NR703 FerdinandAkontai Applied Organizational and Leadership Concepts

Chamberlain University NR703 Course

NR703: Applied Organizational & Leadership Concepts

Week 1 Coach Check-In

Play

00:00

Mute

Welcome to Week 1 of NR703! Over the next eight weeks, you will deepen your understanding of leadership concepts and organizational models. You will begin your journey with an investigation into your skills, abilities, and talents in leadership. Reflecting honestly about your capacity will help you to learn about yourself as a leader. As you continue to build your translation science knowledge and skills repertoire, this course adds the practical applications of leading change and managing practice change projects in the clinical setting. Developing yourself into an effective leader of change within this environment is critical. As a DNP-prepared nurse, you will influence transformation of the healthcare delivery system to improve outcomes. There is so much vital work to be done, so let’s get started!

NR703 FerdinandAkontai Applied Organizational and Leadership Concepts

Lesson 1 Assessing Leadership Strengths

Assessing Leadership Strengths

There are several leadership assessments, tools, and reflection methods available to help you reflect on your skills, abilities, and talents in leadership. Many also focus on management skills, and some reveal personality characteristics.

Assessing your leadership strengths is an important first step to discovering your leadership gaps and developing a plan to bridge those gaps. One area of distinction to make is that management skills and leadership strengths differ in focus. However, both are incorporated in transformational leadership roles from the executive suite to the bedside. A transformational leader cultivates leadership behaviors and management practices to create a role that transforms people and environments.

The following table shows how leadership strengths and management skills combine to create transformational leadership.

Management Skills, Leadership Strengths, & Transformational Leadership

Leadership Strengths Management Skills Transformational Leadership
Drives innovation Drives policy Supports but validates policy using evidence and creative innovation
Guides, influences, motivates Organizes, schedules Strategically guides
Motivates, coaches, trusts Plans, budgets, evaluates Empowers teams to perform
Develops intuition and insight Develops analytic abilities Develops analytical insight
May not have developed management skills May not have developed leadership strengths Develops both management skills and leadership strengths
Power from leadership strengths Power from position and authority Power from influence
Enables Orders Guides
Develops personal agency Develops organizational agency Creates positive agency for both the team and the organization
Ethic of Care persona Ethic of Justice persona Balances the Ethics of Justice and Care in one leadership personality
Care-based Rules-based Change-based
Vision-focused Resource-focused Outcome-focused
Internal locus of control External locus of control Informed internal locus of control
Situational awareness Policy awareness Emotional intelligence

Now, stop for a moment and consider the leadership strengths you have just examined. Think also about the skillset of a manager. Although both leadership and management strengths and skills tend to cross over in transformational leadership, alone they do define distinct characteristics worth consideration.

NR703 Self-Reflection: Performance Behaviors of Transformational Leaders

The NR703 Self-Reflection: Performance Behaviors of Transformational Leaders helps you define your transformational leadership strengths and talents. Through this reflection, you can better develop effectiveness as a leader.

Click on the following link and reflect on this representative list of leader and manager performance behaviors while thinking about the Strengths-to-Strategy interactive that follows in the next section of this lesson. You can use this reflection to evaluate your overall leadership effectiveness. Then, focus on just the leadership strengths that you feel are your strongest and weakest for the Strengths-to-Strategy Interactive.

NR703: Week 1 | Self-Reflection

Self-Reflection: Performance Behaviors of Transformational Leaders

Strength Category & Performance Behaviors

Leading Strengths

Creates a Behavioral Vision

  • Behaviors reflect vision
  • Generates an image of healthy team integration
  • Inspires personal goal achievement
  • Creates a desirable image for the future

Imagines innovations

  • Courage to experiment
  • Takes calculated risks to change
  • Accepts suggestions for new ideas
  • Drives innovation & synthesis of ideas

Empowers People

  • Trusts others to act
  • Encourages individuals to take action
  • Builds confidence
  • Creates a collaborative culture
  • Reacts with situational awareness

Demonstrates Personal Ethics/Morals

  • Operates with caring (Leadership Ethic of Care)
  • Known for personal integrity
  • Does the right things when no one is watching
  • Does the right thing even if directed otherwise
  • Respects and values people
  • Exercises self-awareness & self-management (emotional intelligence)

Builds Relationships

  • Demonstrates relationship behaviors
  • Exercises social awareness & management (emotional intelligence)
  • Delivers honest but constructive communication
  • Embraces diversity & connects people
  • Reaches out to make connections
  • Adapts with Positivity

Influences Others

  • Launches events into action
  • Exhibits calmness in change
  • Inspires allegiance
  • Motivates commitment
  • Direction is future-focused

Managing Skills

Represents Organizational Vision

  • Uses positive vision language
  • Interprets the vision of the future for each individual
  • Projects the big picture
  • Promotes organizational goal achievement

Demonstrates the Workplace Standards

  • Drives organizational policy
  • Makes policy and procedure
  • Understands the business
  • Has professional (technical) expertise

Creates Organization

  • Organizes, schedules, orders, strategizes
  • Plans, budgets, evaluates (employee management tasks)
  • Directs work routines
  • Adapts to change through complexity & resolves chaos
  • Achieves strategic and operational goals

Demonstrates Organizational Ethics

  • Operates with fairness (Leadership Ethic of Justice)
  • Enforces regulations and rules fairly
  • Acts on organizational values over personal values
  • Creates a positive organizational culture

Communicates to Create Best Outcomes

  • Challenges the status quo
  • Engages evidence-based practice
  • Translates science to bridge practice gaps
  • Collaborates with interprofessional efficiency
  • Embraces & encourages change

Enables

  • Delegates authority
  • Authorizes decision-making
  • Empowers problem-solving
  • Promotes individual development

Rewards

  • Gives honest complements
  • Avoids empty praise
  • Acknowledges efforts
  • Gives public acclaim appropriately

After completing the reflection, consider your findings as you watch this video clip.

Reflect on Your Leadership Strengths (0:50)

The practical results of any leadership reflection are discovered when you apply them to those you lead. Therefore, self-reflection should focus on how best to use those results to modify your own leadership personality and behaviors. Throughout this course, you will have the opportunity to reflect on yourself as a leader in relation to different leadership topics and concepts. So, keep your mind open to change. Use the results from your NR703 Self-Reflection: Performance Behaviors of Transformational Leaders to reflect on your personal Johari window (Sharma & Sharma, 2019).

Johari Window Interactive Transcript

When you leave this course, we hope you will find that you have matured as a leader, regardless of your current role, through self-reflection and explorations—keep an open mind and be ready to change as you explore your leadership “windows”!

Leveraging Strengths as a Practice Scholar

One of the strengths of leadership is the ability to leverage skills and talents—both in yourself and in others. By developing your own Strengths-to-Strategy plan, you can better assess where strengths can be applied to compensate for areas that require development. The same dynamic can be applied to those for whom the leader manages.

Leaders also leverage the strengths of others and their teams. Astrid Baumgardner (2017) is a successful career coach who offers three tips to leverage the strengths of the team to achieve the best outcomes:

  • Know the strengths of your team members
  • Have a strengths conversation at the outset of your project
  • Allocate roles based on the strengths of your teammates (para. 8)

By knowing your strengths as a leader and the leadership strengths of your team, you can create your leadership Strengths-to-Strategy plan by identifying the following:

  • Your leadership strengths
  • Areas of opportunities for growth, improvement, and development in leadership (i.e., leadership gaps/shortcomings/weaknesses)
  • Strategies to turn these opportunities into strengths
  • Strategies for leveraging the strengths of others

An important Strengths-to-Strategy plan uses your strengths to leverage others’ strengths to provide a full complement of skills. Likewise, leveraging others’ strengths through delegation can often strengthen your own leadership gaps. As a leader, you may use this tool to create a Strengths-to-Strategy plan to support professional formation in others that you lead.

Week 1Lesson 2

Building Leadership Capacity

The Emotionally Intelligent Leader

The seminal work on emotional intelligence (EI) by Goleman (1998), suggested that EI, also called emotional quotient or EQ, may be more important in the functional world than an individual’s intellectual capabilities. In fact, one of today’s most top-rated television situational comedies, the Big Bang Theory, is based in part on that idea. Sheldon, the genius physicist, is uncomfortable with emotions, so he tries to shut them down and think rationally about himself and others around him, unable to understand why they may be happy, sad, or upset. Penny, Sheldon’s next-door neighbor, is the opposite of Sheldon. Although she has a messy, unsuccessful life in Sheldon’s opinion, she is a foil to Sheldon’s emotional blindness and self-regulatory failure by showing him her success as an EI “genius.” Ironically, Penny the waitress can teach Sheldon the genius those insights required for his further growth.

Goleman (1998) outlined the five components of EI.

  • Self-awareness
  • Self-regulation
  • Social skills (relationship management)
  • Empathy
  • Motivation

Marshall and Broome (2021) emphasize EI’s importance in numerous leadership models and even define it as a leadership model. These traits, combined with transformational leadership styles, contribute to higher project success rates than in their counterparts without high EI (Maqbool et al. (2017)

DNP-prepared nurse leaders must recognize that EI competencies are influential in both individual and organizational performance and fundamental to creating a transformational work environment.

Further your exploration of EI by viewing the following video.

View the following activity to explore emotional intelligence competencies.

Emotional Intelligence Competencies Interactive Transcript

Professional Leadership Communication

Building professional leadership capacity is a multifaceted process and one that is lifelong. EI is just one skillset through which leaders build capacity. It is not a skill that is achieved but a continuous developmental process responding to different situations, people, and environments. Leadership communication is also a facet of leadership capacity. Verbal, non-verbal, and written communication are critical nursing leadership skills, especially for the DNP-prepared nurse.

Interprofessional collaboration, effective networking, decision-making, relationship-building, conflict resolution, project dissemination, project management, and all role functions performed by the DNP-prepared nurse are dependent on effective communication skills. Like EI, communicating is learned, refined, and perfected over time and through studied application and practice.

In this course, you will use several tools to improve your standard English and writing style. This week introduces (or re-introduces) you to the CARE Plan, Grammarly, and the Chamberlain Guidelines for Writing Professional Papers—three essential professional writing tools.

CARE Plan

Use the writing CARE plan to organize the content of each paragraph purposefully!

The CARE plan acronym stands for the following:

  • Central Idea
  • Authority
  • Relevance
  • Exit

The CARE Plan helps defend against writer’s block. Likewise, if you tend to be more verbose, the CARE Plan will help slim down the unnecessary words and delete the “bunny trails” within the paragraph.

CARE Plan Interactive Transcript

Grammarly

If you have not done so already, please download the free version of Grammarly to instantly review your writing of discussions and papers in the course (and in future courses, especially the practicum courses).

Download the free Grammarly app to both your browsers (Google Chrome, Safari, or Firefox browsers work best) and your Microsoft Word program. Grammarly will prompt you for each. Grammarly will clean up most typographical errors, misspellings, grammar errors, and punctuation mistakes (including omissions and additional punctuation). It is compatible with our standard English style guide, the Publication Manual of the American Psychological Association (most current edition).

Grammarly is a FREE paper review resource that offers an upload function to submit your paper for review. It works with Google Chrome, Safari, or Firefox browsers. Grammarly scans your text for needed grammar and spelling corrections and provides vocabulary suggestions.

Punctuation Image Description

Watch the following video for a tutorial on Grammarly:

The APA Basics section of the Writing Center contains several resources such as APA paper templates and guidelines.

NR703 Week 1 Building Leadership Capacity Discussion

Purpose

The purpose of this discussion is to examine your leadership skills, determine your leadership gaps, explore developmental opportunities, and differentiate between a leader’s strengths and a manager’s skills.

Instructions

Reflect on your personal and professional experience using the lessons in Week 1, your NR703 Self-Reflection: Performance Behaviors of Transformational Leaders, and the Strengths-to-Strategy Plan results. Address the following:

  1. Describe and give examples of your two strongest leadership competencies and two most significant leadership gaps, weakness, or developmental opportunities. (1 paragraph)
  2. Describe and explain how your leadership strengths differ from management skills or behaviors. (1 paragraph)
  3. Describe how you will integrate emotional intelligence into your leadership identity and how this may impact the characteristics of your followers. (1 paragraph)

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
  2. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  3. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample NR703 Week 1 Building Leadership Capacity Discussion DQ Alexi Turk

According to Squazzo (2019), an effective leader is defined as someone with effective communication, strong relationship-building skills, adaptability, innovation, and accountability.  My two strongest leadership competencies include adaptability and effective communication.  An example of effective communication as a nurse practitioner working in the hospital or critical care setting is the ability to coordinate care across a multidisciplinary team of healthcare professionals. 

Each of these professionals has their own role and responsibilities, and in order to work effectively with different team members, one may need to adjust a communication style in order to better collaborate with a team member (Marshall and Broome, 2021).  My two biggest areas to develop as a leader include lack of focus and taking on too many tasks when leading a team.  An example of taking on too many tasks can include managing too large of a caseload while also taking on administrative tasks or completing paperwork.  This in turn can lead to a lack of focus, burn-out, and reduced job satisfaction. Sometimes I find myself saying “yes” to too many tasks and spreading myself too thin to do an effective job at the tasks.

Leadership and management are often used interchangeably, but they are distinct concepts. According to Lush (2021), management is about planning, organizing, coordinating, and controlling resources to achieve specific objectives, while leadership is about influencing people to follow a vision, inspiring them to give their best, and creating an environment that enables them to achieve their full potential. While both management and leadership are important for the success of an organization, they require different skills and behaviors.

Management is more focused on the operational aspects of an organization, while leadership is more about inspiring and motivating people toward a common goal (Lush, 2021). As a leader, this focus is more on inspiring and motivating people toward a common goal, while a manager focuses on planning, organizing, and controlling resources to achieve specific objectives (Lush, 2021). Both skills are necessary for the success of an organization, and a good leader should also have strong management skills and vice versa

Integrating emotional intelligence (EI) into leadership identity involves developing self-awareness, empathy, and self-regulation (Goleman, 1998; Maqbool et al., 2017).  Leaders who have a high degree of emotional intelligence are better able to understand their own emotions and those of others, communicate effectively, manage conflict, and build strong relationships (Goleman, 1998; Maqbool et al., 2017). Maqbool et al. (2017) found that emotional intelligence, along with project managers’ competencies and transformational leadership, significantly impacted project success. Emotional intelligence was found to be positively associated with project success, suggesting that leaders who possess high levels of EI are more likely to lead successful projects (Goleman, 1998; Maqbool et al., 2017).

References

Goleman, D. (1998). Working with emotional intelligence. Bantam Books.

Marshall, E. S., & Broome, M. E. (2021). Frameworks for becoming a transformational leader. In M. E. Broome & E. S. Marshall (Eds.), Transformational leadership in nursing: From expert clinician to influential leader (3rd ed). Springer Publishing Company.

Lush, M. (2021). The leadership versus management debate: What’s the difference? The Institute of Management New Zealand. https://www.imnz.co.nz/the-leadership-versus-management-debate

Maqbool, R., Ye, S., Manzoor, N., & Rashid, Y. (2017). The impact of emotional intelligence, project managers’ competencies, and transformational leadership on project success: An empirical perspective. Project Management Journal, 48(3), 58-75. https://doi.org/10.1177/875697281704800304

Squazzo, J. D. (2020). Defining moment for leadership: How CEOs are leading successfully. Healthcare Executive, 35(6), 20-22.

NR703 Week 2: Building Translation Science through Leadership Presence

Week 2 Student Lesson Plan

Overview

Program Competencies

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Weekly Objectives

  1. Apply leadership theories and conceptual frameworks to guide professional practice. (PCs 2, 4; PO 6; COs 1, 2)
  2. Create a foundational framework for leading translational science through transformative innovation by examining theories and conceptual models. (PCs 2, 4; PO 6; COs 1, 2)
  3. Explore mindfulness as an intentional leadership behavior. (PCs 2, 4; PO 6; CO 3)
  4. Develop an organizational needs assessment. (PC 6; PO 8; CO 5)

Main Concepts

  1. The mindful leader (PCs 2, 4, 6; POs 6, 8; COs 3, 5)
  2. Organizational needs assessment (PCs 2, 4, 6; POs 6, 8; COs 1, 5)
  3. Leading through translational science frameworks and models (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 5)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 3, 5 Wednesday
Explore Lesson COs 1, 2, 3, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 1, 2, 3, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 1, 2, 3, 5 Sunday
Translate to Practice Assignment COs 1, 2, 3, 5 Sunday
Reflect Reflection COs 1, 2, 3, 5 No submission

Foundations for Learning

Start your learning this week by reviewing the following mindfulness videos:

Benson-Silvia, D. (2013, May 6). Mindless vs mindful listening [Video]. YouTube. 

Kimball, J. (2017, July 15). Needs assessment-security coverage [Video]. YouTube. 

National Center for Complementary and Integrative Health. (2015, March 18). What is mindfulness? Q and A with Dr. Amishi Jha [Video].

