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NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal Example

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initiative Proposal

NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal Assignment Brief

Course: NURS-FPX 6016 Quality Improvement of Inter-professional Care

Assignment Title: Assessment 3 Data Analysis and Quality Improvement Initiative Proposal

Overview:

The NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal Assignment is designed to enhance students’ understanding of healthcare quality improvement processes and their ability to analyze data to identify areas for improvement. In this assignment, students will critically analyze data from a healthcare institution and develop a comprehensive Quality Improvement Initiative Proposal (QIIP) to address identified issues.

The Student’s Role:

As a student enrolled in NURS FPX 6016, your role in this assignment is to act as a healthcare quality improvement specialist tasked with evaluating data from a hypothetical healthcare institution. You will utilize your knowledge of healthcare quality improvement principles and evidence-based practices to develop a comprehensive Quality Improvement Initiative Proposal. Your proposal should address key areas of concern identified through data analysis and propose strategies to enhance patient safety, treatment quality, and overall healthcare outcomes.

You Can Also Check Other Related Assessments:

NURS FPX 6016 Adverse Event or Near-Miss Analysis

NURS FPX 6016 Quality Improvement Initiative Evaluation

NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal Example

Introduction

Greetings esteemed colleagues; I am Levin, a Registered Nurse at Valley Hospital. I extend a warm welcome to everyone present for today’s presentation on Data Analysis and Quality Improvement Initiative Proposal. Our focus today revolves around devising a proposal for a quality improvement initiative based on an analysis of our hospital’s dashboard metrics. Through meticulous data analysis, we aim to pinpoint a specific health issue and craft a comprehensive Quality Improvement Initiative Proposal (QIIP) targeted at mitigating medication adverse events.

The imperative of this endeavor stems from our unwavering commitment to delivering superior healthcare, which hinges on enhancing patient safety and treatment quality, particularly in the realm of medication management. Failing to uphold stringent standards across all facets of healthcare provision jeopardizes patient well-being and may lead to dire consequences. Thus, our presentation is centered on formulating a QIIP tailored to address a critical health issue identified through our hospital’s dashboard data analysis.

Dashboard Metrics and Quality Improvement

Healthcare institutions worldwide leverage quality dashboards to furnish clinical teams and managers with essential metrics and analytics for monitoring care quality and orchestrating improvement initiatives. These dashboards encompass a spectrum of metrics ranging from performance indicators to data quality assessment and are instrumental in driving localized service enhancements. By harnessing the power of dashboards, organizations can gain invaluable insights into prevailing health policies and recalibrate strategies accordingly (Randell et al., 2020; Salgado et al., 2022).

Dashboard Data Analysis and Healthcare Issue

In pursuit of our Quality Improvement Initiative Proposal, we collaborated with Valley Hospital’s quality management department to procure pertinent data. Adhering to the stringent standards stipulated by the Health Insurance Portability and Accountability Act (HIPAA), we meticulously scrutinized patient health reports to discern prevailing care quality. Our analysis spotlighted key dashboard metrics encompassing patient satisfaction, patient safety, treatment errors, and hospital readmission rates, which served as lynchpins in identifying critical healthcare issues warranting remedial action.

Data Analysis

The analysis of data from Valley Hospital revealed concerning findings regarding patient satisfaction and medication errors. Patient satisfaction was notably low at only 40%, largely attributed to the high occurrence of medication errors. Approximately 30 out of 100 patients experienced harmful medication errors, leading to significant safety concerns. Tragically, 10 patients lost their lives due to these errors (Randell et al., 2020). Medication errors ranked as the most prevalent among treatment errors, contributing to increased hospital readmission rates. This analysis underscores the urgent need for a quality improvement initiative to address medication errors within Valley Hospital.

While the analysis provides valuable insights into the extent of medication errors, there are notable knowledge gaps. Specifically, details regarding the types of medication errors, such as wrong dosage, incorrect medication, or improper administration routes, are missing. This information could have facilitated a more targeted analysis to pinpoint specific areas for improvement within the hospital’s medication processes (Randell et al., 2020).

Selected Quality Improvement Initiative Proposal

Upon identifying the significant issue of adverse medication events, Valley Hospital recognized the pressing need for a quality improvement initiative to enhance patient care, safety, and satisfaction. To address this concern, the proposed approach is the implementation of the six sigma DMAIC model. This model comprises five key steps: Define, Measure, Analyze, Improve, and Control (Ahmed, 2019). The initial step involves identifying specific areas for improvement, with a focus on nursing practices given their pivotal role in medication administration. Additionally, attention can be directed towards the prescribing and dispensing processes conducted by physicians and pharmacists, respectively.

The DMAIC model offers a structured framework to address the identified issues comprehensively. For instance, to mitigate adverse medication events, the hospital team will first define and delineate the problem among all stakeholders. Subsequently, data pertaining to these events, including their frequency and impact on patients, will be collected. This measurement phase serves as a baseline for further analysis. Through root-cause analysis, underlying factors contributing to medication errors will be identified. Subsequent steps involve devising improvement plans to prevent medication errors and implementing system changes. Continuous monitoring and evaluation ensure sustained improvements in patient safety and care quality.

Evidence-Based Strategies

To enhance the quality of care and reduce medication-associated events, several evidence-based strategies can be implemented:

Firstly, the adoption of computerized provider order entry systems during transitions in care, especially when coupled with clinical decision support systems, can significantly mitigate medication errors (Agency for Healthcare Research and Quality, 2019).

Secondly, involving clinical pharmacists in overseeing the medication dispensing process is crucial. Additionally, employing the ‘Tall man’ lettering strategy can help distinguish between look-alike and sound-alike medications, thereby minimizing confusion. Automated dispensing cabinets also play a vital role in reducing errors associated with high-risk medications.

Thirdly, adherence to the “Five Rights” of medication administration is imperative to ensure safe medication practices. These rights include administering the right medication, in the right dose, at the right time, via the right route, to the right patient.

Lastly, leveraging technologies such as Barcode medication administration can further enhance medication safety by verifying that the correct medication is administered to the intended patient (Agency for Healthcare Research and Quality, 2019).

However, the absence of specific information regarding the types of medication-associated adverse events poses a challenge in tailoring the proposal to address this particular area effectively. Having this information would have strengthened the proposal and facilitated a more targeted approach to improving medication safety.

Inter-professional Perspectives and Needed Actions

In order to ensure effective, competent, and safe patient care, collaboration among inter-professional teams is essential. Each member of the team works towards a common goal of enhancing patient health and safety. Adverse events such as medication errors not only impact patient well-being but also affect the quality of work-life for healthcare professionals. These events can lead to repercussions such as penalties or detention for healthcare providers, thereby increasing costs for both patients and the healthcare facility. Additionally, medication errors may necessitate further treatment for patients experiencing non-fatal injuries. Therefore, it is imperative for inter-professional teams to work together to minimize such events (Manias, 2018).

In Valley Hospital, various healthcare professionals including hospital administration, physicians, nurses, pharmacists, and IT personnel, such as nurse informaticists, are actively engaged in analyzing dashboard metrics and are committed to improving their performance. Their collective efforts aim not only to enhance patient safety but also to promote cost-effectiveness and improve the overall quality of work-life within the hospital setting.

Needed Actions

To achieve shared objectives of enhancing patient safety, cost-effectiveness, and work-life quality, it’s crucial for all members of the inter-professional team to collaborate effectively. Here are the specific actions identified by the team to meet these goals:

• Communication Enhancement: Utilizing tools such as guidelines, protocols, and communication logs to facilitate clear and effective communication among team members (Manias, 2018).
• Involvement of Pharmacists: Incorporating pharmacists into clinical settings to provide their expertise in medication management and usage, thereby reducing the occurrence of medication errors (Manias, 2018).
• Collaborative Medication Review: Conducting joint medication reviews upon admission and discharge to ensure accuracy and safety in medication administration (Manias, 2018).
• Educational Workshops and Conferences: Organizing collaborative educational sessions to share knowledge and best practices among healthcare professionals, promoting a culture of continuous learning and improvement (Irajpour et al., 2019).

Implementing these actions will contribute to enhancing patient safety by improving communication and raising awareness about appropriate practices. Additionally, involving pharmacists in clinical settings and conducting collaborative medication reviews will help mitigate medication errors and adverse events. This approach not only benefits patient outcomes but also enhances the cost-effectiveness of treatment. Moreover, educational workshops and conferences foster a supportive environment for ongoing learning, ultimately improving the quality of work-life for healthcare professionals.

The effectiveness of these suggestions relies on the assumption that healthcare professionals across all departments will work collaboratively towards the common goal of enhancing patient safety. By fostering positive work relationships, sharing objectives, and improving job performance, professionals can feel more competent and satisfied in their roles, thereby reducing mental stress and enhancing overall job satisfaction.

