The General Surgery Unit (GSU) at Eastern Massachusetts University Hospital (EMU) is currently plagued with multiple issues affecting the staff. The nurse manager has realized that these issues are primarily faced by the 25 registered nurses (RNs) in the department.
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Running head: LB52341 LB5234: Status Report Student’s Name Institution
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LB52342 LB5234: Status Report Overall Status of GSU The General Surgery Unit (GSU) at Eastern Massachusetts University Hospital (EMU) is currently plagued with multiple issues affecting the staff. The nurse manager has realized that these issues are primarily faced by the 25 registered nurses (RNs) in the department. For one, there is a staffing shortage given that two RNs have left the practice in the previous one month. The current RNs have expressed extreme levels of dissatisfaction particularly in relation to their working environment. For instance, workplace incivility is prevalent within the unit as a culture of confrontation, blaming and favoritism has prevailed in GSU. The hiring freeze implemented by EMU’s administration has also hampered nurses from getting paid for the overtime hours that they have worked. The nursing manager has consequently been inclined to rely on patient care assistants and RNs from general float pool. However, this staff have compromised the quality of care offered at the and also raise concerns regarding patient safety since they are not familiar with GSU’s procedures and care protocols. Key Indicators The following key indicators are identified contributing to the hostile working environment at GSU; Staff conflict incidences are on the rise. Lack of a transparent review system that supports staff growth and development. Lack of teamwork and collaboration Limited staff recognition. Staff resistance to change.
LB52343 Limited number of nursing staff in GSU compared to patient population. Assignments are allocated based on favoritism. Poor performance appraisal system. Minimal involvement of RNs in the department’s decision making. GSU Goals for Items to be Addressed Fostering a Culture of Collaboration and Teamwork The nursing manager has an important role in creating a cohesive team that maintains collaboration and teamwork. The nursing leader should in this case ensure that the team is working together in a bid to produce the best results for EMU while providing the best nursing care for every patient (Tomajan, 2012). At GSU, therefore, the nurse manager will aim at fostering a culture of collaboration and teamwork. To do so, the manager will rely on the unit meetings to help build a community and a healthier culture at the unit. Unit meetings in building community and a healthier culture in GSU will ideally entail constructing meaningful relationships between the leader and the nursing staff at the unit. The nurse manager will in this case schedule short weekly meetings running for 45 minutes. In these meetings, RNs will be encouraged to share their triumphs and challenges that they have faced throughout the week. The items of discussion will not be limited since the team members will be allowed to share any story or experience. The idea behind encouraging employees to talk in these weekly meetings is so that they can normalize their communication and in turn get more comfortable with each other in their conversations (Dyess, Sherman, Pratt & Hanisko, 2016). Nurses will thus be likely to communicate with their colleagues and further find it easier to ask their fellows for anything when they are in need.
LB52344 The nursing manager will also take an extra initiative to get to know the RNs personally. The nurse manager will take more time in getting to know each team member. This interaction will ideally take a few minutes on a random basis for example over a cup of coffee or a quick lunch break. Matters of discussions will entail the staff’s area of interest and what they do when they are not working. It will also be crucial to get to understand the nurses’ families. This initiative will ideally build trust between the nursing leader and the team members (Neptune & Hader, 2013) Acknowledging Nurses’ Performance and Rewarding Performers Instituting a fair and transparent review process will be essential. The unit manager intends to implement a collaborative peer review system where RNs will be allowed to review each other based on their performances (Salmond & Echevarria, 2017). The nurse manager will also make it a personal mission to appreciate the performance of every nurse. A simple ‘thank you’ or ‘well done’ from time to time would suffice. In other cases, the nurse manager would take time to write thank you notes and hand them out to nurses who have performed exemplarily (Rosanne, 2014). For the biggest occasions, the nursing manager intends to organize celebratory invents at the unit level where nurses will be appreciated for their achievements in any area within the unit. The nurse manager will take RNs appreciation to another level by liaising with the marketing department to develop advertising strategies that aim to appreciate GSU staff for the work that they have done. In so doing, catchy and inspiring statements will be used throughout this strategy. In particular, to appreciate the performance efforts made by every nurse in the unit, the nursing manager will work with the marketing team of the hospital to develop beautiful