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

  • Read Chapter 3
    • Section: Practice Question & Evidence
  • Read Chapter 4
    • Section: Developing Answerable EBP Question

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

  • Read Chapter 9

Required Articles

Scan the following articles on Professional Practice Models:

White, L. (2014).  Mindfulness in nursing: An evolutionary concept analysis. Journal of Advanced Nursing, 70(2), 282-294. https://doi.org/10.1111/jan.12182

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

Grimsley, S. (2015, December 24).  What is needs assessment? – Definition & example. [Video]. Study.com. 

Platt, G. (2010, June 24).  From performance gap to needs analysis. 

Learning Success Strategies

  • Start early in the week to complete the Organizational Needs Assessment
  • Start incorporating the concepts of emotional intelligence and mindfulness into your professional leadership identity.
  • Develop an awareness of the purpose for the organizational needs assessment.
  • Develop your ideas and thoughts through the interactive discussion. Review the discussion guidelines and rubric to optimize your performance.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 2 Lesson 1

  • The Mindful Leader

·   Mindfulness: The Leader’s Compliment of Emotional Intelligence

  • Mindfulness is an extension of emotional intelligence, and it is a concept that promotes the DNP-prepared nurse’s success in the many roles of leadership they will fill. Bunting (2016) defines mindfulness as “maintaining an open-hearted awareness of our thoughts, emotions, bodily sensations, and environment in the present moment” (p. xviii). Competence as a leader implies managing people, problems, and complex situations while managing your own stress. Bunting also stresses that mindfulness is a position of strength, which leads from values and accountability, inspiring vision, empowering others, caring transparently, and transforming in a positive way.
  • The evidence is clear that practicing mindfulness is a key to both self-care and leadership success. The randomized control trial conducted by Nadler et al. (2020) supports that mindfulness training enhances the traits of emotional awareness, increases resilience, promotes a positive mood, and improves leadership competencies, especially creativity and decisiveness. DNP-prepared nurses should integrate this evidence into their own practices. Effective leaders shut down and reboot during the day through mindfulness practices. Listening to your body and the world around you, being present and aware, and relaxing in the moment decrease situational stress and improve creativity and productivity.
  • View the following activity to discover mindful practice techniques. Click “Begin Here” and go through the four mindfulness practice activities. Click the “Home” button after completing each activity to return to the main menu.

·       Mindfulness Activity Transcript

 Cultivating Mindfulness

  • Breathe Mindfully: Use your breath as an anchor to still your mind and bring your focus back to the present moment.
  • Listen Deeply: Listen with intention; let others express themselves and focus on understanding how they think and feel.
  • Cultivate Insight: See life as it is; allow each experience to be an opportunity for learning.
  • Practice Compassion: Consider the thoughts and feelings of others and let kindness and empathy be your guides.
  • Limit Reactivity: Stop, breathe, and choose a skillful response; be accountable for your actions.
  • Express Gratitude: Practice gratitude and expand it outward, appreciating everyone you encounter.
  • Nurture Mutual Respect: Appreciate and value different perspectives as well as your own.
  • Build Integrity: Cultivate constructive values and consistently act from respect, honesty, and kindness.
  • Foster Leadership: Share your unique talents to inspire others.
  • Be Caring: Cultivate your own inner caring and the caring of colleagues and patients.
  • Reflection: Mindfulness is a powerful approach to self-care. It is purposefully paying attention in the present moment with a sense of acceptance and nonjudgment. How can you incorporate mindful activities into your life?  Which one will you try today? How will you use mindfulness activities to teach with purpose?

Reducing Stress through Resilient Coping

To counter stress responses, practice the 5 C’s of Coping

  • Calm. Stay calm. The brain responds best when the body is in a physiological state of equilibrium, calm and relaxed yet engaged and alert. Mindfulness practice cultivates this state of equilibrium.
  • Clarity. Nonjudgmental awareness and acceptance of experience increases the capacity to see clearly what is happening and to respond with openness.
  • Connection. Clarity of response illuminates resources. Reach out for help as needed. Learn from others.
  • Competence. Call on skills and competencies previously learned.
  • Courage. Persevere until arriving at a resolution or acceptance.

Click next to cultivate calmness, clarity, connection, competence, and courage.

  • Image of forest: Breathe in the quietude of the forest.
  • Image of mountain: Breathe in the solidity of the mountain.
  • Image of water: Breathe in the stillness of the water.
  • Image of bird soaring in air: Breathe in the spaciousness of the sky.

Guided Meditation 5 minutes

This short, guided meditation is intended to help facilitate mindful awareness on the spot in whatever you are doing. Mindfulness can be practiced at any time as a way to slow down and be fully present. Allowing the body to become still, just inviting awareness to be right here in this moment totally present. You may notice any sounds in the room, perhaps the temperature, aware of the ocean of air that you inhabit, and bringing the mind into the body, becoming aware of the movement of the breath.

Feeling the breath as it comes into the body and leaves the body. Breath flowing in and breath flowing out. Not thinking about the breath but sensing the breath directly. Observing the reliable cycle of the breath without trying to change it in anyway. Breathing in, you’re aware that you’re breathing in, and breathing out, you’re aware that you’re breathing out. And then attending to the breath, you may also become aware of sensations in the body. Just expanding your awareness to include the whole of the body. Noticing sensations, the point of contact with your seat. Perhaps noticing sensations at the soles of the feet, making contact with the floor or perhaps your hands making contact with the keyboard.

Just drawing awareness to the whole of the body in this moment. If this is a moment where you feel particularly distressed or anxious or discomforted, you may wish to take deep long in-breaths, full and deep expanding the chest, breathing down into an expanding valley, and then consciously and slowly releasing and allowing on the out breath, breathing in deeply and fully, and then releasing and allowing. Just settling into this moment. Nothing to attain. Completely inhabiting the present moment, knowing that at any point in the day, you can return to awareness of the breath.

Guided Meditation 10 minutes

In order to make a place in our lives for the regular practice of meditation, we can decide to set aside some time each day for ourselves. Time to take a break from the busyness of life, switching from a familiar mode of doing to a practice of non-doing, not having to change anything or make anything different just becoming present with kindness and curiosity to our unfolding moment-to-moment experience. So now allowing the body to become still, sitting in a straight back chair or cushion on the floor.

The back is straight without being stiff. Getting in touch with the quality of uprightness that supports awake, alert awareness. Your feet flat on the floor just under your knees, arms resting in your lap. Eyes open or closed, whichever’s most comfortable for you. Mouth slightly open to release any tension in the jaw. Just settling into this moment, feeling the support of the cushion or chair. Settling into this stable seat and allowing yourself to simply be with the feeling of sitting upright and dignified. Bringing the mind into the body and now becoming aware of the movement of the breath.

Feeling the breath as it comes into the body and leaves the body. Breath flowing in and breath flowing out. Not manipulating the breath or changing it in any way. Simply being aware of the natural rhythm of breathing. Perhaps the breath is short or maybe it’s deep and long. But just noticing and attending to the sensations of your breath exactly as it is in this moment. You may notice the breath most prominently at the nostrils. Perhaps noting the breath is slightly cooler on the in-breath and warmer on the out-breath. Just following the full journey of the in-breath and the out-breath.

You may notice on the in-breath as the chest expands and deflates on the out-breath. Perhaps you may notice the breath most prominently at the belly, sensing the belly expand and then fall back toward the spine. Picking one of these areas–the nostrils, chest, or the belly–just attend to the sensations of the in-breath and out-breath, not thinking about breathing, but feeling the breath as best you can. Observing the full and reliable cycle of breathing. Breathing in, you’re aware that you’re breathing in, and breathing out, you are aware that you are breathing out. Just allowing the breath to breathe itself.

You will find from time to time that your mind will wander off into thoughts. When you notice that your attention is no longer here and no longer with your breathing, without judging yourself, just bringing your attention back to the sensation of breath, riding the waves of your breathing. Fully conscious of the duration of each breath from moment to moment. Just gently but firmly bringing your awareness back to the present. Using your breath as an anchor to focus your attention, to bring you back to the present whenever you notice that your mind is becoming absorbed or reactive. Using your breath to help you tune into a state of relaxed awareness and stillness.

As you observe your breathing, you may find from time to time that you’re becoming aware of sensations in your body. As you maintain awareness of your breathing, see if it’s possible to expand the field of your awareness so that it includes a sense of your body as a whole. Feeling your body from head to toe. Becoming aware of all the sensations in your body. Observing not only the flow of breathing, but the sense of your body as a whole. Completely inhabiting the present moment. Dwelling in the present.

Receiving this moment, welcoming this moment, attending to each moment. Just this breath. Just this moment. Being here with whatever feelings and sensations come up at any moment, without judging them, without reacting to them, just being fully here, fully aware. Whenever you notice that your mind is wandering off, just bringing it back to your breathing and your body as you sit here, not going anywhere, not doing anything, just simply being, simply sitting. As the practice comes to an end, you might give yourself credit for having spent this time nourishing yourself in a deep way by dwelling in this state of non-doing, in the state of being. For having intentionally made time for yourself to simply be who you are, and as you move back into the world, allow the benefits of this practice to expand into every aspect of your life.

  • Further your exploration of mindfulness practice by viewing the following activity.

·       Mindfulness Slideshow Interactive Transcript

  • Slide 1: Mindfulness is the basic human ability to be fully present, to be aware of where we are and what we are doing, and not to be overly reactive or overwhelmed by what is going on around us. Please click on the “NEXT” button for tips to guide your mindfulness journey.
  • Slide 2: Keep an open mind; explore your world (yourself) and the ones around you with a spirit of curiosity.
  • Slide 3: Recognize the body’s stress reactions and decompress often (and reboot).
  • Slide 4: Learn from the theatre of life around you (mistakes are growth opportunities).
  • Slide 5: Be humble in your wisdom and make your heart accessible (practice kindness).
  • Slide 6: Be real and authentic.
  • Slide 7: Stay enthusiastic and happy.
  • Slide 8: Attend a mindfulness seminar or retreat and learn more.

Week 2 Lesson 2

NR703 FerdinandAkontai Applied Organizational and Leadership Concepts

Leading through Translational Science Change Frameworks

Organizational Needs Assessment

A primary role of DNP-prepared nurses is translating evidence into practice. You have already been conceptualizing the topic areas you are interested in developing for your DNP practice change project and have begun collecting evidence for them in a Johns Hopkins Individual Evidence Summary Tool (Dang & Dearholt, 2018).

However, you may not have considered what your practicum site needs, which may not be what you have envisioned. That raises several questions.

  • What do the stakeholders or practicum site decision-makers want you to do?
  • What answers to practice gaps do stakeholders invested in your project need answered?
  • Is the idea you have practical for the practicum site?
  • Does the organization have a larger project or agenda that a DNP project might serve?

So, the first thing a DNP-prepared nurse must do to implement a practice change project is to understand what needs to be done and why. An organizational needs assessment is the foundational planning step that you must take for your DNP practice change project. Benjamin Franklin once said, “By failing to prepare, you are preparing to fail.” You cannot prepare unless you know what needs to be done, and that may not necessarily be what you have in mind.

As Yogi Berra once quipped, “If you don’t know where you’re going, you’ll end up someplace else.”

Many nurses conceptualize an organizational needs assessment by using the familiar nursing process format (ADPIE).

ADPIE Image Description

The needs assessment also drives the three primary conceptual project areas shown here in this Conceptual Project Portrait.

Conceptual Project Portrait Image Description

Practice Gap Identification

In this week’s assignment, you will construct an organizational needs assessment at a hypothetical practicum site. This will give you practice in performing the task and reinforce that a needs assessment to identify the practice gap is the foundational starting point for your practice change project. (Typical practicum sites include advanced practice setting, acute hospital care, LTC, community setting [church], health department, and home care.)

To perform a needs assessment with the practicum site stakeholders, use the following guide to help you understand what gaps are occurring between current practice and evidence-based practice.

Practice Gap Identification Image Description

Review the following examples:

Practice Problem What is currently happening in the practicum site that causes problems? What should be happening in the practicum site based on current evidence? What do the stakeholders (decision-makers) and the evidence identify as the gap between what is currently happening and what should be happening (this is your practice gap)? Why is there a gap in practice? What factors are contributing to a gap in practice? What evidence do you have to demonstrate there is a practice gap (NDNQI, AHRQ Quality Indicators, National Hospital Quality Measures, CAHPS Hospital Survey, Joint CommissionORYX®, etc.)?
Pediatric Practice There are no clinical practice guidelines being used for the management of obese patients in a pediatric setting. Nurse Practitioners (NPs) should be using evidence-based clinical practice guidelines to better manage children who are obese. Approximately 40% of the patient population have been identified as being obese; however, there are no clear guidelines in place for the NPs to use/follow when planning patient care. Potential issue with lack of knowledge associated with updated guidelines for pediatric obesity.

Physician-owned facility; potential lack of NP autonomy regarding practice.

 Comments provided by the NPs.

NPs report they want to be able to better manage and plan care for pediatric patients who are obese.

National best-practice identifies that clinical practice guidelines should be used.

Diagnostic indicators by incidence demonstrate an increase in obesity at this practice.
Long-Term Care Facility The current practice for the prevention of unassisted falls is ineffective. Unassisted falls, including falls with injuries, should not occur in the facility. Stakeholders (particularly administrator, DON, & corporate governance) and ACHA survey results have established that there is an unacceptable rate of unassisted falls in the facility that is not being adequately addressed. The current falls prevention process is not being followed.

Specifically, the gap in practice revealed

·    The initial fall risk factor assessment was not completed consistently.

·    Patients’ medications were not always reviewed for fall risk.

·    Patients with frequent toileting needs are not always assisted in a timely manner.

 MDS assessment data for falls

Nursing Home Compare (NHC) measures

Internal QI data reports per unit

Internal Falls Prevention Audit

Risk Management data & litigation results

Week 2 References

Bunting, M. (2016). The mindful leader: 7 practices for transforming your leadership, our organization and your life. John Wiley & Sons Australia, Ltd.

Dang, D., & Dearholt, S. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau International.

Nadler, R., Carswell, J. J., & Minda, J. P. (2020). Online mindfulness training increases well-being, trait emotional intelligence, and workplace competency ratings: A randomized waitlist-controlled trial. Frontiers in Psychology, 11, 1-19. https://doi.org/10.3389/fpsyg.2020.00255

NR703 Week 2 Transformative Leader Presence Discussion

Purpose

The purpose of this discussion is to apply leadership skills, including mindfulness, to manage and sustain a practice change project.

Instructions

Understanding that the leadership characteristics you discovered in Week 1 are different competencies than management skills, describe how you might accomplish the following:

  1. Engage the project team through leadership competencies.
  2. Use mindfulness as a component of emotional intelligence to lead the project team.
  3. Influence an environment that will sustain the practice change.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample NR703 Week 2 Transformative Leader Presence Discussion Dr. Dickson and Colleagues,

Understanding that the leadership characteristics discovered in Week 1 are different competencies than management skills, I will describe how I might accomplish the following:

  1. Engage the project team through leadership competencies.
  2. Use mindfulness as a component of emotional intelligence to lead the project team.
  3. Influence an environment that will sustain the practice change.
  • Engage the project team through leadership competencies.

Leadership is essential in moving the needle to a more engaged team. In doing so, through leadership competencies I can increase the engagement levels of the project team. Team engagement, is by far one of the most important aspect in leading a project team as team member engagement strongly predicts performance. With this said, I will elicit feedback by always talking to my project team to find out how they are doing.

In addition take their proposals and solicit new ways of doing things in order to make progress on changes as this will make the members of the project team feel valued. Asking for feedback and not willing to address them will lead to the unintended consequence is disengagement (Ruiter, 2019). Communication is the cornerstone of engagement. It will be especially important to communicate during times of stress and uncertainty to empower my project team. This will be achieved by Emotional Intelligence (EI).

EI allows leaders to communicate well and make decisions that are best for all the organizations members (Barinua et al., 2022).  Competence as a leader implies managing people, problems, and complex situations while managing your own stress.  I will demonstrate empathy to engage my project team. The number one driver of engagement is trust in leadership and the best way to build trust is to show concern about the wellbeing of my team members. Also, in keeping a positive attitude the project team members will mirror my behavior.

  • Use mindfulness as a component of emotional intelligence to lead the project team.

Mindfulness is an extension of emotional intelligence that will promote my successful leadership of the project team. Mindfulness meditation has proved to be effective in increasing the well-being of those who practice it, leading to better mental health, self-care and job satisfaction (Jiménez-Picón et al., 2021). Maintaining an open-hearted awareness of my thoughts, emotions, bodily sensations, and environment in the present moment (Bunting, 2016) is essential in leading my project team.

Nadler et al. (2020) endorses that mindfulness training enhances the traits of emotional awareness, increases resilience, promotes a positive mood, and improves leadership competencies, especially creativity and decisiveness. By utilizing mindfulness to lead the project team I will be able to reduce burnout, which can manifest as emotional exhaustion, depersonalization and a reduced sense of personal accomplishment (Jiménez-Picón et al., 2021).

The reduction of burnout leads to a better performance at work, which is reflected in better communication with project teams, higher sensitivity to teams’ experiences, clearer analysis of complex situations and emotional regulation in stressful contexts (Jiménez-Picón et al., 2021). Being mindful will help me to build trust amongst the project team members.  I will achieve this by creating an environment where team members consistently feel supported and have the resources and time they need to prioritize their tasks, build healthy collaborations, and have open and positive communications.