Effective Collaboration Strategies

To enhance the quality of inter-professional care, it’s essential to implement effective collaboration strategies that foster teamwork and communication among healthcare professionals. These strategies are crucial for ensuring that all members of the inter-professional team work together towards common goals, ultimately improving patient safety and the quality of care provided. Here are some evidence-based collaboration strategies:

• Role Clarification: Clearly defining the roles and responsibilities of each team member helps in understanding their scopes of practice and identifying areas of overlap. By acknowledging these interdependencies, team members can work together more effectively, leveraging their knowledge and expertise to provide comprehensive care (White-Williams & Shirey, 2021).
• Promoting Ethical Values: Creating an environment that values transparency, openness, and willingness to collaborate is essential for effective teamwork. Educating team members about inter-professional values and ethics encourages ethical behavior and fosters a culture of collaboration. Incorporating these values into organizational onboarding and training programs can further promote inter-professional collaboration (McLaney et al., 2022).
• Utilizing Communication Tools: Employing effective communication tools facilitates timely and efficient exchange of information among team members. Using a common language that is easily understandable by all members and leveraging technologies such as social media and hospital communication portals can enhance communication and promote collaboration (De Las Heras-Pedrosa et al., 2020).

These strategies are predicated on the assumption that the inter-professional team shares a common vision and goals aimed at improving patient safety and quality of care. By working together collaboratively, healthcare professionals can fulfill their duties effectively, leading to enhanced job satisfaction and ultimately improving patient outcomes.

Conclusion

In conclusion, the Data Analysis and Quality Improvement Initiative Proposal presented here underscore the critical importance of data-driven decision-making and collaborative efforts in healthcare settings. Through meticulous analysis of dashboard metrics, Valley Hospital identified medication errors as a significant concern impacting patient safety and satisfaction. Leveraging evidence-based strategies and the DMAIC model, the proposed Quality Improvement Initiative aims to address these issues comprehensively, focusing on areas such as nursing practices, medication administration, and inter-professional collaboration.

Effective collaboration among healthcare professionals is paramount to achieving shared goals of enhancing patient safety, treatment quality, and work-life satisfaction. Strategies such as role clarification, promoting ethical values, and utilizing communication tools can facilitate seamless teamwork and communication, ultimately improving patient outcomes.

By implementing the proposed Quality Improvement Initiative and fostering a culture of collaboration, Valley Hospital can mitigate medication errors, enhance patient safety, and improve overall care quality. However, it is essential to address knowledge gaps and ensure ongoing monitoring and evaluation to sustain improvements over time.

Through these concerted efforts, Valley Hospital can continue its mission of delivering high-quality, patient-centered care while fostering a supportive and fulfilling work environment for healthcare professionals.

References

Ahmed, N. (2019). Six Sigma DMAIC Model: A Roadmap for Process Improvement. Quality Engineering, 31(1), 37–55. https://doi.org/10.1080/08982112.2018.1492981

Agency for Healthcare Research and Quality. (2019). Barcode Medication Administration: Lessons Learned from an Intensive Care Unit Implementation. https://www.ahrq.gov/hai/tools/barcoding/index.html

De Las Heras-Pedrosa, C., Sáez, M. E., García-Peñalvo, F. J., & Therón, R. (2020). Social Media Tools as a Support of Interprofessional Collaboration: A Systematic Review. Journal of Medical Internet Research, 22(4), e16806. https://doi.org/10.2196/16806

Irajpour, A., Farzi, S., Saghaei, M., Ravaghi, H., & Ghotbi, M. (2019). Impact of educational intervention on improving interprofessional collaboration among Iranian critical care nurses. Journal of Interprofessional Care, 33(2), 242–250. https://doi.org/10.1080/13561820.2018.1537697

Manias, E. (2018). Medication safety: Nurses’ role in improving patient outcomes. British Journal of Nursing, 27(6), 316–321. https://doi.org/10.12968/bjon.2018.27.6.316

McLaney, A., Deloney, L. A., McKnight, R., & Young, H. M. (2022). Fostering Interprofessional Collaboration Through Values Integration. Journal of Professional Nursing, 38(1), 74–79. https://doi.org/10.1016/j.profnurs.2021.07.001

Randell, R., Honey, S., & Alvarado, N. (2020). Information dashboards for improving patient care: A narrative review. Journal of Innovation in Health Informatics, 26(1), 21–30. https://doi.org/10.14236/jhi.v26i1.1005

Salgado, G., Timenetsky, K., Menezes, S., Isoni Auad, L., & Lara, E. (2022). Information systems for quality indicators in health care: a systematic review. BMC Medical Informatics and Decision Making, 22(1), 1–11. https://doi.org/10.1186/s12911-021-01739-7

White-Williams, C., & Shirey, M. R. (2021). Enhancing Interprofessional Collaboration in Healthcare Through Role Clarification. Journal of Professional Nursing, 37(1), 63–68. https://doi.org/10.1016/j.profnurs.2020.06.004

Detailed Assessment Instructions for the NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal Assignment

Prepare an 8-10 page data analysis and quality improvement initiative proposal based on a health issue of interest. Include internal and external benchmark data, evidence-based recommendations to improve health care quality and safety, and communication strategies to gain buy-in from all interprofessional team members responsible for implementing the initiative.

Introduction

Health care providers are perpetually striving to improve care quality and patient safety. To accomplish enhanced care, outcomes need to be measured. Next, data measures must be validated. Measurement and validation of information support performance improvement. Health care providers must focus attention on evidence-based best practices to improve patient outcomes.

Health informatics, along with new and improved technologies and procedures, are at the core of all quality improvement initiatives. Data analysis begins with provider documentation, researched process improvement models, and recognized quality benchmarks. All of these items work together to improve patient outcomes. Professional nurses must be able to interpret and communicate dashboard information that displays critical care metrics and outcomes along with data collected from the care delivery process.

For this assessment, use your current role or assume a role you hope to have. You will develop a quality improvement (QI) initiative proposal based on a health issue of professional interest. To create this proposal, analyze a health care facility’s dashboard metrics and external benchmark data. Include evidence-based recommendations to improve health care quality and safety relating to your selected issue. Successful QI initiatives depend on the support of nursing staff and other members of the interprofessional team. As a result, a key aspect of your proposal will be the communication strategies you plan to use to get buy-in from these team members.

Preparation

To develop the QI initiative proposal required for this assessment, you must analyze a health care facility’s dashboard metrics. Choose Option 1 or 2 according to your ability to access dashboard metrics for a QI initiative proposal.

Option 1

If you have access to dashboard metrics related to a QI initiative proposal of interest to you, complete the following:

• Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. For example, in a hospital setting, you would contact the quality management department to obtain the needed data. It is your responsibility to determine the appropriate resource to provide the necessary data in your chosen health care setting. If you need help determining how to obtain the needed information, consult your faculty member for guidance.
• Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic. Please abide by Health Insurance Portability and Accountability Act (HIPAA) compliance standards.

Option 2

If you do not have access to a dashboard or metrics related to a QI initiative proposal:

• Use the hospital data set provided in Vila Health: Data Analysis. You will analyze data to identify a health care issue or area of concern.
• Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic.

Instructions

Use your current role or assume a role you would like to have. Choose a quality improvement initiative of professional interest to you. Your current organization is probably working on quality improvement initiatives that can be evaluated, so consider starting there.

To develop your proposal you will:

• Gather internal and external benchmark data on the subject of your quality improvement initiative proposal.
• Analyze data you have collected.
• Make evidence-based recommendations about how to improve health care quality and safety relating to your chosen issue.

Remember, your initiative’s success depends on the interprofessional team’s commitment to the QI initiative. Think carefully about these stakeholders and how you plan to include them in the process, as they will help you develop and implement ideas and sustain outcomes. Also, remember how important external stakeholders, such as patients and other health care delivery organizations, are to the process. As you are preparing this assessment, consider carefully the communication strategies you will employ to include the perspectives of all internal and external stakeholders in your proposal.

The following numbered points correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your proposal addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels related to each grading criterion.

