Discussion
Purpose
The purpose of this discussion is to identify the importance of leading evidence-based practice change as a nurse leader.
Instructions
Reflect on the readings and lesson this week and respond to the following:
- Identify at least one gap in practice within your organization.
- What evidence supports the need for this practice change?
- What strategies will you use as a nurse leader to champion the project and garner buy-in for the change?
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Course Outcomes
This discussion enables the student to meet the following course outcomes:
- Express the role of the nurse leader in the advancement of the profession through personal and professional accountability. (POs 2, 4, 6, 8)
- Formulate strategies to adapt leadership style to situational needs and rapid change in the healthcare environment. (POs 6, 8, 9)
Due Dates
| Welcome to Week 3. The purpose of this week’s discussion is to identify the importance of leading evidence-based practice change as a nurse leader. This discussion enables you to meet the following course and program outcomes: 1. Express the role of the nurse leader in the advancement of the profession through personal and professional accountability. (POs 2, 4, 6, 8) 2. Formulate strategies to adapt individual leadership style to situational needs and rapid change in the healthcare environment. (POs 6, 8, 9) 1. Identify at least one gap in practice within your organization. 2. What evidence supports the need for this practice change? 3. What strategies will you use as a nurse leader to champion the project and garner buy-in for the change? Please review the discussion grading guidelines and support your post with scholarly references. |
Rubric
| Professionalism in Communication | Presents information using clear, concise language in organized manner (0-1 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information using clear, concise language in organized manner (2-3 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information using understandable language; information is not organized 4-5 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information that is not clear, logical, professional, or organized; reader has difficulty understanding the post; 6 or more error patterns in English grammar, spelling, syntax, punctuation). |
Participation
| Left blank | 5 points | 0 points |
| Participation Wednesday Response: Responds to initial discussion question(s) by Tuesday 3:00 p.m. MT. | Posts substantive response to initial discussion question(s) by Tuesday 3:00 p.m. ET. | Does not post substantive response to initial discussion question(s) by Wednesday, 11:59 p.m. MT. |
| Total Participation Responses: Participates in discussion thread at least three times on at least 2 different days. | Posts in discussion at least three times AND on two different days during discussion week. | Posts fewer than three times OR does not participate on at least two different days during discussion week. |
Lesson 1
The Decisions of a Nurse Leader
Introduction
As a DNP-prepared nurse leader, your role will be essential in developing a vision and leading your organization towards improved patient outcomes, a reduction in the burden of disease, and resource sustainability in an ever-changing healthcare environment. Decision-making is a crucial skill of the nurse leader, especially in light of the complexity of today’s healthcare market. Decisions should be made after the completion of an analysis, synthesis, review of the evidence, and appraisal of data to support the identified goal of the decision. Let’s begin this week by discussing the decision-making process of a nurse leader.
Making Decisions Like A Leader
As a DNP-prepared nurse leader, the decisions that you make will ultimately impact the safety and quality of patient care provided within and by your organization. Decisions will be made based on the daily needs that arise, as well as the overall goal and vision of the organization. Analytical decision-making has been identified as a key competency not only by the American Organization for Nursing Leadership (AONL) but also in the Institute of Medicine (IOM) Future of Nursing 2011 report (Huber, 2018).
While various models can be used in the decision-making process, it is the responsibility of the nurse leader to seek a clear understanding of the problem before moving forward with a decision. There are many tools, such as clinical protocols or smart alerts, that can be used when making decisions. However, one of the most important steps to consider in today’s complex healthcare setting is making informed decisions based on evidence. Evidence-informed decisions, just like evidence-based practice (EBP), can assist in driving the quality of care upward while reducing the risk of stagnant practices and processes or a compromise to the safety of staff or patients.
Leading With a Spirit of Inquiry and Innovation
Decisions made with the best available evidence can assist the DNP-prepared nurse leader in nurturing a culture in which translation of evidence to the bedside is not only anticipated but expected throughout the organization. As the nurse leader incorporates evidence into their daily work and decision-making, the spirit of inquiry and innovation will proliferate among staff. A spirit of inquiry is a continuous inquisitiveness that cultivates questions and creates strategies to address practice problems. Staff will begin to seek answers to questions or problems from the existing body of evidence and a culture of continuous examination and analysis will accelerate innovation within the organization.
The current state of healthcare in the United States has many complex problems that require a spirit of inquiry and innovative thinking to affect change. DNP-prepared nurse leaders are in the perfect position to be innovative leaders of change. Nurse leaders can use innovative practice models to provide care for diverse populations and to collaborate with other disciplines.
