NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Post your definition of quality, and apply it to the work of one major quality theorist (e.g., Donabedian, Juran, Deming, Triple Aim (IHI) – Berwick). Identify a practice problem that you have had some experience with as a customer or as a practitioner and explain how eliminating wasteful practices could have improved the experience. Include how your definition of quality applies to that experience.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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 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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Take on the role of the staff nurse in the scenario and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all components of HEDIS comprehensive diabetes care.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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.
Document: Strategies and Interventions (PDF)Download Strategies and Interventions (PDF)
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 exceeding 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?
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the quality improvement tools and explain how they contributed to the outcome.
Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Post each of the following:
Analyze the composition of the RCA team. Explain what knowledge they can contribute to the RCA.
Describe the collaboration in the case study that led to effective problem solving. Identify the evidence you observe in the scenario that demonstrates effective collaboration and the avoidance of blaming.
Explain the team’s process in testing for and eliminating root causes that were not contributing.
Select one of the performance improvement charts presented in the scenario and critique its effectiveness by explaining how it contributes to identifying the root cause and determining a solution to prevent repeat medication errors.
Identify the contributing factors and discuss how to prevent this kind of error from occurring in the future.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Select one of the scenarios, and post the following:
Describe the most appropriate leadership style and/or strategy to apply in the scenario you chose in order to implement the recommendations successfully. Justify your selection.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3
Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 1: Practice Experience – Project Groups
IDENTIFYING A PRACTICE PROBLEM IN NEED OF IMPROVEMENT
In this week’s Discussion, you shared your experiences with health care practice problems as a consumer and/or as a practitioner. Now, consider your current practice setting and think about something specific and relevant to your practice setting that you would like to see improved or changed. Interview a key leader in your practice setting who can confirm that your practice problem is one that should be addressed to enhance delivery or performance in the field. It is important to remember from the beginning that your practice problem must be measurable, and that you identify data that suggests a problem exists, and although this comes up more specifically in Week 2, it is important to consider this from the start.
This will be the problem discussed in your Practice Experience Project, Capstone Paper, and Storyboard.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Identify a measurable patient-centered practice problem related to quality or safety and relevant to your practice setting that you will also focus on in your Capstone Paper and post a brief description of the problem and an explanation of why you selected it. Explain how the conversation you had with the key leader in your practice setting impacted your decision to address this particular practice problem. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from your practice area and describe the data that is available.
You will not be collecting any data during the practice experience project; you will use data already available to you in your workplace or other practice setting. Think about the different kinds of data that is shared with you in your work area. For example, data may include patient satisfaction scores, medication error rates, fall, CLABSI or CAUTI rates. Analyzing the data available to you is how you will identify that a quality problem exists. Data identifies potential areas for improvement and monitors the effectiveness of any changes. It is important to obtain baseline data before beginning a quality improvement project and to analyze results during and at the end of a project.
Note: The practice problem must be related to patient outcomes. (Staffing cannot be your main practice problem for the completion of the Practice Experience Project and Capstone Paper.)
Note: If you use the same practice problem that was presented in the Week 1 Discussion on quality theories, keep in mind that you must be much more specific in this post and explain how it is relevant to your setting and nursing practice.
BY DAY 7
Read two or more of your colleagues’ postings from the Discussion question.
Respond to at least two of your classmates. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project. Provide support and suggestions on the importance of the practice problem in improving patient outcomes.
Post a Discussion entry on three different days of the week.
Capstone Paper (4–5 pages)
In each week of this course you will apply the steps of the quality improvement process to a real practice problem. This Capstone Paper will provide the comprehensive discussion of your Practice Experience Quality Improvement Project.
The Capstone Paper will be submitted in two parts. Part I is submitted in Week 3 and Part II will be submitted in Week 5. The two parts of the Capstone are designed to be easily combined into one document and used in conjunction with your storyboard to present a quality improvement plan. After incorporating instructor feedback, you may use these documents demonstrate to your employer an understanding of quality improvement processes that improve patient care and/or patient safety.
You are expected to use high-quality, credible, relevant sources to develop ideas that are appropriate for the discipline and genre of the writing. You must use a minimum of five evidenced based resources. Including research studies (at least two or three), clinical guidelines, expert opinions, and other relevant information. You will incorporate the results into your quality improvement project, capstone paper, and storyboard. Textbooks may be used on a limited basis but do not count in the five references. (All work must be supported by the literature and cited correctly in text and in the reference list.)