1. Analyze data to identify a health care issue or area of concern.
   • Identify the type of data you are analyzing from your institution or from the Vila Health activity.
   • Explain why data matters. What does data show related to outcomes?
   • Analyze the dashboard metrics. What else could the organization measure to enhance knowledge?
   • Present dashboard metrics related to the selected issue that are critical to evaluating outcomes.
   • Assess the institutional ability to sustain processes or outcomes.
   • Evaluate data quality and its implications for outcomes.&
2. Determine whether any adverse event or near-miss data needs to be factored in to outcomes and recommendations.
   • Examine the nursing process for variations or performance failures that could lead to an adverse event or near miss.
   • Identify trends, measures, and information needed to critically analyze specific outcomes.
   • Specify desired outcomes related to prevention of adverse events and near misses.
   • Analyze which metrics indicate future quality improvement opportunities.
3. Develop a QI initiative proposal based on a selected health issue and supporting data analysis.
   • Determine benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.
   • Identify any internal existing QI initiatives in your practice setting or organization related to the selected issue. Explain why they are insufficient.
   • Evaluate external national or international QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and nongovernmental bodies on quality improvement.
   • Define target areas for improvement and the processes to be modified to improve outcomes.
   • Propose evidence-based strategies to improve quality.
   • Analyze challenges that meeting prescribed benchmarks can pose for a health care organization and the interprofessional team.
4. Communicate QI initiative proposal based on interdisciplinary team input to improve patient safety and quality outcomes and work-life quality.
   • Define interprofessional roles and responsibilities relating to data and the QI initiative.
   • Explain how to ensure all relevant interprofessional roles are fully engaged in this effort.
   • Identify how outcomes will be measured and data used to inform interprofessional team performance related to specific tasks.
   • Reflect on the impact of the proposed initiative on work-life quality of the interprofessional team.
   • Describe how the initiative enhances work-life quality due to improved strategies supporting efficiency.
5. Determine communication strategies to promote quality improvement of interprofessional care.
   • Identify interprofessional communication strategies that will help to promote and ensure the success of the QI initiative.
   • Identify communication models, such as SBAR and CUS, to include in your proposal.
     • SBAR stands for Situation, Background, Assessment, Recommendation.
     • CUS stands for “I am Concerned about my resident’s condition; I am Uncomfortable with my resident’s condition; I believe the Safety of the resident is at risk.”
   • Consult this resource for additional information about these fundamental evidence-based tools to improve interprofessional team communication for patient handoffs:
     • Agency for Healthcare Research and Quality (AHRQ). (n.d.). Module 2: Communicating change in a resident’s condition. https://www.ahrq.gov/professionals/systems/long-term-care/resources/facilities/ptsafety/ltcmod2ap.html
6. Communicate QI initiative proposal in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
7. Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

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NURS FPX 6016 Adverse Event or Near-Miss Analysis Essay Example

NURS FPX 6016 Assessment 1 Adverse Event or Near-Miss

NURS FPX 6016 Adverse Event or Near-Miss Analysis Assignment Brief

Course: NURS-FPX 6016 Quality Improvement of Inter-professional Care

Assignment Title: Assessment 1 Adverse Event or Near-Miss Analysis in Healthcare

Assignment Overview:

In healthcare, patient safety is of utmost importance. Despite numerous quality improvement initiatives, adverse events and near misses still occur, highlighting the need for continuous analysis and improvement. This assignment aims to provide students with an opportunity to analyze a real or simulated adverse event or near miss from their nursing experience. By examining the circumstances, root causes, and implications for stakeholders, students will propose evidence-based quality improvement initiatives to prevent similar incidents in the future.

The Student’s Role:

As a student in the NURS FPX 6016 course, your role is to analyze an adverse event or near miss that you or a peer experienced during your nursing career. You will critically examine the circumstances surrounding the event, identifying missed steps or protocol deviations that contributed to the incident. Additionally, you will evaluate the implications of the event for all stakeholders involved, considering short- and long-term effects.

Furthermore, you will research and evaluate quality improvement technologies and metrics relevant to the event, proposing evidence-based initiatives to prevent similar incidents in the future. Your analysis should be communicated effectively, demonstrating clear and logical writing, adherence to APA style, and integration of scholarly sources to support your arguments and recommendations.

You Can Also Check Other Related Assessments:

NURS FPX 6016 Quality Improvement Initiative Evaluation

NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal

NURS FPX 6016 Adverse Event or Near-Miss Analysis Essay Example

In healthcare, ensuring patient safety and providing optimal care is paramount. Adverse events and near misses highlight the critical need for continuous quality improvement initiatives (Isaksson et al., 2021). This assessment focuses on a case study centered around patient John Smith, exploring the circumstances, sequence of events, and root causes that led to an adverse event. By analyzing this scenario, evaluating existing quality improvement technologies, and considering evidence-based practices, we aim to uncover valuable insights into preventing similar incidents in the future. This assessment underscores the significance of proactive measures, interprofessional collaboration, and the application of best practices to safeguard patient well-being and enhance healthcare outcomes.

Patient Scenario

John Smith, a 55-year-old with heart issues, was admitted to Villa Hospital for chest pain. Amidst understaffing and a high workload, Nurse Lisa, stressed and overwhelmed, mistakenly administered nitroglycerin meant for another patient. John’s blood pressure dropped, and though the error was caught, his condition worsened due to inadequate monitoring. A delayed arrhythmia detection led to a code blue, and he was transferred to the ICU. Despite efforts, John’s heart damage was irreparable, and he passed away on Day 6. This tragic event highlights the dangerous mix of staffing shortages, nurse stress, and inadequate monitoring, emphasizing proper nurse-patient ratios, stress management, and a robust patient safety culture.

Implications of the Adverse Event for Stakeholders

The adverse event involving John Smith carries significant implications for all stakeholders involved in his care. The consequences for the patient and his family were tragically severe, as John lost his life due to a chain of errors and delays in his treatment. This sudden loss not only devastated the family emotionally but could also lead to a lasting distrust in the healthcare system, impacting their future interactions with healthcare professionals.

The interprofessional team, including Nurse Lisa and other healthcare providers, experienced immediate emotional distress after the event. Feelings of guilt, anxiety, and grief were likely to have occurred. In the long term, this incident may catalyze changes within the team dynamics. It could lead to reevaluating protocols, fostering an environment of enhanced communication and collaboration to prevent similar incidents from occurring in the future. Healthcare professionals might become more vigilant and open to discussing errors to facilitate improvements in patient safety (Rigamonti & Rigamonti, 2021).

The healthcare facility faces not only reputational damage but also potential legal consequences due to the unfortunate outcome of medical errors. Regulatory bodies might closely scrutinize the facility’s operations and protocols, possibly affecting its accreditation status. The event could trigger a series of assessments and improvements to ensure patient safety measures are strengthened (Behrens et al., 2022).

Within the community, incidents such as Adverse Event or Near-Miss Analysis could erode trust in the healthcare system. Word-of-mouth discussions and media coverage might impact community members’ perceptions and choices when seeking medical care. The incident’s effects could ripple beyond the hospital, shaping the community’s perspective on healthcare institutions in general.

Adverse Event or Near-Miss Analysis

Following the adverse event, the interprofessional team must take a proactive approach to address the situation. A thorough root cause analysis is crucial to identify the underlying factors contributing to the errors. Reviewing and revising protocols, prioritizing training in stress management and proper medication administration, and addressing staffing shortages are measures the team must undertake collectively (Laatikainen et al., 2021).

Responsible parties include frontline healthcare providers like Nurse Lisa and higher-level management, who must ensure adequate staffing and support mechanisms. The impact of the incident has likely led to changes in workflows, stricter adherence to protocols, and potentially altered reporting mechanisms to facilitate a more transparent and proactive approach to patient safety (Nantsupawat et al., 2021).

Adverse Event with Root Cause Analysis

The sequence of events that led to the adverse event involving John Smith can be analyzed through a root cause analysis. The event resulted from a series of missed steps and protocol deviations in his medical management, exacerbating the impact of his underlying condition. The missed steps and deviations began with Nurse Lisa’s crushing workload due to understaffing. This led to the first error – administering the wrong medication, nitroglycerin, due to stress-induced cognitive overload. Subsequently, inadequate monitoring of John’s condition due to Nurse Lisa’s multiple responsibilities delayed the recognition of a developing arrhythmia (Raeissi et al., 2022).

The adverse event stemmed from these protocol deviations in the context of “Adverse Event or Near-Miss Analysis” rather than solely from John’s underlying heart condition. The sequence of errors amplified the stress on John’s already compromised cardiovascular system, leading to a rapid deterioration of his health. The missed steps failed to provide appropriate medication, timely monitoring, and accurate recognition of critical changes. Nurse Lisa’s cognitive overload and the facility’s staffing shortages contributed to these lapses. Communication breakdowns were also evident as the team failed to identify and rectify the medication error in a timely manner (Hsieh et al., 2021).

To prevent this event, effective interprofessional communication is crucial. Regular team briefings, handoffs, and clear protocols could have played a vital role in preventing medication errors. Improved communication channels between nurses, doctors, and other team members would ensure timely intervention and error correction (Hsieh et al., 2021).

The adverse event was partially preventable through proper nurse staffing, stress management support, and stringent medication administration protocols. While unexpected medical complications can occur, the sequence of errors due to workload, cognitive overload, and communication gaps significantly contribute to the adverse outcome (Behrens et al., 2022).

Knowledge Gaps

There are some knowledge gaps about the specific medications, dosages, and monitoring procedures relevant to John’s case. Additionally, it doesn’t provide clear insights into the underlying heart condition, the nature of the arrhythmia, and how these medical aspects interacted with the protocol deviations to lead to the adverse event.

Evaluation of Quality Improvement Technologies Related to the Event

Healthcare facilities could implement quality improvement measures to mitigate risks and bolster patient safety in response to adverse events involving John Smith. Electronic Medication Administration Records (eMARs) represent a significant technological solution. These systems can help prevent medication errors by providing accurate records and alerts, ensuring that the right patient receives the right medication at the right dose and time. Integrating eMARs seamlessly into the workflow is essential to maximize their effectiveness (Pruitt et al., 2023).

Appropriate Utilization and Training

The successful deployment of such technologies necessitates proper training and education for healthcare staff. Conducting regular training sessions on how to use eMARs effectively and navigate other related systems is vital. Moreover, ensuring that nurses and other healthcare providers are well-versed in the technology can substantially enhance its usefulness and impact (Karnehed et al., 2021).

