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Transformational leadership models and styles essay

The purpose of this assignment is to research different leadership models and styles, including transformational leadership.

Choose five leadership models and styles. One model must be transformational leadership. Design a graphic organizer to compare servant leadership with the other models. Consider how these models or styles bring about organizational, team, or individual change or growth. How do leaders implement each of the models and how do they fit with your personal beliefs? {Autocratic leadership, Laisser-faire leadership, democratic leadership & transformational leadership}

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Different Leadership Models and Styles to Include Transformational Leadership

Servant Leadership

The objective of servant leadership is to serve. It entails listening, empathy, stewardship, awareness, healing, persuasion and conceptualization, communication building, foresight, and committed to growth of others. It requires attention and empathy  towards the followers needs by the leaders. Servant leaders mentor followers to become healthier, more autonomous, freer and wiser. It is based on strong ethical overtones.

It is characterized by collaboration of employees and improves satisfaction.

Leadership focuses on personal growth and performance of the team. Encourages employee autonomy

Organizational growth: employee performance increases with increased motivation and commitment.

Decreases turnover through job satisfaction and motivation. Transformational leadership models and styles essay.

Team work involves collective operation

Individual development involves personal development, improvement of motivation and employee satisfaction. Followers observe and emulate the positive actions of the leader. Social exchange theory reveals reciprocal relationships developed between the employees and the servant leaders. It also improves responsibility at the family level (Chiniara & Bentein, 2016).

Leader’s implementation: Leaders lead by example and stay away from the spotlight. They involve employees in decision making and recognition for good performance.

Fitting into beliefs: I believe in collaborative efforts, team building and employee motivation for effective performance. These beliefs are supported by servant leadership.

Autocratic Leadership

Managers have absolute decision making authority. It is implemented in situation demanding close supervision. It limits creativity in the organization and discourages the participation and engagement of teams in collective performance. It ensures the organizations goals are met through Transformational leadership models and styles essay

Differences

No collaborative efforts

Does not lead by consensus but practice command and control.

Long-term effects include lower morale, lower productivity, higher turnover, and lower-quality decisions.

Discourages autonomy of employees

Encourages turnover and increases job dissatisfaction

Similarities

Both have potential for high levels of productivity

Efficient decision making

 

Transformational leadership

Involves implementation of change It engages teams in the creation of visions, identification of changes, inspiration towards achievement and implementation. It is characterized by individualized consideration of group members, intellectual creativity and stimulation, inspirational motivation and ability to inspire confidence as well as idealized influence of leaders.

Similarities

Inspires personal development of employees and leaders through emphasis on positive behavior and morals (Newmanet al., 2017).

Gives employees autonomy

Is collaborative

Improves the morality, motivation and productivity of the employees and the leader

Enhances organizational development through execution of positive changes

Both work to create leaders and decision making is collective

Differences

Has an ethical dimension unlike the servant leadership

Leaders motivate and influence followers unlike in servant where followers come first

Laisser-faire leadership

This leadership allows the group members to make decisions. The staff is challenged to take up tasks and responsibilities to determine their failures and achievements. Leaders are involved in the provision of tools and minimal guidance. Workers have complete freedom in the resolution of problems.

Similarities

Both give decision-making freedom to employs

Both give up their control and power to engage the teams (Van Dierendonck & Patterson, 2018).

Differences

Laisser-faire leaves the team to work on their own while servant leadership serves the team

Decision-making is left to the team members

Leaders do not take care of the needs of the followers

Servant leadership serves while Laisse-faire delegates

Increased potential of low productivity and motivation

Fail to provide regular feedback to the team members

Are not directly involved in supervision of followers

Lack managerial control

Transformational leadership models and styles essay

 

Democratic leadership

The decision-process is more participative. Involved parties are engaged in free participation, generation of ideas and discussions regarding decision making. It is characterized by group empowerment, responsibility distribution and aiding of the decision-making process. It facilitates the resolution of organizational problems and issues through informed decision-making. It encourages creativity and innovation as well as improves the job satisfaction among employees.

Similarities

Collective decision making

Improves productivity, motivation and job satisfaction (Hoch et al., 2018)

Collaboration between the leaders and workers

Employees and employers have equal say in the decision-making process

Leaders and team members commit to achieving positive results for the organization

Both are not very effective for urgent decision making considering the process and time used in collaborative decision-making efforts

Transformational leadership models and styles essay

They both encourage learning from previous employee mistakes

They are both employee-centered, consensual, consultative, considerate and concerned with creating and maintaining good relationships at the workplace.

Differences

Servant leaders stay out of the limelight and let the teams receive recognition unlike the democratic leaders who are recognized for their successful leadership roles in projects

My Thoughts

Different leadership styles and models exist in different organizational settings. The most common include servant leadership, transformational, autocratic, democratic and laisser-faire leadership (Set & Sarros, 2016).  The implementation of each depends on the organizations vision and anticipated results. They all have the potential to impose positive changes in the individual, teams and the organization as a whole. Servant leadership is the most effective type of leadership style considering its abilities to improve the workplace and inspire change in the followers and the organization through service provision.

However, the five styles fit in my personal beliefs since they all are effective in achieving both the long-term and short-term goals of the organization. Their uniqueness is influenced by the desired results and type of urgency in decision-making. Transformational leadership models and styles essay

 

References

Chiniara, M., & Bentein, K. (2016). Linking servant leadership to individual performance: Differentiating the mediating role of autonomy, competence and relatedness need satisfaction. 
The Leadership Quarterly
, 
27
(1), 124-141.

Hoch, J. E., Bommer, W. H., Dulebohn, J. H., & Wu, D. (2018). Do ethical, authentic, and servant leadership explain variance above and beyond transformational leadership? A meta-analysis. 
Journal of Management
, 
44
(2), 501-529.

Newman, A., Schwarz, G., Cooper, B., & Sendjaya, S. (2017). How servant leadership influences organizational citizenship behavior: The roles of LMX, empowerment, and proactive personality. 
Journal of Business Ethics
, 
145
(1), 49-62. Transformational leadership models and styles essay

Seto, S., & Sarros, J. C. (2016). Servant Leadership Influence on Trust and Quality Relationship in Organizational Settings. 
International Leadership Journal
, 
8
(3).

Van Dierendonck, D., & Patterson, K. (Eds.). (2018). 
Practicing Servant Leadership: Developments in Implementation
. Springer Transformational leadership models and styles essay

Personal model of leadership Nursing essay

As a nurse leader, it is important to understand a variety of leadership models and styles. This will help you adapt to different settings and apply strategies to support and inspire others. It may also be necessary to apply models in different professional settings to satisfy certification requirements. Write a 1,000‐1,250 word paper about your personal model of leadership, including the following:

1. How might your personal model of leadership be applied in your professional setting? Personal model of leadership Nursing essay.

2. How does your personal model of leadership compare to the models you researched for the Leadership Styles Graphic Organizer?

3. Does your personal leadership model follow the lines of servant leadership or transformational leadership?

 

Personal Model of Leadership

Name

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Institution

The graphic organizer explored five leadership styles essential in the management of organizations. In general, leadership styles describe the manner and approaches through which leaders provide direction and motivation to people as well as implement plans particularly in an organizational setting. Each leadership style is unique based on the reason for implementation and the vision of the organization as well as the intendent outcomes of the operations. The five leadership styles examined included the servant leadership, transformational, autocratic, democratic and laisse-faire. Considering my professional setting, I need to adapt to different settings and apply strategies that inspire and support others during practice. In this case, a personal model characterized by a mixture of servant, democratic and situational leadership styles of leadership will facilitate the achievement of my leadership goals Personal model of leadership Nursing essay.

The personal model of leadership seeks to provide optimum leadership results. Being a mixture of three styles, it guarantees superiority and delivery of optimum results. For instance, servant leadership is essential in providing strong ethical overtones and altruistic that compels the leaders to pay attention to the followers’ needs (Kashyap & Rangnekar, 2016). In general, it seeks to serve in a manner that enriches individual lives, builds a caring and just environment as well as creates better organizations. On the other hand, the democratic leadership style engages the followers in decision-making. They are able to raise their healthcare concerns and suggest possible solutions for the problems they encounter in the healthcare setting. Therefore, it helps identify the areas of concern in the healthcare setting through the all participatory approach.