Each section of the Capstone Paper must meet the following Capstone Level writing expectation:
Demonstrate a thorough understanding of context, audience, and purpose.
Use appropriate, relevant, and compelling content to illustrate mastery of the subject, conveying the writer’s understanding and shaping the whole work.
Employ the revision process and take responsibility for proofreading for writing errors before submission.
The capstone must demonstrate detailed attention to, and successful execution of, a wide range of conventions particular to a specific discipline and/or writing task(s), including:
Show organization, content, presentation, formatting, and stylistic choices.
Demonstrate skillful use of high quality, credible, relevant sources to develop ideas that are appropriate for the discipline and genre of the writing.
Use appropriate and persuasive language that communicates meaning to readers with clarity and fluency and is virtually error-free.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 2: Practice Experience – Project Groups
APPLYING MEASUREMENT TOOLS TO A PRACTICE PROBLEM
Conduct a collaboration interview with two or three key leaders in your practice setting to determine the measures for your practice problem and associated challenges impacting measurement for your practice problem (include confidentiality, anonymity, access issues, etc.). Perform an existing evidence review on your practice problem and search for evidence that demonstrates how your practice problem is measured across the country.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Post a description of the measures identified from the interviews, the challenges to obtaining the data that were discussed, and a summary of how this quality indicator is measured in the literature. Discuss any gaps in the data that were identified and additional sources that might be needed to obtain this data. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from practice and data that is available.
BY DAY 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on the quality of data that was obtained and recommendations on where additional sources of data might be found. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 3 Practice Experience – Project Groups
APPLYING PROCESS IMPROVEMENT MODELS
Choose a Quality Improvement Model from Chapter 5 in the Spath (2018) textbook and apply this model to your practice problem. Please do not choose Lean or Six Sigma as your quality model unless you have an expert in these quality models in your organization to guide you through the process.
PDSA (p.124).
RCI (p.127).
FOCUS PDCA (p.128).
FADE (p.129).
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Post a Discussion entry describing the model that you selected and how each step of the model will be used to develop the plan for the Practice Experience Project. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
BY DAY 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on the selected model, and offer other models if appropriate for their project. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 4 Practice Experience – Project Groups
STAKEHOLDER ANALYSIS
The next step in the process is to begin identifying the challenges and impediments to implementing a quality improvement plan. In the analysis consider the individuals affected by the change as well as the cost of implementing the quality improvement plan.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Post a description of some of the proposed action steps for implementing improved practice and explain where potential challenges might compromise your proposed improvement project. Describe what resources are needed for your solution and explain whether those resources are cost-effective or not. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
BY DAY 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on potential challenges you see might compromise the improvement project and what other resources might be more cost effective. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 5 Practice Experience – Project Groups
APPLYING KEY INTERVENTIONS TO A PRACTICE PROBLEM
The final step is to develop the plan discussing the steps clearly and succinctly. The plan must be evidence-based.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Post an explanation of how you could apply key interventions supported by the scholarly research evidence to potentially help resolve the issue in measurable ways. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
BY DAY 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback about the selected measures or provide suggestions for improving how the patient quality and safety outcomes could be addressed by care coordination techniques and effective leadership style. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Leadership Competencies-Summer 2024
Week 3 Assignment
CAPSTONE PAPER, PART I: INTRODUCTION, ANALYSIS OF EXISTING EVIDENCE, AND QUALITY IMPROVEMENT PROCESS
The Assignment you will submit this week will combine the work you completed in Week 1 (Introduction) and Week 2 (Analysis of Existing Evidence) and this week’s assignment, the Quality Improvement Process. These three sections, when combined, will complete Part I of your Capstone Paper.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare for this Assignment:
Review the Capstone Paper Assignment GuideDownload Capstone Paper Assignment Guide
Locate the most current version of your Week 1 and Week 2 Assignment. You will add this section to that document.
Review the new expectations for Use of evidence and Credit to Source:
http://academLinks to an external site.icguides.waldenu.edu/writingcenter/scholarlyvoiceLinks to an external site.
http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859Links to an external site.
