BSc Leadership and Innovation Module: Nursing Assignment Report 2018

This report examines leadership and innovation within a nursing context, specifically focusing on change management strategies for healthcare settings. The assignment explores two key leadership theories: behavioral and situational leadership, analyzing their strengths, weaknesses, and practical applications. It further investigates the importance of innovation in healthcare, utilizing a SWOT analysis to assess the working environment during change implementation. The report proposes the implementation of Barcode Medication Administration (BCMA) in a renal unit, discussing change management models and linking theoretical frameworks to practical scenarios. The situational or contingency theory of leadership is chosen to implement the change. The report also details the benefits of BCMA, such as reducing medication errors and improving patient data security. The report is a contribution by a student on Desklib, a platform providing AI-powered study tools.

Running head: NURSING ASSIGNMENT
BSc Leadership and Innovation Module 2018
Name of the Student
Name of the University
Author note

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Table of Contents
Introduction..........................................................................................................................2
Discussion............................................................................................................................3
Leadership........................................................................................................................3
Behavioral leadership theory...........................................................................................3
Strengths and limitation...............................................................................................4
The situational or contingency theory.............................................................................5
Strengths and weaknesses............................................................................................5
Innovation in healthcare..................................................................................................7
Strength........................................................................................................................7
Weakness.....................................................................................................................8
Opportunities...............................................................................................................8
Threats.........................................................................................................................8
Change and change management theory.........................................................................9
Rodgers model.............................................................................................................9
Kurt Lewin model......................................................................................................10
Discussion..................................................................................................................12
Conclusion.........................................................................................................................12
References..........................................................................................................................14

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Introduction
Regulatory systems, increased market competition and fixed targets are unable to bring
the necessary fundamental changes required to face the challenges of the healthcare system.
Therefore, there are changes in each aspect such as cultural, operational and service should be
brought about so that improvement in the continuous delivery, quality and patient concerned care
(Burke, 2017). Hence, leadership is an important aspect that helps to drive the organization and
associated professionals to bring the necessary changes within the organization and maintain
stability and sustainability while the change management is implemented (Fullan, 2014).
Leadership is always associated to innovation as while setting direction for the growth of
organization, they implement several innovative ideas that inspire associated professionals to
achieve the prime goal. Innovation bears supreme importance, as in the phase of globalization,
where each industry including healthcare sector is shattering boundaries, innovative skills, ides
and processes has become prime driver of value, growth and performance of the employees
(Burke, 2017). This process of improvement and development is known as change management
and the strategies of change management is implemented to effective, controlled and easily
adaptive change.
Medication error is one of the biggest shortcoming of the modern medication system as
increased patients, variety of diseases and preventive measures lead the healthcare professionals
to commit mistakes unintendedly (Bonkowski et al., 2013). Therefore, this assignment is
proposing usage of Barcode Medication Administration (BCMA) in one of the busiest unit of
hospital, the renal unit. In this assignment, the two leadership theory needed for implementation

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of change in healthcare facility will be discussed with their strength and weakness. Further, the
importance of innovation in health sector will be described with SWOT model. Finally, the
change management will be discussed and two change theories will be included in the
assignment and evidences will be used to link theory with the practical practice.
Discussion
Leadership
For a successful change management process, there are six steps that need to be followed
so that compliance to the new process can be achieved. These steps are managing support for
introducing change to the employees as well as customers, deciding the primary target for
change and seek employee assistance for implementation and finally taking follow-ups after
implementation of the change in the process (García-Morales, Jiménez-Barrionuevo &
Gutiérrez-Gutiérrez, 2012). Hence, leaders are also at pressure while conducting change
management as while going through change process, employees seek assistance, accountability,
clarity and connection from their leaders. Therefore, it is important for the healthcare
organization leaders to implement leadership theories so that the change management process
becomes easier and convenient for the healthcare professionals (Carter et al., 2013). There are
two leadership theories that the leaders should implement while implementing change in the
process, such as the behavioral theory and the situational or contingency theory.
Behavioral leadership theory
Human behavior is an important aspect that is reflected while the person goes through
pressure or implements any change in his/her personal or professional life. This change in
behavior is influenced by persuasions, hypnosis, culture, attitude and coercion (Dinh et al.,