Mindfulness teaches non-judgment. In being non-judgmental of me and non-judgmental of others when things do not turn out optimally, me and the project team will refrain from judging ourselves as failures. Rather, shift our stance from failure to feedback to determine what we can learn from this situation in order to move forward.

  • Influence an environment that will sustain the practice change.

To boost productivity and quality, it is necessary to motivate an environment that will sustain practice change. This includes keeping the lines of communication open between me and the project team. To Influence the environment that will sustain the practice change I will take the time to explain to my team why the change is happening, and what it will look like in practice.

I will make myself open to questions, hold team meetings, and invite project team members to come see me and talk through their concerns or thoughts in a neutral atmosphere. I will create a road map to help the project team understand how does the change play into the organization’s history, and how is it going to shape its future. Laying this out will clearly demonstrate the thought and strategy behind the change, and will help the project team see how it fits into, or is evolving from, what they’ve become accustomed to.

I will also invite participation as giving project team members the opportunity to participate in, or give feedback on decisions can be a really positive strategy. Project team members will be appreciative for the chance to make their voices heard, and it will also be a great way to get different perspectives and understand impacts I might not have thought of otherwise. Above all else, I will focus on maintaining and exemplifying the qualities of a great leader.

I will inspire my team; demonstrate strategic thinking; be open-minded and flexible; and show my project team that they can depend on me to have their best interests at heart. A strong leader can help their team weather the storms of change with confidence and clear-sightedness, no matter how challenging they might be.

Reference

Barinua, V., Chimere-Nwoji , C, C., & Ford, H. O. (2022). Manager’s emotional intelligence and team effectiveness: A theoretical review. Saudi Journal of Business and Management Studies. 

Bunting, M. (2016). The mindful leader: 7 practices for transforming your leadership, our organization and your life. John Wiley & Sons Australia, Ltd.

Jiménez-Picón, N., Romero-Martín, M., Ponce-Blandón, J. A., Ramirez-Baena, L., Palomo-Lara, J. C., & Gómez-Salgado, J. (2021). The relationship between mindfulness and emotional intelligence as a protective factor for healthcare professionals: Systematic Review. International Journal of Environmental Research and Public Health, 18(10), 5491. https://doi.org/10.3390/ijerph18105491

Nadler, R., Carswell, J. J., & Minda, J. P. (2020). Online mindfulness training increases well-being, trait emotional intelligence, and workplace competency ratings: A randomized waitlist-controlled trial. Frontiers in Psychology, 11, 1-19. https://doi.org/10.3389/fpsyg.2020.00255

Ruiter, P. J. A. (2019). Disengagement in health care: Today’s new culture. Canadian Journal of Physician Leadership. https://cjpl.ca/disen.html

NR703 Week 2 Organizational Needs Assessment Assignment

Purpose

The purpose of this assignment is to identify a practice problem based on an organizational needs assessment, including the identification of the practice gap and formulation of the practice question. This assignment will allow for the assimilation of professional leadership competencies in project management as a DNP-prepared nurse. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.

Please note that this is the first part of a 3-part assignment submitted in Weeks 2, 5, and 7. You will receive corrective feedback from your course faculty on the Week 2 and Week 5 assignments that you will use to prepare the Week 7 assignment.

NOTE: All NR703 assignments and their requirements should be discussed in relation to your proposed or hypothetical DNP practicum project. **No DNP practicum project will be approved for implementation until the second practicum course, NR-705 Project & Practicum II

Instructions

Complete the Organizational Needs Assessment: Practice Gap Identification Table on a healthcare organization of your choice. This will be submitted as Table 1.

Include the following in your paper:

  1. Introduction
    1. Introduce the topic and establish the importance of an organizational needs assessment.
    2. Present a clear purpose statement.
    3. Create an organizing (outline) statement for the paper that matches the required level 1 headings (except for listing the conclusion).
  2. Problem: Using the information that you gathered on the Organizational Needs Assessment: Practice Gap Identification (Table 1), describe the practice problem by explaining these elements:
    1. Describe a specific location (hospital unit, community health clinic, surgical suite, primary care practice).
    2. Identify the key stakeholders (decision-makers).
    3. Explain the practice problem as would be identified by the stakeholders.
  3. Practice Gap
    1. In 1-2 organized paragraphs, summarize your findings in table 1, the Organizational Needs Assessment: Practice Gap Identification. Ensure the table is placed after the reference list starting on its own page with the heading Table 1.
  4. Practice Question: Define and briefly explain the project’s intended population, evidence-based intervention, and measurable outcomes (PICOT):
    1. Population: Describe the specific characteristics of the population that is the focus of the intervention.
    2. Intervention: Citing evidence listed in the Johns Hopkins Individual Evidence Summary Tool (Table 2) which was initiated in NR-716, describe the evidence-based intervention. There should be a total of three (3) references listed in Table 2 for this assignment. If necessary, add one research study or systematic review to support your intervention unless one already exists on the table from your previous courses.
    3. Comparison: State “compared to current practice” for the purposes of this assignment.
    4. Create and explain specific outcome measurements based on the current evidence you have collected in the Johns Hopkins Individual Evidence Summary Tool (attached as Table 2). If needed, add one research study or systematic review that supports your proposed outcome measurements. The source can be the same one that was used to support the intervention as long as it speaks to measurable outcomes. There should be a total of three (3) references listed in Table 2 for this assignment.
    5. Time: Time frame for the project implementation. (Practicum projects are typically 8 – 10 weeks long).
    6. State the Practice Question. Example: (P) For the critical care team in X hospital’s ICU, (I) does the implementation of the medical sepsis protocol (C) compared to the current practice (O) reduce the incidence of medical sepsis diagnoses in ICU patients as measured before and after the intervention (T) over a 10-week period?
  5. Conclusion
    1. Recap the paper’s purpose statement and organizing (outlining) statement of the three level 1 headings (not including the conclusion).
    2. Draw major conclusions from the body of your paper.
    3. Summarize the importance of effective communication for the DNP-prepared nurse in performing the practice gap and problem identification.
  6. References
    1. Create the reference page.
    2. Ensure each reference has a matching citation.
    3. Include a minimum of three (3) scholarly references (all three references on the Johns Hopkins Table should be included).
  7. Tables
    1. Add the completed Table 1 & Table 2 after the reference list. For directions on how to copy a table in Microsoft Word go to the following link:
      • Link (webpage): Move or Copy a Table.
      • Table 2, the Johns Hopkins Individual Evidence Summary Tool, is attached (after Table 1) & completely filled out with at least three (3) quantitative research studies at a minimum. (NOTE: a minimum of three [3] references should be included on the reference list, including those in Table 2).

Table 1: Organizational Needs Assessment: Practice Gap Identification

What is currently happening in the practicum site that causes the problem? What should be happening in the practicum site based on current evidence*? What do the stakeholders (decision-makers) identify as the gap between what is currently happening and what should be happening (this is your practice gap)? Why is there a gap in practice?

What factors are contributing to the gap in practice?

 What evidence* do you have to demonstrate there is a practice gap (e.g., NDNQI, AHRQ Quality Indicators, National Hospital Quality Measures, HCAHPS, Joint Commission ORYX®, etc.)?
*Reference & citation required.        
[Add text] [Add text] [Add text] [Add text] [Add text]
[Add text] [Add text] [Add text] [Add text] [Add text]

PICOT Problem Statement:

P (Population – example: For critical care team in X hospital ICU…)

I (Intervention – example: Does the implementation of the medical sepsis protocol…)

C (Comparison – example: Compared to current practice). NOTE: “C” is most commonly used for research projects, not DNP translation science projects. “C,” or Comparison intervention, is implied for DNP projects, although you will see instances where the C does not apply.

O (Outcome, measurable – example: Reduce the incidence of medical sepsis in patients as measured before and after…)

T (Time – Usually 8-10 weeks for a DNP practicum project)

Review the rubric below for the grading criteria.

APA Guidelines

Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing Professional Papers: Graduate Programs (located in the Canvas Resources menu under the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.

  1. Use the standard APA Paper Template (located in the Canvas Resources: Writing Center) to format this assignment.
  2. Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before constructing the assignment.)
  3. Use the title, “Organizational Needs Assessment,” for your project and construct a title page using the APA paper template.
  4. Use the following prescribed Level 1 headings for this paper (do not include the outline letters):
    1. Problem
    2. Practice Gap
    3. Practice Question
    4. Conclusion

Writing Requirements (APA format)

  • Length: 3-4 pages (not including title page, references page, or attachments)
  • 1-inch margins
  • Double-spaced pages
  • 12-point Times New Roman
  • Headings & subheadings
  • In-text citations
  • Title page
  • Reference page
  • Standard English usage and mechanics
  • CARE Plan paragraph development structure

Program Competencies

This assignment enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Date

  • By 11:59 p.m. MT on Sunday
  • Late Assignment Policy applies

NR703 Week 3: Leading Interprofessional Teams

Week 3 Student Lesson Plan

Overview

Program Competencies

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Weekly Objectives

  1. Characterize nursing professional practice models. (PCs 2, 4; PO 6; COs 1, 2)
  2. Create an approach to lead sustainable improvements. (PCs 2, 4; PO 6; CO 2)
  3. Appraise principles of interprofessional collaboration in advanced nursing practice. (PCs 2, 4, 6; POs 6, 8; COs 2, 3, 4)
  4. Explore conflict management in an interprofessional environment. (PC 6; PO 8; CO 4)

Main Concepts

  1. Interprofessional collaboration models (PC 6; PO 8; CO 4)
  2. Professional practice models (PC 6; PO 8; CO 4)
  3. Leading sustainable improvements (PCs 2, 4; PO 6; COs 2, 3)
  4. Conflict management & leadership style (PCs 2, 4; PO 6; CO 1)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 3, 4 Wednesday
Explore Lesson COs 1, 2, 3, 4 Wednesday
Translate to Practice Discussion: Initial Post COs 1, 2, 3, 4 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 1, 2, 3, 4 Sunday
Reflect Reflection COs 1, 2, 3, 4 No submission

Foundations for Learning

Start your learning this week by reviewing the following:

Interprofessional Education Collaborative. (2011). The core competencies for interprofessional collaborative practice. 

Interprofessional Education Collaborative. (2016). The core competencies for interprofessional collaborative practice: 2016 update 

World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. 

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 4
    • Section: Understanding Professional Practice Models
    • Section: Basic Elements of a Professional Practice Model
    • Section: Building the Case for Innovative Practice Models
    • Section: Care Delivery Practice Model Influencers
    • Section: Cultural Competency of Healthcare Professionals: Leading Through Diversity
  • Read Chapter 7
    • Section: Shared Leadership and Managing Team Conflict
    • Section: Leaders Strive for Consensus

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

  • Read Chapter 9
    • Section: Interprofessional Collaboration
    • Section: Sustaining the Change
    • Section: Setting Expectations for EBP

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

  • Read Chapter 15
    • Section: Interprofessional Collaboration and Teamwork for Translation

Zaccagnini, M., & Pechacek. (2021). The Doctor of Nursing Practice essentials: A new model for advanced practice (4th ed.). Jones & Bartlett Learning.

  • Read Chapter 6
    • Section: Interprofessional Collaboration
    • Section: Barriers to and Drivers of Effective Collaboration in Interprofessional Healthcare Teams

Required Articles

Scan the following articles on Professional Practice Models:

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing. Nursing Economic$, 28(3), 171-189.

  • Please review the figure on page 172 of this seminal article.

Olender, L., Capitulo, K., & Nelson, J. (2020). The impact of interprofessional shared governance and a caring professional practice model on staffʼs self-report of caring, workplace engagement, and workplace empowerment over time. JONA: The Journal of Nursing Administration, 50(1), 52-58. https://doi.org/10.1097/NNA.0000000000000839

Review the following images/drawings of nursing professional practice models and consider how you would create a similar one:

Keleekai-Brapoh, N., & Toresco, D. (2020). Anchoring a professional practice model: Success through collaboration. Nurse Leader, 18(6), 552-556. https://doi.org/10.1016/j.mnl.2020.08.007

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

The Myers-Briggs Company. (2019, July 31). Four tips for managing conflict [Video]. YouTube. 

Silverstein, W., Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration. American Nurse Today, 12(9). 

Learning Success Strategies

  • As you review many familiar concepts in this week’s lesson and readings, reflect on their applications for you in your current and prospective practice settings.
  • Look ahead to the Week 5 assignment. Begin an outline using the assignment guidelines, and start collecting ideas and evidence now.
  • Develop your ideas and thoughts through the interactive discussion (Review the discussion guidelines and rubric to optimize your performance).
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 3 Lesson Leading Interprofessional Teams

Interprofessional Collaboration Models

The American Association of Colleges of Nursing’s (AACN, 2021) revision of The Essentials: Core Competencies for Professional Nursing Education emphasizes the importance of interprofessional partnerships and intentional collaboration across professions. At the advanced nursing education level, specific competencies are being reframed to guide nursing leaders and DNP-prepared nurses. These competencies address several areas to facilitate person-centered care by professional teams. In this draft (AACN, 2021), there are four primary competency categories:

  • Communicate in a manner that facilitates a partnership approach to quality care delivery.
  • Perform effectively in different team roles, using principles and values of team dynamics.
  • Use knowledge of nursing and other professions to address healthcare needs.
  • Work with other professions to maintain a climate of mutual learning, respect, and shared values. (pp. 43-45)

Interestingly, the core competencies of Interprofessional Education Collaborative, itself a collaboration of leaders from many different healthcare education professions, developed a similar set of competencies (IPEC, 2011/2016, p. 10).

Click on the segments in the following interactive form more information on the competencies.

IPEC Domains Interactive Transcript

An exciting study of Swiss medical and nursing interprofessional collaboration found that role clarification in interprofessional teams is crucial since leadership can change depending upon the function of the team (Josi et al., 2020). It corroborated other interprofessional collaboration models in emphasizing six domains of interprofessional care:

  1. Patient-centered care
  2. Interprofessional communication
  3. Role clarification
  4. Team functioning
  5. Collaborative leadership
  6. Interprofessional conflict resolution

Escape From the Isolated Silo!

Now that you have been introduced to leading thought trends of interprofessional collaboration, navigate your way from the nursing silo in which you are trapped into the fresh air of interprofessional collaborative practice.

Silo Interactive Transcript

Nursing Professional Practice Model

The American Nurses Credentialing Center (ANCC, 2020) historically has led the way in the development of nursing professional practice models. Most are based on, or modeled after, the ANCC’s own five components of magnet (excellent) healthcare organizations within which are embedded the 14 forces of magnetism (excellence). Notice that, while not one of the five components, the global issues in nursing and healthcare represent the global challenges faced by both. This is known as the Global Burden of Disease.

Click on each of the ANCC components to compare to the Forces of Magnetism.

Five Components Interactive Transcript

The magnet model stimulates individual organizations to create their own professional practice model tailored to their cultures, values, philosophies, quality methods, research methodologies, nursing theories, management styles, and communities. Nursing professional practice models are usually displayed graphically throughout the organization in all units to remind teams that they are all professionally performing within the same operational methods and framework. In some organizations, the model is adopted by the entire organization (not just the nursing service) to align the efforts of all.

Three explanations or examples of organizations that have implemented a professional practice model and can inform your professional understanding and leadership practice are Al-Ruzzieh and Ayaad (2020), Silverstein and Kowalski (2017), and Miles and Vallish (2010).

Conflict Management and Leadership Style

Conflict is recognized as a part of life, so conflict management is an essential tool for leaders to acquire. Conflict resolution involves problem-solving and decision-making. Regrettably, many organizations fail to recognize the value of preparing their leaders in conflict resolution because the costs are significant. Whether it is our profession, a specific institution, an individual, or a group, adverse outcomes from unresolved conflicts are multiplicative. Before conflict escalates to unresolved anger, depression, and organizational costs such as litigation, it is best to approach conflict from a preventive standpoint. Just as health promotion leads to high-quality and cost-effective outcomes for healthy individuals, conflict prevention can lead to high-quality and cost-effective outcomes for healthy organizations.

Although early conflict management focused on conflict avoidance, such a course is unhealthy at best. One of the most significant conflict examination models and research tools since the 1970’s is the Thomas-Kilmann Conflict Mode Instrument (Thomas & Kilmann, 2007). The model describes five styles of interacting with others and approaching conflict. The most productive style for interprofessional collaboration is the collaborating mode. Study these five modes and identify your preferred mode of interaction. Next, identify what leadership strengths you may need to develop to reach the collaborative mode. If you reflect deeply enough, you will discover that your default mode aligns highly with your current leadership style. Any surprises?

Thomas-Kilmann Conflict Modes Interactive

Leading Sustainable Improvements

Sustaining change in the healthcare environment can be a challenge, even after the successful implementation of an evidence-based intervention. This is often the case with practice change projects. Even when an organization’s stakeholders are invested in a practice change project, and the DNP student completes the relatively short intervention, the team reverts to its previous behaviors and practices. Sometimes these old practices recur even during the project itself. For example, a manager may implement walking rounds based on the most recent best evidence, find that they are being implemented by the team, but discover later that they only occur when the manager is in the building and nearby. Such unsustainable improvements are common.

