Leadership - Case Study Analysis

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the student
Name of the university
Author’s name

CASE STUDY ANALYSIS
Introduction
Leadership is central to the nursing profession and considered to be a fundamental aspect
of an effective and enhanced nursing care (Sfantou et al. 2017). Nursing care involves the
development and implementation of evidence based interventions addressing the health concerns
of the patients and improve their health outcome. Every nurses working in the clinical settings
must possess the key competencies and the required skill set to facilitate the delivery of an
enhanced nursing care (Sfantou et al. 2017). Every registered nurse must practice by adhering to
the registered guidelines and code of conduct for the nurses in order to accomplish an effective
outcome. In every clinical setting, nurses are registered as clinical leaders through the integration
of clinical expertise in their practice, exhibiting the roles of and responsibilities of a clinical
leader and practicing by adhering to evidence based guidelines (Crisp 2016). The existence of a
strong nurse leader has a positive impact on the patient’s outcome. This is because nursing units
with a RN having strong leadership skills have shown less medication errors and eventually a
low patient’s mortality rate (Bushe and Marshak 2017).
Clinical Scenario 1
Q1- The role of nurse leaders are multifaceted and challenging and requires a lot of skills in
order to get an effective outcome (Joseph and Huber 2015). A nurse leader has the responsibility
of decision making and directing other nursing staffs towards achieving the same goal. They also
have the responsibility of advocating nurses and patients (Joseph and Huber 2015). A nurse
leader must possess the skills set and the core competencies in order to enable an effective
nursing care. Nurse leaders must practice by following the standards or competencies for nursing

CASE STUDY ANALYSIS
leadership for professional practice that will direct them in achieving an improved health
outcome of the patient (Joseph and Huber 2015). Nurse leaders influence the nursing staffs for
being honest, practice forward thinking, be sufficient competent, inspiring, hold a commitment
towards achieving excellence and have a clear vision in improving the quality of care (Khoshhal
and Guraya 2016). Thus, leadership qualities and skills of the nursing leaders have strong impact
on the quality of care of the patient and their safety. Leadership skills that are needed for
achieving these goals include effective communication, shared decision making, healthy work
environment, coaching and mentoring and delegation and collaboration (Khoshhal and Guraya
2016). Effective leaders believes in shared decision making practices and facilitates active
participation of all the stakeholders and continuously support, mentor and coach the staff
members. Furthermore, they also motivate and influence other staff members in making effective
decision based on evidence based practice to ensure an effective outcome. Besides adhering to
clinical guidelines, they must also ensure to practice adhering legal and ethical guidelines in
order to promote safe and quality care of the patients (Brunt, B.A. and Bogdan 2019).
In the first case study, the nurse leader must guide and monitor all the staff members in
the treatment process of the patients. Also, the nurse leader must effectively manage these
patients by taking effective decisions that will improve the quality of care and enhance an
improved health outcome of the patients. Aarya must develop the care plan for all these patients
addressing their health concern according to the priority area and direct other enrolled nurses to
implement the same and ensure an effective outcome. Aarya as a leader should also monitor,
advocate and supervise other staff members in order to facilitate the delivery of an enhanced
nursing care.

CASE STUDY ANALYSIS
Q2- Nurses should make clinical decisions following a collaborative approach and thus, the
nurse in the case study must consult the nurse leader and utilize the knowledge and skills to
ensure an effective outcome (Melin‐Johansson, Palmqvist and Rönnberg 2017). The purpose of
the decision making framework is to guide and direct decision making in relation to the scope of
practice and delegation.
Thus, the nurse in the case study must promote decision making that is safe, consistent,
person centred and evidence based. Nurse Leaders must practice adhering to the NMBA
Decision-making framework for nurses and Midwives. According to the NMBA Decision
making Framework, a nurse leader must first identify the benefits and need of the decision
making, reflection on their scope of practice and the standards of nursing practice, governance
and risk identification. A nurse leader must select appropriate and competent person for
performing delegated activities (Nursingmidwiferyboard.gov.au, 2020).
The nurse leader, Aarya, a graduate nurse who is leading one Enrolled Nurse and six
carers, is responsible of taking care of fifty residents. She has many responsibilities and a lot of
patient to care of which can be managed though effective leadership skills.
Q3- Nurses are pioneering professionals and are able to lead teams in treatment and support.
Nurse practitioners participate in reflective practice and through clinical guidance or mentoring
assist others in this process (Salmond and Echevarria 2017). Nurse leaders are able to manage
episodes of treatment, including focused care for the safety and wellbeing. The primary care
provider as members of a care team may be nurse practitioners. They engage and collaborate
with health care patients, their families and communities, other practitioners, and health workers,
to prepare, deliver and assess coordinated treatment that optimizes success for clients and health

