L160: Nursing Leadership and Management Field Experience
Task 1: Proposed Project Pre-Implementation Field Experience
Agenda and Leadership Strategies
Leadership is the process of facilitating individual and collective efforts to influence people to realize what needs to be done to achieve set goals (Mikkelsen & Riis, 2017). Effective behaviors of leaders have a positive influence on employees and can help give meaning to the actions of employees leading to the achievement of set objectives. Leadership effectiveness utilizes various strategies that include leadership communication styles, the behavior of the leader, leadership ethics, and leadership style. The first leadership strategy I will use during the HIP kick-off meeting to encourage the project team is effective communication. I will ensure to use a functional communication style that suits all stakeholders to ensure they understand the importance of the project and what can be achieved upon completion.
The second leadership strategy that I believe will be most effective is employing the participative leadership style. This leadership approach involves listening to the employees and involving them in the decision-making process (Mikkelsen & Riis, 2017). I will allow the stakeholders to give their views about the implementation of hourly rounding and any changes to the implementation plan that they feel could produce the best results. I will establish a shared vision to motivate team members to be part of the HIP and seek their help to ensure the project succeeds. The third strategy that can help keep the implementation team together is the application of leadership ethics and behavior (Mikkelsen & Riis, 2017). For example, I will demonstrate concern for sustainability, and integrity, and present the project with consideration of internal and external forces driving the change. Demonstrating concern for the well-being of the organization and the patient during the initial meeting will help encourage the project team members to be supportive.
Training Plan
Key topics. Intentional rounding is a structured process where nurses in acute wards carry out regular checks using a standardized protocol (Harris et al., 2017). The first topic during training will focus on enlightening the healthcare providers on the components of the intentional rounding protocol. For example, nurses will be trained on how to introduce themselves to patients and tasks that should be of priority during rounding. The second topic will focus on the 4ps of intentional rounding. These include positioning, personal needs, pain, and placement (Harris et al., 2017). The third topic will focus on documentation of findings in the EHR and how to review fall rates at the end of each shift.
Training method. Healthcare research demonstrates that there are no simple magic bullets to achieve effective training. Nurse educators are advised to use a variety of means to ensure staff gets the message clearly and at their convenience. Because the majority of the staff operating area is available during the day, the primary training method will be in-person training. The face-to-face training method will allow for interaction with staff and demonstration of intentional rounding. The second method will involve online training using computer-based presentations and virtual lectures. Staff that usually do night duty and those not available in the facility will benefit from this online training method.
Training Schedule. The training schedule considered for this project will involve both morning and evening training sessions from Monday to Friday. In the morning, training will begin from 9.00 a.m to 10.00 a. m to allow night duty staff enough time to break from their duties. In the evening, training will begin from 3.00 p.m to 4. 00 p.m and will mainly target the day-shift staff. Online training will be available during the weekend and it begins from 3. 00 p.m to 4.00 p.m on Saturday and Sunday.
Training outcomes. Assessing staff for knowledge and skills gained during training will be crucial to determine the overall success of the HIP. After completion of training, a small quiz containing approximately 5 to 10 questions will be given. Each member will be required to score 80% and above to pass the exam. An online version of the questions will also be available for those wishing to complete their training online.
Validation of Training Plan
To ensure that time, effort, and money invested in training is worthwhile, it is important to validate the training. Validation means evaluating the training to see if it meets the identified needs and it succeeds in raising productivity. The first step of validation will involve presenting the plan to the nurse educator who has expertise and knowledge on how intentional rounding is done and how staff should be trained. Secondly, I will use performance measures to gauge the success of the process for which the training is being used. For example, the number of complaints from staff regarding the topics discussed will determine if the training was effective or not. Lastly, I will validate the training using an evaluation questionnaire designed using elements from the standardized intentional rounding protocol. Staff will provide their feedback regarding the effectiveness of the training, skills gained, and how the training helped them better understand intentional rounding.