Nurse leaders can also serve as expert consultants to solve unique practice problems through evidence-based interventions. Innovation does not happen overnight but takes time and work. The nurse leader must continually monitor market disturbances and be able to respond in a timely manner to ensure the sustainability of the organization (Boston-Fleischhauer, 2020). Healthcare innovation may require influences from other disciplines, including business. Innovators spend time watching, listening, and reading diverse topics. Innovative leaders not only develop and implement the innovation, but they also spread the word and share their innovative ideas with others. Innovation, therefore, fosters innovation. Innovative leaders encourage others to think big and take risks. Innovators also need to be able to secure the appropriate resources and partnerships to make the innovation successful.
In the book Evidence-Based Leadership, Innovation, and Entrepreneurship in Nursing and Healthcare (2021), Melnyk and Raderstorf identify the Seven Steps of EBP as the building blocks for developing a spirit of inquiry within an organization.
Leading With a Spirit of Inquiry and Innovation Image Description
As we examine the Seven Steps of EBP, let’s consider how the DNP-prepared nurse leader can be a champion for the integration of evidence into each area of practice, both as a nurse leader and as an expert clinician.
Week 3Lesson 2
Championing Evidence-Based Practice as a DNP-Prepared Nurse Leader
Introduction
With today’s increasingly complex healthcare environments, the DNP-prepared nurse leader has a vital role in transforming healthcare through the translation of evidence to the practice setting. As the consummate consumer of published research, the DNP-prepared nurse emerges with the knowledge, skills, and abilities to identify gaps in practice and render evidence to address the eight National Practice Problems and the Global Burden of Disease facing all communities. The DNP-prepared nurse leader is well-positioned to champion the introduction and advancement of evidence-based practice in diverse healthcare settings.
As a change agent, the DNP-prepared nurse can assist in expediting the stream of innovation while being careful to not strain the healthcare system with disproportionate information. The nurse leader must be astute to recognize information overload, which can result in a barrier to translation of evidence and innovation. The more open an organization is to change, the easier it is to accelerate innovation (Crowell & Boynton, 2020). It is through innovation that we consistently improve the quality of care provided locally, nationally, and globally.
Examine the following graphic, The Conceptual Framework for Healthcare, and how this model supports a culture of evidence-based practice and leads to improved patient outcomes.
The Conceptual Framework for Healthcare Image Description
Leading Rapid Change Across Complex Healthcare Environments
As a DNP-prepared nurse leader, you will be expected to not only lead change but at times respond to the necessity for rapid change. This was the situation for many nurse leaders when the COVID-19 pandemic first emerged in 2020. Changes were needed swiftly to respond to the influx of critically ill patients and staff. Do you remember what we discussed during Week 1? When rapid change occurs, the nurse leader must use both head and heart to guide staff and provide a sense of direction, alleviate fears of the unknown, maintain high ethical standards, and maintain morale and motivation to meet the needs of patients and the organization (Daft, 2017). The nurse leader’s skills of leading with both head and heart were essential as COVID-19 began to take a toll on the human and material resources of healthcare organizations.
When rapid change is needed, the nurse leader must have a seat at the table for decisions impacting patients, staff, and operations. The standard procedures and policies can become antiquated during rapid change as the needs of complex healthcare environments are not always compatible with strategies that focus on authoritarian power and control (Boston-Fleischhauer, 2020). As the need for rapid change developed during the early months of COVID-19, nurse leaders across the country, as well as globally, brainstormed to quickly identify potential solutions and processes to adapt to the pandemic environment. Innovative ideas were brought forth and tested for their efficacy in addressing the problems at hand. Reliance on existing policies and procedures did not always support the quickly evolving demand on healthcare systems.
As a need for rapid change is identified, the nurse leader should collaborate with staff and other disciplines to identify and engage in a viable solution. Even small rapid changes that have a positive outcome can instill confidence in staff and cultivate an environment in which change is readily accepted and adopted. Change is not easy for many individuals and at times the initial response to change may be one of emotion and resistance.
Emotional Support Strategies
The DNP-prepared nurse leader needs to provide emotional support through strategies such as:
- Communicating with transparency
- Listening objectively to concerns
- Asking for feedback
- Inspiring participation
Monitoring reactions from stakeholders is important with any change, especially when rapid change is needed. By using the strategies discussed, the nurse leader can reduce fear and resistance to change and establish a healthy work environment where change is viewed as a positive disruption.
References
American Organization for Nursing Leadership. (2015). AONL nurse leader competencies. https://www.aonl.org/resources/nurse-leader-competencies
Boston-Fleischhauer, C. (2020). Chief nurse executive readiness for the here and now. Journal of Nursing Administration, 50(6), 307-309. https://doi.org/10.1097/NNA.0000000000000889
Crowell, D., & Boynton, B. (2020). Complexity leadership: Nursing’s role in health care delivery. F.A. Davis.
Daft, R. L. (2017). The leadership experience (7th ed.). Cengage Learning.
Melynk, B., & Raderstorf, T. (2021). Evidence-based leadership, innovation, and entrepreneurship in nursing and healthcare: A practice guide to success. Springer Publishing.