Patient Monitoring Technologies at Other Institutions

Across different healthcare institutions, a proactive approach involves using real-time patient monitoring systems. Wearable devices that continuously track vital signs allow for the early detection of deteriorating conditions. These systems provide healthcare teams with timely insights, enabling prompt intervention and preventing adverse events (Fuller et al., 2022).

Dashboard Data and Metrics

Within the facility’s dashboard data, metrics related to medication errors, patient monitoring frequency, patient satisfaction, and readmission rates are crucial. These metrics provide a comprehensive overview of patient outcomes and care quality. By comparing internal data with external benchmarks, healthcare facilities can identify areas for improvement and align their strategies with best practices.

External Research and Data

While specific external data about the exact adverse event might not be available, broader research on the effectiveness of technologies like eMARs and patient monitoring systems can guide improvement efforts. Utilizing insights from the broader healthcare literature can help tailor strategies to prevent future adverse events (Karnehed et al., 2021).

Criteria to Evaluate

To evaluate the discussed actions and technologies, criteria such as effectiveness in reducing errors, ease of integration into existing workflows, staff competency in utilizing the technologies, patient outcomes, and alignment with external best practices should be considered. Comparing internal data trends with external benchmarks can further assess the impact of these measures on patient safety and care quality (Fuller et al., 2022).

Quality Improvement Initiative to Prevent a Future Adverse Event or Near Miss

A comprehensive quality improvement initiative can be implemented to prevent future adverse events. Beginning with a thorough analysis of the incident involving John Smith, the initiative could introduce electronic Medication Administration Records (eMARs) to reduce medication errors by ensuring accurate dosages and timely administration. Standardized protocols for interprofessional communication during medication administration and patient monitoring can also be established to enhance coordination (Cotton et al., 2022).

To manage and monitor such incidents, the selected institution engaged in incident reporting, immediate intervention, and post-event analysis. Incident reports were filed to capture errors, followed by a detailed examination to determine root causes and implement preventive measures. Dashboard metrics tracking medication errors, patient monitoring frequency, and patient satisfaction facilitated ongoing monitoring and improvement assessment (Laatikainen et al., 2021). Evidence-based practices support the effectiveness of such initiatives. Research demonstrates that eMARs significantly reduce medication errors, improving patient safety. Real-time patient monitoring technologies have shown success in the early detection of deteriorating conditions, contributing to enhanced outcomes and decreased adverse events.

Applying these principles to prevent future adverse events, entails the implementation of eMARs for accurate medication administration, stress management support for healthcare providers, introduction of wearable patient monitoring devices for timely intervention, and the utilization of dashboard metrics to monitor progress (Cotton et al., 2022).

Conflicting Data

Conflicting data suggests that success with eMARs hinges on proper integration and staff training, while wearable monitoring technologies might face reliability and acceptance challenges. This underscores the need for careful implementation and ongoing evaluation to ensure the effectiveness of these technologies and practices. By combining evidence-based strategies with data-driven insights, healthcare facilities can cultivate a safety culture and minimize adverse events (Tanui, 2022).

Conclusion

John’s case, exemplifies the critical importance of patient safety and the need for robust quality improvement measures. The sequence of errors, stemming from nurse workload, medication administration, and monitoring lapses, resulted in tragic consequences. Implementing eMARs, enhancing interprofessional communication, and utilizing real-time patient monitoring can mitigate risks. Incident analysis, evidence-based initiatives, and benchmarking are vital for preventing future adverse events. Striking a balance between conflicting data underscores the necessity of thoughtful implementation and continuous evaluation to ensure patient safety.

References

Behrens, D. A., Rauner, M. S., & Sommersguter-Reichmann, M. (2022). Why resilience in health care systems is more than coping with disasters: Implications for health care policy. Schmalenbach Journal of Business Research. https://doi.org/10.1007/s41471-022-00132-0

Cotton, K., Booth Richard Booth, R. G., McMurray, J., & Treesh, R. (2022). Understanding health information exchange processes within Canadian long‐term care: A scoping review. International Journal of Older People Nursing. https://doi.org/10.1111/opn.12501

Fuller, A. E. C., Guirguis, L. M., Sadowski, C. A., & Makowsky, M. J. (2022). Evaluation of medication incidents in a long-term care facility using electronic medication administration records and barcode technology. The Senior Care Pharmacist, 37(9), 421–447. https://doi.org/10.4140/tcp.n.2022.421

Hsieh, M.-C., Chiang, P.-Y., Lee, Y.-C., Wang, E. M.-Y., Kung, W.-C., Hu, Y.-T., Huang, M.-S., & Hsieh, H.-C. (2021). An investigation of human errors in medication adverse event improvement priority using a hybrid approach. Healthcare, 9(4). https://doi.org/10.3390/healthcare9040442

Isaksson, S., Schwarz, A., Rusner, M., Nordström, S., & Källman, U. (2021). Monitoring preventable adverse events and near misses. Journal of Patient Safety, Publish Ahead of Print. https://doi.org/10.1097/pts.0000000000000921

Karnehed, S., Erlandsson, L.-K., & Norell Pejner, M. (2021). Nurses’ perspectives on an electronic medication administration record in home healthcare: Qualitative interview study (Preprint). JMIR Nursing, 5(1). https://doi.org/10.2196/35363

Laatikainen, O., Sneck, S., & Turpeinen, M. (2021). Medication-related adverse events in health care—what have we learned? A narrative overview of the current knowledge. European Journal of Clinical Pharmacology. https://doi.org/10.1007/s00228-021-03213-x

Nantsupawat, A., Poghosyan, L., Wichaikhum, O., Kunaviktikul, W., Fang, Y., Kueakomoldej, S., Thienthong, H., & Turale, S. (2021). Nurse staffing, missed care, quality of care and adverse events: A cross‐sectional study. Journal of Nursing Management, 30(2). https://doi.org/10.1111/jonm.13501

Pruitt, Z. M., Kazi, S., Weir, C., Taft, T., Busog, D.-N., Ratwani, R., & Hettinger, A. Z. (2023). A systematic review of quantitative methods for evaluating electronic medication administration record and bar-coded medication administration usability. Applied Clinical Informatics, 14(01), 185–198. https://doi.org/10.1055/s-0043-1761435

Raeissi, P., Aryankhesal, A., Shahidi Sadeghi, N., & Kalantari, H. (2022). Root Cause Analysis (RCA) of adverse events in one of the biggest western Iranian general hospitals: Short communication. Health Scope, 11(4). https://doi.org/10.5812/jhealthscope-118032

Raisi-Estabragh, Z., & Mamas, M. A. (2022). COVID-19: Health care implications. Cardiology Clinics. https://doi.org/10.1016/j.ccl.2022.03.010

Rigamonti, D., & Rigamonti, K. H. (2021). Achieving and maintaining safety in healthcare requires unwavering institutional and individual commitments. Cureus, 13(2). https://doi.org/10.7759/cureus.13192

Tanui, A. K. (2022). Ethical management of incidental findings related to development and use of digital health platforms for older people. www.theseus.fi. https://www.theseus.fi/handle/10024/785923

Detailed Assessment Instructions for the NURS FPX 6016 Adverse Event or Near-Miss Analysis Assessment

Write a comprehensive analysis (5-7 pages) of an adverse event or near miss from your nursing experience. Integrate research and data on the event to propose a quality improvement (QI) initiative to your current organization.

Health care organizations strive to create a culture of safety. Despite technological advances, quality care initiatives, oversight, ongoing education and training, legislation, and regulations, medical errors continue to be made. Some are small and easily remedied with the patient unaware of the infraction. Others can be catastrophic and irreversible, altering the lives of patients and their caregivers and unleashing massive reforms and costly litigation. Many errors are attributable to ineffective interprofessional communication.

This assessment’s goal is to address a specific event in a health care setting that impacts patient safety and related organizational vulnerabilities with a quality improvement initiative to prevent future incidents.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses.
  • Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
  • Analyze the missed steps or protocol deviations related to an adverse event or near miss.
  • Analyze the implications of the adverse event or near miss for all stakeholders.
  • Outline a quality improvement initiative to prevent a similar adverse event or near miss.
• Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
  • Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
• Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
  • Communicate analysis and proposed initiative in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

Instructions

For this assessment, you will prepare a comprehensive analysis on an adverse event or near miss that you or a peer experienced during your professional nursing career. You will integrate research and data on the event and use this information as the basis for a quality improvement (QI) initiative proposal in your current organization.

The following points correspond to the grading criteria in the scoring guide. The subbullets under each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your adverse event or near-miss analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels relating to each grading criterion.

