ASSIGNMENT: ORGANIZATION AND UNIT MISSION

ASSIGNMENT: ORGANIZATION AND UNIT MISSION

ASSIGNMENT: ORGANIZATION AND UNIT MISSION

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Overview

• Use the information from your assigned readings and the self-paced tutorial to discuss the mission, vision, values, and stated goals of the organization where you are employed. You may find the information on your hospital’s website or you may wish to explore this with administrative staff of your organization. If you are not employed, you may find this information from the website of a hospital or by interviewing a nursing colleague to answer questions 1-6.
• Describe the nursing mission or philosophy in your organization.
• Describe the nursing mission or philosophy on your unit. Is the mission or philosophy consistent with those of the larger organization? Describe the similarities and differences.
• Describe your individual role in meeting your unit’s or department’s mission or goals.
• Describe the structure of the nursing department. Is it a centralized or decentralized model? Support your answer with rationale.
• Cite a minimum of two pros and two cons of the organization’s nursing model.
• Use your analysis to describe ways in which nursing could strengthen the mission and vision and organizational structure of nursing. Include at least two examples.

Objectives

• Explain key theories of organizations as social systems.
• Determine how the mission, vision and values of an organization provide strategic direction.
• Explore organizational design and structure in the workplace.
• Discuss how centralization and decentralization structures function in your organization.
• Define shared governance including benefits and risks to nursing.

WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 6th edition formatting, citations and references. to download the Microsoft Word APA 6th edition template. Make sure you cross-reference the APA 6th edition book as well before submitting the assignment.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

Textbooks:

Leadership and Nursing Care Management, Elsevier-Saunders, 2013, 5th edition

• • Read Chapters 3,13,14,15,16.

WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE

NRSE_4580_M2_A5_RUBRIC: WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE

(40 pts) Criteria Introduction Accomplished 7 to 7 Points  Clearly states the purpose of the paper.  Provides a comprehensive overview of topic or questions.  Engages the reader.  Organized and has easy follow. Key Requirement 1 Mission, Vision and Values, Stated Goals: Organization Key Requirement 2 Mission and Philosophy: Nursing Department and Unit 6 to 6 Points  Clear depiction of organization’s mission, vision, values and stated goals.

 Examples are included that demonstrate understanding. Key Requirement 3 Nursing Department Structure/Model 5 to 5 Points  Clearly describes the structure of the nursing department in their organization, including whether it is a centralized or decentralized model.  Provides examples to support description of structure.  Cites a minimum of 2 pros and 2 cons of the organization’s nursing model. Body Last updated: 06/07/2017 9 to 9 Points  Clear depiction of the organization’s nursing mission and philosophy, and the nursing unit’s mission and philosophy.

 Discusses own role in meeting the mission and stated goals of their work unit.  Discusses the connection between the nursing department, nursing unit, and the organization’s mission and philosophy using multiple examples.  Provides at least 2 strategies to strengthen the mission, vision and organizational structure of nursing in their organization. Levels of Achievement Needs Improvement 2 to 6 Points  Overview is provided, but key points/ideas are missing.  Purpose statement is not clear.  Does not engage the reader.

 Somewhat disorganized but still comprehensible 3 to 5 Points  Clear depiction of organization’s mission, vision, values and stated goals.  Examples are vague and do not demonstrate understanding. 4 to 8 Points  Depiction of the organization’s nursing mission and philosophy, and nursing unit’s mission and philosophy is not clear.  Own role in meeting the unit’s mission and philosophy is not clear.  Vague description and examples of the connection between nursing department, nursing unit and the organization’s mission and philosophy.  2 strategies to strengthen the mission, vision and organizational structure of nursing are vague. 2 to 4 Points  Description of the structure of the nursing department in their organization is provided but is missing clear delineation of a centralized or decentralized structure.  Examples to support description of the structure are vague.