CASE STUDY ANALYSIS
care systems (Salmond and Echevarria 2017). To promote productive work, nurse practitioners
working at the level of specialist clinical practice should be able to form collaborative
relationships and enable coordination of roles across teams (Altman et al. 2016). They should
practice evaluating their own involvement and involvement in the multidisciplinary process and
team evaluation, demonstrating effects on the service's operation, effectiveness and quality (i.e.
performance of treatment, expertise and safety). Involve peer review and critically educate one's
and others ' activities in formulating and applying performance development approaches (Altman
et al. 2016). Supervisors who work as advanced clinicians promote a corporate culture of
learning which promotes existing and future staff. Allowing for the identification of wider
organizational collaboration and peer review frameworks for individual and team learning.
Identify and support the individual and wider team's additional development needs. Help the
wider capacity-building team through research and interprofessional coaching, and realistic use
of instruction. Act as a reference for others, executives, supervisors, coaches and counselors to
develop and strengthen the confidence of other colleagues or employees (Folkman, Tveit and
Sverdrup 2019). Clinical leadership challenges is how to structure the skills, knowledge and
abilities needed to enable nurses to take on roles that are still needed for which formal work may
not yet exist. One example is the extension and enhancement of the role of registered nurses
(RNs) from traditional care delivery to integrated care where they work with authority, autonomy
and accountability in coordinating and managing care across settings and disciplines (Folkman,
Tveit and Sverdrup 2019).
Clinical Scenario 2

CASE STUDY ANALYSIS
Q1- In this case study, the nurse the second-year post graduate registered nurse must be guided
and supervised by the nurse leader in all possible way. Jade has to take care of a variety of
patients with diverse healthcare needs, thus, she must be assisted and supported by the nurse
leader in developing care plan targeting the diverse health concerns of the 8 different patients.
For example, for the patient in bed 1, Kay White who has undergone appendicectomy 2 days
before, must be kept at rest at Semi-Fowler’s position in order to reduce the pain. Gravity
localizes inflammatory exudate to the lower abdomen or pelvis and relieves abdominal
discomfort, which is accentuated by supine posture. Thus, the nurse leader must guide and assist
her in this. For Mark Black who has undergone total knee replacement and buzzes needing to
open bowels, must be assisted and supported well. He must be given medicine for relieving his
pain. Also, he must be given physiotherapy to improve his condition and regain strength and
mobility. He must be recommended to do muscle strengthening exercises. Constipation is a
major post-operative complication associated with knee replacement surgery. Thus, he should be
given with fiber rich diets. Thus, for these patients the nurse Jade must learn leadership skills and
must be guided by the nurse leader to facilitate the delivery of an effective nursing care.
Q2- Decision making in nursing requires surpassing skills and the ability to evaluate complex
situations and factors taking into account the benefits and need of the decision making, scope of
practice and the standards of nursing practice, governance and risk identification. NMBA states
that decision making is based on competence and the delivery of safe and quality care (Nibbelink
and Brewer 2018). Thus, the nurse in the clinical scenario must practice by adhering to and
following the guidelines provide by the NMBA decision making framework for nursing and
midwifery on their scope of practice, supervision and delegation for nurse practitioners, enrolled
nurses, registered nurse and midwives (Nibbelink and Brewer 2018). Thus, NMBA decision

CASE STUDY ANALYSIS
making framework for nursing and midwifery (the DMF) is an evidence based and contemporary
document used in combination with the standards of policies, regulation, policies and legislation
in relation to the nurses and midwifery (Nursingmidwiferyboard.gov.au 2020). This framework
is used to direct and guide decision making in the scope of practice and professional conduct
among nurses. Thus, the NMBA decision making framework guide nursing practice decisions,
midwifery practice decisions and delegations decisions (Nursingmidwiferyboard.gov.au 2020).
As per the NMBA standards, the primary responsibility of the nurses is to make a decision of the
care approaches to meet the unique healthcare needs of a diverse patients and improve their
health outcomes (Nursingmidwiferyboard.gov.au 2020). Thus, they should make decisions in
partnerships with the patient supporting shared decision making. The decision must be taken
based on comprehensive assessments of the person, their health needs. However, any Registered
Nurse (RN) prior to taking any clinical decision must consult the nurse leader or supervisor
before implanting it. Thus, the RN, Jade must consult the nurse leader prior to taking any
decision.
Q3- The mechanism to control care point advancement and to develop both organizational
processes and care procedures, is characterized as clinical leadership to ensure consistency and
reliability of care results. Clinical leadership is very valued (Mianda and Voce 2017). Clinical
leadership uses the RN skills and adds components of leadership, care management skills and
focused skills to use evidence-driven practices to troubleshoot and manage results (Mianda and
Voce 2017). Clinical leadership in nursing is clearly needed because of the many and varied
implementation issues. In case of loss of team contact, for example, patient health can be
threatened. In case of overloaded or short-term nurses, manual coordination may be disrupted
and care gaps can be established (Nieuwboer et al. 2019). The transfers to discharge cannot be