1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
   • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
   • Identify and evaluate the missed steps or protocol deviations leading to the event.
   • Explain the extent to which the incident was preventable.
   • Research the impact of the same type of adverse event or near miss in other facilities.
2. Analyze the implications of the adverse event or near miss for all stakeholders.
   • Evaluate the short- and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze each stakeholder’s contribution to the event.
   • Analyze the interprofessional team’s responsibilities and actions. Explain what measures each interprofessional team member should have taken to create a culture of safety.
   • Describe any change to process or protocol implemented after the incident.
3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
   • Analyze the quality improvement technologies put in place to increase patient safety and prevent recurrence of the near miss or adverse event.
   • Determine the appropriateness of the technology application for a specific patient or situation.
   • Research scholarly, evidence-based literature to learn how institutions can integrate solutions to prevent similar events.
4. Incorporate relevant metrics of the adverse event or near-miss incident to support need for improvement.
   • Identify the salient data associated with the adverse event or near miss that is generated from the facility’s dashboard.
     • Note: Dashboard means data generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.
   • Analyze what the relevant metrics show.
   • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data. Use resources such as the Centers for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Institute for Healthcare Improvement (IHI), and the World Health Organization (WHO).
5. Outline a quality improvement initiative to prevent the recurrence of an adverse event or near miss.
   • Explain, from an evidence-based viewpoint, how your facility now manages or should manage the process or protocol.
   • Evaluate how other institutions addressed similar incidents or events.
   • Analyze QI initiatives developed to prevent similar incidents. Explain why they are successful. Provide evidence of their success.
   • Propose solutions for your selected institution that can be implemented to prevent similar future adverse events or near-miss incidents.
6. Communicate analysis and proposed initiative in a professional, effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
7. Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

Example Assessment: You may use the Adverse Event or Near-Miss Analysis Exemplar [PDF] for an idea of what an assessment receiving a proficient or higher evaluation would look like.

Additional Requirements

• Submission length: 5–7 typed, double-spaced pages.
• Font: Times New Roman, 12 points.
• Number of references: Cite a minimum of 5 current scholarly and/or authoritative sources to support your evaluation, recommendations, and plans. Current literature is defined as no older than 5 years unless it is a seminal work.
• APA formatting: Citations and references must adhere to APA style and formatting guidelines. Consult these resources for an APA refresher:
  • APA Style & Format.
  • APA Module.
  • American Psychological Association. (n.d.). APA style. Retrieved from https://www.apastyle.org/

Grading Rubric: 

1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.

Passing Grade:  Analyzes the missed steps or protocol deviations related to an adverse event or near miss. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty where further information could improve the analysis. 

2.  Analyze the implications of the adverse event or near miss for all stakeholders.

Passing Grade:  Analyzes the implications of the adverse event or near miss for all stakeholders. Identifies assumptions on which the analysis is based. 

3.  Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.

Passing Grade:  Evaluates quality improvement technologies related to the event that are required to reduce risk and increase patient safety. Identifies criteria by which to evaluate the technologies. 

4.   Incorporate relevant metrics of the adverse event or near-miss incident to support need for improvement.

Passing Grade:  Incorporates relevant metrics of the adverse event or near-miss incident to support need for improvement. Evaluates the quality of the data. 

5.  Outline an evidence-based quality improvement initiative to prevent an adverse event or near miss.

Passing Grade:  Outlines an evidence-based quality improvement initiative to prevent an adverse event or near miss. Impartially considers conflicting data and other perspectives. 

6.   Communicate analysis and proposed initiative in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.

Passing Grade:  Communicates analysis and proposed initiative in a professional, effective, and error-free manner, writing clearly and logically. 

7.   Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

Passing Grade:  Integrates relevant sources to support arguments, formatting citations and references, using APA style without errors. 

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NURS FPX 6011 Evidence-Based Population Health Improvement Plan Example

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

NURS FPX 6011 Evidence-Based Population Health Improvement Plan Assignment Brief

Course: NURS FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Assignment Title: Assessment 2 Evidence-Based Population Health Improvement Plan

Assignment Overview:

In this assignment, you will develop an evidence-based population health improvement plan aimed at addressing a prevalent health issue within a specific community. Your task involves analyzing data, identifying community health concerns, evaluating environmental factors, and proposing targeted interventions grounded in ethical principles and cultural sensitivity.

Understanding Assignment Objectives:

The primary objective of this assignment is to apply evidence-based practice principles to develop a comprehensive population health improvement plan tailored to the unique needs of a specific community. You will critically analyze data on health prevalence, environmental factors, and community determinants to formulate effective interventions aimed at reducing health disparities and improving health outcomes.

The Student’s Role:

As a student, your role is to act as a healthcare practitioner tasked with developing a population health improvement plan aligned with the needs and circumstances of a specific community. You will utilize your knowledge of evidence-based practice, cultural competence, and ethical principles to propose interventions that promote health equity, community empowerment, and cultural relevance. Through research and critical analysis, you will identify key health concerns, environmental factors, and barriers to healthcare access within the target population, and develop targeted strategies to address these challenges.

NURS FPX 6011 Evidence-Based Population Health Improvement Plan Example

Data Evaluation

Identifying Community Health Concerns

In analyzing the data on diabetes within the American Indian (AI) community, it’s evident that this population faces a significant health challenge. More than 90% of diabetic cases in the U.S. are diagnosed as type 2 diabetes mellitus (T2DM), with American Indians being particularly affected. Research from the Centers for Disease Control and Prevention (CDC) indicates that approximately one in two American Indians suffers from diabetes, a rate significantly higher than that of white non-Hispanic populations. This prevalence of T2DM among AI individuals is concerning, especially considering that they have twice the likelihood of developing T2DM and experiencing related mortality compared to their white counterparts.

Furthermore, the data highlights the interconnectedness of diabetes with other health issues within the AI community. Conditions such as obesity and cardiovascular diseases often coexist with T2DM, contributing to the overall health burden among American Indians. Despite some improvements in diabetes rates since 2013, it remains a leading cause of illness and mortality among AI populations. Additionally, the incidence of diabetes varies across tribal groups, with certain communities, like the Pima tribe, experiencing higher rates.

Overall, the data underscores the urgent need for targeted interventions to address T2DM and its associated health concerns within the American Indian community. By understanding the unique challenges and disparities faced by this population, healthcare practitioners can develop more effective strategies for prevention, management, and treatment of diabetes and its complications.

Community Data Evaluation: Environmental Factors

Environmental factors significantly contribute to the prevalence of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community (Lucero & Roubideaux, 2022). Traumatic events, such as forced migration and lifestyle modifications enforced by government policies like the Indian Removal Act, have created severe hardships for AIs. These experiences have led to societal insults and forced lifestyle adjustments, exacerbating health inequalities. Historically, AIs were displaced from their traditional lands, disrupting their way of life and forcing reliance on government aid. Destruction of traditional irrigation methods further compounded the situation, leading to dependence on government subsidies.

Moreover, disparities in healthcare facilities and access contribute to the health burden experienced by AIs. Limited availability of resources, coupled with environmental factors such as the consumption of fat-rich foods, increases the risk of obesity and subsequently, diabetes among AIs. This underscores the importance of addressing environmental factors in population health improvement initiatives aimed at mitigating the prevalence of T2DM within the AI community.

Relevance and Validity of the Resources

The information gathered from credible sources provides valuable insights into the environmental risk factors contributing to T2DM prevalence among AIs (Lucero & Roubideaux, 2022). Reports from reputable databases such as the Centers for Disease Control and Prevention (CDC) and Indian Health Service (IHS) serve as reliable sources of information on AI health issues. By relying on evidence-based data, healthcare professionals can better understand the environmental determinants of health disparities within the AI community, thus informing targeted interventions aimed at improving population health outcomes.

Meeting Community Needs: Population Health Improvement Plan

To effectively address the population health concern of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community, a comprehensive health improvement plan is proposed, grounded in ethical principles and tailored to meet community needs (Hailes et al., 2020). The plan encompasses five ethical principles: equity, empowerment, openness, respect, and participation, which serve as guiding values in the development and implementation of interventions. These principles aim to empower community members while honoring their cultural values and promoting health equity.

The proposed strategies include providing budgetary support and training to community members to facilitate sustainable health practices. By equipping individuals with the necessary resources and skills, the plan seeks to promote self-efficacy and community ownership of health initiatives. Additionally, culturally relevant cooking classes will be offered to promote healthy dietary choices tailored to the preferences and traditions of the AI community. These classes will not only impart practical cooking skills but also raise awareness about the importance of nutrition in diabetes prevention and management.

Recognizing potential barriers to health improvement, such as limited access to healthy food options and cultural preferences for traditional meals, the plan incorporates targeted solutions to address these challenges (Zamora-Kapoor et al., 2019). Strategies include facilitating access to low-fat and low-carb dietary options through community partnerships and education initiatives. Furthermore, the plan respects cultural food traditions while promoting healthier alternatives through culturally sensitive education and engagement efforts. By fostering understanding and acceptance of dietary modifications, the plan aims to overcome resistance to change and promote long-term health outcomes.