Consequently, the situational leadership style entails making of adjustments to fit the followers’ levels of development. As such, it allows flexibility in decision-making depending on the current situation.it also promotes the adaptation of the leaders and the followers to the current environment through the assessment of the levels of maturity among the followers, the culture and structure of the organization as well as the visions that is sought to be achieved.  It is thus able to set a beneficial balance between the followers and the organization through adaptation to the needs of the team. Directive, coaching, directing and supportive behaviors are involved in the situational leadership style. Considering the benefits of these leadership styles, it is evident that a mixture of the three will provide a superior personal model of leadership that will facilitate the achievement of individual, teams and organizational goals.

The personal leadership model will have multiple applications in healthcare practice. For instance, it will be employed in the improvement of productivity within the organization through the creation of a supportive and motivating environment. Good relations are also created within the healthcare organization to facilitate flow of ideas, easy decision making and enhance collective and collaborative efforts. The model is applied in nursing care to facilitate the meeting of the patients and the employee’s needs. More applications include strengthening the society and the institutions of healthcare through advocating of decision-making that is group-oriented. It is also implemented in creation of job satisfaction through fostered participation from employee’s autonomy. The personal model is therefore applicable in all aspects of the nursing care setting. Personal model of leadership Nursing essay.

The personal model borrows from three leadership models which make it superior to all other styles. It shares the servant leadership characteristics and principles and also focuses on serving the people. Similar to servant leadership, it involves the practices that enrich individual lives, create a caring, just and better healthcare environment. In comparison to the democratic style of leadership, the mixed style gives the followers the freedom to make decisions. However, it does not limit the final decision-making to the leader but rather accommodates the group’s decisions. It also boosts morality and creativity like the democratic model. The leader also values the team inputs and collective decision making is done with the aim of serving the followers.

On the other hand, laissez-faire allows the followers the freedom of decision-making and operation without the supervision and feedback from the leader. This is different from the mixed model which involves both the teams and the leaders in decision-making. The managers are also engaged in supervising, serving and provision of feedback and thus ensure there is motivation, learning, increases productivity and collaboration. Personal model of leadership Nursing essay. The laissez-faire model is bound to result to low productivity, lack of organization and control, and as well increase the cost of production unlike the mixed model which produces positive outcomes on these factors (Yang, 2015). It is also not applicable to employees who are not experienced in the healthcare practice unlike the mixed leadership style.

The transformational leadership style share several similarities with the mixed model. They are both dependent on high levels of communication between the followers and the leaders and they both seek to impose positive changes in the healthcare organization. The both motivate and engage the followers interactively thus focusing on the achievement of the organizational goals as a team rather than as individuals. However, it is often characterized with delegation of duties unlike in the personal model which involves everyone in decision making and service delivery (Avolio et al., 2016). Notably, the autocratic model was explored. Unlike the personal model, autocratic style of leadership relies on the leader as the sole decision maker of the organization. It also limits creativity, innovation and collaboration within the organization contrary to the mixed model Personal model of leadership Nursing essay. Even though, both models are characterized by close supervision of operations. They also support urgent decision-making situations.

The personal model of leadership follows the servant leadership line and not the transformational one. This is because; the nursing practice is dominated by provision of services, caring, empathy, care, persuasion, healing, foresight, conceptualization and commitment to development of the community and the people (Chiniara & Bentein, 2016). This entails the provision of quality life for the patients and the nurses which is supported by informed decision making from all the nursing stakeholders. The situational model promotes serving by ensuring flexibility and determination of the needs affecting the followers. Furthermore, it makes adjustments to suit the development levels of the employees to enhance quality service provision.

Eventually, the democratic characteristics promote service for the people. This is achieved through the involvement of people in airing their problems and suggesting decisions that resolve their health concerns. As such, the personal mixed model of leadership is a superior version of the servant style of leadership. Even though it ears some transformational leadership characteristics such as the communication effectiveness, motivation of followers and initiation of organization and individual changes, the model is more inclined to serving the people more than transforming the society (Hoch et al., 2018). Therefore, the personal model of leadership presents the most reliable approach to nursing leadership in the contemporary healthcare setting. Personal model of leadership Nursing essay.

References

Avolio, B. J., Keng-Highberger, F. T., Schaubroeck, J., Trevino, L. K., & Kozlowski, S. W. (2016). How follower attributes affect ratings of ethical and transformational leadership. In 
Academy of Management Proceedings
 (Vol. 2016, No. 1, p. 16854). Briarcliff Manor, NY 10510: Academy of Management.

Chiniara, M., & Bentein, K. (2016). Linking servant leadership to individual performance: Differentiating the mediating role of autonomy, competence and relatedness need satisfaction. 
The Leadership Quarterly
, 
27
(1), 124-141. Personal model of leadership Nursing essay

Hoch, J. E., Bommer, W. H., Dulebohn, J. H., & Wu, D. (2018). Do ethical, authentic, and servant leadership explain variance above and beyond transformational leadership? A meta-analysis. 
Journal of Management
, 
44
(2), 501-529.

Kashyap, V., & Rangnekar, S. (2016). Servant leadership, employer brand perception, trust in leaders and turnover intentions: a sequential mediation model. 
Review of Managerial Science
, 
10
(3), 437-461.

Yang, I. (2015). Positive effects of laissez-faire leadership: conceptual exploration. 
Journal of Management Development
, 
34
(10), 1246-1261. Personal model of leadership Nursing essay

Nurse leader interview paper Example

Identify three nursing leaders you would like to interview for this paper.

Write a paper (1,000-1,250 words) that describes the results of the interviews and addresses the following:

A. Ask the leaders what they believe is their preferred leadership style and (1b) ask them to describe how that style has helped them achieve success.

B. Explain why you chose each individual leader.

C. Identify, compare, and contrast their styles and note any examples of servant or transformational leadership.

D. Identify missed opportunities or questions you wish you had asked during the interviews.

 

Nurse Leader Interview Paper

Introduction

Nursing leadership refers to the ability of the leader to influence others to directly participate in clinical care and improve the quality of care. Nursing leadership entails a setting with a clear vision, where followers are empowered as well as motivated (Bahadori et al, 2016). This assignment will present the results of interviews conducted with three nurse leaders. Nurse leader interview paper Example

Leaders’ Preferred Leadership Style

The first leader said that the preferred leadership style is a transformational leadership style. The leader attributed her leadership style choice to being inspirational and motivative. According to Afzal et al (2016) transformational leaders act as role models, motivate followers, are concerned with followers’ needs, and encourage creativity and innovation. Nurse leaders use transformational leadership style to motivate nurses to attain organizational goals.

The second nurse leader combines authoritative, situational, transformational and servant leadership styles. This is because she applies each leadership style according to the situation. In the authoritative leadership style, the leader makes all decisions and does not consider the staff’s input. Servant leadership involves leaders influencing and motivating followers by developing relationships and improving skills of followers or team members. A servant leader ensures that the needs of each team member are addressed and all team members are involved in decision making. Characteristics of servant leadership include persuasion, listening, awareness, building others, acceptance and foresight (Bahadori et al, 2016). The leader also uses a situational leadership style whereby she chooses the leadership style that is most suitable to the situation and goals.

 

The third nurse leader described her leadership style as transformational. The leader attributed her leadership style to her desire to improve others. As aforementioned, transformational leadership involves inspiring and motivating followers through a shared vision.

How the Style has helped to Achieve Success

According to the first nurse leader using transformational leadership style, the leadership style has helped her to be influential in changing her unit for the better. In addition, the people under her, are happier than before and willing to do more for the unit. The leader reported that she listens to her staff and with that, any new change has been successful. The leader also seeks followers’ input before making the final decision which has benefited both my staff and the hospital. The nurse leader concluded the interview by affirming that a transformational leadership style has helped her to empower her team and accomplish many organizational goals in the process. Nurse leader interview paper Example. According to Afzal et al (2016), transformational leaders form empowering work environment and this gives nurses chances to be creative and innovation during care delivery; this improves staff job performance and also the quality of patient care.