CASE STUDY ANALYSIS
seamless because all areas of transmission and reception do not interact well. Drug management
can be less than seamless if the pharmacy and transcribing procedures in various organizations
that care about an individual are not coordinated. This is valid across the spectrum of critical
treatment. To resolve ongoing care deficiencies, vigorous actions are necessary, based on best
practices, teamwork, coordination of care and clinical leading skills (Nieuwboer et al. 2019).
According to the NMBA standards, the nurse leader, in this case study, must think
critically, provide safe and high quality nursing care by following an effective care plan and
adhering to the professional code of conduct while treating all the patients and must direct and
advocate all other nursing staff regarding the treatment approach to be followed addressing the
health concerns of the patients and identifying the priority area (Nursingmidwiferyboard.gov.au
2020). In this case study, the nurse the second-year post graduate registered nurse must be
guided and supervised by the nurse leader in all possible way. Jade has to take care of a variety
of patients with diverse healthcare needs, thus, she must be assisted and supported by the nurse
leader in developing care plan targeting the diverse health concerns of the 8 different patients.
Conclusion
Clinical reasoning, critical thinking and decision making shapes an effective nursing care.
Both Clinical reasoning and critical thinking are essential nursing skills and thus according to the
NMBA standards of Nursing Practice (Standard 1), a RN should critically think and analyze the
situation. A RN must access, analyze and use the best evidence available grounded on strong and
conclusive research findings (Nursingmidwiferyboard.gov.au 2020). Thus, in this case the nurse
by practice following the registered standards of practice in order to get an effective outcome. A
RN in their career program, take on leadership roles within the health care organization as they

CASE STUDY ANALYSIS
improve their skills and expertise that are intrinsic to a high quality nursing care. RN as leaders
have the ability to influence others with the help of effective communication and intuitions.

CASE STUDY ANALYSIS
References
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Medicine, 2016. Collaborating and leading in care delivery and redesign. In Assessing Progress
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Brunt, B.A. and Bogdan, B.A., 2019. Nursing Professional Development (NPD) Leadership.
Bushe, G.R. and Marshak, R.J., 2017. Transforming Leadership.
Crisp, C., 2016. Nursing Leadership. Tennessee nurse, 79(1), pp.10-10.
Folkman, A.K., Tveit, B. and Sverdrup, S., 2019. Leadership in interprofessional collaboration in
health care. Journal of multidisciplinary healthcare, 12, p.97.
Joseph, M.L. and Huber, D.L., 2015. Clinical leadership development and education for nurses:
prospects and opportunities. Journal of healthcare leadership, 7, p.55.
Khoshhal, K.I. and Guraya, S.Y., 2016. Leaders produce leaders and managers produce
followers: a systematic review of the desired competencies and standard settings for physicians’
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Melin‐Johansson, C., Palmqvist, R. and Rönnberg, L., 2017. Clinical intuition in the nursing
process and decision‐making—A mixed‐studies review. Journal of clinical nursing, 26(23-24),
pp.3936-3949.
Mianda, S. and Voce, A.S., 2017. Conceptualizations of clinical leadership: a review of the
literature. Journal of healthcare leadership, 9, p.79.

CASE STUDY ANALYSIS
Nibbelink, C.W. and Brewer, B.B., 2018. Decision‐making in nursing practice: An integrative
literature review. Journal of clinical nursing, 27(5-6), pp.917-928.
Nieuwboer, M.S., van der Sande, R., van der Marck, M.A., Olde Rikkert, M.G. and Perry, M.,
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standards/registered-nurse-standards-for-practice.aspx [Accessed 1 Mar. 2020].
Nursingmidwiferyboard.gov.au 2020. Nursing and Midwifery Board of Australia - Frameworks.
Nursingmidwiferyboard.gov.au. Available at: https://www.nursingmidwiferyboard.gov.au/codes-
guidelines-statements/frameworks.aspx [Accessed 2 Mar. 2020].
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nursing. Orthopedic nursing, 36(1), p.12.
Sfantou, D.F., Laliotis, A., Patelarou, A.E., Sifaki-Pistolla, D., Matalliotakis, M. and Patelarou,
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