Measuring Outcomes

To evaluate the effectiveness of the health improvement plan, several measurable criteria are proposed (Domingo et al., 2021). Firstly, increased preference for healthy food options among community members will be assessed through surveys and dietary assessments. Changes in dietary habits and adherence to recommended guidelines will serve as indicators of the plan’s impact on promoting healthier lifestyles and reducing the incidence of T2DM and related complications. Additionally, the plan aims to enhance trust and communication between healthcare providers and the AI community. Qualitative feedback and patient satisfaction surveys will be utilized to gauge improvements in trust and communication, thereby ensuring that healthcare services are culturally competent and responsive to community needs.

Communication Strategy

To effectively communicate and implement the population health improvement plan within the American Indian (AI) community, it is crucial to engage community leaders and members in the decision-making process (Gillson et al., 2022). Research has shown that historical injustices and marginalization have led to a lack of trust in medical treatments and healthcare institutions among AIs, highlighting the importance of building trust and rapport. By involving community leaders in the development of the healthcare plan, healthcare professionals can demonstrate respect for AI customs and traditions, thereby fostering trust and cooperation.

Understanding the culture and traditions of the AI community is essential for healthcare providers to effectively interact and communicate with community members (Gillson et al., 2022). By gaining insights into cultural norms and spiritual beliefs, healthcare professionals can tailor communication strategies to be more culturally sensitive and relevant. This understanding also enables clinicians to provide care that respects and honors the cultural background of AI individuals, bridging the trust gap and promoting better health outcomes.

Moreover, actively involving community members in decision-making processes can further enhance trust and accountability (Magkos et al., 2020). By inviting community members to participate in discussions and decision-making related to their healthcare, healthcare providers can empower individuals to take ownership of their health and well-being. This participatory approach fosters a sense of community ownership and ensures that interventions are culturally appropriate and responsive to community needs.

To promote adherence to medical treatments and lifestyle interventions, it is essential to integrate western healthcare practices with traditional cultural and spiritual beliefs (Magkos et al., 2020). This can be achieved by organizing community events and workshops that combine western medical knowledge with AI customs and traditions. By involving community elders and other respected members, healthcare providers can overcome linguistic and cultural barriers, facilitating effective communication and engagement.

Value & Relevance of Evidence

The evidence supporting the population health improvement plan underscores its significance and potential impact on addressing community health concerns. According to Carter et al. (2011), understanding the five fundamental facets of ethics is crucial for guiding the ethical framework of the health improvement strategy. This research emphasizes the importance of incorporating ethical considerations into health promotion efforts, especially when addressing cultural and traditional values within a community. By providing insights into epidemiological and community statistics, evidence assists healthcare professionals in making informed decisions about patient care.

Moreover, Lucero and Roubideaux (2022) shed light on the environmental factors influencing food choices among American Indians (AIs), offering valuable insights into the socio-economic determinants that drive unhealthy dietary habits. Their research emphasizes the importance of addressing these factors through targeted interventions, such as financial management training and cooking classes, to promote healthier food choices while considering economic constraints.

Furthermore, VanderWeele et al. (2019) identify cultural obstacles that contribute to the prevalence of diabetes among AIs, highlighting the need for culturally tailored interventions to improve health outcomes. Understanding these barriers enables healthcare professionals to develop effective health improvement initiatives that resonate with the cultural values and beliefs of the AI community.

Conclusion

In conclusion, the evidence-based population health improvement plan outlined in this paper addresses the significant health challenge of type 2 diabetes mellitus (T2DM) within the American Indian (AI) community. By analyzing data on diabetes prevalence and its associated health concerns, it is evident that AIs face disparities in health outcomes compared to other populations. Environmental factors, historical injustices, and cultural barriers contribute to the higher prevalence of T2DM among AIs, highlighting the need for targeted interventions tailored to their unique needs and circumstances.

The proposed health improvement plan integrates ethical principles, community engagement strategies, and evidence-based interventions to address T2DM and its related complications. By empowering community members, promoting culturally relevant interventions, and fostering trust and communication, the plan aims to mitigate the impact of T2DM and improve overall health outcomes within the AI community.

Moving forward, it is essential to implement and evaluate the effectiveness of the proposed interventions, measuring outcomes such as changes in dietary habits, adherence to treatment guidelines, and improvements in trust and communication between healthcare providers and the AI community. By prioritizing community needs and leveraging evidence-based strategies, healthcare practitioners can work collaboratively with AI communities to achieve better health outcomes and reduce health disparities.

References

Centers for Disease Control and Prevention. (2021, December 16). Type 2 Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/type2.html#:~:text=More%20than%2037%20million%20Americans

Carter, S. M., Rychetnik, L., Lloyd, B., Kerridge, I. H., Baur, L., Bauman, A., Hooker, C., & Zask, A. (2011). Evidence, ethics, and values: A framework for health promotion. American Journal of Public Health, 101(3), 465–472. https://doi.org/10.2105/ajph.2010.195545

Domingo, A., Charles, K.-A., Jacobs, M., Brooker, D., & Hanning, R. M. (2021). Indigenous community perspectives of food security, sustainable food systems and strategies to enhance access to local and traditional healthy food for partnering Williams treaties First Nations (Ontario, Canada). International Journal of Environmental Research and Public Health, 18(9), 4404. https://doi.org/10.3390/ijerph18094404

Gillson, S. L., Hautala, D., Sittner, K. J., & Walls, M. (2022). Historical trauma and oppression: Associations with internalizing outcomes among American Indian adults with type 2 diabetes. Transcultural Psychiatry. https://doi.org/10.1177/13634615221079146

Hailes, H. P., Ceccolini, C. J., Gutowski, E., & Liang, B. (2020). Ethical guidelines for social justice in psychology. Professional Psychology: Research and Practice. https://doi.org/10.1037/pro000029

Lucero, J. E., & Roubideaux, Y. (2022). Unpublished manuscript.

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16. https://doi.org/10.1038/s41574-020-0381-5

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16. https://doi.org/10.1038/s41574-020-0381-5

VanderWeele, T. J., McNeely, E., & Koh, H. K. (2019). Reimagining Health—Flourishing. JAMA, 321(17), 1667. https://doi.org/10.1001/jama.2019.3035

Zamora-Kapoor, A., Sinclair, K., Nelson, L., Lee, H., & Buchwald, D. (2019). Obesity risk factors in American Indians and Alaska Natives: A systematic review. Public Health, 174, 85–96. https://doi.org/10.1016/j.puhe.2019.05.021

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NURS FPX 5007 Intervention Strategy in Healthcare Essay Example

NURS FPX 5007 Assessment 3 Intervention Strategy

NURS FPX 5007 Intervention Strategy in Healthcare Assignment Brief

Course: NURS FPX 5007 Leadership for Nursing Practice

Assignment Title: Assessment 3 Intervention Strategy

Assignment Overview:

The NURS FPX 5007 Intervention Strategy in Healthcare assignment aims to explore leadership principles and intervention strategies within the healthcare sector. This assignment requires students to analyze a provided case study and propose an intervention strategy utilizing relevant leadership theories and models. Additionally, students will explore organizational change management and its implications in healthcare settings.

Understanding Assignment Objectives:

1. Analyze a case study focusing on a healthcare professional facing personal challenges impacting their work performance.
2. Propose an intervention strategy utilizing appropriate leadership theories and models to address the identified challenges.
3. Discuss the application of organizational change management principles within the healthcare context.
4. Examine the implications of healthcare policy and legislation on addressing employee well-being and performance issues.

The Student’s Role:

As a student, your role is to critically evaluate the provided case study and develop a comprehensive intervention strategy aligned with the principles of effective leadership in healthcare. You are tasked with:

• Understanding the provided case study and identifying the key issues faced by the healthcare professional.
• Applying relevant leadership theories and models to devise an intervention strategy aimed at addressing the identified challenges and improving overall team performance.
• Exploring how organizational change management can facilitate the implementation of the proposed intervention strategy within the healthcare setting.
• Analyzing the impact of healthcare policy and legislation on addressing employee well-being and enhancing organizational performance.
• Presenting your analysis and intervention strategy in a clear and structured manner, supported by evidence from academic literature and scholarly sources.

NURS FPX 5007 Intervention Strategy in Healthcare Essay Example

Effective leadership plays a pivotal role in steering group efforts towards achieving common objectives within healthcare organizations. To foster effective leadership amidst the challenges of the healthcare environment, various leadership philosophies can be adapted. It is imperative to devise strategies that inspire employees to collaborate towards shared goals. Furthermore, the efficacy of leadership styles and change management practices significantly influences the success and sustainability of healthcare organizations. While there are numerous ways to define and conceptualize leadership, at its core, it involves the actions undertaken by individuals or groups responsible for overseeing the activities of others towards a common goal. Ensuring the delivery of high-quality patient care necessitates supervising the efforts of healthcare professionals, including doctors, nursing staff, and other medical personnel. Among the crucial aspects of effective healthcare leadership is the establishment of processes and structures that promote employee collaboration towards common objectives, involving clear communication channels, shared goal-setting, and fostering a culture of teamwork and collaboration (Bass, 2019).