For the second nurse leader combining authoritative, situational, transformational and servant leadership styles, the leader reported that combining the leadership styles has enabled her to be fair to all staff members and to be more affirmative in her leadership. The leader reported that she uses authoritative leadership style when she needs to enforce the rule of the job for example when reminding staffs in the unit that they cannot just leave the unit to buy their lunch just because the cafeteria closes at a certain time. Since the charge nurse position is rotated, the leader said that she uses laissez-fair when she is aware of her staff’s capability while at times, she uses servant leadership in prioritizing the needs of her staff members.

The third nurse leader reported that transformational leadership has helped her achieve success in various ways. First, as a transformational leader, she has the vision to follow this hospital’s mission to improve patients’ quality of care and patient satisfaction. Secondly, she has used the style to ensure shared governance in order to encourage the staff to make decisions; this has improved the quality indicators and employee satisfaction. Third, as a transformational leader, she has been encouraging the staff under her unit to seek professional growth and higher education. This, therefore, has helped to improve nurse retention and have improved staff competency. These assertions are supported by Sfantou et al (2017) who explain that transformational leaders mentor and nurture innovativeness and also motivate staff members; improves job performance. As a result, this leads to improved care delivery and better health outcomes.

Reason for Selecting Each Individual Leader

The rationale for selecting the first leader is because she has been a bedside nurse for more than ten yours and now as a nurse manager in an acute cardiac step-down unit over five years and counting; she has experienced firsthand experience regarding both ends. The reason for choosing the second nurse manager is because she is in a different setting which is an outpatient setting; the priority in this setting is to make sure all supplies are sterile and staffing is done only during weekdays. Unlike the acute care setting, staffing in the same day procedure unit is done only during weekdays. The third nurse manager was a bedside nurse for about three years but has also successfully managed her unit for the past six years and still counting and this is the reason she was selected. Basically, the rationale for selecting the various settings was to enable me to analyze diverse settings as a future inpatient (hospital) or outpatient (clinic) nurse manager. Nurse leader interview paper Example

 

Compare and Contrast Their Leadership Styles

The first and the third nurse leaders use transformational leadership style. As indicated, transformational leadership style goes beyond the call of duty; this is because such leaders inspire, motivate, nurture and work collaboratively with followers to achieve the set goals and vision (Duwayr, 2019). Transformational leadership style is recommended in nursing because evidence shows it improves patient care in regard to patient safety, quality of care, and better health outcomes (Wong et al, 2015). The is because the transformational leadership style focuses on collaborative effort towards achieving goals. However, the second nurse leader combines different leadership styles such as authoritative, situational, transformational and servant leadership styles. Apart from using a transformational leadership style, the leader also uses a servant leadership style which is very effective in nursing practice. Just like in transformational leadership style, servant leadership style also involves leaders influencing and motivating followers by developing relationships and improving skills of followers or the team members (Duwayr, 2019). Basically, all the nurse leaders who were interviewed use transformational leadership style but the second nurse goes ahead to combine different leadership styles with transformational and servant leadership style.

Missed Opportunities or Questions

Some of the questions I would have asked during the interview include:

Looking back what each one of the nurse leaders would have changed about their leadership styles?

What they would have done differently knowing what they know today? Nurse leader interview paper Example

Conclusion

From the interview, the first and the second nurse reported that they use a transformational leadership style. Transformational leadership style involves inspiring and motivating followers to achieve the set goals. On the other hand, the second nurse leader combines different leadership styles such as authoritative, situational, transformational and servant leadership styles. Each nurse leader attributed their choice of leadership style to the ability to influence followers and have better quality of care.

 

 

References

Afzal M, Ali W, Farooq A & Hussain M. (2016). The Impact of Transformational Leadership Style on Nurse’s Self-Esteem of Public Hospitals of Lahore Pakistan.
Int. J. Soc. Sc. Manage
. 3(4), 287-293.

Bahadori A, Peyrovi H, Ashghali-Farahani M, Hajibabaee F & Haghani H. (2016). The relationship between nursing leadership and patient satisfaction.
International Journal of Medical Research & Health Sciences
. 5(1), 10:134-141.

Duwayr T. (2019). Leadership Styles of Nurse Managers/Leaders and Staff Nurses Job Satisfaction and Outcome Pattern in the Workforce: A Systematic Review.
Journal of Nursing and Health Science (IOSR-JNHS
. 8(2).

Sfantou D, Latiotis A, Athina P, Michail M & Patelarou E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review.
Healthcare (Basel
). 5(4), 73.

Wong C. (2015). Connecting nursing leadership and patient outcomes: State of the science.
J. Nurs. Manag.
23(1), 275–278. Nurse leader interview paper Example

Nursing Capstone proposal Example – Chronic pain management essay

Nurses’ perception and attitude towards pain management: Chronic Pain

Name

Institution

Background

Chronic pain management is a critical component of the fundamental patient rights and nursing care in general. Untreated causes adverse impacts on the patient which in turn cripples the treatment efforts and responses, triggers hopelessness and affects the quality of life (Samarkandi, 2018). Pain is also stressing to the patient and therefore, assessment and management is necessary to improve their health condition. The main barriers to chronic pain management include negative attitudes and nurses’ perceptions. Some of the nurses perceive the patients report as attention-seeking rather than the reality which results in addiction to opioids (Krokmyrdal & Andenæs, 2015). Misconceptions and negative attitudes increase the suffering of the patient and hence, effective interventions are necessary to ensure that the…

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capstone proposal instructions

your proposed problem description for your EBP project, should address the following:

My capstone proposal would be on

Nurses perception and attitude towards pain management

1. Describe the background of the problem. Tell the story of the issue and why it deserves attention.

2. Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.

3. Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization. Nursing Capstone proposal Example – Chronic pain management essay

4. State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence‐based practice is introduced to identify the expected changes.

5. 5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.

6. Develop an initial reference list to assure that there is adequate literature to support your evidence‐based practice project. Follow the ”Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use ”NUR‐699 Search Method Example” to assist you. Nursing Capstone proposal Example – Chronic pain management essay

7. 7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.

8. Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence‐based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

 

Nurses’ perception and attitude towards pain management: Chronic Pain

Name

Institution

Background

Chronic pain management is critical component of the fundamental patient rights and nursing care in general. Untreated causes adverse impacts on the patient which in turn cripples the treatment efforts and responses, triggers hopelessness and affects the quality of life (Samarkandi, 2018). Pain is also stressing to the patient and therefore, assessment and management is necessary to improve their health condition. The main barriers to chronic pain management include negative attitudes and nurses’ perceptions. Some of the nurses’ perceive the patients report as attention seeking rather than reality which results in addiction to opioids (Krokmyrdal & Andenæs, 2015). Misconceptions and negative attitudes increase the suffering of the patient and hence, effective interventions are necessary to ensure that the issue is addressed to minimize the provider-related barriers. A significant improvement of the attitudes and perceptions towards the patient is essential in improving chronic pain management practices. Nursing Capstone proposal Example – Chronic pain management essay

Stakeholders

Nurses of the pain management unit are the key stakeholders in implementing changes. A modification of attitudes towards their job, their patients and change of perceptions will prevent ignorance and improve the quality of the patient’s life through timely care (Shaw et al., 2010). Patients in the pain management unit will play notable roles in initiating changes in the healthcare setting. Their reporting of real pain and not seeking attention from the nurses when the pain is manageable will help prevent addiction. They can also use the interventions independently and in collaboration with the nurses to prevent overreliance on the practitioners. It will also help nurses identify genuine chronic pain incidences and attend to them promptly. Students are also essential stakeholders. They learn to attend to patients and build the right attitudes towards patients to allow effective and quality care delivery during practice. Consequently, the Joint commission is a stakeholder providing accreditation roles to promote healthcare quality and safety (Dennis, n.d). It ensures improved performance of the nurses and the organizations and hence, provides guidelines and standards of practice in the pain management units. Nursing Capstone proposal Example – Chronic pain management essay

Picot Question

Does improving nurses’ perception and attitude towards chronic pain management promote the recovery of the patients during the duration of hospitalization? This question addresses the nursing population working in the pain management unit and the chronic pain patients. The problem addressed by the question is chronic pain management. The intervention is improving perceptions and attitudes of the nurses while the comparison is done with negative attitudes and perceptions. The expected outcome for the research is increased patient recovery and time covers the hospitalization period.