However, there are steps that both the nurse leader and the DNP student can take to improve sustainability. One foundational measure, over which the DNP student may not have control, is creating a supportive organizational culture. Organizations with a robust professional practice model or widely accepted magnet model have a built-in framework to support evidence-based interventions. But what steps might you take as a DNP student to improve the chances of sustainability?

Transactional styles of management should be replaced by transformational leadership using tips like these to sustain change:

  • Use a science translation framework or QI model such as one of these:
    • Rogers’s diffusion of innovation
    • Knowledge-to-action
    • Promoting action on research implementation in health services
  • Create a project culture
  • Create a vision and the need for change
  • Enlist the leadership team in supporting the change
  • Seek early buy-in
  • Use emotional intelligence skills to build relationships
  • Lead from an Ethic of Care
  • Enlist champions
  • Expect barriers and be flexible to modifications
  • Communicate clearly, transparently, and frequently
  • Monitor the improved process through measurement
  • Model the change
  • Hold team members account

Week 3 References

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937 

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

American Nurses Credentialing Center. (2020). Magnet model—Creating a magnet culture. https://www.nursingworld.org/organizational-programs/magnet/magnet-model/

Interprofessional Education Collaborative. (2020). What is Interprofessional Education (IPE)? https://www.ipecollaborative.org/about-ipec.html

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. https://nebula.wsimg.com/2f68a39520b03336b41038c370497473?AccessKeyId=DC06780E69ED19E2B3A5&disposition=0&alloworigin=1

Josi, R., Bianchi, M., & Brandt, S. K. (2020). Advanced practice nurses in primary care in Switzerland: An analysis of interprofessional collaboration. BMC Nursing, 19(1), 1-12. https://doi.org/10.1186/s12912-019-0393-4

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing. Nursing Economic$, 28(3), 171-189.

Silverstein, W., & Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration. American Nurse Today, 12(9). https://www.americannursetoday.com/adapting-professional-practice-model/

Thomas, K. W., & Kilmann, R. H. (2007). Thomas-Kilmann conflict mode Instrument: Profile and interpretive report. Xicom, Inc. http://www.lig360.com/assessments/tki/smp248248

NR703 Week 3 Leading Interprofessional Teams Discussion

Purpose

The purpose of this discussion is to explore your interprofessional collaboration skills to sustain a practice change project, manage conflict, and apply a professional practice model effectively.

Instructions

DNP-prepared nurses typically lead and manage interprofessional teams, departments, divisions, and healthcare organizations. Refer to the interactive exercise from this week’s lesson and respond to the following:

  1. Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration.
  2. Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models.
  3. Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample NR703 Week 3 Leading Interprofessional Teams Discussion

Hello Dr. D and class, 

Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration. 

Once a practice change project has been implemented, sustainability will be the focus of the project.  Intra- and interprofessional collaboration from the planning stages through implementation will help to sustain the project.  I am fortunate that as a palliative nurse practitioner I am part of an intra-disciplinary team and thus am used to working collaboratively with multiple disciplines.  

We are all on the same medical team, but we are in different disciplines – nurses, nurse practitioners, physicians, chaplains and social workers. I have learned a lot working in this style of team and I believe it will help me with my project implementation. I know that my ability to understand and respect the roles of others and to recognize them as the experts in their role will be reflected in the success of the practice change project. Clear and consistent communication with the team will also be necessary and I plan to ask my team the best way for them to receive communications and to adapt to the responses. Continuing to build relationships through trust and collaboration  

Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models. 

Relationships will be integral to implementing a practice change project, and so will be awareness of the conflict that is inevitable with relationships. My response to potential conflict can affect the successful outcome of the project. Steen & Shinkai (2020) discuss an example of conflict in the healthcare workplace and how understanding the Thomas-Kilmann Conflict Model is useful to conflict resolution.

The Thomas-Kilmann Conflict Model recognizes five unique responses to conflict that emphasize agenda or relationship or a combination of both (avoiding, competing, compromising, accommodating, collaborating).  People can have any of these responses in different situations but tend to gravitate towards one they are most comfortable with.  Steen & Shinkai (2020) allow that some of the responses are more effective with different types of conflict, so none are inherently “good” or “bad”. 

Since any of these five responses can be appropriate for different situations, Steen & Shinkai (2020) advocate that recognizing and mastering all these styles is important for effective leadership.  Most of the time my own reaction to conflict is collaboration — a method to protect my relationships as they are very important to me. Collaboration comes naturally to me as my palliative medicine team by its nature is highly collaborative both within the team and with the rest of the patient care teams.

If there is conflict that I fear will hurt relationships and there is no other way around it, I tend to sacrifice my own wishes (accommodation) to make others happy. As Steen & Shinkai (2020) discussed, I can remember specific instances when I have had each of these reactions including more assertive means for conflict resolution as the situation required swift and decisive action in order to protect a patient (competing).  In general, my response to conflict should always ensure that I’m taking into account everyone else’s opinion and also valuing it. I like to address conflict quickly as it makes me uncomfortable, and likely if I’m more patient, the most appropriate conflict reaction would become apparent.  

Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment. 

Potential barriers to implementation of a practice change project are considered in the planning stages of the project, although some barriers that weren’t anticipated are likely to arise during the process.  Using a practice professional model can help overcome barriers that are encountered. I work for Northwestern Medicine at one of their Magnet hospitals and the nursing model that we use is called the “Northwestern Medicine Interprofessional Relationship Based Care Model”. This professional practice model is pictured below and intertwines interprofessional collaboration among interdisciplinary teams with safety, quality and innovation/research while also encompassing the healthcare systems values which are based on the motto “patient first”. 

(Northwestern Medicine, 2023).  

I will use this practice model in implementing my project as it can help overcome barriers as it stresses the importance of interprofessional collaboration in order to improve patient outcomes and safety. I work in a Magnet hospital (one of the first in Illinois) and was one of the writers of our first Magnet re-designation documents (when the entire submission was paper and had to measure “x” height), and therefore I am comfortable and confident in using the Northwestern Medicine practice professional model. Working in a research-based facility with a highly collaborative culture will also help me overcome barriers.  

References 

Northwestern Medicine (2023). Delnor Hospital professional practice model. https://www.nm.org/for-medical-professionals/for-nurses/nursing-at-delnor-hospital/delnor-professional-practice-model.  

Steen, A. & Shinkai, K. (2020). Understanding individual and gender differences in conflict resolution: A critical leadership skill. International Journal of Women’s Dermatology, 6(1), 50–53. https://doi.org/10.1016/j.ijwd.2019.06.002. 

NR703 Week 4: Leading Through Ethical Relationships

Week 4 Student Lesson Plan

Overview

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 2, 3, 5 Wednesday
Explore Lesson COs 2, 3, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 2, 3, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 2, 3, 5 Sunday
Reflect Reflection COs 2, 3, 5 No submission

Foundations for Learning

The foundational resources for this week begin with the exploration of your own emotional reactions to social injustice, whether experienced vicariously or personally. These feelings and reactions will inform your leadership development for leading through ethical situations.

Start your learning this week by reviewing the following video:

Psych Hub Education. What is cultural humility? [Video]. YouTube. https://www.youtube.com/watch?v=c_wOnJJEfxE

Student Learning Resources

Click on the following tabs to view the resources for this week.

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 3
    • Section: Social Determinants of Health
  • Read Chapter 8

Learning Success Strategies

  • As you read the Week 4 lesson, consider how each topic can be transferred into your current practice and leadership style.
  • The discussion topics this week focus on social injustice, implicit biases, and cultural humility. Reflect on each of these in the lesson to better prepare your thoughts for discussion.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 4 Lesson Leading Interprofessional Teams

Chamberlain Care

Chamberlain Care (Groenwald, 2018) is a cultural model that evolved through the vision of Chamberlain College of Nursing’s founding president and became the philosophy of Chamberlain University College of Nursing. A philosophy can become our belief system when we accept its concepts as our own beliefs. Most faculty and colleagues already had similar values and attitudes about caring for students, so the concept quickly was accepted and became the culture. Dr. Groenwald (2018) explains:

Clearly, there was an opportunity in higher education, and especially in nursing education, to create a bold new vision of student services and student support. Chamberlain’s hypothesis was that by modeling and teaching critical values while students are in school, we would arm our graduates with the characteristics that would empower them to be leaders in creating positive, healthy work environments.

To achieve our mission of creating an environment in which students and colleagues thrive, and students become extraordinary nurses, we shaped and drove a culture of care that incorporates the concepts of care for self, care for colleagues, and care for students. What started as a quality improvement initiative drove a new vision, mission, and purpose for Chamberlain University College of Nursing, making us who we are today (pp. xiii-xiv).

Bridging Traditional Ethics and Contemporary Practice

Test your memory: Match each term to the image representing it.

Branches of Philosophy Interactive Transcript

Epistemology, ontology, and axiology, the three historical branches of philosophy or underpinnings of science, which most of you have seen in ethics courses over the years, describe how we understand the world from different perspectives. They have laid the foundations for more contemporary discussions of ethics.

Traditional Ethics Approach and the Ethic of Care Versus the Ethic of Justice

Ethical principles inform our sense of moral obligation and responses to ethical dilemmas, and they may look familiar to you. They include the following principles:

  • Autonomy
  • Beneficence
  • Confidentiality
  • Fidelity
  • Nonmaleficence
  • Veracity

In addition, two competing leadership paradigms of ethical comportment that have emerged in recent healthcare discussions, especially in leadership, are the Ethic of Care and the Ethic of Justice (Juujärvi et al., 2020). It is typically the competing values, both of which may be morally correct, that result in an ethical dilemma or conflict for leaders. Barbara Sorbello (2008) synthesized this ethical foundation for nurse leaders in her landmark discussion of Ray’s theory about these dichotomous ethics.

Nicholson and Kurucz (2020) further help define these ideas as building relational leadership. They stress that a leader’s attitude projects a relational stance that must spring from an Ethic of Care to be sustainable. Although transformational leaders focus on building a relational leadership stance by projecting an Ethic of Care, they must also balance the Ethic of Justice in their management styles.

Ray’s Two Leadership Ethics Image Description

ANA Code of Ethics

One of the primary ethical practice guidelines for nurses and nurse leaders is the American Nurses Association’s (ANA, 2015) Code of Ethics for Nurses with Interpretive Statements. There are nine provisions of the code of ethics. Under each provision are listed sub-provisions of ethical beliefs for nurses. If the provisions were briefly restated for DNP-prepared leaders, they might look like the following list. Reflect on these as you complete your discussions and assignments for the remaining weeks of the course.

View the following activity to examine examples of Provisions for DNP Leaders.

Provisions for DNP Leaders Interactive Transcript

Ethical Dilemmas

The definition of an ethical dilemma explains that there is no clear right or wrong. The constant change in healthcare challenges ethics. Just as informed decision-making influences change, the need to protect patient rights and patient safety are also influenced by decision-making. We often see the tension among nurses who find themselves trapped between ethical decision-making that leads them in one direction based on their personal values and another direction based on their sense of duty to patients or the profession. These are times when ethical theories provide guidelines for professional behavior and decision-making. Nursing ethical codes have long been the basis of decisional processes, especially in leadership situations.

View the following activity to further your exploration of ethical principles and theories in the healthcare setting.

Workplace Aggression Interactive Transcript

Slide 1

Workplace aggression is still prevalent in most organizational settings today, including the nursing workplace. Although it is hard to imagine that a caring profession such as nursing would tolerate bullying behavior, recent research reveals that such behavior is more prevalent in nursing than in many other professions.

Slide 2

Such concepts have proliferated in nursing literature over just the last decade. Evidence regarding bullying, mobbing, incivility, professional stalking, workplace aggression, and horizontal and lateral violence sums up just a few areas that define a common attack of one nurse upon another.

Slide 3

These forms of behavior have a characteristic of abuse in common, whether verbal, emotional, professional, or otherwise, but they can be arrested through several interventions such as cognitive rehearsal, leadership modeling, and policy enforcement.

Slide 4

What ethical theories and principles would you use to address workplace aggression in your unique

Leading in the Contemporary Social Environment

Social Justice

Most nurses are aware of the social inequities in the healthcare system. Most healthcare systems have addressed common healthcare inequities faced by those living in poverty, people with mental illnesses, and the older adult population. Many healthcare providers actively address health inequities faced by people with substance use disorders or disabilities. These social determinants of health represent systemic disadvantages that have been created by structural inequities in healthcare delivery.

The need to reexamine healthcare’s structural inequities has become apparent. The National Academies Press (2017) defined the root cause of healthcare inequity as structural inequities, the “personal, interpersonal, institutional, and systemic drivers—such as, racism, sexism, classism, ableism, xenophobia, and homophobia—that make those identities salient to the fair distribution of health opportunities and outcomes” (p. 100).

Reflection

What can the DNP-prepared nurse and leader do about structural inequities, systemic racism, and discrimination?

Implicit Bias

The first thing to address is our own thinking and belief systems. Implicit biases are unconscious biases that are projected to others who are different. Systemic racism is generated on the microlevel by implicit racial bias. According to Kempf (2020),

The study of implicit race bias relies on the assumption that our unconscious negative and positive associations regarding people of different races are formed through various processes of socialization and can correspond with and impact conscious race-based interactions. (p. 116)

Our own thinking creates unrealistic (and inaccurate) expectations about others that further contribute to the general racism of our own race toward others who are different. When many individuals of one race have similar implicit racial biases, that racism generates systemic racism and structural inequities in our systems based on race. The same phenomenon occurs with implicit bias against gender, age, religious affiliation, sexual orientation, and other categories that, ironically, generate issues from the very social determinants of health we overtly work to combat.

Combating Implicit Bias & Social Injustice

Think back on the Week 1 lesson about the emotionally intelligent leader and Johari Window. As DNP-prepared nurses, we can unravel our implicit biases and thoughts by first being aware that they exist. We must seek to open our Johari windows to reveal those unrecognized biases about ourselves that even we do not realize. These implicit biases may be discovered in the micro-inequities toward others that we unconsciously project, like communicating negative nonverbal insults by eye-rolling, sighing, or unapproving facial expressions. Perhaps you create non-flattering nicknames for some but not others or consistently mispronounce names of those from a different culture or country. These could be cues to you that your implicit and undiscovered biases make you part of the problem, not part of the solution.

To become part of the solution, self-reflect and seek to become emotionally self-aware about your own subtle and unconscious behaviors. Then, integrate these discoveries into your self-regulation while translating them into a revised set of social skills that better empathize with and motivate others around you. Make your application of emotional intelligence transformative in combating your implicit biases and in speaking up when you see others employ those behaviors to exclude, marginalize, offend, or even harass.

As a DNP-prepared leader, stop the micro-inequities by yourself and others in the moment, if possible, or later if needs be. As Mahatma Gandhi instructed, become the change that you want to see. Only then will you foster diversity and inclusion and help to reverse the systemic discrimination of race, gender, age, religious affiliation, and other diversities.

Cultural Humility

One constructive attitude to combat implicit bias and social injustice is to develop a cultural humility towards others. Cultural humility aligns with Chamberlain Care, as the term captures the importance of being other-focused and building relationships, not walls. The DNP-prepared nurse who becomes open to understanding the cultural identity of others will be less likely to develop biases towards them.

This becomes more relevant when the DNP-prepared nurse explores their own negative, automatic emotional triggers to discoveries of cultural differences that generate avoidance behaviors. As with emotional intelligence, the practice of cultural humility becomes a life-long process of discovery and maturity. This attitude grooms the DNP-prepared nurse leader to guide social justice reform on all healthcare and society levels.

Week 4 References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Publishing. https://www.nursingworld.org/coe-view-only

Groenwald, S. L. (2018). Designing & creating a culture of care for students & faculty: The Chamberlain University College of Nursing Model. National League for Nursing.

Juujärvi, S., Kallunki, E., & Luostari, H. (2020). Ethical decision-making of social welfare workers in the transition of services: The ethics of care and justice perspectives. Ethics & Social Welfare, 14(1), 65-83. https://doi.org/ 10.1080/17496535.2019.1710546

Kempf, A. (2020). If we are going to talk about implicit race bias, we need to talk about structural racism: Moving beyond ubiquity and inevitability in teaching and learning about race. Taboo: The Journal of Culture & Education, 19(2), 115-132.

Nicholson, J., & Kurucz, E. (2020). Relational leadership for sustainability: Building an ethical framework from the moral theory of “Ethics of Care.” Journal of Business Ethics, 156(1), 25-43. https://doi.org/10.1007/s10551-017-3593-4

Sorbello, B. (2008). The nurse administrator as caring person: A synoptic analysis applying caring philosophy, Ray’s ethical theory of existential authenticity, the ethic of justice, and the ethic of care. International Journal for Human Caring, 12(1), 44-49. https://doi.org/10.20467/1091-5710.12.1.44 

The National Academies Press. (2017). Communities in action: Pathways to health equity. https://doi.org/10.17226/24624

NR703 Week 4 Leading Through Ethical Relationships Discussion

Purpose

The purpose of this discussion is to prepare the DNP-prepared nurse leader to guide social justice reform.