Review the Walden University Writing Center webpage: Using Evidence: SynthesisLinks to an external site.
Review the Week 3 Assignment Rubric
For this Assignment
Describe the quality improvement process and the Quality model that will be used. Include a description of a quality improvement tool(s) that you will use in your quality improvement plan. See Spath, (2018) chapter 6 for examples.
Explain why the specific process was selected and document your explanation with references.
For the Week 3 Assignment, you will combine your Week 1, 2 and 3 assignments and submit a 3-4-page paper that addresses the following:
Practice Problem (Completed in Week 1)
State the practice problem in measurable terms and that reflect quality indicators. Include data that suggests a practice problem exists. Do not use anecdotal experiences or opinions.
Provide a purpose statement including the importance of improving patient outcomes.
Analysis of the Existing Evidence (Completed in Week 2)
Summarize the findings from the evidence analysis that support your practice problem. Include minimum of at least 5 evidence-based practice sources that support your practice problem. Identify research, clinical guidelines, expert opinions, and other relevant information. You must include two-three research studies in your analysis. Using your own words synthesize the evidence that supports your identified practice problem. There should be no quotes or personal opinions included in this section.
Quality Improvement Process (Completed this Week) (Approximately 2-3 paragraphs)
Describe the quality improvement process and the quality model that will be used. This is not your entire quality improvement plan, only a description of the quality improvement process and the quality model you chose. You will develop your specific quality improvement plan in week 4. Include a description of a quality improvement tool(s) that you will use in your quality improvement plan. See Spath, (2018) chapter 6 for examples.
Explain why the specific process was selected and document your explanation with references.
Conclusion
BY DAY 7
Submit your Assignment.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK3Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 5 Assignment
CAPSTONE PAPER, PART II: QUALITY IMPROVEMENT PLAN, RESOURCES AND CONCLUSION
In Week 5 you will write the final section your Capstone Paper. The Assignment you will submit this week will combine the work you completed in Week 4 (Evidenced-Based Practice Plan) and will integrate the Resources and Conclusion details in approximately 3-5 paragraphs for your Capstone Paper. Be sure to include scholarly references identified in the literature review to support your EBP plan. Use appropriate and persuasive language that communicates meaning with clarity and fluency to readers, and is virtually error-free.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare for this Assignment:
Review the Capstone Paper Assignment GuideDownload Capstone Paper Assignment Guide
Locate the most current version of your Week 4 Assignment. You will add these sections to that document.
Review the new expectations for Use of evidence and Credit to Source:
http://academLinks to an external site.icguides.waldenu.edu/writingcenter/scholarlyvoiceLinks to an external site.
http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859Links to an external site.
Review the Walden University Writing Center webpage: Using Evidence: SynthesisLinks to an external site.
Review the Week 5 Assignment Rubric
Review Chapter 5 in your Spath text for examples of practice improvement plans.
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
Refer to Writing Center guidelines for how to write a summary.
Write a 3–4-page paper that addresses the following:
Introduction. Briefly review your practice problem and include a purpose statement. Include data to support the problem.
Evidence-Based Practice Plan Explanation (Completed in Week 4)
Provide a detailed explanation of the evidence-based practice quality improvement plan that you will use to address the practice problem.
Support your plan with scholarly references (the sources you found in the analysis of the evidence).
Resources (new in Week 5)
Describe the resources needed to support the change in practice such as personnel time, supplies for staff education, cost of new equipment, or cost of software.
Explain why each resource is necessary.
Conclusion
Discuss all key points addressed in this assignment.
BY DAY 7
Submit your Assignment
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
NURS-4220K-3/ NURS-4221K-3 Leadership Competencies-Summer 2024
Week 6 Assignment
QUALITY IMPROVEMENT STORYBOARD
Storyboard Instructions
The Practice Experience Project Storyboard is a brief, visual summary of a completed quality improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end.
The course template uses a PowerPoint format to complete this assignment. You only need to provide two slides, no more. The first slide is the summary of your project; the second slide is the reference page. You will need to choose the most pertinent information from your practice experience and Capstone Paper to complete the Storyboard. No voiceover is required.
The completed storyboard is submitted for grading. Optional: You may submit your storyboard to the group discussion area and share your presentation with your classmates and instructor.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 4
Submit your quality improvement storyboard using the provided template.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review
