Putting in place a plan for nursing leadership and management

Putting in place a plan for nursing leadership and management
Chapter 3: Implementation
The steps
Meeting with the teacher to talk about the project was the first step in putting the capstone project into action. The talk was mostly about the healthcare problem, and the steps needed to solve it were made clear. The second step was to look at the relevant literature to find reliable sources to back up the new change. During the literature review, the WGU library was used to find original research sources that gave enough information on how to improve communication in healthcare. During this process, the WGU library was asked for help to make sure that the right sources for the project were found. Based on what was found in the books, the next step was to make a plan for how to deal with the problem of communication. The SBAR communication tool was chosen as the best way to solve the problem of nurses not being able to talk to each other. The last step in putting the project into action was to show the planned plan to the preceptor. Due to the limitations of COVID-19, there was no need for real implementation at the organizational level.

Changes Talked About

Almost at every step of the project management cycle, things change. When the project manager knows that changes are going to happen, he or she can plan for and carry out the change process. During the project’s execution, several changes were made to the original plan in order to get the expected results. Due to COVID-19 rules, the first change was to move the project from the level of healthcare organizations to the level of institutions. The original plan was for the project to be fully carried out, with both the hospital management and the employees taking part. The new idea was to show the capstone project to the preceptor so that they could look it over and give comments. The second change was that the time frame for putting the project into action was changed from six weeks to four weeks. This change was needed because there was no communication and discussion with people outside the organization. The new changes also shortened the project management cycle to include reviewing the literature, presenting to the teacher, and talking about any changes.

Talking about the problems

Leaders in long-term care face a problem when they have to carry out big organizational change projects. (Sullivan et al., 2018) One way to make sure projects are finished successfully is to understand the hurdles to change. One thing that made it hard to start the project was that there were limits because of the COVID-19 pandemic. First, the restrictions made it impossible to interact with the healthcare group and try out the new strategy for change management. Second, there wasn’t much contact with the preceptor, and students were free to go to the library to get information. Most of the work was done online, and they only went to the library and instructor a few times.

Getting Past Obstacles

To solve the problem that was found, the first step was to talk to the preceptor about other ways to talk during the meeting. For example, using emails and zoom meetings to plan how to carry out a job turned out to be helpful. The second method was to make the most of the short amount of time spent in the library and ask the librarian to help find the materials needed for the literature review. Also, searching online for reliable sources from peer-reviewed journals added to the information found in the library, which cut down on visits to the institution.

Identifying the Relationships Between Professionals

Interprofessional cooperation is when multiple health workers from different professions work together with patients, families, caregivers, and communities to provide the best care possible. The goal of this approach is to improve the experience of care for patients, improve the health of populations, and lower the costs of health care. Effective dialogue is the key to getting professionals from different fields to work together. Communication makes sure that everyone on a professional team is working toward the same goals and helps people on different healthcare teams get along. At different points in the project, I talked to pros like the librarian and the preceptor to make sure the project went well.

Talk about relationships

Nurse educators teach in both nursing schools and teaching hospitals. They pass on their valuable knowledge, experience, and skills to their students, who will become the next wave of nurses. These people work in education and also help guide and set an example for the students. During the project’s implementation, I kept in close touch with my preceptor to learn more about handling healthcare change and get advice. The preceptor helped with studying the project’s first steps, calling out changes, and giving feedback on how the project was going. The school librarian was the other worker who worked on the project. This person helped look for information in the books and find reliable sources to back up the project.

Chapter 4: Things to think about after the capstone project
Talking about what went well
Projects involve activities meant to produce unique results, services, or products. The goal of this project was to improve how nurses talk to each other by using the SBAR communication method. The first part of success was being able to collect data and make a plan for how to improve nurses’ ability to communicate in hospital settings. Even though the COVID-19 pandemic made things hard, I was able to get the preceptor and the librarian to help me find the SBAR communication approach for better communication. The interprofessional collaboration practices that were seen made sure that the student had enough help to finish the job.

Evidence-based practice is a way to solve clinical problems that combines research evidence, clinical knowledge, and the patient’s wishes (Bonds, 2018). Nurses use evidence-based practices to make well-informed decisions about different parts of patient care, especially how to communicate about patient care. This project was a success because it showed how evidence-based practice can be used to help nurses talk to each other better. The IHI and other sources say that the SBAR communication tool can help healthcare workers talk to each other better. Using structured processes, the tool makes it possible for people to share correct information about patients.

(Moss et al., 2016) Teamwork in health care uses collaboration and better communication to expand the traditional roles of health workers and make decisions as a group working toward a shared goal. This project was put into action with help from the preceptor and the library. During the project, these teams were able to work together, which helped bring about the expected results. The preceptor gave advice during the project’s early stages and gave comments when it was needed to help the project get done. The librarian was easy to talk to about reviewing the literature and finding reliable sources for the project.

How Past Projects Will Help Plan Future Ones

Organizational change is a continuous process that includes making new systems, processes, and technologies in order to reach goals. The success of one project leads to the success of other projects because it leads to new ways of doing things that get the best results. The success of this project shows how important dialogue between professionals is when managing change. With the help of the preceptor and the library, the student was able to set the right goals and reach them on time. For future projects to be successful, they should use an interdisciplinary strategy.

Using evidence-based practice to manage organizational change is the second thing that can be used in future projects. Professional standards from the IHI suggested using the SBAR technique to improve communication in healthcare, so that’s what was done. After looking at the research, many articles were found to support this approach. Using evidence-based practice made it easy to finish the job because it helped the preceptor agree with the plan and plan how to put it into action.