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LB52345 commemorations that will be attached on different locations of the unit. Ideally, the plaques will be attached on the walls of the department (Neptune & Hader, 2013). These plaques will contain pictures of the highest performing RNs with their achievements and inspiring nursing phrases that highlight the commitment of the nursing staff in their profession. The nurses with special skills, techniques and knowledge for example in nursing technologies will also be appreciated by having their plaques on the walls as well. It is worthy to note that the plaques would be changed from time to time depending on the level of performances. Focusing on Patient Centered Care Since many RNs have expressed their concerns noting that the unit had neglected patient centered care and instead was being run from an administration perspective, the nurse manager has made it a priority to focus on patient centered care. This will notably involve maintaining the highest possible patient safety and quality standards within the unit. The first strategy under this objective will be to administer a patient safety survey to assess the culture of GSU in relation to maintaining patient safety and quality care (Dyess et al., 2016). In this survey, RNs and PCAs will be asked to identify their patient safety concerns within GSU. Following the findings from the survey, a report will then be generated to guide the approach that will help improve of quality of care and patient safety. The nursing manager will embark on research to identify the best evidence-based practice that can be implemented within the GSU to improve the quality of care. In consideration of the already conducted preliminary research, the comprehensive Unit-Based Patient Safety Program (CUSP) has already been identified as a workable framework that can be implemented within the unit. This framework developed by John Hopkins Hospital has previously been used in several
LB52346 hospitals and has proved to be effective. Implementers of the model such as Hospital Hope succeeded in enhancing patient safety since the staff learnt from their mistakes and integrated safety practices in their daily work flow (Sammer & James, 2011). Some of the guidelines expected to be incorporated under CUSP include; good hand hygiene, usage of chlorhexidine for disinfection during skin preparation and full barrier precautions (Sammer & James, 2011). To enhance patient safety and channel focus on patient centered care, the GSU team will develop a quality and safety notice board that would be placed centrally within the unit’s environs so that every staff and patient can be able to view. These set of guidelines will detail the national and state’s standards. Also, unique and specific contributions made by RNs concerning the issues at EMU’s GSU will be denoted on the board (Fix et al., 2018). It is worthwhile to note that these contributions will be based on the findings from the report previously generated by the RNs regarding patient safety and quality care. At the bottom center of the bulletin, the phrase of the Nightingale pledge will be denoted. This statement will act as a reminder to all nurses that they should devote themselves to the care or wellbeing of the patients to whom they are in service. Positive patient-nurse relationships will also be encouraged by the nurse manager. The nurse manager to ensure that all RNs maintain high levels of empathy by identifying with the patients or understanding the perspectives of the patients. Even so, nurses will be reminded of their ethical responsibility to the patient and the patients’ families (Luxford, Safran & Delbanco, 2011). Likewise, RNs at the GSU will be expected to include the patient’s input in their care plans in a process that ensures the participation of patients in the healing process. Eliminating Favoritism
LB52347 The culture of blaming and favoritism will be eliminated and replaced by a culture of reliance on evidence-based practices in the GSU working environment. Nurses will be expected to collaborate in the establishment of standardized care in their working environment. The nurse manager will take the initiative to invite and arrange for in-service tutorials from outside experts and educators. From this program, it is expected that nurses would learn on how to relate better with each other. In these educational sessions, inter-professional collaboration will be emphasized upon in a bid to enable nurses learn how to rely on each other while on duty and attending to patients in GSU (Moss, Seifert & O’Sullivan, 2016). The benefits of collaboration, teamwork and positive relation will likewise be explained. The nurse manager will towards developing a system background assessment recommendation (SBAR) communication as a standard reporting practice. In this approach, handoffs between team members and on shift-shift basis will be made clear to every staff in GSU. This will ideally promote mutual respect among every personnel in the working environment. In turn, a structured and swift information exchange avenues will be made possible at the unit (Weston, 2010). Enhancing Nurses’ Contribution in Decision Making The best way to increase nurses’ participation in the decision making of the unit is by supporting and empowering the decision making process. The nursing manager will in this case gather and disseminate quality information on the factors that drive performance improvement. This data will be shared with every staff in GSU. The RNs will be informed that they are allowed to hold each other accountable in the event that they realize an improved outcome and this should be done through open communication (Salmond & Echevarria, 2017).