Instructions

For this discussion, address the following:

  1. Identify a health inequity in your healthcare setting, community, or population.
  2. Propose how you could address this identified healthcare inequity describing attributes of an effective leader guiding a healthcare team.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  2. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  3. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample NR703 Week 4 Leading Through Ethical Relationships Discussion

Dr. Dickson and class,

An example of a health inequity within a healthcare facility would be the judgement that is passed on patients that are actively battling addiction or have a past history of addiction. After the delivery of a baby, it is expected that our patients are uncomfortable and will need pain medication to help with the discomfort they are experiencing. However, if the patient has a history of substance abuse, it is not uncommon for those providing care to make comments such as “they must be drug seeking or of course they want the strong medication”.

The moment a comment like that is made as a leader it is clear to me that there is bias present that will affect the quality of care being delivered. Having stigmatizing attitudes and thoughts towards a patient who may use drugs such as, the belief they are unfit to parent, they do not care about their baby, they should have their parental rights taken away, negatively impacts the care they receive (Weber et al., 2021). Addressing this issue is important to ensure high quality care is provided to all patients regardless of their history and situation. 

As a leader, discovering this example of inequity I believe would need to be addressed immediately. Having strong communication and interprofessional relationships with the team will allow for conversations to be had to understand where one maybe coming from. However, after that, providing education about the mission of the organization, about bias and inequities, putting the patients health first and illustrating how that correlates with healthcare outcomes would be something I would like to do with the team.

Each individual as their own opinions, work experiences and personal experiences that guide them in their thoughts and actions. A strong leader is able to recognize that but at the same time build up the team to be the best they can be while breaking down the inequities that exist. The challenge is that there is a significant amount of data that shows the existing disparities that exists but there is a strong need of evidenced-based recommendations for the interventions to be used to improve health equality needs (Kovach et al., 2019). Remembering that there is room for growth in all of us and being able to self-reflect on our own ideas and bias that may exist can open up avenues to the way we practice in healthcare.

– Maggie    

References

Kovach, K.A., Lutgen, C.B., Callen, E.F., & Hester, C.M. (2019). Informing the American academy of family physician’s health equity strategy – an environmental scan using the delphi. International Journal for Equity in Health, 18(97), 1-12. doi:10.1186/s12939-019-1007-1Links to an external site. 

Weber, A., Miskle, B., Lynch, A., Arndt, S., & Acion, L. (2021). Substance use in pregnancy: Identifying stigma and improving care. Substance Abuse and Rehabilitation, 12, 105-121. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627324/pdf/sar-12-105.pdf

NR703 Week 5: Leading Innovation with Creative Solutions

Week 5 Student Lesson Plan

Overview

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 3, 4, 5 Wednesday
Explore Lesson COs 1, 2, 3, 4, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 3, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 3, 5 Sunday
Translate to Practice Assignment COs 1, 2, 3, 4, 5 Sunday
Reflect Reflection COs 1, 2, 3, 4, 5 No submission

Foundations for Learning

Start your learning this week by reviewing the following:

The Medical Futurist. (2018, June 27). 8 digital health technologies transforming the future of nursesLinks to an external site. https://medicalfuturist.com/the-future-of-nurses-superheros-aided-by-technology/

Student Learning Resources

Click on the following tabs to view the resources for this week.

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 5
    • Section: Communication
    • Section: Meeting Management: Communicating to Get the Work Done
    • Section: Sharing the News: Your Story and the Organization
    • Section: Decision-Making: The Art and Science of Organizational Leadership
  • Read Chapter 9
    • Section: Nurses as Innovators to Increase Access and Decrease Costs

Learning Success Strategies

  • As you read the Week 5 lesson, consider how each topic can be transferred into your current practice and leadership style.
  • The discussion topics in Week 5 focus on leading through innovation, creating new opportunities, and leveraging others’ creativity as a leader in healthcare. Reflect on each of these in the lesson to better prepare your thoughts for discussion.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 5 Lesson Leading Innovation with Creative Solutions

Addressing Healthcare’s Innovation Challenge

Innovation for translation science is the new knowledge or new evidence that is applied to a problem or situation. The knowledge or evidence itself may not be new, but it is new to the nursing situation or practice problem to which it is being applied. Sometimes these creative solutions are actually new applications for existing challenges. Nurses, in fact, are often compared to MacGyver, the fictional television secret agent who could solve problems with any common tool nearby, like his Swiss Army Knife, a rubber band, or a paperclip. Nursing leaders do likewise, but with an arsenal of creative leadership tools.

In 2020, the Novel 2019 Coronavirus SARS-CoV-2 (COVID-19) pandemic created an unanticipated healthcare environment for innovation. One example was chronicled by Castro (2020), who described the spacesuit-looking noninvasive COVID-19 ventilation helmet device, which prevented many COVID-19 patients from having to be placed on a ventilator. Not only did this device become lifesaving in U.S. hospitals but also in Italy where it was used on a much larger scale.

Watch the following video to learn more about the helmets:

A local healthcare crisis in Las Vegas also spurred an innovation that was later rediscovered during the 2020 pandemic. After the October 2017 Las Vegas music festival shooting, a critical care physician, who ran out of ventilators for the victims, resurrected a hypothetical idea from his residency experience: adapting one ventilator to use with two patients. It worked! This same innovation was applied in the critical care settings in New York during the early days of the 2020 pandemic (Gabrielson & Edwards, 2020). By rerouting the ventilator breathing circuits in parallel to a mechanical ventilator with a T-tube connector and one-way valves, two patients could be ventilated simultaneously (Babcock, 2020; de Jongh et al., 2020).

Watch the following video to learn more about ventilating patients simultaneously:

Nurses are often at the forefront of healthcare invention, leading innovation with creative solutions. Review the following article about five nurses involved in healthcare innovation:

Types and Values of Innovation

View the following activity to learn more about the types and values of innovation.

Types and Values of Innovation Interactive Transcript

Types and Values of Innovation

The word innovation, or innovate, is of Latin origin: “in” (into) and “novare” (make new). We use the word today when we talk about making changes to established processes, elements, or technology or changing them in some way to address a problem or challenge. An innovation could be a new idea about how to perform an old task, a more efficient method for a procedure, or a newly formed gadget that solves a physical problem.

Click each type of innovation button to learn more. When ready, click Explore Further to learn more about the types and values of innovation.

Tab: Incremental Innovation

Usually, incremental innovation is seen most often in healthcare, where emerging ideas and technologies slowly adjust and replace existing processes and technologies. For example, email platforms, online web and video conferencing enterprises, and online learning management systems are adjusted and upgraded/updated with new software innovations.

Tab: Disruptive Innovation

Disruptive innovation is a term that emerged from Christensen’s (1997) exploration of business and technical innovations that were so successful that they replaced the existing product or service. For example, the telephone rapidly replaced the telegraph (to the chagrin of Western Union executives who laughed at the idea and refused to buy Alexander Graham Bell’s patent). The innovation disrupted the communication status quo, much like the cell phone did to landlines.

Tab: Architectural Innovation

We have all used some type of architectural innovation. These are practices or technologies borrowed from innovations in other disciplines (or, in business terms, other markets). Architectural innovations change the architecture of a service or a product without necessarily changing its components. For example, healthcare adapted aviation’s use of checklists or standard procedures. From the U.S. Navy, healthcare adopted the effective Situation-Background-Assessment-Recommendation (SBAR) communication tool.

Tab: Explore Further

Disruptive Innovation – Explore Further

In healthcare, we have seen similar disruptive technologies and ideas take root and change the established market. For example, the placing of advanced nurse practitioners in retail pharmacies, iPad charting, telemedicine, and new technologies in blood glucose monitoring may all be emerging disruptive innovations from a business perspective.

How might the role of the DNP-prepared nurse be a disruptive innovation that will positively change the face of healthcare?

Architectural Innovation – Explore Further

What architectural innovation have you identified or could you adopt as a DNP leader?

Purposeful Innovation

Innovation is vital to any business, whether it is a new idea, a different method, or a technical creation. But to have these innovations requires purposeful planning, analysis, and methodical improvements. Innovation just doesn’t happen spontaneously. It is born of need.

Click Challenge and Solution to learn more. When ready, click Explore Further to reflect upon purposeful innovation.

Tab: Challenge and Solution

Ginny Porowski, RN, needed to find a solution to easily prevent contamination from a soiled gown, so she created the GoGown website..

Tab: Purposeful Innovation – Explore Further

What issue need solving in your nursing practice? How can innovation be used to solve this issue? Start by asking these questions, “In what ways might we…?” or “How could we…?” or “What new…might…?”

As a DNP-prepared nurse, you can manage this type of purposeful innovation through your leadership. Many of the characteristics of transformational leadership that we have explored aid in purposeful innovation.

Technology as an Innovative Strategy

In today’s rapidly changing electronic and robotic environment, technology as an innovative strategy is evident. Just a few years ago, smartphones were banned from many clinical settings because they were seen as distractors to care. Today, more and more organizations embrace smart technology as a facilitator of care. Patient teaching, medical facts, medication calculations, inter-unit and inter-organizational communication, and emergency management are just a few of the innovative solutions available in this technology.

What new technology might make your current practice obsolete?

Intervention Planning

Soon you will be planning your DNP practice change project. You will craft your project proposal, and much of that document will involve intervention planning. Translation science is an integral part of planning for a project intervention. Rogers’ (2003) Diffusion of Innovation model is one of the translation science models. This theory consists of the 5-Stage Innovation-Decision Process that occurs through communication channels over time among individuals within a social system:

  • Knowledge Stage: members are introduced, and acquisition of the new knowledge or technology occurs, but the willingness to change does not
  • Persuasion Stage: the members are open to change
  • Decision Stage: the members commit to change through innovation implementation or reject it
  • Implementation Stage: the members implement the innovation
  • Confirmation Stage: the innovation is in place and confirmed (often in terms of validity and reliability)

The Adaptive Leader

A rapidly changing environment, like today’s healthcare landscape, requires leaders to adapt their styles, behaviors, and even attitudes to reflect the current situation. Adaptive challenges must be met by adaptive leaders who are transformational in nature and draw from all resources (including other leaders). During the pandemic of 2020, adaptive leadership was crucial to responding to the rapidly changing healthcare environment.

Nature has taught us the importance of adapting to changing surroundings, and leaders who survive have developed the ability to adapt to changes within the environment, especially in uncertain times.

Just as the military created the architectural innovation of SBAR, so too did they discover many of the successful ideas for adaptive leadership. Dunn (2020) explained how adaptive leadership evolved in both the Australian and United States military to address navigating complex organizations in crucial situations (sometimes battlefield) and uncertain environments. One useful model that grew from this need was the Act, Sense, Decide, Adapt (ASDA) model. As an adaptation itself from observations in nature (e.g., the chameleon), it frames the leader’s thinking to be able to move beyond the rules of the system when necessary to solve complex problems.

Click on the color fields on the chameleon to learn more about the ASDA model.

ASDA Interactive Transcript

Act: The leader must interact, stimulate, start the action, create movement, energize the team, take a risk, or move into the conflict.

Sense: The leader must perceive or intuit what happens after action is initiated. That requires learning from the reaction to assess dynamics, understand opportunities, and reevaluate your presumptions. Sensing allows the leader to entertain options for responding to the situation.

Decide: The leader makes decisions for the course of action and adjusts them as needed, based on knowledge, wisdom, experience, team input, and continuous reevaluation of the situation.

Adapt: The leader employs competitive learning of an innovative and creative nature. Adapting requires constantly testing premises and refining assumptions of what will happen next based on the changing realities of the situation and the environment.

Ramalingam et al. (2020) explains that for a leader to implement adaptive responses, like ASDA, adaptive leaders must develop four skills, which have been named the 4 A’s: anticipation, articulation, adaptation, and accountability.

4 A’s Image Description

Leading through unpredictability, especially in crises like those experienced during the 2020 COVID-19 pandemic, requires these characteristics to respond and lead adaptively.

Professional Communication

Communication skills are taught at some point in almost every professional academic program, level, and discipline. Communication involves the sender, message, receiver, and feedback loop. We also know from experience that nonverbal communication can reinforce a verbal message or negate it. The sender encodes a message using words, symbols, pictures, symbols, and sounds and sends the message via a channel (one of the five senses) to the receiver.

The receiver decodes (interprets) the message, but sometimes noise can get in the way, preventing the audience from receiving the message the way the sender intended. Verbal and nonverbal skills are even more crucial at the DNP-prepared nurse’s level, where comportment, non-verbal messaging, and body language communicate as significantly as the DNP-prepared nurse’s verbal message.

Review the following graphic that depicts the communication model.

Communication Image Description

Many students find challenges in some way or another with writing, especially in formal assignments and professional papers (Shellenbarger & Gazza, 2020). The expectations for communication at the doctoral level are even greater, both professionally and individually. However, the expectation does not meet the reality, and inadequate writing skills continue to be a primary barrier to success for nurses in academic and professional environments.

That is one reason why the CARE Plan is prescribed for writing paragraphs. It helps organize and guide small segments of writing. According to Johnson and Rulo (2019), nurses, in general, struggle with writing—from its mechanics to its organization. They also outline a 10-point plan to improve writing at any stage of professional development.

Review the following graphic for those points.

10-Point Plan Image Description

These ten points may seem like an easy solution to the challenges that many face, but professional writing requires developing many holistic competencies (Miller et al., 2018), including cognitive processing, values acquisition, affective application, knowledge and skill development, and adaptability. Professional written and verbal communication must, therefore, become a continuous developmental process. As a DNP student, seek to develop a mindset open to improving and nurturing your communication skills in all domains.

Click on the following tabs for writing tips.

Writing Tips

Standard English

APA

Source Incorporation

Writing Resources

Week 5 References

Babcock, C. (2020, March 14). COVID-19 how to use one ventilator to save multiple lives [Video]. YouTube. https://www.youtube.com/watch?v=uClq978oohY

Castro, B. (2020, March 30). North Texas company offering ventilator alternatives [Video file]. NBCDFW News. https://www.nbcdfw.com/news/coronavirus/north-texas-company-offering-ventilator-alternatives/2342307/

Christensen, C. M. (1997). The innovator’s dilemma: When new technologies cause great firms to fail. Harvard Business Review Press.

de Jongh, F. H. C., de Vries, H. J., Warnaar, R. S. P., Oppersma, E., Verdaasdonk, R, Heunks, L. M. A., & Doorduin, J. (2020). Ventilating two patients with one ventilator: Technical setup and laboratory testing. ERJ Open Research, 6(2). http://doi.org/10.1183/23120541.00256-2020

Dunn, R. (2020). Adaptive leadership: Leading through complexity. International Studies in Educational Administration, 48(1), 31-38.

Gabrielson, R., & Edwards, K. (2020, March 26). Desperate hospitals may put two patients on one ventilator. That’s risky. ProPublica [Online newsletter]. https://www.propublica.org/article/desperate-hospitals-may-put-two-patients-on-one-ventilator-thats-risky

Johnson, J. E., & Rulo, K. (2019). Problem in the profession: How and why writing skills in nursing must be improved. Journal of Professional Nursing, 35(1), 57-64. https://doi.org/10.1016/j.profnurs.2018.05.005

Miller, J. J., Grise-Owens, E., Drury, W., & Rickman, C. (2018). Teaching note—Developing a professional writing course using a holistic view of competence. Journal of Social Work Education, 54(4) 709-714. https://doi.org/10.1080/10437797.2018.1474152

Ramalingam, B., Nabarro, D., Oqubuy, A., Dame, R. C., & Wild, L. (2020, September 11). 5 principles to guide adaptive leadership. Harvard Business Review. https://hbr.org/2020/09/5-principles-to-guide-adaptive-leadership

Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press.

Shellenbarger, T., & Gazza, E. A. (2020). The lived experience of nursing faculty developing as scholarly writers. Journal of Professional Nursing, 36(6), 520-525. https://doi.org/10.1016/j.profnurs.2020.04.016

NR703 Week 5 Leading Through Innovation Discussion

Purpose

The purpose of this discussion is to explore leading through innovation, creating new opportunities, and leveraging the creativity of others.

Instructions

For this discussion, review the Week 5 lesson and construct and explain a strategy for one (1) of the following:

  1. Create an environment that fosters innovation and creativity.
  2. Propose how the use of adaptive leadership will affect your leadership identity.
  3. Identify how you could improve your leadership communication across interprofessional teams.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  2. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

Week 5Leading Practice Change Projects

Assignment

Purpose

The purpose of this assignment is to create a leadership approach to address the hypothetical DNP practicum project described practice gap identified in the Week 2 assignment.  The approach focuses on three specific DNP-prepared nurse leadership skills:

  • Interprofessional collaboration
  • Communication
  • Leadership ethics

This assignment will allow for the assimilation of professional leadership competencies in project management as a DNP-prepared nurse. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.

Please note that this is the second part of a 3-part assignment submitted in Weeks 2, 5, and 7. You will receive feedback from your course faculty on the Week 2 and Week 5 assignments, which you should use to prepare the Week 7 assignment.

NOTE: All NR703 assignments and their requirements should be discussed in relation to your proposed or hypothetical DNP practicum project described in the Week 2 assignment.