Things that didn’t work out

Improving the quality and safety of healthcare is known to be hard, and sometimes the results of efforts to improve can be frustrating. One thing that didn’t go well was that the COVID-19 rules made it hard to fully put the project into place at the company level. The project didn’t give the student a chance to talk to heads of healthcare organizations and try to get them to make changes. Second, many people with an interest in the project were not involved enough in its planning and execution. The teacher and the school librarian were the only people who could help. This means that the part about working with people from different fields wasn’t used to its full potential. Lastly, the changes made in the implementation part made it so that people didn’t commit to the project as planned. Because the organization wasn’t involved, the time for the job was cut by two weeks, and there was no reason to do it carefully and precisely.

Understanding What Did Not Go Well

Most of the problems with the project were caused by the rules that COVID-19 put on how it could be done. When you know about this weakness, you should be ready to start a job early in the future. Changes to the project management cycle need to be looked at in terms of the risks and unknowns they could cause. Second, I think that, during this pandemic, future projects should be about things that can be easily used in the healthcare organization. This would give the student a chance to change the way the healthcare organization works.

Explain how the gap was closed

When nurses and other health care workers don’t talk to each other well, it can hurt patients’ safety, quality of care, and outcomes in a big way. It was found that the nurses’ inability to talk to each other was getting in the way of giving safe care to patients. There wasn’t a way for nurses to talk to each other, and this needed to change. A review of the literature showed that the SBAR communication approach was the best way for nurses in the facility to talk to each other better. Bonds (2018) says that this tool was chosen because it gave nurses a practical way to use a non-hierarchical communication model to improve clinical care results. The IHI also backed the use of the tool to improve communication in healthcare, both between nurse teams and between nurse teams and medical teams. When this approach was found, a narrative paper was given to the preceptor for review because it was not allowed to be used at the organizational level. A positive reaction from the instructor meant that the project showed how to get nurses to talk to each other better.

Getting behind the plan

Even though the new change doesn’t have to be put into action, this talk shows what the healthcare organization can do to support the change. In the short term, the charge nurses will use a bedside shift reporting (BSR) checklist to make sure that the new change stays in place. The list will make sure that shifts are changed in the right way and point out places that might be hard to staff. Second, audits will be done regularly in every area to see if nurses are communicating better. In order to keep the project running in the long term, the staff, especially new workers, will need to keep learning about SBAR communication. The educational programs will remind nurses how important the new change is and how it has helped the company improve quality and patient safety. Lastly, setting rules to guide the new strategy will be very important if the facility wants to keep using the new way of communicating.

Resources for Post-Implementation

For the new communication plan to work, different tools will be needed. First, BSR checklists will be needed to keep the project going in the short run. The charge nurses will use the checklists to check on SBAR contact at the end of each handoff shift. Second, the conference room will be used for continuing education and to teach new workers how to use the new way of communicating to make it better. Whiteboards in hospitals will be used a lot to show patients the new strategy and talk about the current program to improve quality. When it comes to the people who will be needed to help with the change, the clinical nurse educator and the IT department will be very important for making sure the communication plan works.

Chapter 5: Looking back

Integration of the Results of the MSN Program

Put together information from science

The fourth goal of the MSN degree is for nurses to use scientific findings from nursing, biopsychosocial fields, genetics, public health, and organizational sciences to improve nursing care in a variety of settings (American Association of Colleges of Nursing, 2011). Using scientific evidence from study and national guidelines, the project made sure that the changes were put into place. For example, the Institute for Healthcare Improvement (IHI) made the SBAR collaboration tool that the company used. The tool is also backed by professional groups like the Joint Commission and the World Health Organization, which say it will have a big impact on how healthcare professionals talk to each other. In addition to these professional groups, the project involved looking at 30 reliable sources from different databases to back the chosen communication strategy.

Nursing Practice at the Master’s Level

The ninth MSN program outcome says that nurses with a Master’s degree should have a deep understanding of nursing and related studies and be able to use this knowledge in their work (AACN, 2011). By taking care and following the COVID-19 guidelines for project implementation, the project implementation showed that this result was integrated. I also knew that there were both direct and indirect parts to nursing care actions. Part of the indirect nursing care component was coming up with a plan to improve dialogue in health care.


How well nurses and patients talk to each other has a big effect on how well the patient does. To provide high-quality, safe, and cost-effective care, it is important to understand what the patient is saying and how they feel. The organization’s problem was that the nurses didn’t talk to each other well, especially when they switched shifts. There were not enough clear ways to communicate, which led to more medication mistakes, less patient satisfaction, and less patient participation in their care. To deal with this problem, the plan was to put in place a uniform communication tool that nurses could use to share information about patients when they switched shifts. Because of the COVID-19 pandemic, the project did not have to be put into action at the level of healthcare organizations. After the problem was found, a review of the literature was done to find a way to solve the communication problem that was supported by proof. The literature review method used 30 reliable sources to find that the best way to solve the healthcare problem was to use the SBAR (situation, background, assessment, and recommendation) communication strategy. The last step in putting the plan into action was to give the idea to the preceptor for approval.

American Association of Colleges of Nursing. (2011). The essentials of Master’s

education in nursing. Washington, DC: Author.


Bonds, R. L. (2018). SBAR tool implementation to advance communication, teamwork, and the perception of patient safety culture. Creative Nursing24(2), 116–123. https://doi.org/10.1891/1078-4535.24.2.116

Moss, E., Seifert, P. C., & O’Sullivan, A. (2016). Registered nurses as interprofessional collaborative partners: Creating value-based outcomes. Online Journal of Issues in Nursing21(3), 4.


Sullivan, J. L., Adjognon, O. L., Engle, R. L., Shin, M. H., Afable, M. K., Rudin, W., White, B., Shay, K., & Lukas, C. V. (2018). Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration. Health Care Management Review43(3), 193–205. https://doi.org/10.1097/HMR.0000000000000152

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