Nursing Leadership: Change Management and Improving Quality of Care

This report delves into the challenges within healthcare facilities, particularly focusing on nursing shortages and their impact on service quality. It emphasizes the critical role of nurses in achieving healthcare objectives and maintaining patient trust. The report identifies difficulties in recruiting and training skilled nurses as a primary cause of staffing shortages, further exacerbated by incomplete data. It highlights the crisis in mental health and maternity care due to nurse shortages, potentially compromising patient access and care quality. Applying Lewin's change management model, the report proposes solutions such as onboarding programs to enhance nurse retention and strategies to improve overall patient care by focusing on a patient-oriented framework that addresses both medical and non-medical factors.

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Nursing leadership
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Contents
Executive summary.........................................................................................................................3
Introduction......................................................................................................................................4
Findings...........................................................................................................................................5
Improving the quality of care........................................................................................................10
Solution..........................................................................................................................................11
Communication of the proposed solution......................................................................................14
Conclusion.....................................................................................................................................14
Bibliography..................................................................................................................................16

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Executive summary
In this paper, we are going to look deeply into the current level of employment in the
healthcare facilities especially in nursing and examine the effects that are as a result of the level
of employment and how we can try to overcome the challenge and regain the stability required
and trust from the patients who expect maximum attention from the healthcare departments and
most of all from nurses.
Nurses are the fundamental expert part of the 'cutting edge' staff in most wellbeing frameworks,
and their commitment is perceived as basic to meeting advancement objectives and conveying
sheltered and viable consideration. One trouble in making a precise worldwide gauge of
quantities of medical caretakers is the meaning of 'nurture.' Diverse global offices, on various
occasions, have created distinctive definitions, some identified with instructive level, some too
long stretches of preparing. These are among the things that are critically looked into through
this paper.

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Introduction
Nursing is a field that experiences many challenges especially on the terms of leadership
and also the quality of service delivery to clients. The challenges may tend to affect the
performance of the health facility, and if not taken care of at the right time, the facilities may end
up making an underperformance. In this proposal, we focus on one major challenge that is
potentially capable of affecting the management, leadership and quality improvement. The
nursing shortage is one challenge that has caught my attention due to the impact it has in the
nursing department (Ross, 2014). Unlike doctors, every patient being attended requires the
attention of the nurse in order to make a follow up on the progress of the patients and their
management by the healthcare facilities. Staffing shortages in the nursing department refer to the
situation where the demand of the nursing profession is higher than the available team. In this
case, when we talk about the nursing professions, we refer to diversified professions in the field
of nursing such as registered nurses within a health care facility (Rosseter, 2014).
There are different reasons that led to the selection of this change topic. The major one, in
this case, is that the shortage of staff in nursing is experienced worldwide which means that this
is a challenge that has had no solution in the past few years (Fischer, 2016). It, therefore, shows
the need for finding a solution for the issue in order to enhance leadership in nursing, the
management and the quality improvement of service delivery in the nursing department and the
healthcare facility generally. The conclusion on the worldwide shortage of staff in the nursing
department within the healthcare facilities is cited from the consideration of the report provided

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by the international council of nurses on the shortage, maldistribution, and misutilization of
nurses (Cherry, 2016).
Findings
There are different reasons that lead to the above occurring issue on the shortage of staff in
the nursing department. The major reasons, in this case, are established to be difficulty in
recruiting and training skilled nurses in the public and private sectors. The most disturbing fact is
that research has established, on the basis of quantitative records obtained and regression of the
occurrence nature of the foreseen issue, that the situation has a high probability of worsening in
the near future in a very high rate (Lavoie, 2017). It is, therefore, the responsibility of the
anticipating individuals and teams to try and come up with a solution in order to solve this threat
in the healthcare department. It has also been established that the shortage of staff in nursing is
hidden since the data to be configured in the process is inadequate and for unknown reasons
always incomplete. There are different situations that have led to the classification of the
situation as an international crisis. Some of these situations include;
1. Reported cases on the shortage of nurses in mental health care facilities, and
2. Shortage of staff to take care of patients during the process of giving birth to newborn
(midwifery)
As the healthcare department would explain it, the two areas mentioned above are very
critical especially when it comes to the necessity of the nurses taking care of the patients under
the departments. A department like maternity is one that requires total attention from
professional and experienced nurses and other professional staff to enhance the quality of service
delivery and to reduce the probability of casualties during the process. As stated by the