Proposed Project Implementation and Control Field Experience
Project Proposal Journal
Project managers are busy people, often managing many aspects of the project at the same time. A project journal can help the manager to think about the project from a different angle and gain clarity from random thoughts that arise during the day. The first way I will use my HIP journal is to organize time and adjust schedules according to the perceived changes. For example, The project journal will keep track of the dates and time of the meetings spent on each meeting. I will use the information from the journal to adjust time frames during training and meetings with key stakeholders. I believe the journal will be crucial in dictating what minutes will be discussed in meetings and other important aspects like postponement of meetings based on the availability of the stakeholders.
The second way I will use the HIP journal will be to solve emerging problems during the implementation phase of the project. For example, using the brainstorming and reflection approaches, I will keep notes on the anticipated problems and strategies to solve each problem as it arises. Additionally, I can use the journal to plan for the next steps including agendas for other meetings with staff or stakeholders. I will use the journal to identify lessons learned from key interventions during the project and use it to avoid errors earlier observed to cause technical hitches.
Project Management Strategy
Identifying and removing barriers. Barriers are a common phenomenon during the implementation of projects, but the key to the project’s success is early identification and mitigation of barriers. To identify and remove barriers, I will use the force-field analysis done during the proposal and involve the subject matter expert. For example, I will involve the SME if my team will appear unprepared before the start of the project and implement communication strategies to ensure all stakeholders are on the same page.
Using rapid cycle improvement modification. A rapid cycle modification will be used if the project implementation including training fails to meet the expected goals. To effectively modify the cycle, I will involve key stakeholders like the nurse educator whose expertise can help to achieve set goals. For example, staff may fail to understand what is expected of them during intentional rounding during training. Using the plan-do-study-act cycle, I will compare the goals and teaching strategies used to make necessary changes that can lead to desirable outcomes.
Monitoring and supporting the staff. Monitoring and supporting staff during the project is crucial to minimizing errors and promoting acceptance of the new change. One of the strategies that I intend to use to monitor and support staff is through regular meetings with staff including individual sessions with those with personal problems. I will use the meetings to clarify challenging aspects of the project and provide solutions. For example, I will conduct weekly meetings with CNAs and check their logs to ensure active participation in hourly rounding as assigned by the unit managers.
Monitoring the project schedule. I will use the Gantt chart to monitor the project schedule and mark tasks as they are completed. If problems with scheduling arise during the implementation of the HIP, I will organize meetings with stakeholders to discuss changes. For example, during the training of staff, I will keep a checklist of the items required to be done and their due dates. I will mark the completion of these tasks on the Gantt chart and provide weekly updates to staff and other stakeholders.
Monitoring the project budget. Project budget tracking enables managers to monitor how much of the budget has been spent over time, see how much is remaining, and correct any deviations from the original plan. The best strategy to monitor the HIP budget is through weekly evaluation and discussion of the budget with stakeholders. For example, the training budget will be discussed at the end of every training week and changes made if necessary. Any deviations from the original budget will be investigated and the results discussed openly during scheduled meetings.
Ensuring compliance with organizational standards and practices. Compliance with organizational standards and practices will be monitored by the assigned accreditation manager. During weekly meetings, the manager will provide updates on rounding changes that may develop. For example, the organization may consider modifying the 4ps of the intentional rounding protocol and include another quality intervention like ‘protect’ during the project. The accreditation manager will discuss such changes during meetings and ensure staff is informed and trained accordingly.
Project Status Reporting Methods
A project status report is a document that summarizes the overall progress of the project against the initial plan. The aim of providing the report is to keep the stakeholders updated, mitigate issues, and ensure the completion of the project according to the time frame. The first method that will be used to provide updates to the project team members is planned meetings. The meetings will be held after the completion of each phase of the project to discuss important issues like budgeting and training. The second method of updating the team members will be through emails and internal memos. These platforms will be used to provide members with weekly status report updates and meeting dates. Providing information via these platforms will enhance feedback delivery and regular communication of progress.
References
Harris, R., Sims, S., Levenson, R., Gourlay, S., Ross Cbe, F., Davies, N., Brearley, S., Favato, G., & Grant, R. (2017). What aspects of intentional rounding work in hospital wards, for whom and in what circumstances? A realist evaluation protocol. BMJ Open, 7(1), e014776. https://doi.org/10.1136/bmjopen-2016-014776
Mikkelsen, H., & Riis, J. O. (2017). Project Management: A Multi-Perspective Leadership Framework. Emerald Group Publishing.