Purpose and Objectives

The purpose of the evidence based research is to determine the effectiveness of attitude and perception change in the pain management unit. The study will investigate the attitudes and perceptions of the healthcare providers, assess the weaknesses and strengths of the nurses in managing pain and consequently inform scholars on the ways of modifying the nursing courses to improve pain management. This follows the increased number of stresses and suffering experienced in the chronic pain management units. The heightening number of opioids addiction among the emergency room patients also triggered the need for this research with the intention of informing the nurses on the best evidence based approaches towards managing pain. Nursing Capstone proposal Example – Chronic pain management essay

The main objective of the research is to identify the impact of positive attitudes on pain management. This will involve the assessment and exploration of attitudes and perceptions of nurses towards pain management and the patient responses towards positive and negative provider attitudes. Overall, the project seeks to improve chronic pain management in hospitalized patients through interventions that improve the patient and nurse experiences. Nursing Capstone proposal Example – Chronic pain management essay

Importance

The project is significant in that it assists in the resolution of chronic pain management problems in the hospital setting. Chronic pain lasts for at least 3 months and presents with aching or burning sensations and can be either dull or sharp depending on the cause. Underlying health disorders are likely causes of chronic pain. Cancer is one of the major causes of chronic pain that demands continuous management. According to Ung, Salamonson, Hu and Gallego (2016), $560 billion is used in the chronic pain economy resulting from diabetes, heart disease and cancer in the US every year. With the increase in pain inflicting illnesses in the contemporary society, management has imposed a notable emotional, personal, economic and social burden thus necessitating the active engagement of nurses in evidence-based practice to improve the patient’s quality of life.

Considering the increased need for pain management, exploration of the nurse’s attitudes and perceptions is necessary in resolving the chronic pain problem. In this case, the use of relevant professional literature sources in this research is essential in obtaining the evidence-based approaches towards resolving the problem. As such, previous studies on the nurse attitudes and perceptions and their effects in the provision of healthcare are relevant for the research. other important information include the role of stakeholders, the effective interventions relating to modification of attitudes, the impacts of negative attitudes and perceptions and the results on patient recovery from the previous literature studies. Therefore, the project is important in improving the management of chronic pain in hospitalized patients. Nursing Capstone proposal Example – Chronic pain management essay

References

Dennis S. O. The Role of the Joint Commission in Health Care Quality. Joint Commission on Accreditation of Healthcare Organizations. Retrieved from
http://www.ehcca.com/presentations/qualitycolloquium4/oleary_2.pdf on August 27,2019

Krokmyrdal, K. A., & Andenæs, R. (2015). Nurses’ competence in pain management in patients with opioid addiction: A cross-sectional survey study. 
Nurse education today
, 
35
(6), 789-794.

Samarkandi O. A. (2018). Knowledge and attitudes of nurses toward pain management. 
Saudi journal of anaesthesia
, 
12
(2), 220–226. doi:10.4103/sja.SJA_587_17

Shaw, T. J., Pernar, L. I., Peyre, S. E., Helfrick, J. F., Vogelgesang, K. R., Graydon-Baker, E., … & Gandhi, T. (2012). Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial. 
BMJ Qual Saf
, 
21
(10), 819-825. Nursing Capstone proposal Example – Chronic pain management essay

Ung, A., Salamonson, Y., Hu, W., & Gallego, G. (2016). Assessing knowledge, perceptions and attitudes to pain management among medical and nursing students: a review of the literature. 
British journal of pain
, 
10
(1), 8–21. doi:10.1177/2049463715583142 Nursing Capstone proposal Example – Chronic pain management essay

picot and Case for ebp – sample pain management nursing essay

The organization is an acute inpatient surgical unit setting (a multicultural stakeholder hospital)

Before making a case for an evidence‐based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

1. Develop an analysis of 250 words from the results, addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry.

2. Make sure to include the rationale for the survey categories scores that were significantly high and low, incorporating details and/or examples. Also explain how to integrate clinical inquiry into the organization, providing strategies that strengthen the organizations weaker areas.

3.Formulate PICOT question for the intended proposal= Nurses perception and attitude towards pain management

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Nurses Perception And Attitude Towards Pain Management

Student’s Name

Institution of Affiliation

Course Name

Date

 

Introduction

           
Most organizations have embraced tighter regulations which promote good patient health outcomes through the implementation of evidence based practice. According to Melynyk & Fineout-Overholt (2015), EBP inarguably transforms an organization’s culture through the adoption of new practices, behaviors and attitudes. This paper is a proposal for implementing EBP in an acute inpatient surgical unit which has multicultural stakeholders. Apart from evaluating the culture of the organization, it also assesses the organization’s level of readiness to implement EBP, which has a critical role in the organization’s philosophy. Using the System-Wide Integration of EBP survey tool, a discussion on the possible barriers and facilitators for the implementation of the EBP project will also be provided. This survey tool efficiently explores potential factors which either hinder or influence the adoption of EBP in an organization, including changes that should be anticipated. picot and Case for ebp – sample pain management nursing essay

Level of Organizational Readiness

The evaluation revealed that the acute surgical unit is ready to adopt and implement evidence-based practice. The nurses of the surgical unit, who comprise the majority of the healthcare workforce, are not only committed but also passionate of their practice. Basically, this serves as an inner drive to stay motivated and engage in further research. To add on, the physicians are collaborative, open-minded and self-driven thus can easily interact with nurses while caring for patients (Yano, 2014).  Although pain is a universal experience, it distresses patients as compared to any other single surgical illnesses. Therefore, this acute surgical unit provides pain relief for surgical patients.

The hospital’s staff was greatly concerned with the issue of pain management for post-operative patients and there was an urgent need to ensure pain relief for post-operative surgical patients. Despite the numerous measures instituted to provide relief for post-operative pain, other patients still experience chronic severe pain following major surgeries. It is also worth recognizing that, the presence of a well and fully equipped library within this organization promotes the availability of resources which can be used to research or rather conduct literature.

Project Barriers and Facilitators

           
Potential barriers that are likely to hinder the implementation of this EBP project are organizational and human in nature. More specifically they include: staff members with inadequate experience in EBP, time and having very tight work schedules. Based on the fact that this acute care surgical unit often receives a lot of patients as it serves a larger population and nurse’s work routinely under very tight work schedules, their availability to actively engage in the EBP is limited (Solomons & Spross, 2011).picot and Case for ebp – sample pain management nursing essay

The facilitators towards the implementation of this EBP project are as follows: the surgical unit has serves a larger population which includes both children and adults. The nursing staffs in the surgical unit have focused on improving patients’ quality of care   to ease post-operative pain while integrating evidence based practice and pain management guidelines. As a result, the organization’s administrations as well as other healthcare providers have become concerned on the need to determine how their perception, attitude and knowledge influence pain management (Solomons & Spross, 2011). Besides, the organization’s leadership acknowledges and supports that in order to attain quality health outcomes, EBP should be implemented. Thus, the organization is ready in terms of   the adoption and implementation of EBP.

PICOT Question

Among nurses working in acute inpatient surgical units (P), how does nurse perception and attitude (I) in comparison to No perception(C) influence the management of pain (O)?

References

Melynyk, B. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare. A guide to best practice (3rd ed.). China: Wolters Kluwer Health.

Manwere, A., Chipfuwa, T., Mukwamba, M. M., & Chironda, G. (2015). Knowledge and attitudes of registered nurses towards pain management of adult medical patients: a case of Bindura hospital.
Health Science Journal
,
9
(4), 1.