Instructions

Include the following in your paper:

  1. Introduction
    1. Introduce the paper’s topic and establish its importance.
    2. Present a clear purpose statement.
    3. Provide the reader with a brief organizing statement of what will be discussed in the paper using the level 1 heading topics.
    4.   NOTE: The introduction should present each requirement in relation to your proposed or hypothetical DNP practicum project described in the Week 2 assignment.
  2. Interprofessional Collaboration in Leading Project Teams: Create your approach to implementing your hypothetical practice change project, described in the Week 2 assignment, with an interprofessional team, including a description of how you will manage the following challenges (One paragraph each):
    1. Creating a project environment of mutual respect and shared values
    2. Facilitating team roles and flexibility to perform effectively in the project
  3. Communication Comportment (professional behavior) in Project Management: Create a guideline for your professional communication to serve you in the hypothetical practice change project, described in the Week 2 assignment. Include the following considerations (One paragraph each):
    1. Verbal and non-verbal communication competencies at a doctoral level
      • Communicating leadership through verbal & nonverbal comportment (professional behavior)
      • Creating alignment of verbal and nonverbal messages
    2. Written professional communication
      1. Writing with leadership tone and style
      2. Using standard English
      3. Creating summary and synthesis in writing
    3. Leadership Ethics: Discuss how you will create a consistent image of ethical comportment in your hypothetical practice change project described in the Week 2 assignment, including the consideration of the following (One paragraph each):
      1. Balance an Ethic of Justice with an Ethic of Care in your leadership style.
      2. Create a conflict resolution approach for the project team management of issues such as disagreements or bullying.
      3. Lead social justice change within the project environment (i.e., countering structural inequities, addressing implicit and explicit bias, combating social injustices, and applying cultural humility).
    4. Conclusion
      1. Recap the paper’s purpose statement and organizing (outlining) statement criteria that revisits the three level 1 headings (not including the conclusion).
      2. Draw major conclusions from the body of your paper.
      3. Summarize the importance of effective communication for the DNP-prepared nurse in leading your practice change project.
    5. References (minimum of 2 scholarly, peer-reviewed sources)
      1. Create the reference page.
      2. Ensure each reference has a matching citation.
      3. Support your discussion by using evidence from at least two (2) scholarly peer-reviewed journal article sources (preferably research or systematic reviews) that are retrieved from the Chamberlain library databases. Do not use the internet, textbooks, government sources, or organizational websites for the two sources in this assignment. However, you may use other gray materials for additional sources if you need them. Hint: Search other than nursing journals for sources of evidence.

Review the rubric for the grading criteria.

APA Guidelines

Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing Professional Papers: Graduate Programs (located in the APA Basics section of the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.

  1. Use the APA Paper Template (located in the Canvas Resources: Writing Center) to format this assignment.
  2. Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before constructing the assignment.)
  3. Use the title, “Leading Practice Change Projects,” for your paper & format the title page by using the APA paper template.
  4. Use the following prescribed Level 1 and level 2 headings for this paper (Do not include the lettered/numbered outline here:):
    1. Interprofessional Collaboration in Leading Project Teams
      • Creating a climate of mutual respect and shared values
      • Facilitating team roles and flexibility to perform effectively
    2. Communicating Comportment in Project Management
      • Verbal and non-verbal communication competencies at a doctoral level
      • Written professional communication
    3. Leadership Ethic
      • Balance an ethic of justice with an ethic of care
      • Create a conflict resolution approach
      • Lead social justice change within the project environment
    4. Conclusion

Writing Requirements (APA format)

  • Length: 4-6 pages (not including title page, references page, or attachments)
  • 1-inch margins
  • Double-spaced pages
  • 12-point Times New Roman
  • Headings & subheadings
  • In-text citations
  • Title page
  • Reference page
  • Standard English usage and mechanics
  • CARE Plan paragraph development structure

Program Competencies

This assignment enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  5. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Date

  • By 11:59 p.m. MT on Sunday
  • Late Assignment Policy applies

NR703 Week 6: Leading Translational Science

Week 6 Student Lesson Plan

Overview

Program Competencies

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Weekly Objectives

  1. Integrate concepts from historical models of organizational management into professional practice. (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 5)
  2. Apply leadership theories and conceptual frameworks to guide professional practice. (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 4, 5)
  3. Appraise principles of interprofessional collaboration in leading translational science. (PC 6; PO 8; CO 4)
  4. Synthesize leadership and management competencies. (PCs 2, 4, 6; POs 6, 8; COs 1, 5)
  5. Construct your approach to project management using translation science models. (PCs 2, 4, 6; PO 6; COs 1, 2)

Main Concepts

  1. Organizational management models (PCs 2, 4, 6; POs 6, 8; COs 1, 4, 5)
  2. Leadership theories and conceptual frameworks (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 5)
  3. Interprofessional collaboration challenges (PCs 2, 4, 6; POs 6, 8; COs 4, 5)
  4. Leading through translation science models (PCs 2, 4, 6; POs 6, 8; COs 1, 4, 5)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 4, 5 Wednesday
Explore Lesson COs 1, 2, 4, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 1, 2, 4, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 1, 2, 4, 5 Sunday
Reflect Reflection COs 1, 2, 4, 5 No submission

Foundations for Learning

Return to Week 1 and review the Management Skills, Leadership Strengths, & Transformational Leadership table.

Additionally, review the following resources:

Lush, M. (2019). The leadership versus management debate: What’s the difference? NZ Business + Management, 33(4), M20-M23.

Toor, S., & Ofori, G. (2008). Leadership versus management: How they are different, and why. Leadership and Management in Engineering, 8(2), 61-71.

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 1
  • Read Chapter 6
    • Section: Interprofessional Collaboration

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

  • Read Chapter 3

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

  • Read Chapter 2
    • Section: Rogers’s Diffusion of Innovation Model
    • Section: Knowledge-to-Action Model
    • Section: Promoting Action on Research Implementation in Health Services Model

Required Articles

Scan the following articles on Professional Practice Models:

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science. Nursing Science Quarterly, 31(3), 253-258.

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

HGS Concepts. (2017, May 16). Neuroscience and leadership [Video]. YouTube. https://youtu.be/cq4nUqEHiIA

Strategy + Business. (2016, December 1). How strategic leaders use their brain [Video]. YouTube. https://youtu.be/T6h1b4ZtLG4

Learning Success Strategies

  • Review organizational, management, and leadership theories with which you are familiar and reflect on those that have been most impactful in your nursing practice.
  • Explore the theories that are new to you and entertain incorporating new elements into your leadership identity.
  • Develop your ideas and thoughts through the interactive discussion. Review the discussion guidelines and rubric to optimize your performance.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.
  • Look ahead to the Week 7 assignment. Start your draft paper early and incorporate the feedback from the former assignments from Week 2 and Week 5.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 6 Lesson Leading Translational Science

Leadership and Management

Most nursing education programs have leadership and management courses to introduce students to the concepts of leadership and management. Both are required for efficient nursing governance, and neither is as effective alone as both are together. Today, the integration of both transformational leadership methods and management skills are essential to accomplish organizational goals.

Explore management theories by viewing the following video.

Management Theories (3:21) Transcript

Management is both an art and a science. It is commonplace for managers to use more than one theory to achieve productivity or organizational goals. It is also important for managers to understand these different theories and know how to implement them. Let’s discuss four popular management theories. Taylor is considered to be the father of scientific management theory. 

His four principles were based on (a) division and specialization of labor, (b) adherence to a chain of command, (c) structure of organization, and (d) span of control. Taylor consider the staff to be a means to an end with the end justifying the means. He believed in standardizing job performance in which each job has explicit motion rules, standardized elements, and appropriate conditions of working. The focus of scientific management theory is production efficiency. Scientific management theory fits well with the transactional leadership style. Henri Fayol is considered to be the father of classical management theory. 

His five principles were based on (a) foresight, (b) organization, (c) command, (d) coordination, and (e) control. Max Weber expanded on the scientific approach to management. Weber valued principles of logic, order, and legitimate authority. Clear labor divisions and a hierarchical structure were combined with formalized rules and procedures. Mary Parker Follett modified Fayol’s approach. She believed that combining the talents of individuals and forming groups functions for the greater good. We see this notion preserved in current-day 360-degree feedback surveys. 

Her organizational theory paved the way for the leadership theories of transactional leadership. Classical management leads to impersonal interaction with staff, and promotions are achieved solely on merit. Scientific and Classical management theories fit best with a transactional leadership style, although there is some recognition for the unique talents staff bring to an organization, these frameworks form the basis for today’s four functions of management: planning, organizing, leading, and controlling. 

Human Relations Management Theory began its development with the research work of Elton Mayo in 1932. Mayo’s hallmark study found that one of the employee groups he studied had increased productivity due to the attention he gave them. This is called the Hawthorne Effect, named for the location in which Mayo’s research was conducted. His discovery led to Mayo’s realization that motivation was linked to success, group belongingness, cohesiveness was linked to productivity, and morale was linked to output. Interpersonal human relations management style promoted all three. Since then, human relations management theory has emphasized communication, relationship building, negotiating, and conflict resolution.

Management Function and Theories

Click through the following interactive to examine examples of management function and theories.

Click the following link to expand to full screen:

Management Function and Theories Exploration.

Management Function and Theories Interactive Transcript

Management Function and Theories

Management Function and Theories Understanding the history of organizational management concepts and theory helps to inform the DNP-prepared nurse’s leadership in contemporary nursing practice and healthcare environments. The following four traditional elements of management continue to provide a useful framework for today’s healthcare organizations. Review each function. Then, click to view the expert’s example.

Function 1 = Planning

Question: Planning is the process of getting organized to function. Provide an example of planning.

Expert’s example: A nurse manager initiates planning through strategic and tactical steps in preparation for organizational interventions. There are two types of planning: strategic and tactical. Strategic involves long-term planning to achieve the organization’s mission and goals. Tactical planning is short-term decision making for operational management, such as the allocation of resources, scheduling staff, and carrying out the daily routine.

Function 2 = Organization

Question: The next step in the traditional management process is organizing. As a future DNP-prepared nurse, what functions of organizing do you foresee in the organizational process?

Expert’s example: Organizing is the creation of order and structure to complete the first function, which is planning. A nurse manager creates a staffing schedule, arranges educational opportunities to meet operational needs, and positions staff to leverage skillsets for patient care. Organizing is applying appropriate power to ensure operational assets are being effectively applied so that outcomes match those that are anticipated.

Function 3 = Leading

Question: Much like Fredrick Taylor’s scientific management principles in the early 1900s, both Fayol’s original and Follett’s modification to the classical ideas of leadership were similarly methodical and focused on training managers in leadership. From your exploration, what might be functions of traditional leading (or “commanding”) that you might use as a DNP-prepared nurse today?

Expert’s example: Supervising is a management function. One traditional management maxim was that you get what you inspect, not what you expect. The application today is that a good supervisor must trust but verify results. Many other traditional management leadership functions are still applicable to today’s DNP leader: motivating, delegating, and even collaborating evolved from these early principles.

Function 4 = Controlling

Question: Traditionally, Fayol’s idea of controlling was adapting to changing circumstances. What might you learn from this traditional approach that you might apply today as a DNP-prepared nurse?

Expert’s example: Controlling is a management function of assessing performance and adjusting actions to accomplish organizational goals. However, controlling is not just reactive; it is also proactive such that the seasoned manager anticipates deviation from the goal and plans to prevent or otherwise overcome anticipated events. Other controlling adjustments are made by using evaluative processes with practice guidelines, quality improvement plans, audits, total quality management milestones, and accreditation standards.

Selected Historical Management Models

Review the following timeline regarding the different management models.

Management Models Timeline Interactive Transcript

Type Theory Description
Scientific Fredrick Taylor’s (1911/2014) Scientific Management Theory ·    Match workers to tasks

·    Establish command hierarchy

·    Structure the organization through research (Scientific Method)

·    Span of control: monitor and incentivize workers (usually negative reinforcement)
Max Weber’s (1919) Theory of Bureaucracy ·    Rigid division of labor, rules, and regulations

·    Hiring and promoting workers based on competencies (specialized roles)

·    Hierarchy, responsibility, and accountability

·    Impersonal authority and political neutrality
Classical Henri Fayol’s (1949) Classical Management Theory ·    Planning (Foresight)

·    Organizing

·    Command

·    Coordinate and control
Mary Parker Follett (1924)* (Neoclassical) Organizational Theory (and Early Transformational Leadership) (*See Fox & Urwick, 1940) ·    Planning

·    Organizing

·    Leading (toward transformations)

·    Controlling
Human Relations Development Elton Mayo’s (1932)* Management (motivation) Theory (*See Wood & Wood, 2004) ·    Low cohesive-low norm groups  = low productivity

·    High cohesive-low norm groups = negative productivity

·    Low cohesive-high norms = limited productivity

·    High cohesive-high norms = high productivity
Maslow’s (1943) Motivational Theory (Hierarchy of Needs) ·    Although itself not an organizational (or leadership) theory, it has helped shape human relations theory by helping managers explain and adjust to elements of motivation for employees.
Douglas McGregor’s (1960) Theory X and Theory Y Management Theory ·    Managing Theory X style = Authoritative, negative view of employees, all-controlling, uses a transactional leadership style

·    Managing Theory Y style = Participatory, positive approach to people, consensus-seeking, uses transformative leadership styles
Henry Mintzberg’s (1973) Management Theory ·    Interpersonal

·    Informational

·    Decision-maker
Modern Human Relations (Management) (Composite) Frameworks ·    Relationship building

·    Organizing/multitasking

·    Conflict resolution/negotiation

·    Communication

·    The movement in human relations theories since Mayo’s 1932 have informed composite versions of the modern human relations management theories or organizational management theories used today.

Selected Historical Management Models

Fayol, H. (1949). General and industrial management (C. Storrs, Trans.). Pitman Publishing.

Fox, E. M., & Urwick, L. (1940). Dynamic administration: The collected papers of Mary Parker Follett. Pitman Publishing.

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370–396. https://doi.org/10.1037/h0054346

McGregor, D. (1960). The human side of enterprise. McGraw-Hill Book Company, Inc.

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.

Taylor, F. W. (2014). The principles of scientific management (1911 edition reprint). Martino Fine Books.

Waters, T., & Waters, D. (Eds.). (2015). Weber’s rationalism and modern society: New translations on politics, bureaucracy, and social stratification. (T. Waters & D. Waters, Trans.). Palgrave-Macmillan.

Wood, J. C., & Wood, M. C. (2004). George Elton Mayo: Critical evaluations in business and management. Routledge.

Leadership Theories & Conceptual Frameworks

Most of us have been introduced to the common leadership styles of authoritarian, democratic, and laissez-faire that were popularized in the 1950s. However, these styles did not typically match most leaders’ styles; therefore, more operational theories emerged.

View the following activity to examine examples of leadership theories and conceptual frameworks.

ASDA Interactive Transcript

Situational and Contingency Leadership Theories

Mary Parker Follett’s neoclassical management theory also popularized the idea that a leader’s style should be interpersonal (not impersonal) and match the situation and the individuals involved in the situation. Today, her ideas have developed into styles of transformational leadership and grown into successful models like Dr. Paul Hersey’s (1985) The Situational Leader and developed into a modern theory by Hersey and Blanchard (1977). Success in leading depends on how well leadership style is adapted to the situation, specifically in the styles of directing, coaching, supporting, and delegating. Contingency theory is similar and stresses the interrelationships between the leader and those being led.

Servant Leadership Theory

Greenleaf’s (2002) servant leader is simply leadership serving others or leadership in the service of others. The leader serves others in such a way to ensure that others can fulfill their roles, professionally and personally. There are several ways servant leadership can be demonstrated, with authentic leadership as one example.

Transformational Versus Transactional Leadership

Building on the concepts before them, transformational and transactional leadership styles have evolved today. Even though we tend to think of one as good and the other bad, both have a place in the leadership toolbox. Transformational leaders tend to be outward focused, positive, and inspiring; the transactional style tends to be more impersonal, authoritative, and directive.

Transformational Leadership

Transformational leadership has many of the same characteristics as servant leadership. Transformational leaders empower their followers and are dynamic individuals who recognize that their followers have unique abilities. They see their roles as leaders who are responsible for finding the best fits for their followers. Their style is interactive and highly communicative. They demonstrate a vision for the future and inspire others to share in that vision.

Transactional Leadership

Transactional leaders are typically concerned with maintaining the status quo. Rather than seeing the big picture, transactional leaders focus on details. They are sometimes accused of paralysis by analysis. They are unilateral leaders and function best in a no-growth environment. The transactional leader extrinsically motivates. They are best suited for emergency or military leadership, and the transactional style is most successful when used in critical situations, battlefield leadership, or emergency response efforts. Transformational leaders should be able to use transactional styles of leadership when necessary.

Quantum Leadership and Quantum Caring Leadership

Quantum leadership has also been described as a transformational style of leadership that leads from the future (Porter-O’Grady & Malloch, 2011). Quantum leadership means having the ability to anticipate future trends and then engaging innovative strategies to achieve potential future outcomes. Quantum leaders use skills, knowledge, and integrative abilities to encourage others to reach ever-higher levels of functioning. By doing so, they become inspirational and motivating.