 Required number of citations for pros and cons of the organization’s model are not provided. © 2017 School of Nursing – Ohio University Not Acceptable 0 to 1 Points  Does not provide an overview of the paper or is absent.  No purpose statement. 0 to 2 Points  No depiction of organization’s mission, vision, values and stated goals  No examples 0 to 3 Points  Explanation of each level of the nursing mission and philosophy (department and unit) is missing.  No explanation of individual role in supporting unit.  No connection made between nursing department, nursing unit and the organization’s mission and philosophy.  No strategies provided to strengthen the mission, vision and organizational structure of Nursing. 0 to 1 Points  Description of the structure of the nursing department in their organization is missing or vague  No examples to support the description of the structure.

 No citation of pros and cons of the organization’s nursing model. Page 1 of 2 NRSE_4580_M2_A5_RUBRIC: WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE (40 pts) Criteria Conclusion Accomplished 7 to 7 Points  Summarizes paper and reflects on what the reader has learned from the paper.  Demonstrates persuasive thought and is well organized. Stylistics 6    to 6 Points APA Citations are appropriate. Formatted correctly. Reference page is complete and correctly formatted.  At least 4 references provided: Two (2) references from required course materials and two (2) peer-reviewed references. *References not older than five years.  More than 600 words excluding title and reference pages. Levels of Achievement Needs Improvement 2 to 6 Points  Merely summarizes the introduction or contains new ideas not present in the paper contents.  Somewhat disorganized but still comprehensible 3 to 5 Points  APA Citations are appropriate and formatted correctly.  Reference page is formatted correctly.  References are not professional or is not formatted correctly.  Missing 1 professional reference.  At least 600 words or more excluding title and reference pages. Not Acceptable 0 to 1 Points  Simply restates the introduction or is absent.  Disorganized to the point of distraction. 0 to 2 Points  No citations are used or citations are made but not formatted correctly

 Reference page is missing.  Less than 600 words excluding title and reference pages. Peer-reviewed references include professional journals (i.e. Nursing Education Perspectives, Journal of Professional Nursing, etc. –), professional organizations (NLN, CDC, AACN, ADA, etc.) applicable to population and practice area, along with clinical practice guidelines (CPGs – National Guideline Clearinghouse). References not acceptable (not inclusive) are UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases. *All references must be no older than five years (unless making a specific point using a seminal piece of information) Note: You will have three (3) attempts to submit a written assignment, only the final attempt will be graded. For each attempt you will receive a SafeAssign originality report. This will give you a chance to correct the assignment based on the SafeAssign score. Click here to view instructions on how to interpret SafeAssign originality report.

Last updated: 06/07/2017 © 2017 School of Nursing – Ohio University Page 2 of 2 JONA Volume 43, Number 10, pp 509-516 Copyright B 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins THE JOURNAL OF NURSING ADMINISTRATION Using a Shared Governance Structure to Evaluate the Implementation of a New Model of Care The Shared Experience of a Performance Improvement Committee Mary Myers, MSN, RN, PCCN Debra Parchen, BSN, RN, OCN Marilla Geraci, MSN, RN, PMH/CNS Roger Brenholtz, MSN, RN Denise Knisely-Carrigan, BSN, RN Clare Hastings, PhD, RN, FAAN Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability, and ownership. Few recent exemplars in the literature link shared governance, change management, and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence-based practice in determining the best methods to evaluate the implementation of a new model of care. programs of the 27 NIH institutes and centers. In 2007, nursing at the CC launched a national effort, in collaboration with colleagues across the country, to define and describe the emerging practice specialty of clinical research nursing (CRN). This practice development agenda became the strategic focus for the nursing organization as nurses with substantial experience in clinical research as well as those new to the practice specialty began the rewarding process of uncovering, documenting, and standardizing the elements that make their practice unique.

The cornerstone of CRN is the provision and coordination of nursing care for participants in clinical research studies.1 A strategic plan and team structure engaging all leadership in nursing and nursing shared governance (SG), called Clinical Research Nursing 2010 (CRN2010), were established, and groups worked for 4 years to create and validate concept documents, communicate through nursing management and advanced practice nursing structures, and discuss them with staff SG leaders.2 Nursing leadership then turned from the application of the specialty of CRN to the process of planning, delivering, coordinating, and evaluating care provided to research participants in the CC. After discussions involving all areas of practice, a recommitment was made by leadership and staff to the principles and accountability embodied in the concept of primary nursing.3 Four roles at the clinical unit level were defined: primary clinical research nurse (PCRN) (accountable for planning, providing, and coordinating care for an individual research participant), A The National Institutes of Health (NIH) Clinical Center (CC) is a 240-bed research hospital and ambulatory care center supporting the clinical research Author Affiliations: Educator, Medical Surgical Specialties (Ms Myers), Senior Clinical Research Nurse (Ms Geraci), Senior Clinical Research Nurse (Mr Brenholtz), Clinical Research Nurse (Ms Knisely-Carrigan), Nurse Consultant (Ms Parchen), Chief Nurse Officer (Dr Hastings), National Institutes of Health, Clinical Center, Nursing and Patient Care Services, Bethesda, Maryland. The authors declare no conflicts of interest. WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE

Correspondence: Ms Myers, National Institutes of Health Clinical Center, 9000 Rockville Pike, Bldg 10 Room 5-5441, Bethesda, MD 20892 (mmyers@cc.nih.gov). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.jonajournal.com). DOI: 10.1097/NNA.0b013e3182a3e7ff JONA Vol. 43, No. 10 October 2013 509 Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. protocol coordinator (PC) (accountable for the implementation of a clinical study in a particular area and coordination of the medical and protocol-driven requirements of a group of research participants), assigned clinical research nurse (the nurse caring for the participant other than the PCRN), and the clinical research technician (Table 1).4 Standards of care were outlined to serve as a guide to the CRN detailing the ethical, compassionate, collaborative, and informed care delivered to each research participant (Table 2). SG and Evidence-Based Practice at the NIH CC Nursing SG, implemented in 1992, has undergone several updates and revisions, based on internal staff input, benchmarking with colleagues in academic medical centers and periodic review of new evidence. The SG structure includes the nursing practice council (NPC), with representatives from each nursing unit, and each nursing role in the department (eg, managers, clinical specialists, etc), as well as nurses Table 1. Roles in the Care Delivery Model Scope of Activity Primary CRN Role Assigned CRN Role Clinical Research Tech Role Focus of work Group of participants on a given protocol Individual participant who requires continuity for care spanning 91 d or visit Individual participant Individual participant or unit tasks (ie, setting up research bloods) Time frame Duration of protocol or long-term program of care Episode of care (inpatient admission or Q1 protocol related visits) Shift Shift Assessment Overall impact of protocol, level of nursing care required, clinical needs of patient population (group assessment) Health status, needs, and responses over an episode of careVpresenting and as they evolve during participation (individual assessment) Immediate presenting Immediate needs and needs, follow-up based responses to care; on prior caregiver participant initiated report, new or requests or concerns emerging needs based on changes in therapy or health status Planning Plan and standards for specific protocol-based care and patient population-based care that become part of the protocol implementation plan General and specific goals and plan for episode of care (to be achieved by the end of the episode) Priorities for care during shift, including delegation of appropriate activities. WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE

Review of existing plan; recommendations for changes based on shift-to-shift observations Implementation Education of staff; preparation of protocol-specific forms and research participant educational materials; ongoing participation in research team coordination of care Implementation of nursing plan of care, medical orders, and protocol procedures, incorporating participant feedback and adjusting as indicated by participant response Implementation of Implementation of nursing plan of care, delegated care per plan medical orders, and of care and protocol protocol procedures Evaluation 510 Protocol Coordinator Role Quality monitoring to Assessment of patient assess consistency responses over entire in implementation; episode, movement assessment of patient toward identified feedback and need for goals and change as protocol effectiveness of progresses; evaluation protocol procedures of participant outcomes with feedback to assessing for trends clinical research team and needs for and modification of changes in protocol plan as appropriate implementation plan Assessment of patient responses during shift with feedback to clinical team and recommendations for changes as appropriate Priorities for care during shift Monitoring of specific patient responses and reporting g to covering CRN JONA Vol. 43, No. 10 October 2013 Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Table 2. Standards of Care Clinical Research Nursing Standards of Carea 1. Research participants can expect that information about their care and condition is discussed and communicated with confidentiality and that care is being appropriately documented. 2. Research participants can expect that nurses will communicate and collaborate effectively with members of the clinical research team to ensure coordinated, high-quality care. 3. Research participants can expect that their care and treatment are consistent with the research protocol guiding their participation and that valid data are being collected by the nursing staff.