Riemondy, S., Gonzalez, L., Gosik, K., Ricords, A., & Schirm, V. (2016). Nurses’ perceptions and attitudes toward use of oral patient-controlled analgesia.
Pain Management Nursing
,
17
(2), 132-139.

Solomons, N. M., & Spross, J. A. (2011). Evidence‐based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review.
Journal of nursing management
,
19
(1), 109-120.

Yano, E. M. (2014). The role of organizational research in implementing evidence-based practice: QUERI Series.
Implementation Science
,
3
(1), 1. picot and Case for ebp – sample pain management nursing essay

Capstone. How to reduce fall rates in post-operative patients on the surgical unit

The organization is an acute inpatient surgical unit setting (a multicultural stakeholder hospital)

Before making a case for an evidence‐based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

1. Develop an analysis of 250 words from the results, addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry.

2. Make sure to include the rationale for the survey categories scores that were significantly high and low, incorporating details and/or examples. Also explain how to integrate clinical inquiry into the organization, providing strategies that strengthen the organizations weaker areas.

3.Formulate PICOT question for the intended proposal Capstone. How to reduce fall rates in post-operative patients on the surgical unit

(How to reduce fall rates for the post-operative patients in the surgical unit)

3.

4. Submit a summary of your results.

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Reducing Fall rates in Post-operative Patients In The Surgical Unit

Student’s Name

Institution of Affiliation

Course Name

Date

 

Introduction

Melynyk & Fineout-Overholt (2015) highly recommend the adoption and implementation of evidence-based practice as the most effective problem-solving approach in clinical practice. This is attributed to the fact that it   incorporates the best available scientific evidence from studies and the preferences/values of patients with a clinician’s expertise in clinical decision making regarding patient care (Solomons & Spross, 2011). This paper discusses the adoption and implementation of EBP   to reduce the fall rates among post-operative patients in the surgical unit of an acute inpatient surgical unit with multicultural stakeholders. An assessment of the organization’s readiness level to implement EBP, which can transform its culture through new practices, knowledge, values and attitude, will be discussed. Using the System-Wide Integration of Evidence Based Practice Survey, an analysis of the most potential facilitators and barriers for implementing EBP will be provided.

Organizational Readiness

Based on the survey results, this organization is ready to implement EBP. Majority of its staff are aware of the processes involved in nursing EBP and are committed to team up with other stakeholders to improve practice in the surgical unit. Besides, they are fully aware on the need for change in practice in line with the organization’s philosophy as revealed in its mission, vision, goals and objectives.

Barriers For The Implementation of EBP

The barriers to the implementation of EBP in this organization include organizational characteristics, individual characteristics of nurses and the nature of research material. It is likely that nurses may lack the skills needed to locate research details and prefer to seek the same information from colleagues as compared to searching a textbook or journal article. Other nurses might be unable to critically appraise or synthesize literature or lack computer and search skills. At organizational level, possible barriers include: lack of time to retrieve information that is clinically relevant since the surgical unit serves a large geographical area. Additionally, despite the fact that nurses are fully aware of the essence of research-based knowledge, the majority consider research as an overwhelming process. As recommended by Melynyk & Fineout-Overholt (2015), in order to integrate it into clinical practice, they need direction and more guidance. Capstone. How to reduce fall rates in post-operative patients on the surgical unit

Facilitators For The Implementation of EBP

           
The organization’s leadership is committed towards providing quality services to its patients. Therefore, it has maintained a good relation with staff and other stakeholders. Its leadership has a similar vision, mission, goals and objectives for practice with stakeholders. In order to change the culture of an organization through new practices, it is essential that the change should be consistent with the organization philosophy with adequate resource to support the intended change (Yano, 2014).

The organization’s healthcare environment promotes the independence, power and authority of nurses in clinical practice. This will undoubtedly increase the integration of EBP. Besides, the organization recently adopted the use of collaborative healthcare teams to provide culturally competent care to clients. Therefore, the ability of nurses to change a clinical practice can easily be made with the input, consent and approval of other stakeholders including: physicians, hospital administrators and other healthcare team members. Working in multidisciplinary teams will inarguably increase the success of implementation. According to Yano (2014), the use of multidisciplinary teams might bring tension among staff. However, this will be addressed by having clearly defined roles and responsibilities of each member.

The EBP has a dedicated leader with the following characteristics: positive, enthusiastic, self-driven, good interpersonal and communication skills and adequate knowledge regarding the project. The leader is also the nurse-in-charge of the surgical unit. This level of hierarchy gives her credibility in front of medical staff and other stakeholders. Lastly, staffs working in the surgical unit have recently realized a remarkable increase in fall incidences among post-operative patients. This has promoted awareness on the need for practice change and ownership of the implementation by clinicians, leaders and nurses. Capstone. How to reduce fall rates in post-operative patients on the surgical unit

PICOT Question

Among post-operative patients in the surgical unit (P), how does bedside shift report (I) compared to reports outside the patient’s room(C) help to reduce fall rates (O)?

 

References

Ackerman, D. B., Trousdale, R. T., Bieber, P., Henely, J., Pagnano, M. W., & Berry, D. J. (2010). Postoperative patient falls on an orthopedic inpatient unit.
The Journal of arthroplasty
,
25
(1), 10-14.

Melynyk, B. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare. A guide to best practice (3rd ed.). China: Wolters Kluwer Health.

Ofori-Atta, J., Binienda, M., & Chalupka, S. (2015). Bedside shift report: Implications for patient safety and quality of care.
Nursing2018
,
45
(8), 1-4.

Solomons, N. M., & Spross, J. A. (2011). Evidence‐based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review.
Journal of nursing management
,
19
(1), 109-120.

Yano, E. M. (2014). The role of organizational research in implementing evidence-based practice: QUERI Series.
Implementation Science
,
3
(1), 1. Capstone. How to reduce fall rates in post-operative patients on the surgical unit

How to Reduce fall rates in post-operative patients Capstone proposal

Capstone proposal on how to reduce fall rates in post-operative patients on the surgical unit

The proposed problem description for your EBP project, should address the following:

My capstone proposal

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How to reduce fall rates for post-operative patients in the surgical unit

1)Describe the background of the problem. Tell the story of the issue and why it deserves attention.

2)Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc

3) State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence‐based practice is introduced to identify the expected changes.

4) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.

5)Develop an initial reference list to assure that there is adequate literature to support your evidence‐based practice project. Follow the ”Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use ”NUR‐699 Search Method Example” to assist you.

6) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem. How to Reduce fall rates in post-operative patients Capstone proposal

 

Capstone Proposal

Name

Institution

Date

Capstone Proposal on how to Reduce Fall Rates in Post-Operative Patients on the Surgical Unit

Background of the Problem

Falls and their ensuing injuries significantly impact the physical, social and mental health of patients within a healthcare organization (Wildes et al, 2015). The length of the hospital stay of patients who sustain fall can extend for almost 13 days, and the incidence of such events can increase healthcare costs by about 61 percent (Mata et al, 2017). According to Luzia et al (2014) falls of hospitalized patients can lead to fracture or trauma that cause a reduction in activities of daily living. Sometimes the falls can be fatal. Accordingly, fall prevention is an important element of nursing care during patients’ hospital stay.

Patients are not normally familiar with the hospital environment and this increases the risk of falls. The arrangement of wards differs since light switches are located at different locations, and so are other facilities such as bathroom and the toilet; this can confuse post-operative patients and increase the risk of such patients falling and sustaining injuries (Vitor et al, 2015).

Surgical recovery is the time in which patients strive to regain their independence and as a result, achieve their return to activities of daily living. However, the surgical procedure increases the risk of fall for post-operative patients due to the weak physical state associated with the illness, and the subsequent surgery (Shida et al, 2015). Therefore, post-operative patients are weaker and can sustain falls afterward.

Therefore, there indicates the need to implement strategies to reduce fall rates for post-operative patients in the surgical unit.