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Queensland University of technology, the school of nursing, if not taken care of, the crisis is in a
position to endanger the access of patients to healthcare facilities and aged care residential
services and worst of all patient care is soon going to be compromised (Démeh, 2015).
while open clinics assume a vital job in social insurance arrangement, their
administrations frame some portion of the continuum of consideration, an expanding measure of
which is given outside the healing facilities. As an outcome of this pattern, there has been a
move of nursing staff into the arrangement of consideration in the network. With the maturing
populace, there is expanding interest for nursing in the matured consideration segment. This area
is currently the following biggest boss of attendants after the intense consideration division.
Medical attendants are likewise assuming a basic job in wellbeing advancement and wellbeing
counteractive action in the essential human services display. In rustic and remote zones, medical
caretakers shape the premise of human services benefits and may, in more remote regions, give
the main medicinal services to the networks in which they work (Urden, 2017).

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Figure 1
Nurse: population proportion (nurture per 1000 populace) – min, max and normal by the World
Health Organization district. Source: Buchan and Aiken, in view of investigation of information
in World Health Organization 2006 (Ma, 2015).

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There are different change management models that are used in order to retrieve the way
towards success in an organization. There are different change management models that may be
applicable in different cases, but there is a need to establish the most applicable in every distinct
case in order to facilitate the production level in an organization to its highest level. In our case
of staff shortage in the healthcare department, we are going to focus on Lewin's model of change
management. This model is one of the most popular and is known to be one of the most
productive models (Burke, 2017). It provides its strategic action through three different stages
which establish a convenient change in the management of the respective organization
(Cameron, 2015). The three stages are as follows;
1. Unfreezing
This stage involves unfreezing the current processes and observe what needs to be put in
place. This is the first stage after realizing that a change needs to be made. In this stage, all the
process involved in making a change are supposed to be analyzed, and evaluation for the
potential improvements be put in place. In our case, this stage requires that the process of hiring
and training the newly hired staff to be stopped for a while and a re-evaluation be done on the
possible improvements of the process in order to solve the issue of shortage of staff in the
healthcare departments especially on nursing (Wong, 2015).
2. Make changes
This stage is also known as the implementation stage. This is where the potential solutions
are put in place to evaluate their effectiveness in the performance of the issue under examination.
In this stage, some things ought to be put into consideration in order to ensure the effective
performance of the model. The few things include communication, education, and support.

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Under the expected changes, there needs to be a support team, especially while undergoing
through this stage in order to facilitate and enhance support for the rest of the contributing teams
(Bradley, 2015).
3. Refreeze
In this stage what specifically happens is refreezing the status quo. This is done after changes
have been deployed, measured, and tweaked according to feedback. General surveys should
be completed to watch that the new strategies are being pursued.
The above three stages depend on preceding stage for a successful and effective change
in an organization.
These progressions have affected on the aptitude level, and ability expected everything
being equal. In the intense part, changes to mind and upgrades in innovation have prompted the
expanding requirement for a very particular workforce (Scully, 2015). For sure, a few fortes
would not have the capacity to work proficiently without a fitting pro-medical attendant
workforce. Changes in the matured consideration area have seen a move far from what has been
depicted as 'custodial consideration' to the arrangement of more intricate and concentrated levels
of consideration, for example, palliative and post-agent care (Rustøen, 2016).
In the network segment, medical caretakers are managing significantly more wiped out
customers because of shorter doctor's facility remains. The consideration of that agony from
medication issues, expanded rate of psychological instability and discouragement and the
development of social issues, for example, youngster and senior maltreatment and brutality, have