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LB52348 The nursing manager will also encourage the experienced nurses as well as other nursing leaders and physicians to accept the contributions made by the new nurses at the unit. In such cases, it will made a unit policy that showing mutual respect for any queries or comments made by all team members be observed provided that the comments do not jeopardize or contradict there area of practice. Furthermore, the GSU nursing manager will always make sure that she supports such queries or comments (Kemppainen, Tossavainen, & Turunen, 2013). Activities such as generating reports concerning workplace issues such as patient safety will also be left solely at the hands of RNs. Furthermore, in the development of a safety and quality bulletin board, the nurse manager will ensure that all of the 25 RNs make a contribution on what they deem to be a safety guideline that should be implemented by the unit.
LB52349 References Dyess, S. M., Sherman, R. O., Pratt, B. A., & Hanisko, L. C. (2016). Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice Environment.The Online Journal of Issues in Nursing, 21(1). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol-21-2016/No1-Jan-2016/Articles-Previous-Topics/Growing- Nurse-Leaders.html Fix, G. M., Lukas, C. V., Bolton, R. E., Hill, J. N., Mueller, N., Lavela, S., & Bokhour, B. G. (2018). Patient-Centered Care is a Way of Doing Things: How Healthcare Employees Conceptualize Patient-Centered Care.Health Expectations, 21(1), 300-307. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750758/ Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses’ Role in Health Promotion Practice: An Integrative Review.Health Promotion International, 28(4), 490-501. Retrieved from https://academic.oup.com/heapro/article/28/4/490/556908 Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting Patient-Centered Care: A Qualitative Study of Facilitators and Barriers in Healthcare Organizations with a Reputation for Improving the Patient Experience.International Journal for Quality in Healthcare, 23(5), 510-515. Retrieved from https://academic.oup.com/intqhc/article/23/5/510/1864420
LB523410 Moss, E., Seifert, P. C., & O’Sullivan, A. (2016). Registered Nurses Inter-professional Collaborative Partners: Creating Value-Based Outcomes.The Online Journal of Issues in Nursing, 21(3). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol-21-2016/No3-Sept-2016/Registered-Nurses-as- Interprofessional-Collaborative-Partners.html Neptune, N. J., & Hader, R. (2013). The Power of Appreciation.Nursing Management, 44(3), 6. Retrieved from https://journals.lww.com/nursingmanagement/fulltext/2013/03000/The_power_of_apprec iation.1.aspx Rosanne, R. (2014). The Importance of Being Appreciated.Nursing Management, 45(5), 6. Retrieved from https://journals.lww.com/nursingmanagement/fulltext/2014/05000/The_importance_of_b eing_appreciated.1.aspx Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing.Orthopedic Nursing, 36(1), 12-25. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266427/ Sammer, C. E., & James, B. R. (2011). Patient Safety: The Nursing Unit Leader’s Role.The Online Journal of Issues in Nursing, 16(3). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol-16-2011/No3-Sept-2011/Patient-Safety-Culture-and-Nursing- Unit-Leader.html
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LB523411 Tomajan, K. (2012). Advocating for Nurses and Nursing.The Online Journal of Issues in Nursing, 17(1). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocating-for-Nurses.html Weston, M. J. (2010). Strategies for Enhancing Autonomy and Control Over Nursing Practice. The Online Journal of Issues in Nursing, 15(1). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/ OJIN/TableofContents/Vol152010/No1Jan2010/Enhancing-Autonomy-and-Control-and- Practice.aspx