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2014). The person who is able to control all these aspects of behavior while going through
pressure has the traits of leadership. Behavioral theory of leadership is defined as the process,
in which the observable actions and respective reactions of the leaders as well as their followers
or employees are assessed for a specific situation. This theory believes that every person can
learn skills and attitudes that can make them leaders and it is the learning capacity of the leaders
that decides their efficiency while introducing change in the organization (Parris & Peachy,
2013).
Strengths and limitation
The strength of this leadership theory is associated to its value that enhances the people
collaboration and has an emphasis on relation between leaders and its followers, which is an
important aspect while going through change management process. Further, as the leaders are
open for learning and gaining knowledge from everywhere, they let employees to participate in
the decision-making processes and put forward their views regarding the implementing change in
the process (Dinh et al., 2014). This made them more flexible towards their employees and
understand the situations that can hamper the relationship between leadership and employees.
Further this behavioral theory let leaders to understand the concerns of each stakeholders
associated to it (such as in the proposed change, implementation of barcode can affect patients
and healthcare professionals) for increased productivity (Parris & Peachy, 2013).
The prime limitation of this process is associated with the acquired attitude and behavior
of the leaders. As the leader acquired the attitude and behavior from different situational pressure
it might possible that he or she is unable to take appropriate step in each situation and enact
according to the theory properly (Dinh et al., 2014). This is more challenging as adapting to the

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acquired behavioral change correctly each time, is psychologically not possible. The second
limitation is related to the adaptability of the leader to the given situation, cultural situation and
organizational aspects. There is a less amount of theory present that demonstrate the appropriate
behavioral trait that the leader should acquire while going through cultural conflicts, and
problematic situations in change management process. The prime reason behind this can be the
subjective nature of behaviors as one person’s behavior to one situation can differ from someone
else’s reaction (Parris & Peachy, 2013).
The situational or contingency theory
The management style of leaders has direct and proportional effect on the failure and
success of the organization or the employees, who struggle to achieve success for the company.
This theory determines that the leadership is the personal trait of people, and does not change
with every coming challenges (McCleskey, 2014). According to this theory, dominant nature of
leaders are help them to achieve task-related and human-relation related tasks and the followers
also feel influenced and inspired to achieve the target for the company. These leadership theory
is beneficial in extreme situation, when sudden change management related to an important
process of the company is implemented (Van de Ven, Ganco & Hinings, 2013).
Strengths and weaknesses
As the leadership style focuses on domination of the leader while going through change
management, the most important strength of this leadership style is that it makes the employees
responsible for their own decisions and actions. Further, as the leadership style focuses on
discussion with experienced and tenured employees regarding their views, a sense of
accomplishment will be created in the tenured employees of the organization, which will lead

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them deliver their tasks honestly and eventually achieve the goal for the organization (Hanisch &
Wald, 2012).
However, this dominant trait is the weakness in few situations. Job readiness and ability
to adapt to the change is different for different people, hence, dominance can lead them to break
down and their entire work performance can collapse. Further, wrongly applied pressure can let
employees to leave the organization which eventually harms the organization as fresher or new
worker will not be able to produce the desired productivity while going through the change
management process (McCleskey, 2014). Further, as this leadership skill is abusive, the
followers may willingly quit working and performing tasks that affects the change management
by delaying the process, as well as affecting the accountability, productivity and efficiency of the
associated employees. Furthermore, according to Wright, Moynihan & Pandey (2012), while
working in a healthcare organization going through change management process, it is quite
impossible to apply one style of leadership skills as each situation brought different difficulty for
which different leadership traits and solutions are required. These are the strengths and
weaknesses of this leadership theory (Van de Ven, Ganco & Hinings, 2013).
Within these two leadership theories, to implement the change related to usage of
Barcode Medication Administration in the renal department of healthcare organization, the
situational or contingency theory of the leadership has been chosen. The reason for choosing this
leadership theory for the implementation of change management related to process is associated
with the personal trait of the leader (Carter et al., 2013). As the behavioral theory described that
leaders acquire attitudes towards issues while suffering from similar situations. However it is
possible that similar situations require different reactions in two different situations, hence, in