The Stakeholders/Change Agents

Registered nurses

Unit manager

Physicians

Orthopedic specialists

Nurse champions

Pharmacy representative

Risk management department

Patients

American Nurses Association

National Database of Nursing Quality Indicators (ANA–NDNQI)

The Purpose and Project Objectives

The specific aim of the proposed project is to attain a 50% decrease of the overall fall incidents per 1000 patient days in the surgical unit and to lengthen days between falls to an average of 30 days within six months. The objective of the program is thus to establish a culture of safety in the surgical unity by decreasing fall events within the unit. Fall events among post-operative patients can lead to patient injury, patient mortality, reduce the functional mobility of the patient, increase the hospital length of stay, as well as raise the healthcare cost (Kobayashi et al, 2018).

The proposed project also aims to prevent patient harm and injury that results from fall incidents using a sustainable fall prevention program. In addition, the proposed project aims to engage the organizational staff members to drive a culture of safety through improved communication and also identify lessons from each fall incident. Finally, the project aims to decrease the cost for fall with injury as well as lower exposure to lawsuits, and improve the unit’s and hospital’s public image (Everhart et al, 2014). Basically, the proposed project can significantly impact the safety and quality of care in the surgical unit and the hospital at large. How to Reduce fall rates in post-operative patients Capstone proposal

The proposed model to guide the surgical unit in reducing the fall rate is the Kotter change model. The model will help in identifying the driving and restraining forces during the fall reduction process. Using the Kotter change model, the hospital leadership will be informed about the urgency and the significance of the fall reduction project and request for aid to support and facilitate the implementation of the proposed project (Vitor et al, 2015).

The project’s efficacy will be measured by measuring the percentage of the fall rate per 1000 patient days pre-project and post-project. The other measurement will involve measuring the number of days between falls for the patients sustaining falls within the surgical unit. Data about fall events within the surgical unit will be collected and entered into the system as falls happen for six months. This will assist in establishing baseline data regarding the rate of falls as well as falls with injury in the unit.  Similarly, after the end of the project’s implementation, data on the same will be collected. The baseline data and the post-project data will be analyzed and compared in order to determine the efficacy of the project and at the same time identify the key contributing factors that cause falls in the surgical unit.

Rationale that the Problem or Issue Needs to be Addressed

As aforementioned, falls are associated with poor health outcomes, increased mortality rate, loss of function, inability to perform activities of daily living, increased the length of hospital stay and increased healthcare costs (Shida et al, 2015). In addition, pre-operative patients are weaker and hence at an increased risk of sustaining falls. This is made worse by the fact that when pre-operative patients sustain falls, this may adversely affect the surgical procedure and even lead to severe injury or fatality (Mata et al, 2017). It is, therefore, the duty of clinicians to influence quality and safe care to the unit they provide care. The proposed project, therefore, aims to reduce the fall rate in the surgical unit and thus improve safety and health outcomes for the pre-operative patients.

 

 

References

Everhart D, Jessica S, Duncan P, Hall A, Neff D & Shorr R. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics.
Health Care Manage Rev
. 39(4), 352–360.

Kobayashi K, Kei A, Yuko I, Yusuke S, Nagao Y, & Shiro I. (2018). Characteristics of falls in orthopedic patients during hospitalization.
Nagoya J Med Sci
. 80(3), 341–349.

Luzia M, Victor G & Lucena F. (2014). Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients. Rev.
Latino-Am. Enfermagem
. 22(2), 262–268.

Mata L. Cissa A, Gabrielle P & Moraes T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.
Rev Lat Am Enfermagem
. 25(2904). How to Reduce fall rates in post-operative patients Capstone proposal

Shida D, Wakamatsu K, Tanaka Y, Yoshimura A, Kawaguchi M, Miyamoto S, et al. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40.
BMC Cancer
. 15(799), 1–6.

Vitor A, Moura L, Fernandes L, Botarelli FR, Araújo J & Vitorino I. (2015). Risk for falls in patients in the postoperative period.
Cogitare Enferm
. 20(1), 29–37.

Wildes T, Dua P, Fowler SA, Miller JP, Carpenter CR, Avidan MS, et al. (2015). Systematic review of falls in older adults with cancer.
J Geriatr Oncol
. 1(6), 70–83.

Research articles evaluation summary table

3 -1

To begin, work through the reference list that was created in the ”Section B: Problem Description” assignment in Topic 2. Appraise each resource using the ”Rapid Critical Appraisal Checklists,” available in the textbook appendix. The specific checklist you use will be determined by the type of evidence within the resource.

Then, develop a research table to organize and summarize the research studies. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention are summarized in this table. Refer to the ”Evaluation Table Template,” available in the textbook appendix. Use the ”Evaluation Table Template” as an adaptable template. Research articles evaluation summary table.

Problem Statement: Reduction of Fall Rates for Post-Operative Patients

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TEXT BOOK

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and

healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Walters Kluwer.

These are the references used in assignment 2

Everhart D, Schumacher, J.R., Duncan R.P., Hall A.G., Neff, D.F., & Shorr, R.I. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics. Health Care Management Review. 39(4), 352–360.

Kobayashi, K., Kei, A., Yuko, I., Yusuke, S., Nagao, Y., & Shiro, I. (2018). Characteristics of falls in orthopedic patients during hospitalization. Nagoya Journal of Medical Science. 80(3), 341–349.

Luzia, M., Victor, G., & Lucena, F. (2014). Nursing diagnosis risk for falls: Prevalence and clinical profile of hospitalized patients. Revista. Latino-Americano. Enfermagem. 22(2), 262–268.

Mata, L., Cissa, A., Gabrielle, P., & Moraes, T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study. Revista Latino-Americano Enfermagem. 25(2904).

Shida, D., Wakamatsu, K., Tanaka, Y., Yoshimura, A., Kawaguchi, M., Miyamoto, S. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40. BioMed central Cancer. 15(799), 1–6.

Vitor, A., Moura, L., Fernandes, L., Botarelli, F.R., Araújo, J., & Vitorino, I. (2015). Risk for falls in patients in the postoperative period. Cogitare Enferm. 20(1), 29–37.

 

Summary Table

Name

Institution

Date

 

 

Summary Table

Author (Year)

Title

Aim

Design

Sample, number of participants

Level of evidence

Findings

Everhart et al (2014)

Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics

To establish if hospitals can be classified into fall rate trajectory groups & to determine the characteristics of the nurses and healthcare organizations allied to hospital fall rate trajectory groups.

4-month longitudinal study

Research articles evaluation summary table

1,529 hospitals

 

U.S. acute care general hospitals taking part in the National Database for Nursing Quality Indicators

Level 4

Magnet hospitals lower rates of falls

Hospitals did not change their fall performance over time

There is a relationship between nurse staffing and the rate of falls

Kobayashi et al (2018)

Characteristics of falls in orthopedic patients during hospitalization

 

To establish characteristics over five years of cases of fall in orthopedic patient

Prospective study

Prospective analysis of 212,617 inpatients

Assessment of fall risk,

research articles evaluation summary table

Level 2

Fall rate is high in orthopedic patients, irrespective of a low risk management score. Therefore, it is important to ensure frequent assessments at short intervals and fall risk assessments for hospitalized orthopedic patients

Luzia et al (2014)

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients

 

To determine the incidence of diagnosis of falls in the adult patients admitted within surgical and clinical wards in order to classify the clinical profile and identify the risk factors associated with risk for falls

A cross-sectional study

174 patients

University hospital in Brazil, with 795 beds

 

Data collection was done using on-line hospital records and computerized nursing care prescriptions system and statistical analysis was done

Level 5

The risk for falls of the inpatients in surgical and clinical wards was found to be low in the researched organizations. The patients at higher risk of falls included older adults, men, surgical patients, and patients with cardiovascular diseases and neurological disorders. The risk factors for diagnosis of risk for falls included impaired mobility, increased age, neurological changes, and vulnerability associated with impaired health and medical procedures

Mata et al (2017)

Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study

To examine factors linked with the risk of fall in patients undergoing surgical procedures