A quantum leader creates nurturing relationships, empowers others, and provides a moral compass while leading from an Ethic of Care. In the traditional meaning of the word, a quantum is the smallest increment of something. Applied to leadership, the quanta might be the very basic elements of interprofessional relationship-building that transform others. Just as the electron is the smallest particle of an atom yet essential for its charge, each small element of leadership creates that same dynamic.

The extension of quantum leadership is defined by Quantum Caring Leadership (Watson et al., 2018). This synthesized concept blends the caring science of nursing with quantum leadership to create a dynamic, universal leadership. This incorporates the intent of relationship-based care, patient-centered care, universal connectedness, mindful leadership, the Ethic of Care, and many of the other caring concepts this course has explored.

The Interprofessional Collaboration Challenge

Transformational leaders in healthcare today must develop interprofessional collaboration skills to successfully accomplish day-to-day operations as well as project management. Creating partnerships with other disciplines is no simple task. Just as we have examined that leaders must establish trust with their teams, so must nursing leaders foster trust with other professionals. Just as nurses are socialized to the nursing family, other professional disciplines are socialized to theirs.

Each has their own professional education, organizations, cultures, standards, licensing process, and occupational language. To ask other professionals to be open to collaborating as professional equals is often incomprehensible for them. Such partnerships are often seen as beneath them. It often takes champions from each camp to help bridge the professional gaps between them.

One helpful guide to initiating interprofessional collaboration as a healthcare leader is the Interprofessional Education Collaborative Expert Panel’s (2016) Practice Competency Domains. (See the Interprofessional Collaboration section in this week’s readings from Broome & Marshall, 2021.) The four domains and their sub-competencies can help align all professionals to contemporary standards to bridge the interprofessional gaps.

Leading Translational Science: Four Translation Science Models

Leading a practice change project requires a transformational leadership style that employs both management structure and leadership strengths. Four translation science models widely used to organize practice change projects include the following:

  • Johns Hopkins Nursing Evidence-Based Practice Model
  • Rogers’s Diffusion of Innovations Theory
  • Canadian Knowledge-to-Action Model
  • Promoting Action to Research Implementation in Health Services (PARHiS) Framework

These four models provide a management structure for knowledge translation and project implementation.

Click on the tabs to see a graphic of each model.

The Johns Hopkins Nursing Evidence-Based Practice Model

Click on the tabs to see a graphic of each model.

The Johns Hopkins Nursing Evidence-Based Practice Model

Rogers’s Diffusion of Innovations Theory

Knowledge-to-Action Model

Promoting Action on Research in Health Services (PARHiS) Framework

Four Models Images Transcript

Tab: The Johns Hopkins Nursing Evidence-Based Practice Model

  • Inquiry
  • Practice Question – Evidence – Translation (encircled in Practice Learning): Leads back to Inquiry or forward to Best Practices
  • Best Practices
  • Practice Improvements (Clinical Learning, Operational): Leads back to Inquiry

©The Johns Hopkins Hospital / Johns Hopkins University School of Nursing

Tab Title: Rogers’s Diffusion of Innovations Theory

  • Knowledge
  • Persuasion
  • Decision
  • Implementation
  • Confirmation

Tab Title: Knowledge-to-Action Model

  • Action Cycle (Application)
    • Identify problem – Identify, review, select knowledge
    • Adapt knowledge to local context
    • Assess barriers to knowledge use
    • Select, tailor, implement interventions
    • Monitor knowledge use
    • Evaluate outcomes
    • Sustain knowledge use
  • Knowledge Creation (inverted pyramid from top to bottom – tailoring knowledge)
    • Knowledge inquiry
    • Synthesis
    • Products/tools

Note: Knowledge-to-action model. Adapted from “Lost in Knowledge Translation: Time for a Map?” by I. D. Graham, J. Logan, M. B. Harrison, S. E. Straus, J. Tetroe, W. Caswell, & N. Robinson, 2006, The Journal of Continuing Education in the Health Professions, 26, 13–24 (https://doi.org/10.1002/chp.47). CC-BY-SA 2.0

Tab Title: Promoting Action on Research in Health Services (PARHiS) Framework

  • Evidence: research, clinical and patient experience, local data
  • Context: culture, leadership, evaluation
  • Facilitation: purpose, role, skills and attributes

What these four models do not explicitly describe is the leadership skills that must be used to implement translation science models to improve outcomes. However, you have many of these skills already stored in your leadership toolbox as we have polished them in the last five weeks.

Reflection

Reflect on your chosen translation science model and the skills in your leadership toolbox. Imagine how you will blend the two into a synthesized leadership approach to implement and sustain a practice change, especially in an interprofessional environment.

Week 6 References

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed). Springer Publishing Company. https://doi.org/10.1891/978082613505

Fayol, H. (1949). General and industrial management (C. Storrs, Trans.). Pitman Publishing.

Fox, E. M., & Urwick, L. (1940). Dynamic administration: The collected papers of Mary Parker Follett. Pitman Publishing.

Greenleaf, R. K. (2002). Servant leadership: A journey into the nature of legitimate power and greatness (25th anniversary edition). Paulist Press.

Hersey, P. (1985). The situational leader (4th ed.). Warner Books.

Hersey, P., & Blanchard, K. H. (1977). Management of organizational behavior: Utilizing human resources (3rd ed.). Prentice-Hall.

Maslow, A.H. (1943). A theory of human motivation. Psychological Review, 50(4), 370–396. https://doi.org/10.1037/h0054346

McGregor, D. (1960). The human side of enterprise. McGraw-Hill Book Company, Inc.

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.

Porter-O’Grady, T., & Malloch, K. (2011). Quantum leadership: Advancing innovation, transforming healthcare (3rd ed.). Jones & Bartlett Publishers.

Taylor, F. W. (2014). The principles of scientific management (1911 edition reprint). Martino Fine Books.

Waters, T., & Waters, D. (Eds.). (2015). Weber’s rationalism and modern society: New translations on politics, bureaucracy, and social stratification (T. Waters & D. Waters, Trans.). Palgrave-Macmillan.

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science. Nursing Science Quarterly, 31(3), 253-258. https://doi.org/10.1177/0894318418774893

Wood, J. C., & Wood, M. C. (2004). George Elton Mayo: Critical evaluations in business and management. Routledge.

NR703 Week 6 Effective Leadership Styles Discussion

Purpose

The purpose of this discussion is to synthesize the concepts from historical organizational management models, leadership frameworks, and interprofessional collaborative competencies to create your own approach to effective leadership styles.

Instructions

For this discussion, think of a problem you have seen in your current or previous place of employment and address the following:

  1. Provide examples of how you as a transformational leader within an interprofessional team would address the practice problem.
  2. Provide examples of how you as a transactional leader within an interprofessional team would address the practice problem.
  3. Which leadership style do you think would be most effective in addressing this problem? Explain why.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

NR703 Week 7: Leading Healthcare’s Management Priorities

Week 7Student Lesson Plan

Overview

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 3, 4, 5 Wednesday
Explore Lesson COs 1, 2, 3, 4, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 2, 3, 4, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 2, 3, 4, 5 Sunday
Translate to Practice Assignment COs 1, 2, 3, 4, 5 Sunday
Reflect Reflection COs 1, 2, 3, 4, 5 No submission

Foundations for Learning

Start your learning this week by reviewing the following:

American Physical Therapy Association. (2018, February 22). Understanding the value of “value-based care” [Video]. YouTube. https://youtu.be/en0Iw9bDo_Q

Student Learning Resources

Click on the following tabs to view the resources for this week.

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 9

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

  • Read Chapter 11

Learning Success Strategies

  • Reflect on previous discussions from NR715 and NR716 about the Global Burden of Disease (GBD), including pandemic responses, and consider how you, as a DNP-prepared nurse, will manage the problem in a practice setting.
  • Develop your ideas and thoughts through the interactive discussion. Review the discussion guidelines and rubric to optimize your performance.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 7 Lesson Leading & Managing High-Value Healthcare Management Priorities

Leadership’s Role in Materials Resource Management Across Systems

Planning strategically and operationally to address the disease conditions identified as the eight National Practice Problems and how they impact a healthcare organization requires sound fiscal and human resources management. Leading from the future includes strategically preparing to care for those who will need specialized services.

Consider how you, as a leader in a practice setting, might prepare to manage the resources required to address a hospital service line for one of the eight National Practice Problems causing increased mortality and morbidity in the setting. In the United States, illnesses such as ischemic heart disease, chronic obstructive pulmonary disease, colorectal cancer, and lung and breast cancer are all common practice problems.

The magnitude of any one of these conditions can be intimidating for a leader charged with its intervention and management at the practice level. In your practice setting, a number of key leadership questions must be answered.

  • What should the strategic plan for this disease or condition include?
  • Which intervention(s) should be applied?
  • Who are the key stakeholders?
  • What and who are the needed resources?
  • How should I approach this challenge as a transformational leader?

Human and Materials Resource Management

It is important that DNP-prepared nurses understand the human capital required to apply an intervention in a practice change project. As we have determined in Week 2, it is first critical to identify the project’s stakeholders and discover the practice gaps through a needs assessment. Stakeholders will include not only the affected population who are treated at the practice site but also those key individuals who bring the expertise to treat, manage, finance, and support the project (Dang & Dearholt, 2018).

Responsible materials management requires you as a practice leader to ask questions about equipment, support services, supplies, and the necessary infrastructure to manage these assets. This may include interprofessional collaboration with key stakeholders from many different organizational departments, including materials management, finance, and maintenance. Clinical departments and human resources may also partner with you to determine the material requirements for clinical pathways and the additional expertise you may need to plan for disease management intervention.

Both human and materials resource management will require leadership strengths and management skills to orchestrate a successful interprofessional partnership. Leveraging the strengths and skillsets of professional experts in managing a service line becomes essential in today’s healthcare infrastructure.

Strategic Planning for Effective Leadership

Having an awareness of the Global Burden of Disease (GBD) environment, many healthcare organizations re-invent themselves to specialize in specific disease areas for healthcare delivery, such as cardiovascular or cancer treatment. Planning for those specialty clinicians, equipment, and required licenses involves strategic planning that often looks ahead five years or further.

Similar strategic planning may be required at a more granular or division-level scale. One approach for strategic planning involves the forward-looking creativity and flexibility of quantum leadership (Porter-O’Grady & Malloch, 2018), which focuses on future trends that engage innovative strategies to achieve potential future outcomes. Reflect on a specific GBD condition that may require you to take a quantum leap into the future to examine the resources that might be needed for an initiative in a practice setting.

Financial Fidelity in Leadership

The DNP-prepared nurse as a financial steward may be responsible for the budget. The DNP-prepared nurse often makes hard decisions about budgets that may affect personnel or patients. Effective managing of resources can be learned. With practice, you can learn to be proficient in resource allocation, even when managing resources to address a pandemic response or the burden of disease associated with the nation’s top causes of morbidity and mortality. Leaders have an ethical obligation to balance the health of the community and its resources.

Balancing costs and improving quality do not have to be mutually exclusive. Spending more may not in itself improve quality or enhance safety. Being financially responsible in a value-driven market implies that the leader makes informed decisions that will improve patient outcomes and maintain a financially viable operation. One of the best assets most organizations have to assist nurse leaders in financial management is an accounting or finance support department. It is the DNP-prepared leader’s responsibility to leverage those assets to manage the financial environment. On any level, managing the GBD necessitates respect for and creativity about limited resources in a frugal healthcare economy.

Evaluating Performance at the Micro, Meso, and Macrosystems Levels

Evaluating the effectiveness of management methods, healthcare interventions, human performance, or practice change projects at any healthcare delivery level requires measurements to ensure that what you expect is what you inspect. Strategic plans are measured by operational outcomes to measure their effectiveness and determine if the strategic plan requires modification or reframing. Budgets and financial plans are measured by quarterly financial analyses to determine if they are on track, over budget, or under budget. Effective human resource and materials management are assessed against projected benchmarks and prior-year comparisons, among other indices.

Practice change projects are usually measured by quantitative analysis, using methodologies adopted from research designs. While qualitative analysis is becoming more widespread, the most common measurements are quantitative methods, such a descriptive, pre-post measurement, and cohort comparison designs, all calculated for statistical significance. One important consideration for project planning is to ensure that your measurement design is planned in advance for the type of intervention you are undertaking and that the statistical model is determined before the project is initiated and the data is collected.

Evaluating all performance outcomes, from materials management implementation to a practice change project, requires rigorous pre-planning and serious consideration by the leader. Without reliable measurements, performance cannot be assessed or improved.

Global, National, State, and Local Influence on Leadership Initiatives

Leading from the future as a caring DNP-prepared nurse implies that you have an awareness that all you do is connected to the whole. In a globalized world, this realization takes on even more significance. Traditional boundaries are changing, if not disappearing altogether. Even political divides and social borders take on new meaning for the responsibility of leaders in healthcare.

Quantum leadership theory (Porter-O’Grady & Malloch, 2018) and quantum caring leadership (Watson et al., 2018) have practical implications for you as you consider a practice change project. Inclusivity, leveraging, collaborating interprofessionally, and big-picture planning help to tie a specific practice problem and intervention to the greater initiative of a system. Likewise, using all the resources that the system has to offer a specific initiative promotes its successful implementation and continued sustainment. This is all connected.

Healthcare is not performed in a social vacuum but rather in a social environment. The political climate, social issues, and economic conditions at all levels of society affect decision-making, especially considering the ubiquitous GBD. Today’s nurses are learning from each other in different countries. The way nurses practice globally is changing through the influence of international nursing organizations, journals, and nursing education. DNP-prepared nurses must be cognizant of the world around them as they address the GBD on the micro, meso, and macrosystems levels.

Week 7 References

Dang, D., & Dearholt, S. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau International.

Porter-O’Grady, T., & Malloch, K. (2018). Quantum leadership: Creating sustainable value in healthcare (5th ed.). Jones & Bartlett Learning.

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science. Nursing Science Quarterly, 31(3), 253-258. https://doi.org/10.1177/0894318418774893

NR703 Week 7 Leading & Managing High-Value Healthcare Discussion

Purpose

The purpose of this discussion is to identify a practice problem and examine the material and human resources needed to support a fiscally responsible practice change solution to address the practice problem.

Instructions

For this discussion, review the lesson for this week and identify a practice problem. Using the practice problem, address the following:

  1. Investigate the material and human resources needed to support a fiscally responsible practice change solution to address the practice problem.
  2. Analyze the role of the advanced practice nurse in addressing the solution.
  3. Propose strategies for project leadership.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  2. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  3. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  4. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

  • Initial Post: By 11:59 p.m. MT on Wednesday
  • Follow-Up Posts: By 11:59 p.m. MT on Sunday

NR703 Week 7 Professional DNP Leadership Capacity Assignment

Purpose

NOTE: This assignment must use the provided Paper Template which is found in this Link (Word doc): Week 7 Assignment Paper Template.

The purpose of this assignment is to demonstrate your leadership capacity to manage a practice change project. You will create a collective manuscript that incorporates the revised Week 2 and Week 5 assignments with an additional section that you will create this week.

This assignment will allow for the assimilation of professional leadership competencies in project management as a DNP-prepared nurse. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.

Please note that this is the third part of a 3-part assignment submitted in Weeks 2, 5, and 7. You have received feedback from your course faculty on the Week 2 and Week 5 assignments, which you should use to revise and prepare the Week 7 assignment.

NOTE: All NR703 assignments and their requirements should be discussed in relation to your proposed or hypothetical DNP practicum project.

Instructions

Use the provided Week 7 Assignment Paper Template and include the following:

  1. Introduction: The organizing introduction is the first paragraph that does the following:
    1. Introduce the paper’s topic and establishes its importance.
    2. Present a clear purpose statement.
    3. Create a brief overview (outline statement) for the combined paper using the three primary Level 1 headings.
  2. Integrate the Week 2 corrected content under the first Level 1 heading, “Organizational Needs Assessment.”
    1. Don’t forget to include the discussions of Table 1 (Organizational Needs Assessment: Practice Gap Identification) and Table 2 (Johns Hopkins Individual Evidence Summary Tool). Both tables must be referred to in the paper’s content.
    2. Include the required level 2 headings (as they are on the template):Practice Gap
      1. Problem
      2. Practice Gap
      3. Practice Question
    3. Integrate the Week 5 corrected assignment content under the second Level 1 heading, “Leading the Practice Change Project,” using the following level 2 headings (Note: level 3 headings for sub-topics are recommended):
      1. Interprofessional Collaboration in Leading Project Teams
      2. Communicating Comportment in Project Management
      3. Leadership Ethics
    4. Create the content to place under the third Level 1 heading, “Leading Practice Change Teams with Innovation and Effective Management,” using the following level 2 headings:
      1. Leading Through Innovation
      2. Integrating Leadership and Management Models
      3. Managing Materials and Human Resources
    5. Conclusion
      1. Recap the paper’s purpose statement and brief overview (outline statement) for the combined paper using the three level 1 headings (don’t include “conclusion”).
      2. Draw major conclusions from the body of your paper.
      3. Summarize the paper’s relevance to the practice change project.
    6. References (minimum of 4 scholarly, peer-reviewed sources)
      1. Create a reference page.
      2. Include the references from the first two papers that you have used in this paper if they are still used.
      3. Ensure each reference has a matching citation.
      4. Support your paper by using evidence from at least four (4) scholarly peer-reviewed journal article sources (preferably research or systematic reviews) that are retrieved from the Chamberlain library databases. Do not use the internet, textbooks, government sources, or organizational websites for these four sources in this assignment. However, you may use other gray materials for additional sources if you need them.
    7. Attach the revised Table 1 (Organizational Needs Assessment: Practice Gap Identification) and Table 2 (Johns Hopkins Individual Evidence Summary Tool) from the Week 2 assignment as displayed on the Week 7 Assignment Template

Review the rubric for the grading criteria.