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such situation, a strong and dominant leadership is required who can lead the followers through
tough situations. Further, as the contingency theory, focuses on boardroom discussions with
employees, and creating a roadmap for implemented change, its efficiency increases compared to
the behavioral theory (García-Morales, Jiménez-Barrionuevo & Gutiérrez-Gutiérrez, 2012).
Hence, for the proposed change management, the contingency or situational theory will be
applied.
Innovation in healthcare
Innovation is a critical aspect for organizations, as it helps to increase the business related
productivity and enhance the chances of survival in the competitive culture (Weber & Rohracher,
2012). Especially in healthcare system, innovation increases the quality of the process and
enhances the reliability of patients and service users within the process. There are two types of
innovations related to different aspects of healthcare process such as product innovation and
process innovation (Bock et al., 2012). Product innovation in healthcare is related to new
medication and instruments that helps to easily diagnose and provide faster recovery from the
disease, whereas the process innovation enhances the capability of associated healthcare
professionals so that they can utilize the newly innovated products for the betterment of the
patients (Weber & Rohracher, 2012).
The role of working environment also determines the level of compliance of the
employees towards the proposed change as it can increase or decrease the capability of people to
combat the difficulties while change management. The SWOT analysis of this working
environment is mentioned below.

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Strength
While change management process, the strength of the working environment is regarding
the competitive and adjustable nature of the employees. These two aspects help the organization
to take necessary steps while implementing change. Further, fixed target of the working force,
local support and presence of professional employees are strengths of working environment
(Opsahl, George & Gann, 2012).
Weakness
Excess workload, leader’s pressure and unsupportive working environment are the
primary weakness that affects the change management process by delaying its speed. Further, as
the entire process related to the tasks are changed, employees take time to acquire the knowledge
regarding the new process prior to speed up their production (Somech & Drach-Zahavy, 2913).
Opportunities
The most important opportunity that the working environment in the midst of change
management the organization has regarding the relation between leader and its followers. It helps
to enhance the effective communication skills, enhance the employee’s ability to withstand
pressure with training and development programs (Bock et al., 2012).
Threats
As the working environment in change management process is full of domination and
work pressure, the chances of resignations from the employees’ increases and new or fresh
workforce may take time to understand the process and implement change, creating a lag in the
change management plan (Opsahl, George & Gann, 2012).

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The prime implication of change regarding usage of barcodes instead of paper works
regarding the medication administration of patient is decreases amount of medication errors,
which usually causes more than 65% of patient worldwide (Weber & Rohracher, 2012). Further,
as the nursing and healthcare professional will be using barcode and associated electronic
medication administration record system, it will be easier for the patient and the healthcare
facility to keep the patient data securely. The staff interpersonal communication also increases
(Bock et al., 2012). For example, while implementing Barcode medical administration in the
renal unit of the healthcare facility, if the healthcare professionals and staff support the hospital
authority, the authorities will be able to take further harsh steps for the overall growth of the
organization (Weber & Rohracher, 2012).
Change and change management theory
Change is a specific idea or notion that helps to improve the condition of organizations
and combining with different theories it helps to create new concepts of change, implementing
which can help the leaders to transform the process completely (Burke, 2017). On the other hand,
change agents are people who help the organization by transforming or improving the process
and the effective communication within the system. The change agent can be anyone who helps
to drive or influence people to accept the new system or program inside the process and helps to
develop or improve the process effectiveness (Fullan, 2014). For better management of the
change applied in the healthcare organization, different change management models are present,
within which, two has been presented in this study.

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Rodgers model
According to Cameron and Green (2015), Rodger’s described four elements as driving
force to diffuse newer ideas and inspiration while implementing change and these are
Innovations related to new ideas, project, object and practice, effective communication, time to
determine accurate decision-making and solving problems in groups so that goals can be
achieved with cumulated force (Cameron & Green, 2015). In the Rodger’s model of change,
there are five kinds of people in every organization, and depending on their level of adaptations,
the change can be implemented within the organization. The categories are innovators, early
adaptors, early majority, late majority and laggards. The innovators are the one who primarily
adapts the change and willing to take risk for the benefit of the company, early adaptors are the
group of people who based on evidence, join the change management willingly (Benn, Dunphy
& Griffiths, 2014). Early and late majorities are in neutral position in case of joining change
management whereas the laggards are people who join the change process at last, unwillingly.
Hence, this model believes that each employee will take their own time to implement change and
organization should provide them time to adjust to the new process (Cameron & Green, 2015).
Kurt Lewin model
This model of change is comprised of three steps such as unfreezing, change and
refreezing, which makes it easy to apply and implement in any organization irrespective of its
complexity (Burnes & Cooke, 2013). Unfreezing determines the preparation stage of change
management by informing the employees regarding change and seeking their valuable feedback
so that their complete support can be achieved. This step challenges the belief, values, attitude
and behavior of the employees, current practices so that newer model and process can be
implemented (Shirey, 2013). The second step, which is change and in this, people set their minds

