Walden NURS4221 All Weeks Discussions Latest 2019 April

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 1 Discussion

Defining Quality

As health care consumers, we all expect quality care and positive outcomes. It is important as professionals that we meet these demands of health care consumers. Consider the work of the major theorists you examined in this week’s Resources, and think about how these theories apply to your own experience as a health care customer and/or practitioner.

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 2 Discussion

Applying Measurement Tools

One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the eight components of HEDIS comprehensive diabetes care; then consider the following scenario.

You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes.

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 3 Discussion

Applying Performance Improvement Tools

Read the following scenario:

Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.

You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.

For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit eclipsing the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 4 Discussion

Root Cause Analysis

Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario.

In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 5 Discussion

Leadership Strategy

As a nurse, you serve an important role in identifying strategies to effectively manage health care resources and in leading health care quality improvement. You must be able to decide what leadership style or strategy to apply in a given situation to achieve an effective resolution of the issue. Read the following two scenarios and select one to focus on in this Discussion. Consider the leadership style or strategy that might be most effective in the scenario you selected.

Scenario 1

You work in a for-profit nursing home, with about 100 beds, on a 20-bed unit that is largely patients with Alzheimer’s disease. Your patient mix is predominantly Medicare and Medicaid patients. Your nursing home is part of a larger system that includes a major medical center, as well as VNA, outpatient dialysis, and a fully integrated network. Your nurse manager is getting feedback from the hospital that your nursing home is sending too many patients to the ED who really don’t need to go. How would you go about figuring out what could be done at the nursing home to prevent avoidable ED visits?

Scenario 2

You’ve been associated with an outpatient cardiology clinic that is part of a large academic medical center. Your patients are mostly charity care and managed Medicaid. Most have a prescription plan, but none have a “family doctor” and use the clinic (and the ED) regularly. Most are unfamiliar with their medications and do not have the resources for care coordination in their family/social network. About 25 CHF patients have been “lovingly,” but inappropriately, called “frequent fliers” because of their inability to manage their own care, their frequent visits to the ED, and their “one night stays” paid at the observation rate. As a staff nurse in this clinic, describe the strategies you could devise for you and your fellow staff nurses targeting these 25 patients. Find at least one article from the professional literature to corroborate your recommendations.

NURS4220/NURS4221 Leadership Competencies in Nursing and Healthcare

Week 6 Discussion

The Nurse’s Role in Promoting Quality Health Care

As you have noted in this course and in your practice, nurses have an integral role in promoting a just culture focused on patient safety in their health care organizations. Determining resources to prevent error and improve patient safety can often be a battle, and this scenario illustrates how one organization makes strides to make sure resources are available in the interest of patient safety. As you review the scenario, consider the nurse’s role in promoting a just culture in your practice setting.