Case Study Analysis: “Sleeping on the Job: A Managerial Challenge”

The case study “Sleeping on the Job: A Managerial Challenge” revolves around a nurse named Marty, who has been encountering personal challenges while working in an office environment for the past three years. Marty’s work performance has been adversely affected due to personal circumstances, including her parents moving in with her, leading to a lack of personal time after work. Her colleagues have expressed dissatisfaction with her performance, reporting instances of lateness, early departures, and even falling asleep during work hours. Marty has attributed her behavior to her health issues and has also missed work due to personal matters such as family deaths and injuries. However, her manager has not provided any assistance or attempted to find a solution to address Marty’s challenges.

In order to assist Marty effectively, her manager must evaluate potential measures to support her and the rest of the staff. One plausible approach could involve the implementation of transformational leadership, characterized by engaging in open and sincere dialogue with Marty. Through this dialogue, both the manager and Marty can identify the barriers hindering her success and collaboratively devise an improvement plan. The manager can encourage Marty to share her perspectives on overcoming these challenges, while also exploring her career aspirations and goals. However, it is imperative to emphasize that sustaining transformational leadership necessitates consistent communication and collaboration among all stakeholders involved (Alrowwad et al., 2020).

Leadership Strategy: Tailoring Leadership Models to Healthcare Settings

To enhance leadership effectiveness within the complex environment of the healthcare sector, various leadership models can be employed. For instance, some managers may opt for a transformational leadership approach, which emphasizes empowering staff members to work towards shared goals (Collins et al., 2020), while others may prefer a transactional leadership style focusing on setting clear objectives and providing incentives for their attainment (Kelly & Hearld, 2020).

In healthcare settings, transformational leadership can prove particularly efficacious as it underscores the significance of teamwork, collaboration, and communication. This leadership style empowers individuals to take ownership of their work and fosters a sense of collective responsibility towards achieving common objectives. By cultivating a positive and inclusive work environment, transformational leaders can nurture a culture of trust and respect that bolsters employee engagement and job satisfaction. Such leadership is especially critical in healthcare, where personnel frequently operate in high-stress and emotionally charged environments (Espinoza et al., 2018).

Application of Leadership Strategy to Address Marty’s Challenges

In Marty’s case, two primary issues need to be addressed: her subpar work performance and its detrimental impact on the entire nursing team. Employing a transformational leadership approach proves to be the most effective means of tackling these challenges. This leadership paradigm revolves around encouraging and supporting employees to realize their fullest potential (Akdere & Egan, 2020).

Given the information provided, it appears that Marty’s personal circumstances significantly influence her professional performance. Therefore, a transformational leader could leverage motivation and inspiration to enhance her work performance. Once an improvement plan is formulated to address Marty’s performance issues, the departmental leader can focus on rebuilding trust among team members. A transformational leader would empower employees to take charge of their responsibilities and decisions for achieving success collectively. Clear departmental goals and principles would be established collaboratively between management and staff. Moreover, an environment conducive to open communication would be fostered, facilitating effective collaboration among nurses to meet departmental objectives and patient needs.

In addition to its efficacy in addressing Marty’s personal and team-related challenges, it is noteworthy that transformational leadership has broader positive implications for healthcare organizations. By prioritizing teamwork, communication, and a shared sense of purpose, transformational leaders can cultivate a culture of continual improvement and excellence in patient care. This, in turn, can lead to enhanced patient outcomes, heightened employee job satisfaction, and improved financial performance for the organization. In essence, by focusing on employee development and empowerment, transformational leaders can engender a virtuous cycle of success benefiting all stakeholders involved (Collins et al., 2020).

Organizational Change Model and its Influence: Utilizing the ADKAR Model

The ADKAR model offers a valuable framework for implementing change, whether at an individual or organizational level, across various contexts. Comprising five stages—awareness, desire, knowledge, ability, and reinforcement—the ADKAR model provides a structured roadmap for guiding individuals through the process of transformation.

In Marty’s case, the initial step entails engaging in one-on-one discussions to assess her past performance and its implications for the organization. This discussion serves to raise awareness regarding the need for change and explores how implementing changes can benefit not only Marty but also the department, organization, and the patients served.

Subsequently, creating a desire for change becomes imperative, which can be facilitated by familiarizing Marty with the organization’s mission, vision, values, and policies. This serves to inspire a desire to change and align with the organization’s overarching goals.

The third stage involves re-educating Marty about her role’s components and expectations, potentially addressing any knowledge gaps or resource needs she may have. Furthermore, any information pertinent to departmental improvements and her role must be communicated effectively.

Transitioning into the fourth phase entails assisting Marty in translating her understanding and information into actionable ability. It is essential to acknowledge that Marty may not immediately exhibit full proficiency in her role during this transitional phase. Continual meetings with Marty throughout this implementation phase enable the assessment of her improvement plan and necessitate any requisite modifications.

The final phase, reinforcement, assumes paramount importance to prevent Marty from reverting to previous behaviors of substandard work productivity and performance. Positive reinforcement mechanisms, such as positive feedback, recognition, rewards, and performance metrics, can be effectively leveraged in the workplace to sustain productivity and align individuals with their goals (Wong et al., 2019; Cronshaw et al., 2021).

Implication of Care Policy and Legislation

Nurses occupy a pivotal position in shaping public health policy owing to their direct interactions with patients and their profound understanding of community dynamics. According to the American Nurses Association (ANA), nurses wield substantial influence on healthcare policy at multiple levels. The ANA, through initiatives like “Healthy Nurse. Healthy Nation,” underscores the importance of health and safety policy, advocating for regulations conducive to health and safety in the healthcare setting. This program encompasses five key areas: fitness, sleep, lifestyle quality, safety, and nutrition, with the overarching goal of enhancing the health and well-being of the nation’s four million nurses. Through this campaign, nurses and managers gain access to a web platform housing resources, data, and connections with employers and organizations aimed at improving their health and well-being (Nolan et al., 2020).

This movement holds promising implications for individuals like Marty, grappling with poor work performance stemming from personal circumstances affecting their mental and physical health. Marty’s colleagues have expressed concerns regarding her sleep patterns and medical conditions, such as apnea and CPAP usage. The “Healthy Nurse. Healthy Nation” campaign could furnish Marty with resources to establish home support systems, alleviating the burden of caregiving for her aging parents and enabling her to prioritize her own well-being. Addressing these underlying concerns could potentially ameliorate Marty’s job performance, thereby enhancing her capacity to deliver optimal patient care. The ANA’s advocacy for nurses’ health and safety assumes pivotal significance in empowering nurses to practice to their fullest potential and catalyze improvements in healthcare delivery.

Conclusion

Effective leadership constitutes a cornerstone for organizational success, whether at the macroscopic level or within specific departments. A perceptive leader cognizant of the organizational structure recognizes the pivotal role of employee job satisfaction and motivation in achieving success. Transformational leaders inspire their employees to work towards the collective good of the organization, fostering a culture of continuous improvement. Moreover, effective leaders adeptly navigate change, guiding employees through challenging circumstances and facilitating departmental growth. In the healthcare domain, robust leadership assumes paramount importance in enhancing patient outcomes.

In essence, effective leadership strategies tailored to the complexities of the healthcare sector are indispensable for navigating the challenges inherent to this field. By leveraging transformational leadership approaches, healthcare organizations can foster collaborative environments conducive to employee engagement, innovation, and ultimately, superior patient care.

References

Alrowwad, A. A., Abualoush, S. H., & Masa’deh, R. E. (2020). Innovation and intellectual capital as intermediary variables among transformational leadership, transactional leadership, and organizational performance. Journal of Management Development, 39(2), 196-222. https://doi.org/10.1108/jmd-02-2019-0062

Akdere, M., & Egan, T. (2020). Transformational leadership and human resource development: Linking employee learning, job satisfaction, and organizational performance. Human Resource Development Quarterly, 31(4), 393-421. https://doi.org/10.1002/hrdq.21404

Bass, B. L. (2019). What is leadership?. Leadership in Surgery, 1-10. https://doi.org/10.1007/978-3-030-19854-1_1

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nurs Stand, 35(5), 59-66. https://doi.org/10.7748/ns.2019.e11408

Cronshaw, A., Boddye, E., Reilly, L., Boardman, R., Portas, L., Hagen, J., & Marufu, T. C. (2021). Engaging the nursing workforce to achieve a culture of excellence: Nottingham Children’s Hospital ANCC Pathway to Excellence® Journey. https://doi.org/10.7748/nm.2021.1980

Espinoza, P., Peduzzi, M., Agreli, H. F., & Sutherland, M. A. (2018). Interprofessional team member’s satisfaction: a mixed methods study of a Chilean hospital. Human Resources for Health, 16(1), 1-12. https://doi.org/10.1186/s12960-018-0290-z

Kelly, R. J., & Hearld, L. R. (2020). Burnout and leadership style in behavioral health care: A literature review. The Journal of Behavioral Health Services & Research, 47(4), 581-600. https://doi.org/10.1007/s11414-019-09679-z

Nolan, S., Carpenter, H., Cole, L., & Fitzpatrick, J. (2020). The HealthyNurse [R] Leader: How do the health behaviors of nurse leaders measure up?. American Nurse Journal, 15(1), 30-32. https://www.myamericannurse.com/the-healthynurse-leader/

Wong, Q., Lacombe, M., Keller, R., Joyce, T., & O’Malley, K. (2019). Leading change with ADKAR. Nursing management, 50(4), 28-35. https://doi.org/10.1097/01.numa.0000554341.70508.75

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NURS FPX 5007 Nursing Leadership Styles Application Essay Example

NURS FPX 5007 Assessment 1 Leadership Styles Application

NURS FPX 5007 Assessment 1 Leadership Styles Application Assignment Brief

Course: NURS FPX 5007 Leadership for Nursing Practice

Assignment Title: Assessment 1 Leadership Styles Application

Overview:

In this assignment, you will explore the application of various leadership styles in a healthcare setting. You will analyze a case study involving a healthcare worker facing challenges in balancing work responsibilities with caregiving duties for her mother. Through this analysis, you will identify relevant leadership styles and practices and propose the most suitable approach to address the situation.

