positively. As we move forward and to this type of patient documentation, it is to focus on high quality patient care and enhance patient confidentiality. In addition, staff understanding and comprehension is proposed so that all staff understands that a move toward this type of patient documentation is necessary to the continued success of this...
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...Organizational Change Plan - Part I Deluxe Fernandez HCS 587- Creating Change Within Organizations January 26, 2015 Professor Thomas Sloan Organizational Change Plan - Part I Health care is subject to numerous changes at any given time along with the organizations and their employees. In today's climate, organizations have to be adaptive to changes as it is a requirement to survive, thrive, and succeed (Rafferty et al., 2013). One important aspect for success is to promote job satisfaction. "Job satisfaction is closely related to the performance and quality of work performed by an employee and, consequently, translates into the success of any organization" (Sypniewska, 2014, p. 57, para. 1). Having "lift teams" and equipments for lifting can improve nursing satisfaction. This paper will closely examine why there is a need to propose the "no lift policy". Barriers and influencing factors to change will also be discussed. The influencing factors for readiness will be explored. The theoretical model used for the proposed change will also be discussed. Finally, internal and external resources to support the change will be examined. The Need For The Proposed Change Bedside employees particularly nurses and nursing assistants have higher incidence of back injuries (Weinel, 2008). Such injuries are caused by manual lifting and repositioning patients. For example, in our organization's current ICU department, there are nine nurses on leave due to back or bodily injuries. Lack...
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...Organizational Change Plan Part III Acuity Adaptable Care Delivery Model and the Universal Room Model Brooke A. Dupre Creating Change Within Organization HCS/ 587 April 13, 2015 Instructor: Ginger Weatherspoon At Acadian Medical Center Campus of Mercy Regional Medical Center in Eunice Louisiana, our mission is "Quality Healthcare Close To Home. Organizations seek to change to reach their mission and strategic goals of quality health care. When current ways of working are not allowing us to reach our objectives, we must incorporate new ways that are likely to be more effective, the change should be considered through a process. The organizational change plan will explore Acuity Adaptable Care Delivery Model and the Universal Room Model. It will then describe the organizational change process of the acuity model, possible barriers to change, possible influencing factors, and lastly motivational theories to assist managers in working with and motivating staff during the change process, describe the methods that will be used to monitor implementation of your proposed change, examine the relationship between the organization’s related processes, systems, and personal or professional roles and their effect, identify communication techniques that will be used to address any implementation issues that may arise, the effectiveness once implemented, and outcome measurement with the Acuity Adaptable Care Delivery Model and the Universal Room Model. The acuity adaptable model is when...
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... Commissioning Based Health Care Environment. Specialism: BSc (Hons) Specialist Community Public Health Nursing Submission Date: 15/09/2014 Word Count: 3949 Leadership and Management in a Commissioning Based Health Care environment. In any organization good leadership is not just important but fundamental for the success of the organization. For the purpose of this assignment leadership and management will be explored within today’s rapidly changing health care. This shall be discussed in more depth and in relation to the commissioning of the new service as proposed in the report to the trust board for consideration. As highlighted by the Nursing and Midwifery Council (NMC) Standards of proficiency for specialist community public health nurses (MNC, 2008), nurses are expected to work in partnership with all team members and clients in delivering the best care. A clear understanding of the quality issues in clinical care will be discussed by analyzing the process of change and leadership styles and how this can influence the quality of care in line with the new policy and legislation. Furthermore strengths and weaknesses given to conflict...
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...Journal of Nursing Management, 2000, 8, 265±272 The development of a model to manage change: re¯ection on a critical incident in a focus group setting. An innovative approach M. CARNEY RGN, RM, RNT, FFNRCSI, MBA (HONS) Lecturer, School of Nursing and Midwifery, University College Dublin, Ireland Correspondence Marie Carney School of Nursing and Midwifery University College Dublin National University of Ireland Earlsfort Terrace Dublin 2 CARNEY M . (2000) Journal of Nursing Management 8, 265±272 The management of change: using a model to evaluate the change process. An innovative approach management of change. The Change Management Model may provide nurse managers or change agents with a structured and measurable model for managing and evaluating the change process. A measurement constructs tools to further assist the evaluation process is also described. Background The author argues that certain key variables can be identi®ed which contribute to the successful implementation of change. These variables include critical success factors for change, communication issues, change dynamics that include resistance or acceptance of change, and the variables related to the management of the implementation and evaluation stages of the change process. Key issues Change is a constant in the health care ®eld. Nurse managers must learn to accept change as a normal process and to develop coping and managing strategies for the successful management of change. This acceptance...
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...Change is an unavoidable part of working and living. People can react to change, the stress change causes could be huge, and change could provoke some resistance from the followers to the proposed change by the leadership. If it is presented well, it is possible for it to be an opportunity for the development of a professional rather than additional problem with which nursing staff and their patients have to deal with. Some changes could be unexpected; many are stimulating, leading us to new challenges and opportunities. Anytime changes occur too quickly, it can make us very uncomfortable. Most of the time change is difficult and the leader and the follower will stress because there would be resistance from the followers. The team would question why they would have to leave their comfort zone to experience what they do not know what the outcome would be. The leader must be ready to present to the followers all the objectives for the change and the reason must be genuine. A committee may be formed to research on the way the change will be executed. The outcome of the committee findings will be presented to others, so in a way the idea is not going to sound as if it is it from the leader only or that the leader is imposing on the followers. Two models of change will be discussed in this paper: they are Lewin’s model of change and IOWA model. Lewin’s model of change explained the stages of change process using the changing of ice block. His model was described using these terms...