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and try their best accept to the change and implement newer process in their work system. In this
step the leaders of the organization try to solve all the issues of employees while adapting to the
change. Finally, the third step refreezing is applies to organization, as this determine that all the
employees are accustomed to the new process and are ready to perform for the betterment of the
organization (Burnes & Cooke, 2013).
To implement the proposed change in the desired healthcare organization, the Kurt Lewin
model of change has been selected. According to Cummings, Bridgman and Brown (2016),
change is a process that should be done with the consent of the involved people so that resistance
can be minimized. The Lewin change management model’s first step, Unfreezing is about
informing the associated people about the change in the process so that they can prepare
themselves for the newer challenges mentally (Burke, 2017). Further, as the nurses are the
change agents in this model of change, their adaptation to newer changed process is necessary
and Lewin model provides them with numerous support from the administration and senior
healthcare professionals to understand the new process (Fullan, 2014). Therefore, to implement
barcode medical administration process in the renal unit of the hospital, the Kurt Lewin model of
change has been implemented. For example, providing nurses with training related to BCMA
while implementing change and undertaking several assessments related to the practice will help
them to acquire the process completely and the chances of medication errors will be minimized
(Cummings, Bridgman & Brown, 2016).
Further, for the management of change, the hospital authorities should assess the state of
the renal department and the rate of medication related error in the unit. This will help them to
identify the problems and convince the agent of change that is the nurses to adapt to the newer

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practice (Appelbaum et al., 2012). Authorities or leader of the healthcare organization should
envision the process and effect of implemented change so that the loopholes and resistance of
employee can be minimized on priority basis. Finally, the authorities should implement the
change in orderly manner so that management and transition to the newer process can be done
effectively. Further for the enthusiasm of the change agents, the management should arrange
rewards and recognition so that outstanding efforts of the nurses and other healthcare
professional to adapt to the change can be recognized (Cummings, Bridgman & Brown, 2016).
Discussion
Medication error is an important aspect in this evolving healthcare system, and according
to the Journal of Nursing Administration, this leads to unavoidable situations, if not avoided and
replaced with some other process. To identify the replacing process and minimize the
medicational errors, Oshashi et al. (2014) conducted a systematic review and searched 32 articles
and found that barcode medication administration has been used to effectively minimize the risk
of medication error in all those research articles. The prime reason of errors identified in those
articles was impaired cognitive skills of nursing professional because they had to handle more
than 50 patients’ every day (Bonkowski et al., 2013). Therefore, implementing barcodes in the
administration process will help them to remind the last dose of drug administration to a specific
patient. Further, as per Rack, Dudjak & EWolf (2012), as the shift of a specific nurse is fixed, the
other nurse who replaces the first one is unable to understand the drug administration process
and leads to medication error. Therefore, to restrict the medication error, usage of barcode
medication administration system should be implemented as a changed process in the healthcare
organization in discussion.

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Conclusion
While concluding the assignment it should be mentioned that change is spontaneous and
to attain a sustainable development in every aspect, each organization should undergo change
management process. While, unable to change with the advanced system, the organization, its
employees are unable to provide its customers with effective and quality service. The role of
leaders and innovative ideas are important in this case as leaders holding the hand of employees
and direct them to the desired success determined by them for the organization. Further,
innovation is the process through which, newer ideas and substances are introduced in the
company that helps in expansion or improvement of the process. In combination, leaders with
their innovative ideas implement change in the organization, and the change agents’ helps to
drive the change in the desired direction. In this assignment, the proposed change was the
implementation of Barcode Medication Administration (BCMA) in the renal department of the
healthcare organization, the situational or contingency theory of leadership was implemented and
Kurt Lewin change management theory was implemented in the process. Furthermore, in the
assignment, the SWOT analysis of the working environment in driving the process was carried
out and the benefit of the Lewin change management in driving the change was described in the
process with a proper discussion about the proposed change and its benefit in lowering the error
related to medication.

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