Discuss how CNS leadership and change agent roles will play out i
Discuss how CNS leadership and change agent roles will play out in your clinical practicum project. Relate discussion to the literature cited in your reading list. Be sure to briefly explain purpose of your project??? It is an exciting time for nursing in the United States however, there are a number of key challengesfacing CNSs as nurse leaders. In health care, the focus is no longer just on the process of how care is delivered, but on the outcomes ofthat care. More attention is being given to documenting that the care is provided according to specificstandards associated with better outcomes. Many of the standards are directly related to the care given bynurses, including some indicators that are specifically sensitive to nurse intervention. There is also a newfocus on federal reporting of patient satisfaction with the services provide. Producing quality outcomes,high patient satisfaction and effective measurements of both are now a central theme for the entire hospitaladministrative team. For the CNS, however, it represents explicit accountability for managing and leading thestaff responsible for providing the patient care. The ability to assure nursing effectiveness will likely beachieved by redesigning the manner in which nurses work and deliver care. Safety and quality issues aredirectly linked to financial pressure. Reimbursement for hospital services is being whittled away asfinancial accountability for services receives greater scrutiny from the federal government and privateinsurers. Close on the heels of the financial challenge is the ever present workforce shortage. Anothertroublesome challenge is the absence of an adequate pipeline for nursing leaders. Current nurse leaders inthe U.S. are in their 50s and anticipated retirements may reduce leadership numbers to critical levels. Thereis an urgent need to develop new leaders at all levels. Middle management vacancies in roles such as the CNSand nurse manager are extremely difficult to fill. (Thompson, P.A. (2008). Key challenges facing Americannurse leaders. Journal of Nursing Management, 16, 912)??.Leadership is a hallmark of CNS practice in all three spheres of influence. The essence of leadership isfundamentally the capacity to influence. Influence is the ??power of producing an effect without apparentexertion of force or direct exercise of command’ (Merriam-Webster Online Dictionary, 2008). Influence and,therefore, leadership is not about having postion authority; it is the ability to get others to be motivatedto work toward accomplishing a vision. The importance of influence as the major avenue through which CNSspositively impact both patient outcomes and cost-effectiveness is reflected in the adoption of ?? spheres ofinfluence’ as the framework for the Natinal Association of Clnical Nurse Specialists (NACNS) Statement onClinical Nurse Specialist Practice and Education (2004). (Lyon, BL (2010), Transformational leadership as theclinical nurse specialist’s capacity to influence, pp149. In Clinical Nurse Specialist Practice, SpringerPublishing)??.Because the CNS is often charged with directly or indirectly monitoring quality of care, this advancedpractice nurse is uniquely positioned to effect change throughout and across the health care continuum.Richardson (2010) identifies a number of characteristics of successful change agents:ability to combine unrelated ideas, ability to energize others, skill in human relations, integrativethinking (big-picture focus and detail oriented), flexibility to modify ideas, persistence to resistnonproductive tampering; confidence, realistic thinking regarding timelines, trustworthiness, history ofprevious successes, ability to articulate a vision, ability to handle resistance (p81)??.CNS Core Competencies (NACNS, 2010)Systems Leadership Competency: The ability to manage change and empower others to influence clinical practiceand political processes both within and across systems.Behavioral StatementsC. 1 Facilitates the provision of clinically competent care by staff/team through education, role modeling,teambuilding, and quality monitoring.C.2 Performs system level assessments to identify variables that influence nursing practice and outcomes,including but not limited to:C.2.a. Population variables (age distribution, health status, income distribution, culture)C.2.b. Environment (schools, community support services, housing availability, employment opportunities)C.2.c. System of health care deliveryC.2.d. Regulatory requirementsC.2.e. Internal and external political influences/stabilityC.2.f. Health care financingC.2.g. Recurring practices that enhance or compromise patient or system outcomes.C.3 Determines nursing practice and system interventions that will promote patient, family and communitysafety.C.4 Uses effective strategies for changing clinician and team behavior to encourage adoption ofevidence-based practices and innovations in care delivery.C.5 Provides leadership in maintaining a supportive and healthy work environment.C.6 Provides leadership in promoting interdisciplinary collaboration to implement outcome-focused patientcare programs meeting the clinical needs of patients, families, populations and communities.C.7 Develops age-specific clinical standards, policies and procedures.C.8 Uses leadership, team building, negotiation, and conflict resolution skills to build partnerships withinand across systems, including communities.C.9 Coordinates the care of patients with use of system and community resources to assure successfulhealth/illness/wellness transitions, enhance delivery of care, and achieve optimal patient outcomes.C.10 Considers fiscal and budgetary implications in decision making regarding practice and systemmodifications.C.10.a. Evaluates use of products and services for appropriateness and cost/benefit in meeting care needsC.10.b. Conducts cost/benefit analysis of new clinical technologiesC.10.c. Evaluates impact of introduction or withdrawal of products, services, and technologiesC.11 Leads system change to improve health outcomes through evidence based practice:C.11.a. Specifies expected clinical and system level outcomes.C.11.b.Designs programs to improve clinical and system level processes and outcomes.C.11.c.Facilitates the adoption of practice changeC.12 Evaluates impact of CNS and other nursing practice on systems of care using nurse-sensitive outcomesC.13 Disseminates outcomes of system-level change internally and externallyHamric, A.B., Spross, J.A., & Hanson, C.M. (2008). Clinical and professional leadership, 249-282.TextbookHuston, C. (2008). Preparing nurse leaders for 2020. Journal of Nursing Management, 16, 905-911.Huston 2008.pdfShirey, M.R. (2008). Influencers among us. A practical approach for leading change. Clinical NurseSpecialist. 22(2). 63-65. Shirey-Influencers among us 2008.pdfShirey, M.R. (2007). Leadership and organizational strategies to increase innovative thinking.Clinical Nurse Specialist. 21(4), 191-194. Shirey-Leadership & Org Strat 2007.pdfShirey, M.R. (2007). Moral intelligence for the leader and entrepreneur. Clinical Nurse Specialist,21(2), 71-73. Shirey-Moral Intelligence 2007.pdfSpreir, Fontaine, & Malloy (June 2006).Leadership run amok: The disruptive potential ofoverachievers. Harvard Business Review, 72-82. Spreier-Leadership-2006.pdfKeele, R. (2012. Implementing evidence-based nursing practice: An overview. In Nursing Research andEvidence -Based Practice: Ten steps to success. Hones & Bartlett Learning, LLC. 80586_CH05_Keele.pdfGoleman, D. & Boyatzis, R. (2008). Social intelligence and the biology of leadership. HarvardBusiness Review, 86(9), 74-81. Biology of leadership.Discuss how CNS leadership and change agent roles will play out in your clinical practicum project. Relatediscussion to the literature cited in your reading list. Be sure to briefly explain purpose of your projectin 2 sentences.
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