4. Research participants can expect to receive evidence-based nursing care consistent with the accepted professional standard related to their particular condition or therapy. 5. Research participants can expect to know which nurse is accountable for their care and how to contact that person. 6. Research participants can expect prompt assessment and appropriate response to changes in condition or untoward responses to research procedures. 7. Research participants can expect that treatment and monitoring will be individualized to accommodate individual needs, to the extent allowed by the protocol, and that in all cases participant safety, comfort and well-being will be placed above research requirements. 8. Research participants can expect to develop an understanding of their condition, research participation& and treatment and be able to manage self-care as appropriate after discharge 9. Research participants can expect that while in the CC, they will have a sense of being cared for as an individual and that they will receive prompt, courteous, and individualized services from nurses and patient care staff. 10. Research participants can expect to be involved with discussions and decisions about their plan of care and research participation. a CRN 2010 Model of Care.4 from other departments including perioperative medicine or interventional radiology who do not report through nursing. The chief nurse officer (CNO) is an ex-officio member. The NPC operates through subcommittees representing the areas of practice identified as important for staff representation. WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE

These include the clinical practice committee (CPC), the performance improvement committee (PIC), and the nursing information systems committee (NIS). Recently, the committee structure was expanded to include the nursing research participant education committee and the recognition and retention committee. All SG committees have representation from each clinical area and are led by a chair and cochair elected from the staff. SG works under the guidance of bylaws that are reviewed and revised each year by the NPC and administratively approved by the CNO. Each committee has a senior executive sponsor who ensures resources are provided for committee, provides policy input for the committee’s work, and provides mentorship and support to the chair and cochair. A cornerstone of SG at the CC is the nursing practice council request (NCPR), a communication initiated by a nurse and forwarded to the chair of NPC. Requests are brought forward for discussion at monthly NPC meetings; the nurse initiating the NCPR presents to colleagues and answers questions. The NCPR is assigned to an SG committee. The Figure outlines progress of a staff nurse NCPR from inception and presentation to NPC, subsequent review by the appropriate committee, return to the NPC for final vote, and implementation of practice change. As noted in the Figure, the SG structure is fluid; as prac- JONA Vol. 43, No. 10 October 2013 tice changes occur, the plan, do, study, act (PDSA)5 cycle continues the evaluative process sustaining transformation and guiding future practice changes. In 2003, nursing at the CC embraced the concept of using systematic review and evaluation of evidence Figure 1. NIH CC SG workflow and communication. a Deming.5 SG structure provides the best method to implement change and foster an environment conducive to professional growth, encouraging staff involvement from 5 inception through improved practice. The ensuing PDSA is necessary to influence sustained change and continual practice growth and development. 511 Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. to inform practice standards and practice changes.6 Evidence-based practice (EBP) was introduced to SG by engaging the CPC in the process of reviewing and evaluating evidence when considering changes to practice documents such as nursing procedures or standards of practice. Committee members were taught strategies for searching the literature, collecting and assessing evidence, and summarizing findings in a table of evidence. Nurses were supported and encouraged in making informed decisions that include assessment of feasibility in the practice environment as well as consideration of interdisciplinary colleague acceptance and current practice. EBP is now fully embedded in the nursing organizational culture and structure and is an accepted step in considering practice changes (Table 3). Using Evidence to Find Best Practices for Program Evaluation When nursing leaders at the CC developed a plan to implement a new model of care (MOC), the incorporation of staff nurse participation through SG was a natural strategy.

Partnership with staff leaders and SG provided a well-documented best practice to implement change and foster an environment conducive to professional growth.7-14 Adhering to the process outlined in the Figure, the CNO used the standard NCPR asking NPC to create a plan to support the implementation. Each branch of the SG had a specified charge; CPC was asked to validate the model as feasible for implementation in each of the clinical practice areas represented in SG; NIS was asked to propose requirements for clinical documentation to support the change, and PIC was challenged to develop a strategic plan to evaluate the im.  WRITTEN ASSIGNMENT: ORGANIZATION AND UNIT MISSION, VISION AND VALUES; SHARED GOVERNANCE