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added to the many-sided quality of the network segment working condition (Sharkey, 2017).
Therefore, an all the more very talented generalist workforce is rising in the network part. This
pattern is exemplified in provincial and remote zones where the medical attendant workforce is
the significant supplier of wellbeing administrations (Carpenter, 2016).
Changes to the medicinal services framework, the manner by which administrations are
conveyed and changes to the abilities expected of those working inside the framework, are
altogether influencing the attendant workforce when there is a serious lack of experienced
medical caretakers, and there are intense issues in holding those still in the attendant workforce
(Kingma, 2018).
A noteworthy issue with the information emerges from varieties between the
informational indexes. Varieties emerge because of twofold including of medical attendants with
enrollment in excess of one purview, contrasts in classification and contrasts in the reason for
which the information is gathered. There are likewise delays in the handling of information and
revealing the discoveries (Armstrong, 2015).
Improving the quality of care
Enhancing tolerant consideration has turned into a need though wellbeing couldn't care
fewer suppliers with the general goal of accomplishing a high level of patient fulfillment. More
prominent mindfulness among people in general, expanding interest for better consideration,
quicker rivalry, more social insurance control, and the ascent in restorative misbehavior case, and
worry about poor results are factors that add to this change (Lim, 2016).
The nature of patient consideration is basically dictated by the nature of foundation,
nature of preparing, the fitness of the workforce and the proficiency of operational frameworks.

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The major prerequisite is the selection of a framework that is 'tolerant orientated.' Existing issues
in human services identify with both restorative and non-therapeutic variables and a thorough
framework that enhances the two perspectives must be actualized. Social insurance frameworks
in creating nations confront a significantly more prominent test since quality and cost
recuperation must be offset with equivalent open doors in patient consideration.
Solution
In this case, we focus on the techniques that seem to be more favorable for our case and the
ones that can provide positive feedback or response within the shortest time possible.
1) Utilize an Onboarding Program to Make New Nurses Feel Welcome
Studies and studies demonstrate that network, gather attachment, and medical attendant
self-sufficiency decrease worker turnover among nurses, and nurses who feel they have a feeling
of the network at work report more elevated amounts of employment fulfillment. At the point
when healing centers get new nurses, making these nurses feel welcome with an onboarding
project can help empower worker maintenance. A decent onboarding system can slip new nurses
into the action, so they're less overpowered in an initial couple of weeks at another activity. A
decent precedent is to abstain from doling out new nurses to issue patients immediately. Another
model is to consider occasions that assistance new nurses become more acquainted with current
nurses to energize a feeling of the network. Nurses that vibe like they are welcome and part of a
network not just stay with the activity, will probably bring along their companions (Armmer,
2017).
For new attendants who are similarly newly graduating class, a restorative guardian
residency program may exhibit pleasing, making it less requesting for the newly graduated class

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to advance from being an understudy chaperon to dealing with the commitments of being a
therapeutic overseer. This offers mentorship for newly graduated class by uniting new medical
caretakers with experienced attendants, so they contribute vitality considering patients together
before being released to practice alone. This abatements turnover rates among first-year
attendants and besides give air in which productive partner get-togethers are surrounded (Olson,
2015)
2) Boost Behaviors required from Nurses
Offer forces to encourage rehearses you have to see from your attendants. For example,
consider having a system that surrenders centers around picking terrible moves, taking extra
developments, or adjusting new aptitudes. Centers could be used to buy phenomenal prizes,
or they could be used to empower medical caretakers to construct their remuneration scale
after some time (MacLean, 2014). This makes it less requesting to staff even the despised
moves in a way that keeps medical caretakers cheery. Regardless, while offering inspirations
for the practices, you have to see can help in agent upkeep. Frameworks for Nurse Managers
observe that it's basic to swear off boosting heartbreaking behavior. Come full circle support
driving forces, for example, may make medical attendants come in on days they are wiped
out or not fit to work, exchanging off patient thought (Miner, 2015).
2) Allocate some funds and financial resources into developments
A report being prepared by Robert Wood Johnson Foundation suggests that the health
facilities should focus their attention into long-term projections in the development of their
learning process in order to enhance their maximum cooperation and a comparative working