APA Guidelines

Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing Professional Papers: Graduate Programs (located in the APA Basics section of the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.

  1. Use the NR703 Week 7 Assignment Template provided to insert your content for this assignment.
    1. Link (Word doc): Week 7 Assignment Paper Template.
    2. Personalize the title page by adding your name and the session month and year of the course where indicated.
    3. The title is already provided for you in the template.
  2. Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before the construction of the assignment.)
  3. Note: Because this assignment builds on the materials used in the Weeks 2 and 5 assignments as well as several discussions, similarities are expected; therefore, Turnitin will not be routinely used in this cumulative assignment. However, papers may be reviewed in Turnitin if the instructor deems it necessary.
  4. Use the following prescribed Level 1 and Level 2 headings, which are already provided in the template, for this paper (level 3 headings are encouraged where needed):
    1. Organizational Needs Assessment
      • Problem
      • Practice Gap
      • Practice Question
    2. Leading the Practice Change Project
      • Interprofessional Collaboration in Leading Project Teams
      • Communicating Comportment in Project Management
      • Leadership Ethics
    3. Leading Practice Change Teams with Innovation and Effective Management
      • Leading Through Innovation
      • Integrating Leadership and Management Models
      • Managing Materials and Human Resources
    4. Conclusion

Writing Requirements (APA format)

  • Length: 8-12 pages for accumulated paper (not including the  title page, references page, or tables)
  • Use the Week 7 Assignment Paper Template that is formatted with the following APA conventions
    • 1-inch margins
    • Double-spaced pages
    • 12-point Times New Roman
    • Headings & subheadings
    • Title page
    • Reference page
    • Table 1 and Table 2
    • In-text citations
  • Standard English usage and mechanics
  • CARE Plan paragraph development structure
  • Revisions based on course faculty feedback from Week 2 and 5 Assignments

Program Competencies

This assignment enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  5. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Date

  • By 11:59 p.m. MT on Sunday
  • Late Assignment Policy applies

NR703 Week 8: Transformational Leading as a DNP-Prepared Nurse

Week 8 Student Lesson Plan

Overview

Program Competencies

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  5. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Weekly Objectives

  1. Integrate transformational leadership to promote high-value healthcare. (PCs 2, 4; PO 6; CO 3)
  2. Create a personal leadership plan to enhance professional formation. (PC 6; PO 8; CO 5)
  3. Evaluate the impact of individual leadership styles to influence a shared vision. (PCs 2, 4, 6; POs 6, 8; COs 1, 5)
  4. Reflect on practice readiness related to leadership. (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 3, 4, 5)
  5. Examine how transformational leadership uses innovation to advance nursing practice. ( PCs 2, 4, 6; POs 6, 8;COs 2, 3, 4, 5)

Main Concepts

  1. Transformational leadership for collaboration in advanced nursing practice (PCs 2, 4, 6; POs 6, 8; COs 2, 3, 5)
  2. Beyond transformational leadership (PC 6; PO 8; CO 5)
  3. The Leadership Challenge (PCs 2, 4, 6; POs 6, 8; COs 3, 5)
  4. Leadership reflection (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 3, 4, 5)

Schedule

Section Read/Review/Complete Course Outcomes Due
Prepare Assigned Readings COs 1, 2, 3, 4, 5 Wednesday
Explore Lesson COs 1, 2, 3, 4, 5 Wednesday
Translate to Practice Discussion: Initial Post COs 1, 2, 3, 4, 5 Wednesday
Translate to Practice Discussion: Follow-Up Posts COs 1, 2, 3, 4, 5 Saturday
Reflect Reflection COs 1, 2, 3, 4, 5 No submission

Foundations for Learning

Start your learning this week by reviewing the following video and identifying the five clearly defined practices of transformational leaders.

The Leadership Challenge. (2012, November 7). The Leadership Challenge overview. [Video]. YouTube. https://youtu.be/Ny44jEgJU6s

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

  • Read Chapter 1
    • Section: What Is Transformational Leadership?

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

  • Read Chapter 6
    • Section: Translation of Evidence for Leadership

Zaccagnini, M., & Pechacek. (2021). The Doctor of Nursing Practice essentials: A new model for advanced practice (4th ed.). Jones & Bartlett Learning.

  • Read Chapter 6
    • Section: Strong Leadership

Required Articles

Scan the following articles on Professional Practice Models:

Ghur, N., Lebek, B., & Breitner, M. H. (2019). The impact of leadership on employees’ intended information security behaviour: An examination of the full‐range leadership theory. Information Systems Journal, 29(2), 340-362. https://doi.org/10.1111/isj.12202

Pearson, M. M. (2020). Transformational leadership principles and tactics for the nurse executive to shift nur. The Journal of Nursing Administration, 50(3), 142-151. https://doi.org/10.1097/NNA.0000000000000858

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

42 Fresh Ideas. (2018, March 4). 30 The Leadership Challenge [Video]. YouTube. https://www.youtube.com/watch?v=HMvwaFVlu8I

Learning Success Strategies

  • Remember that the week and discussion end on Saturday at 11:59 p.m. (MT).
  • Develop your course reflection ideas and thoughts through the interactive discussion. Review the discussion guidelines and rubric to optimize your performance.
  • You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
  • Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Week 8Lesson

Transformational Leading as a DNP-Prepared Nurse

Transformational Leadership Factors

Since the turn of the century, the transformational leadership style has been promoted, encouraged, and refined. Today, the elements have been distilled to four essential transformational leadership factors outlined in this week’s reading (Marshall & Broome, 2021).

Four Key Transformational Leadership Factors (Core Concepts)

Match each characteristic with its core concept.

Key Transformational Leadership Factors Interactive Transcript

  • Idealized Influence: Be a positive role model
  • Individualized Consideration: Give personal attention
  • Inspirational Motivation: Inspire and motivate
  • Intellectual Stimulation: Challenge to be innovative

Learn More!

View the following video to examine the role of nurse leaders in transforming healthcare.

Full-Range Leadership Theory: An Adaptive Transformative Approach

Styles such as laissez-faire leadership, transactional leadership, situational leadership, servant leadership, adaptive leadership, and other interactional leadership concepts have created a more expansive toolbox for today’s dynamic leaders. In addition to the recent innovation of Quantum Caring Leadership (Watson et al., 2018) discussed in Week 6, another theory worth examining for its operational usefulness is Full-Range Leadership since its focus is on combining different styles into the leadership repertoire.

Full-Range Leadership Theory (Antonakis et al., 2003; Avolio, 2011; Avolio & Bass, 1991) describes nine characteristics from the three leadership concepts: five from the transformational concept, three attributed to transactional leadership, and one classified as a non-leadership or lasses-fair factor. These are summarized in the following graphic. The construct helps to operationalize the leadership dynamic and provide a better understanding of the application of leadership principles. The laisser-faire concept (which was popular years ago) was included to demonstrate non-productive leadership.

Click on the different theories to examine Full-Range Leadership Theory.

Click the following link to expand to full screen:

Full-Range Leadership Theory.

Full-Range Leadership Theory Interactive Transcript

Originating Leadership Concept Factors/Characteristic Description of Follower’s Perception
Transformational Inspirational motivation Leader’s vision leading to positive attitude and motivation
Transformational Idealized influence (attributed) Followers see leader as positive and charismatic, creating emotional connections, confidence, and trust
Transformational Idealized influence (behavior) Leader acts on values, mission and vision with followers.
Transformational Intellectual stimulation Leader challenges followers’ assumptions, analyzes their problems and creates solutions
Transformational Individualized Consideration Leader fosters followers’ strengths and considers their needs and development
Transactional Contingent reward Leader provides task rewards (material and psychological)
Transactional Active management-by-exception Leader actively looks for deviations from rules/standards to make corrections and prevent further complications
Transactional Passive management-by-exception Leader acts after deviations/errors occur to take corrective action
Laissez-faire Non-leadership Absence of leadership

The Leadership Challenge

Kouzes and Posner (2017) offer an excellent practical leadership model in The Leadership Challenge Model. They have discovered through observation and research that influential leaders lead by modeling the organization’s shared values. Then, they find a way to inspire a shared vision for their teams and enlist them to adopt it. They propose that leaders challenge the way-its-always-been-done mindset, enabling those in their teams to act independently. Finally, they celebrate all gains, which is referred to as encouraging the heart. Their leadership primer has also been used effectively as a change model.

Click through the slides for the five practices for exemplary leadership.

Five Practices for Exemplary Leadership Interactive Transcript

Leadership is not about personality; it is about behavior—an observable set of skills and abilities.

Explore the five practices by clicking the arrow.

  1. Model the way: Leaders create standards of excellence and then set an example for others to follow.
  2. Inspire a shared vision: Leaders envision the future, creating an ideal and unique image of what the organization can become.
  3. Challenge the process: Leaders search for opportunities to create innovative ways to improve the organization.
  4. Enable others to act: Leaders involve others and strive to create an atmosphere of trust and human dignity.
  5. Encourage the heart: Leaders recognize contributions and celebrate accomplishments.

By learning and applying leadership behaviors and attitudes that transform people into better teams, DNP-prepared nurse leaders can become the critical change agents of tomorrow.

As you complete this final week, take the following leadership challenge. Think about how you can apply the leadership challenge to your practice in some way. Click on each level to compare your application idea to the expert answer.

The Leadership Challenge Interactive Transcript

The Leadership Challenge: How to make extraordinary things happen in organizations

Select the correct Golden Cube to reveal the answer.

Level 1: Model the Way

Question:

Choose the best answer from these options:

  1. The manager, who is not a nurse, shows a video of a sterile dressing change and sets the expectation that it should always be done that way.

*b. The manager, who is not a nurse, sees that the team is hectic, so she assumes tasks at the nursing station as she calls for additional staffing.

  1. The manager, who is not a nurse, asks the charge nurse to demonstrate a procedure in the staff meeting.

Model the Way Expert Response:

“Leading by example is more effective than leading by command” (Kouzes & Posner, 2012, p. 17).

A leader does not have to demonstrate the individual job skills of everyone on the team but instead establish the direction and guide the pursuit through clearing the way for the team. Leaders operationalize the golden rule: treating others and the team’s goals as they themselves believe. Modeling the way is setting the example, showing commitment, and caring for the team.

Level 2: Inspire a Shared Vision

Question:

Choose the best answer from these options:

  1. The manager sets operational expectations for the fiscal quarter at a staff meeting.

*b. The manager explains her vision of the future by including a common and desirable goal that excites all team members.

  1. The manager defines her vision of the future in a general way she hopes all of the team will appreciate.

Inspire a Shared Vision Expert Response:

“You can’t command commitment; you have to inspire it. You have to enlist others in a common vision by appealing to shared aspirations” (Kouzes & Posner, 2012, p. 18).

Whether the vision is born of the organizational philosophy or the leader’s own passion, demonstrating that enthusiasm can paint the picture of the future for the team. The leader’s passion becomes magnetic, exhilarating, engaging, and enlivening as each team member arrives at that vision inspired by the leader’s unfailing excitement. During the Vietnam conflict, a ship’s captain pinned a beautiful, exotic picture of Tahiti in the mess hall under which were written the words, “When we are done here. . . .!” A shared vision was inspired.

Level 3: Challenge the Process

Question:

Choose the best answer from these options:

*a. I think we do a great job with end of shift report, but I suggest looking at the evidence behind walking rounds.

  1. I like new ideas, but if it’s not broken, don’t fix it!
  2. The expectation is that everyone will comply with my new initiative.

Challenge the Process Expert Response:

“Maintaining the status quo simply breeds mediocrity” (Kouzes & Posner, 2012, p. 156).

Transformational leaders must always be fearless and willing to take a stand for values over corporate policies that may harm or devalue the patients or the staff. Being a fearless leader means knowing when to pick battles (of course through appropriate behaviors) and when to use collaboration skills. Challenging the “way it has always been done” is vital for innovative improvement, application of best practice, and creative leadership.

Level 4: Enable Others to Act

Question:

Choose the best answer from these options:

  1. The manager encourages educational development even though there is no budget to support it.
  2. The manager creates a unit policy that allows anyone on the team to take action in customer service recovery; however, they should first receive permission from the on-duty supervisor.

*c. The manager creates a unit policy that allows anyone on the team to take action in customer service recovery. It includes examples like allowing visitation after hours when needed, ordering a family member’s meal, and other acts that demonstrate the willingness to make things right.

Enable Others to Act Expert Response:

“The climb to the top is arduous and steep. People become exhausted, frustrated, and disenchanted, and are often tempted to give up. Genuine acts of caring draw people forward. ‘Recognition is the most powerful currency you have and it costs you nothing.’” (Kouzes & Posner, 2012, p. 23).

It is often easier (and sometimes more effective and efficient) for a leader to perform a task rather than delegate it. However, it may send the message that the leader does not trust the staff (or thinks them incompetent). Moreover, enabling others to make decisions or perform functions independently creates a culture of trust and respect. It strengthens each member of the team and creates a collaborative environment. Enabling others to act develops each team member and strengthens the team.

Level 5: Encourage the Heart

Question:

Choose the best answer from these options:

  1. Within the hearing of others, the leader of the organization makes rounds on a unit and says the exact phrase to each person encountered, “I appreciate you and the very important work that you do.”

*b. The unit manager overhears a patient thank a nurse for taking the time to care. While the manager walks with the nurse back to the nurses’ station, she says, “You are amazing. Thank you!”

  1. The unit manager overhears a patient thank a nurse for taking the time to care. While the manager walks with the nurse back to the nurses’ station, she says, “You did a great job, but I think you could do better.”

Encourage the Heart Expert Response:

“Spontaneous, unexpected rewards are often more meaningful than expected, formal ones” (Kouzes & Posner, 2012, p. 292).

Encouraging the heart is an attitude toward others that is continually in motion. The leader can recognize each positive act, successful task, helping behavior, or positive expression when witnessed simply by approving and reinforcing them with this relationship-building attitude. The leader’s approval means much. For individuals and the team, rewarding even small gains can add to the accomplishment of extraordinary things, even when the leader is not present to see them. For leaders and their reinforcement of daily positives, excellence can be achieved. Excellence is encouraging the heart.

You win!! Move on to the discussion for Week 8!

Reference

Kouzes, J. M., & Posner, B. Z. (2012). The leadership challenge: How to make extraordinary things happen in organizations (5th ed.). Jossey-Bass.

Week 8 References

Antonakis, J., Avolio, B. J., & Sivasubramaniam, N. (2003). Context and leadership: An examination of the nine-factor full-range leadership theory using the Multifactor Leadership Questionnaire. Leadership Quarterly, 14, 261-295. https://doi.org/10.1016/S1048-9843(03)00030-4

Avolio, B. J. (2011). Full range leadership development. Sage Publications.

Avolio, B. J., & Bass, B. M. (1991). Manual for the full range of leadership. Bass, Avolio & Associates.

Kouzes, J. M., & Posner, B. Z. (2017). The leadership challenge: How to make extraordinary things happen in organizations (6th ed.). John Wiley & Sons, Inc.

Marshall, E. S., & Broome, M. E. (2021). Chapter 1: Frameworks for becoming a transformational leader. In M. E. Broome & E. S. Marshall (Eds.), Transformational leadership in nursing: From expert clinician to influential leader (3rd ed., pp. 3-34). Springer Publishing Company. https://doi.org/10.1891/9780826135056

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science. Nursing Science Quarterly, 31(3), 253-258. https://doi.org/10.1177/0894318418774893

NR703 Week 8 Reflection on Learning and Practice Readiness Discussion

Purpose

The purpose of this discussion is to reflect on your own readiness to practice as a DNP-prepared nurse and consider what you learned in this course and how this knowledge will impact your practice.

Instructions

Each week, you have been reminded that reflective inquiry allows for expansion of self-awareness, identification of knowledge gaps, and assessment of learning goals. As you reflect on your own readiness to practice as a DNP-prepared nurse, it is important to consider what you learned in this course.

As you review the course outcomes and your experience in this course, address the following:

  1. Analyze and evaluate how your thinking was challenged in this course related to transformational leadership to influence contemporary organizations
  2. Considering this new knowledge, examine how this learning prepares you to practice collaboratively as an innovative DNP-prepared nurse.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Program Competencies

This discussion enables the student to meet the following program competences:

  1. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
  2. Appraises current information systems and technologies to improve health care. (POs 6, 7)
  3. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

  1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
  2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
  3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
  4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
  5. Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Also Read: NR717 Week 1 Leading Culturally and Linguistically Appropriate Healthcare Discussion