A quantitate cross-sectional study

Hospital in state of Minas Gerais, Brazil

257 adult inpatients

Data collection done using sociodemographic and clinical questionnaire, the Morse Fall Scale, and the Quality of Recovery Score

Descriptive statistical analysis and multinomial logistic regression used to perform data analysis

Level 5

Factors associated with the risk of fall in adults in the postoperative hospital stay include age, surgical recovery, diabetes, cancer, and systemic arterial hypertension

Shida et al (2015)

The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40

To examine if early discharge from the hospital after surgery is compatible with a better outcome from according to the perspective of the patients

A cross-sectional study

research articles evaluation summary table

Tokyo Bokutoh Metropolitan in Hospital Tokyo Bokutoh Metropolitan Hospital

Data collected using QoR-40, a recovery-specific and patient-rated questionnaire

Level 5

Surgical procedures affect the quality of life of patients and this included mobility. Therefore, patients should not be discharged early after surgery to lower the risk associated with early hospital discharge post-operative

 

Vitor et al (2015)

Risk for falls in patients in the postoperative period

To determine and identify the factors associated with a diagnosis of risk for falls & the major risk factors in patients recovering after surgical procedures with a university hospital

A descriptive cross-sectional study, using a quantitative approach

Public tertiary teaching hospital located in the municipality of Natal/ Rio Grande do Norte, Brazil

Sample included patients in the postoperative period, admitted within the clinical surgical units of the hospital.

Sample size: 80 patients.

Level 5

Risk for falls ND found in 69 patients (86.25% of the sample)

There is a significant relationship between the surgical procedure (postoperative condition) and the elevated susceptibility of the person the risk of falls. The risk for falls during the postoperative period was attributable to syncope, weakness, and loss of balance

Anemia is a predisposing factor for falls

Narcotic and/or opioid medications used during hospitalization can be attributed to the increased risk for falls

 

 

 

 

References

Everhart D, Schumacher, J.R., Duncan R.P., Hall A.G., Neff, D.F., & Shorr, R.I. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics.
Health Care Management Review
. 39(4), 352–360.

Kobayashi, K., Kei, A., Yuko, I., Yusuke, S., Nagao, Y., & Shiro, I. (2018). Characteristics of falls in orthopedic patients during hospitalization.
Nagoya Journal of Medical Science
. 80(3), 341–349.

Luzia, M., Victor, G., & Lucena, F. (2014). Nursing diagnosis risk for falls: Prevalence and clinical profile of hospitalized patients. Revista. Latino-Americano.
Enfermagem
. 22(2), 262–268. research articles evaluation summary table

Mata, L., Cissa, A., Gabrielle, P., & Moraes, T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.
Revista Latino-Americano Enfermagem.
25(2904).

Shida, D., Wakamatsu, K., Tanaka, Y., Yoshimura, A., Kawaguchi, M., Miyamoto, S. (2015).

The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40.
BioMed central Cancer
. 15(799), 1–6.

Vitor, A., Moura, L., Fernandes, L., Botarelli, F.R., Araújo, J., & Vitorino, I. (2015). Risk

for falls in patients in the postoperative period.
Cogitare Enferm
. 20(1), 29–37. research articles evaluation summary table

Narrative research support for proposed project / problem

3- two

Write a narrative of 750‐1,000 words that presents the research support for the projects problem and proposed solution.

Problem Statement: Reduction of Fall Rates for Post-Operative Patients

Make sure to do the following:

1. Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).

2. Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.

3. Incorporate a description of the validity of the internal and external research. Narrative research support for proposed project / problem

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It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer‐reviewed professional journal articles.

These are the references used in assignment 2

Everhart D, Schumacher, J.R., Duncan R.P., Hall A.G., Neff, D.F., & Shorr, R.I. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics. Health Care Management Review. 39(4), 352–360.

Kobayashi, K., Kei, A., Yuko, I., Yusuke, S., Nagao, Y., & Shiro, I. (2018). Characteristics of falls in orthopedic patients during hospitalization. Nagoya Journal of Medical Science. 80(3), 341–349.

Luzia, M., Victor, G., & Lucena, F. (2014). Nursing diagnosis risk for falls: Prevalence and clinical profile of hospitalized patients. Revista. Latino-Americano. Enfermagem. 22(2), 262–268. Narrative research support for proposed project / problem

Mata, L., Cissa, A., Gabrielle, P., & Moraes, T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study. Revista Latino-Americano Enfermagem. 25(2904).

Shida, D., Wakamatsu, K., Tanaka, Y., Yoshimura, A., Kawaguchi, M., Miyamoto, S. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40. BioMed central Cancer. 15(799), 1–6.

Vitor, A., Moura, L., Fernandes, L., Botarelli, F.R., Araújo, J., & Vitorino, I. (2015). Risk for falls in patients in the postoperative period. Cogitare Enferm. 20(1), 29–37.

 

Reduction of Fall Rates for Post-Operative Patients

Description of the Search Method

A comprehensive bibliographic search was performed using various electronic databases such as PubMed, Wiley library databases, EbscoHost, Web of science, Google Scholar and CINAHL. The purpose of performing bibliographic search was to locate the relevant and quality research articles to be used in the study topic. Reference lists of the retrieved research articles were also analyzed and any article in the list that was found to have met the inclusion criteria of this study was searched. In addition, to conduct the search, the PICO was broken down into difference terms as indicated below:

In post-operative patients (P), what are the evidence-based practice nursing interventions (I), when compared to no interventions (C), that can reduce the fall rate (O)?

The keywords used during the search included fall rates, fall prevention, patient falls, nursing interventions, and safety and inpatient falls.

The inclusion criteria include peer-reviewed research studies; studies published between 2014-2019; studies investigating fall rates among inpatients; and studies published in English language.

Summary of Research Studies used as Evidence

According to Mata et al (2017) falls sustained during hospitalization results to increased length of hospital stay, complications and even increment of the healthcare costs. Luzia et al (2014) further explains that falls in inpatients can result to trauma of fractures that further reduce the quality of life and the ability of the patient to perform activities of daily living. Vitor et al, (2015) explains that the inpatients are unfamiliar with the hospital setting and this increases the probability of the patients sustaining falls. The reason is that the hospital setting is completely different with the home setting where facilities like toilet and bathrooms are located in completely different locations, as well as electricity switches; this can lead to confusing among post-operative patients and thus increase their risk for falls and the subsequent injuries.

Shida et al, (2015) opines that post-operative patients normally try to achieve their mobility and regain independence in order to be able to return to performing the normal activities of daily living. post-operative period is also characterized with pain which hinders the patient in so many aspects such as walking properly. This shows that surgeries increase the risk of fall for the patients because of the associated physical weakness. This is the reason post-operative patients are at an increased risk for falls. Everhart et al (2014) further explain that patient fall in healthcare setting represent a major patient safety concern.  Kobayash et al (2018) majority of patients undergoing surgeries need special circumstances that enable them to adapt to the perioperative period in order to reduce the risk of fall.  This is supported by Victor et al (2014) who exlians that patients in hospitals especially those within the postoperative during are predisposed to a number of complications and one of the complications is the risk for falls. Accordingly, falls rate among the common adverse incidents that occur among the inpatients.

Everhart et al (2014) conducted longitudinal study in an acute care hospital while Kobayash et al (2018) prospectively used a database within the institution’s incident reporting system. Luzia et al (2014) conducted a cross-sectional study with a sample of 174 patients. The data collection was done using a computerized nursing care prescriptions system and then statistical data analysis was done. Mata et al (2017) used quantitative and cross-sectional method and used 257 adult patients. The data collection was done utilizing sociodemographic and clinical questionnaire. Shida et al (2014) used the QoR-40 and questionnaire to assess the patients’ postoperative recovery. Vitor, et al (2015) used a quantitative approach to perform a descriptive cross-section study. Narrative research support for proposed project / problem

Validity of the Internal and External Research

The validity of the studies that were selected to be used in this proposal was addressed using different kinds of validity that include convergent validity, face validity, and content validity. According to Dini et al., 2014) these are the key elements used to assure quality in research. Reliability was achieved by examining the consistency of the studies. Various tools used to text the consistency included instruments like Cronbach’s alpha and KMO Bartlett’s test (Dini et al., 2014). However, in some studies the author developed own tools to collect the data while other authors used data collection tools that reliability and validity has been validated. Finally, rigor of the research ensured the validity of the research. This was achieved by performing a wide literature review to locate all available relevant studies and research on the study topic. Tools such as McMaster appraisal checklists and CASP were also used to rate all the articles included in this study to further ensure their quality (Dini et al., 2014).