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...due to anesthesia that is still in the system and pain medication that is scheduled to help ease the patient during the post-surgical time frame. One of the side effects of anesthesia exiting the body is nausea and vomiting which can make the patient feel dizzy and lightheaded, thus making them a great risk for falls. This has been the reason that the topic was chosen; to attempt to improve this issue in the hospital setting and to provide a system in which all hospital staff collaborate to help increase the quality of patient care. The location that is being observed is the post-surgical/orthopedic floor where the author is currently working. A description of risks and concerns are provided and patient outcomes depend on implementing the proposed interventions. The two solutions that are presented are hourly rounding and the importance of an improved nurse call light button and education on proper usage. Each intervention is supported by evidence-based practice peer-reviewed journal articles. The proposal will show the improvements of patient safety and increased patient compliance to hospital staff, physicians, and administration. A power point presentation that will be presented on Appendix B will also be used to highlight key points of the proposal. Another tool that will be used is...
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...Identify a current nursing practice within your healthcare setting that requires change. DEVELOPING OR CREATING AN INDEX TO MINIMIZE RISKS OFPRESSURE SORE 1. Describe the current nursing practice. An instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities, Veterans...
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...A. Root Cause Analysis A root cause analysis (RCA) is a “systematic approach to understanding the causes of an adverse event and identifying system flaws that can be corrected to prevent the error from happening again” (Huber & Ogrinc, 2010). The root cause analysis is used to determine why the problem occurred in the first place and to identify the cause of a problem using a specific set of steps (Mind Tools, n.d.). The RCA team which consists of interprofessionals who are knowledgeable of the issues and processes related to the incident and the people who are involved in the incident should be formed first before the RCA meeting takes place (Huber & Ogrinc, 2010). In the given scenario, the team includes the emergency department (ED) physician (Dr.T), the RN (Nurse J), the LPN (Mr.B’s LPN), the risk manager, the ER nurse manager, the ER nurse educator, and the quality improvement professional. These members would meet and would discuss the causative factors, errors and hazards that caused Mr.B’s sentinel event. The root cause analysis process has five steps. The first step in conducting a RCA is defining the problem (Mind Tools, n.d.). In the given scenario, the problem is the unexpected death of Mr.B. The second step is collecting the data (Mind Tools, n.d.). It is very important to record and report the data as accurately and as completely as possible. Mr. B’s vital signs, pain scores, laboratory values, and history of medication administered during the situation must...
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...medications. He quit smoking in 1979. He is independent and still working full time as a machine operator. In addition he is a main carer for his partner who has terminal illness. During the assessment Mr John seems well. Apart from the health conditions which are managed well by medication, his obesity was the priority for his health. It was with this knowledge of Mr John and his identified needs that the author used to draw up a meaningful plan of care. Planning is the second phase of the nursing process (Johns 2000). In this phase, the nurse develops a plan to assist the patient to meet needs identified in the assessment process (White 2003). According to Aggleton and Chalmers (2000) planning of care is necessary to identify the problems or needs, setting the goals and planning the care that will meet those goals. Planning also involves making plans to carry out the necessary interventions to achieve those goals. A nursing goal can be defined as a statement of what the nursing intervention is intended to achieve (Ulrich and Canale 2005). Goals should be specific, measurable, achievable, realistic and time scaled (Brooker and Nicol...
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...Nursing Research Utilization Project Proposal Sally Martin Torres NUR 598 September 11, 2011 Dr. Veta Massey Nursing Research Utilization Project Proposal Section D: Methods of Implementation Health care throughout the history has shown many changes. Every change brings in challenges in a workplace because change is more often met with resistance. It also brings in innovative ideas that steers the organization’s advancement and performance. The major motivation of change in this organization is to sustain a successful future in its continuum. For change to succeed, brilliant strategy, and clever implementation are necessary (Gandossy and Sonnenfield, 2004). Organizing the Plan The problem that was stated in Part A of this proposal was medication error and the organization is aiming at reducing the incidents of administration errors that involve medications. Although there are three proposed solutions, the one that gained the highest priority is the use red disposable apron during the medication rounds. This type of innovation is cost-effective, requiring short staff in-service by the nurse clinical educator, it is maintenance free, and does not require space for storage. This intervention will also allow a less difficult data collection for measuring outcomes. Every institution requires the approval of the Chief Nurse Officer (CNO) to pilot an intervention. The intervention will be introduced in a small 30-bed medical-surgical unit which will last for four months...
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...issues that affect nurses directly. Nurse Leaders and Political Organizations Regulation of nursing licensure in the United States has traditionally been a state-based function in which each state regulates the health care workforce within its geographic boundaries (National Council of State Boards of Nursing, 2015). Nurses practicing within a state or territory are required to be licensed by the jurisdiction in which they practice. However, with so many advances in technology, practice is no longer limited by these boundaries. The use of telephone triage and air transport nursing are just a few examples of how nursing practice is crossing state lines, either physically or via technologies (American Nurses Association, 2015). According to the American Nurses Association (2015), “In 1997, the National Council for State Board for Nursing (NCSBN), a private association of state regulatory agencies, proposed a mutual recognition model of nursing licensure, referred to as the Nurse Licensure Compact (NLC)”(para. 3). Political Actions and Awareness The model is an agreement between two or more states to coordinate activities associated with nurse licensure. Although nurses generally do not need education in the legal implications of interstate compact administration, it is important that all nurses understand the implications a regulatory change, such as a mutual recognition model of nursing licensure, may have on consumers, nurses and the profession. Some state...
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