Understanding Assignment Objectives:

The primary objective of this assignment is to enhance your understanding of leadership styles and their application in healthcare contexts. You will critically evaluate the case study provided and demonstrate your ability to identify and analyze different leadership styles relevant to the scenario. Additionally, you will develop a comprehensive understanding of the implications of each leadership style and propose a strategic approach to address the challenges faced by the healthcare worker.

The Student’s Role:

As a student undertaking this assignment, your role is to critically analyze the provided case study and apply theoretical knowledge of leadership styles in healthcare. You will assess the challenges faced by the healthcare worker and propose an effective leadership approach to address the situation. Your analysis should demonstrate a clear understanding of relevant leadership theories and their practical application in real-world scenarios. Moreover, you are expected to provide evidence-based recommendations supported by scholarly literature and research findings.

NURS FPX 5007 Nursing Leadership Styles Application Essay Example

Introduction

The importance of leadership in healthcare cannot be overstated. Effective leadership is essential in healthcare to ensure high-quality care, positive patient outcomes, and a supportive organizational environment. Leaders in this field play a vital role in improving patient care and outcomes. They are responsible for managing workflows, keeping employees satisfied, promoting information sharing, and ultimately, achieving better clinical results. Good leaders also contribute to creating positive and strong organizational cultures. In healthcare leadership roles, guiding and redirecting staff is often necessary to maintain a productive and safe workplace. The healthcare industry recognizes various leadership styles, and the ability to make well-informed decisions and prepare for potential challenges is crucial (Cummings et al., 2021). This essay explores the application of different leadership styles in a challenging workplace scenario involving Marty, a healthcare worker facing difficulties balancing work responsibilities with caregiving duties for her mother.

Case Study Overview

Illustrating a challenging workplace scenario, let’s look at Marty’s case. Marty, an African American healthcare worker with over six years of experience caring for rehabilitation patients at a university healthcare facility, faces difficulties balancing her job responsibilities with caring for her mother. Marty’s mother was diagnosed with dementia three years ago, making Marty responsible for her daily care needs. This responsibility often requires Marty to assist her mother during her off-time and days off, posing challenges in her work life.

Marty’s caregiving responsibilities have adversely affected her work performance. She frequently arrives late to the office and leaves early to attend to her mother’s needs. Consequently, her colleagues have become frustrated with her inconsistent work patterns. When confronted, Marty revealed that she had been diagnosed with a sleeping disorder called “apnea” but refused to use a CPAP machine.

Nursing professionals have accused Marty of neglecting her duties and using her mother’s illness as an excuse to leave work early. Additionally, Marty has taken extended leaves for various reasons, including mourning her sibling’s loss for three weeks and experiencing chronic back problems for twelve weeks. Despite concerns raised by colleagues and clinical staff members to her supervisor, no action has been taken, as Marty is currently on Family and Medical Leave Act (FMLA), and her supervisor is aware of the situation’s stress on the healthcare facility (Cummings et al., 2021).

Relevant Leadership Styles and Practices

Three essential leadership styles that are relevant to Marty’s situation are democratic, transactional, and transformative leadership.

Transformational leadership involves a leader’s ability to inspire change, foster trust, encourage innovation, and empower team members. This leadership style improves team performance, motivation, and reduces work-related fatigue, ultimately leading to increased productivity. Transformational leaders assess each team member’s strengths and allocate tasks accordingly to prevent social loafing (Robbins & Davidhizar, 2020).

Transactional leadership focuses on daily tasks, emphasizing short-term goals, recognizing achievements, and intervening when necessary. This style sets clear objectives, defines responsibilities, and is well-suited for the complex healthcare delivery setting. Combining transactional leadership with other styles, such as transformational leadership, can lead to better outcomes, including improved care delivery, clinical skills, and task delegation (Richards, 2020).

Democratic leadership entails inclusive decision-making and valuing employee input. It promotes teamwork and empowers employees in policy development and implementation. By encouraging employee contributions, this leadership style enhances self-esteem and optimism, which positively impacts employee productivity (Oliveria et al., 2020).

Leadership Style Applicable in the Case Study

Considering Marty’s situation and her struggle to perform well at work, a transformational leadership style is the best fit for her supervisor and colleagues. It’s crucial for the manager to adopt this style to tackle the issues causing a negative work environment instead of ignoring them. Despite Marty being on FMLA, which allows her up to 12 weeks of annual leave, she has surpassed this due to her medical condition and caregiving duties, causing distress among her colleagues. Implementing transformational leadership can shed light on these problems and help Marty realize her consistent rule-breaking, excessive time off, napping during work hours, and frequent lateness or early departures.

The manager needs to motivate the team, address valid concerns, and take appropriate action to build cooperation and trust. Building trust is vital since Marty’s colleagues’ complaints have been ignored for a long time, allowing her to disregard the rules for over a year. Marty needs clear guidance on her job responsibilities, and open communication about her needs may encourage her to follow the rules.

Implementing this leadership approach can create a positive work environment where employees’ concerns and ideas are valued, preventing feelings of neglect and potential office problems. However, it might be challenging to initially inspire employee loyalty due to the prolonged inaction on Marty’s behavior. Introducing a reward system with clear objectives can transform the office culture, improve performance, and motivate Marty to stick to her schedule and reduce absences. This incentive program can benefit all employees by promoting outstanding performance and offering additional leave days over a set period (Richards, 2020).

Implementation and Implications

Implementing this leadership approach brings several benefits, such as acknowledging and rewarding employees for their additional efforts, cultivating a supportive work environment, and enriching the knowledge and skills of all staff members. However, it’s crucial to watch out for potential stress that might arise from transactional leadership, where employees might feel pressured to consistently exceed expectations for rewards. Marty might not respond well to this approach, leading to ongoing dissatisfaction among her colleagues (Nawaz & Khan, 2020).

A democratic leadership style is suitable for this situation as it enables employees to contribute to decisions, addressing their concerns about Marty’s work behavior and punctuality. Marty might become more engaged in her job by participating in decision-making processes, regaining a sense of purpose. Democratic leadership enhances employee involvement and job satisfaction, meeting the needs of all employees (Oliveria et al., 2020).

Implementing this leadership approach can improve Marty’s relationships with her colleagues and supervisor, boost employee engagement, and foster effective collaboration without causing conflicts. However, the downside of the democratic style is the time and patience required to engage employees and gather their input, which might be limited in a busy healthcare setting (Holmgren et al., 2019).

Conclusion

In conclusion, effective leadership in healthcare is vital for ensuring quality care, positive patient outcomes, and a supportive organizational environment. Marty’s case highlights the importance of applying appropriate leadership styles to address challenges in the workplace effectively. Among the leadership styles discussed, transformational leadership emerges as the most suitable approach for Marty’s situation. By adopting a transformational leadership style, Marty’s supervisor and colleagues can address the underlying issues causing dissatisfaction and improve Marty’s performance by fostering trust, motivation, and open communication.

Furthermore, while implementing transformational leadership, it’s essential to consider potential stressors associated with transactional leadership and the time and patience required for democratic leadership. By combining elements of different leadership styles, healthcare leaders can create a positive work environment, enhance employee engagement, and promote effective collaboration while addressing individual needs and challenges.

References

Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. International Journal of Nursing Studies, 115, 103842.

Holmgren, J., Paillard‐Borg, S., Saaristo, P., & von Strauss, E. (2019). Nurses’ experiences of health concerns, teamwork, leadership and knowledge transfer during an Ebola outbreak in West Africa. Nursing Open, 6(3), 824-833.

Nawaz, S., & Khan, I. U. (2020). The Leadership Styles and Occupational Stress: The Mediating Role of Emotional Intelligence. Academic Journal of Social Sciences (AJSS), 4(4), 906-917.

Oliveria, C. D., Santos, L. C. D., Andrade, J. D., Domingos, T. D. S., & Spiri, W. C. (2020). Leadership in the perspective of Family Health Strategy nurses. Revista Gaucha De Enfermagem, 41.

Richards, A. (2020). Exploring the benefits and limitations of transactional leadership in healthcare. Nursing Standard, 35(12), 46-50.

Robbins, B., & Davidhizar, R. (2020). Transformational leadership in health care today. The Health Care Manager, 39(3), 117-121.

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