 

References

Dini, A.P., Alves, D.F.D.S., Oliveira, H.C. and Guirardello, E.D.B., 2014. Validity and reliability of a pediatric patient classification instrument. 
Revista latino-americana de enfermagem
, 
22
(4), pp.598-603.

Everhart D, Jessica S, Duncan P, Hall A, Neff D & Shorr R. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics.
Health Care Manage Rev
. 39(4), 352–360. Narrative research support for proposed project / problem

Kobayashi K, Kei A, Yuko I, Yusuke S, Nagao Y, & Shiro I. (2018). Characteristics of falls in orthopedic patients during hospitalization.
Nagoya J Med Sci
. 80(3), 341–349.

Luzia M, Victor G & Lucena F. (2014). Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients. Rev.
Latino-Am. Enfermagem
. 22(2), 262–268.

Mata L. Cissa A, Gabrielle P & Moraes T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.
Rev Lat Am Enfermagem
. 25(2904). Narrative research support for proposed project / problem

Shida D, Wakamatsu K, Tanaka Y, Yoshimura A, Kawaguchi M, Miyamoto S, et al. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40.
BMC Cancer
. 15(799), 1–6.

Vitor A, Moura L, Fernandes L, Botarelli FR, Araújo J & Vitorino I. (2015). Risk for falls in patients in the postoperative period.
Cogitare Enferm
. 20(1), 29–37.

Proposed EBP Project Solution

proposed evidence‐based practice project solution. Address the following criteria:

1. Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.

2. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.

BUY A PLAGIARISM-FREE PAPER HERE

Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT. PICOT (P) For post-operative patients, (I) can standardized hourly rounding by a medical team be a better deterrent (C) compared to bed alarms or other tools that are readily available within a hospital (O) and designed to reduce patient fall risk (T) during hospitalization.

3. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.

4. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient‐centered quality care, efficiency of processes, environmental changes, and/or professional expertise. Proposed EBP Project Solution

 

Proposed Evidence‐Based Practice Project Solution

Student’s Name

Institution of Affiliation

Course Name

Date

 

Proposed Solution

Postoperative patients are at high risk of falls in acute care settings. The outcomes associated with falls in this patient population include disability, prolonged hospital stays, additional medical costs, loss of independence and loss of hospital revenue. Some of the most prevalent causes of falls among post-operative patients are associated with mental, physical, emotional, social and physiological symptoms of an individual (Mitchell et al., 2014). The most preferred approach to ensure a reduction in fall incidences among post-operative patients in clinical settings is through standardized hourly rounding by healthcare teams.

Standardized hourly rounding has proven to be a highly effective and proactive approach of communicating with families and patients to address their needs during hospitalization. As noted by Moorer et al., (2017), it is used in the clinical setting to promote the ability of the healthcare team members to assess the most potential risks that are likely to result to falls among post-operative patients and institute prevention measures where necessary. Standardized hourly rounding has also shown to increase patient safety, nursing efficiency and to reduce documentation (Morgan, 2019). When conducting around, the medical team should assess the 4 P’s (pain, personal needs, position, and placement).

During the rounding process, a patient’s pain level should be assessed and if need be, pain mediation administered. Members of the medical team can also address a patient’s needs such as offering assistance to use the toilet, nutrition or hydration. For patients who are wrongly positioned, medical team members can help them to get into a comfortable position. For post-operative patients who are immobile, they should be turned to ensure that the integrity of the skin is maintained. With regards to placement, an hourly rounding process would help to ensure that the patient’s most vital needs such as equipment for toileting, phone or bed alarm can easily be reached. Lastly, with regards to preventing falls, in this case, a patient or family caregiver can be asked to sound the bell alarm when the patient needs to get out of bed.

The proposed intervention has been embraced in most care settings as a quality improvement strategy that increases patient safety and the satisfaction of staff and patients. The implementation of this intervention is realistic since there’s available staff who are adequately informed on the need to deliver this intervention. Besides, the intervention is cost-effective as it will not incur any additional costs. Instead, it will help the organization to save on additional healthcare-related costs and collect more revenue.

Organization Culture

The organization purposes to provide quality surgical care for individuals suffering from both chronic and acute illnesses and uphold an environment that promotes healing as revealed in its mission, vision, goals, and objectives. It is also determined to prevent additional harm and complications to post-operative hospitalized patients through interprofessional collaboration, evidence-based research, effective leadership, and communication. Post-operative patients have numerous needs that should be addressed including spiritual, emotional, nutritional, physical, psychological, physiological and social needs. This requires intervention from different providers including a nutritionist, physiotherapist, psychologist, physician and pharmacist among others. As supported by Jacobs (2014), the adoption of a multidisciplinary team approach for standardized rounding will promote nurses ability to change specific clinical practices with the consent, input and approval of other stakeholders and all a patient’s needs will be addressed.

To promote evidence-based research, the organization has been transformed into a learning organization and has a library that is fully equipped with adequate resources. Besides, the staffs have adequate knowledge and skills in conducting literature searches, critiquing and synthesizing literature to address specific clinical problems. Therefore, integrating the proposed evidence-based solution into clinical practice will be efficient and effective. Proposed EBP Project Solution

Method to Achieve Outcomes

The outcomes to be achieved following the implementation of standardized hourly rounding by a medical team are as follows:

A significant reduction in fall incidences among post-operative patients in the surgical unit based on outcome data as compared to baseline data

Shorter hospital stays, reduced mortality and morbidity rates based on monthly mortality and morbidity data

Increased staff and patient satisfaction as evidenced by low readmission rates

Increased hospital revenue based on financial outcome and baseline financial data

Potential barriers to the achievement of the aforementioned outcomes that may hinder the implementation of the proposed solution can be categorized under individual and organizational characteristics. To ensure success, these barriers ought to be assessed and eliminated. Individual barriers: some nurses lacking the skills to locate research sources and opting to seek for information from colleagues as opposed to conducting a scientific search in scientific databases (Odias, 2015). Other stakeholders may have the skills to critique, appraise and synthesize literature but lack technology/computer skills which can, however, be addressed through training. A potential organizational barrier is the lack of adequate time to participate in the entire process since staffs in the surgical department are often engaged.

Outcome Impact

Following the implementation of standardized hourly rounding with a medical team, it is expected that the outcomes will impact the following indicators: improving patient-centered quality care since every patient’s need will be addressed separately by members of a healthcare team. Interprofessional collaboration will promote members of the medical team to acquire new knowledge and skills which enhances professional expertise.  Since the proposed solution aims at reducing the incidence of falls among post-operative patients, it is expected that it will result to shorter hospital stays, reduced medical costs and improved health outcomes which denote an improvement in the quality of care. Proposed EBP Project Solution

 

References

Jacobs, D. (2014). Evidence-Based Falls Management Program in the Nursing Home.

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly rounding to improve nursing responsiveness: a systematic review. 
The Journal of nursing administration
, 
44
(9), 462.

Morgan, K. (2019). Improving Nurse Responsiveness through Advanced Call Bell Implementation & Hourly Rounding.

Moorer, M. B. A., Kunupakaphun, S., Delgado, E., Moody, M., Wolf, M. S. N., Moore, R. N., & Eamranond, M. D. (2017). Using appreciative inquiry as a framework to enhance the patient experience. 
Patient Experience Journal
, 
4
(3), 128-135.

Odias, M. J. B. (2015). Barriers encountered by nurses and nursing assistants that prevent purposeful rounding.

Tatevossian, A. (2017). Fall Prevention: Responder 5 Bed Connectors. Proposed EBP Project Solution