Leadership and Change in Nursing

Leadership and Change in Nursing Leadership and Change Kym Bell I have chosen to use Jersey College in Trenton, New Jersey for my leadership change project. Jersey College is an educational nursing program that provides the combination of Licensed Practical nursing (LPN); Bachelor of Science in Nursing (BSN) and bridge programs for Registered Nurses (RN). The college is located in an urban setting with the student body predominantly from lower income families. The college provides, â€Å"education for adults through an open curriculum that accommodates diverse lifestyles† (Jersey College, 2014). The school prides itself on being the conduit to provide diverse opportunities for Certified Nursing Assistants (CNA), LPN’s, RN’s. The program provides the opportunity for LPN’s and RN’s to acquire a BSN. Jersey College was founded in 2003 and was originally called The Center for Allied Health Nursing Education. In 2004, the LPN program was approved by the New Jersey Board of Nursing. Since opening in 2004, the school has grown to incorporate two New Jersey campuses and two Florida campuses. The school is affiliated with many institutions who provide a variety of other educational opportunities for students (Jersey College, 2014, p. 1). In the past few years, there has been a decrease in the availability of nursing faculties and training sites for nursing students. This has increased the need for nursing instructors to look at alternative clinical sites. A variety of clinical sites are needed to provide students diverse learning and training opportunities. These practice opportunities are needed to prepare students to become independent professional heath care workers. One solution to this problem is to establish a virtual skills laboratory software program. The stakeholders for this project will be the college, instructors, students, parents, and the future communities that these students will be working in. Organizational Structure There is an organizational structure that depicts the framework for running Jersey College (Appendix A). There is a board of directors that hold the governing power. The Chief Executive Officer (CEO) is included in this group. The budget and financial management of the college is overseen by the CEO. The board hires the president of the college. Presently the president of Jersey College is Steven Litvak. He responsible for organizing, constructing, executing, and assessing the financial aspect of the college. The president is responsible for maintaining and establishing the mission, purpose, and policies of the college. The nursing education department is led by the Dean of Students. The education department is split into the Practical Nursing Program and the Professional Nursing Program. The two combined programs have a budget for educational needs. If a large purchase needs to be approved the department must submit a written request to the Dean of Nursing. The request is then submi tted to the president who then submits the request to the Board of Directors. The school is accredited by the Council on Occupational Education (COE), New Jersey Higher (NJ) Education, and the New Jersey State Board of Nursing (Jersey College, 2014). The department of Health and Human Services (HHS) has supported grants that will sponsor a wide variety of research grants to improve the quality, safety, effectiveness, and efficiency of health care in the use of technology. My plan is to apply for a grant called Faculty development: Integrated technology into nursing education and practice (ITNEP). The US Department of Health and Human Services (HHS) (2014) offers a grant that provides support to nursing collaboratives for faculty development in the use of information and other technologies in order to expand the capacity of collegiate schools of nursing to educate students for 21st century health care practice. Nursing collaboratives will use health care information systems to enhance nursing education and practice, optimize patient safety, and drive improvements in health care quality (HHS, 2014, para. 1). Assessment of Readiness Jersey College has a very small simulation lab that has very poor ventilation and very few nursing supplies. There are currently two students in my group that have latex allergies and cannot physically work in the skills lab without having allergic reactions. The students often complain that, even though there are many mannequins, there are no simulators that attach to the mannequins. Many of the other machines and supplies are in disrepair. The mannequins’ teaching capabilities are outdated. Many of them have missing limbs or do not have anatomically correct parts. For example, one of the mannequin’s tracheostomy hole is drilled incorrectly so that the student can only put in the tracheostomy tube upside down. The students do not feel that they are truly getting exposure to best practice in the present skills lab. The cost of replacing the lab has been discussed at many meetings and the concept of implementing a virtual lab has been in committee for the past year. The committee has researched many options and has come up with pros and cons of switching to a virtual lab. With the assistance of community and government funding options, the future of a virtual skills lab appears to be on the horizon. According to the Joint Commission (2014), one of the major causes of a sentinel event in the United States is the lack of communication. This means miscommunication is usually demonstrated in the form of â€Å"wrong patient, wrong site, and wrong procedure†. A sentinel event is a recurring medical issue within a facility that causes patient harm. The Joint Commission has recognized that many of these errors can be avoided by taking a â€Å"time out†. The â€Å"time out† procedure requires a consensus of all healthcare individuals that are involved with the patient. Everyone must stop what they are doing to verify that they have the correct patient; the correct site being assessed; and the correct paperwork/lab results must be verified. Nursing students need to recognize how important it is to verbally and nonverbally communicate with each other to avoid potential medical mistakes. The use of a virtual nursing skills lab can mimic medical situations in a safe and consistent environment. This type of laboratory will provide multiple opportunities for students to interact and communicate with a variety of cyber patients. Nursing students can utilize a virtual environment to learn clinical skills and to practice communication techniques. These skills will be useful when students are interacting with patients, families and other healthcare team members. Currently, the students do not have ample opportunities to access a computer during their class time. Many of the students, over ninety percent, have computers of their own. The nursing program is not currently set up to allow access to class information or other learning materials online. The Dean of Nursing is a very forward thinking person and has petitioned the president to acquire a working virtual laboratory. The Dean and instructors would like to update the school’s equipment and keep the facilities modern and technologically savvy. The new program will keep current students up to date and a new virtual laboratory would be a great way to entice new students into the program. Analysis of Data There are many different types of leadership theories, I chose to use Lippett’s Theory of change. This type of theory decrees that a leader is needed to promote the need for change. Lippitt, Watson, Westley (1958) utilized the basics of Lewin’s Theory of Change which included the concept of freeze, unfreezing and refreezing. Lippitt expanded on Lewin’s theory by adding four more steps. Lippitt et al. (1958) discovered that: Maintaining a favorable balance of forces is a continuous job for the change agent and client system, beginning with the initial decision to undertake a change project or helping relationship and continuing until the project has been completed (p. 73). Lippitt’s Theory of change has seven phases. Phase 1: Recognize there is a problem The problem is that the current hands-on skills laboratory is out of date and in need of a massive facelift. The cost of this renovation would be staggering to the institution. Phase 2: Assess the motivation and capacity for change The students, as well as faculty, have voiced their opinions that either a new skills hands on laboratory or virtual laboratory needs to be added to enhance the teaching/learning capability of the school. Phase 3: Assess the resources and motivation of the change There is a grant and government funding for the school to replace the current lab with a virtual one. Many of the faculty have gone back to school and have been exposed to new technological advances. Virtual software can provide nursing students with a multitude of learning opportunities that cannot always be accessed in the â€Å"real† world. The faculty is eager to learn how to work within an online environment. They have stated that they are willing to be instructed in how to run this type of lab. Upper management is willing to put in the time and energy that is necessary to make this change. Phase 4-Design the progressive stages of change The stages that will take place will be: Have a representative, from the selected virtual laboratory software company to come and speak to those staff members that have volunteered to be â€Å"Super Users†. Implement a training sessions for â€Å"Super Users†. These are fellow colleagues that that are given extensive training to assist others in transitioning to a new product or service. Meet with the nurse managers to provide training using the new laboratory software. Answer all questions and concerns that may affect each individual instructor’s educational needs for each specific laboratory classroom. Provide training sessions for educators to provide each instructor guidelines for the new software. Go â€Å"live† with the virtual laboratory software with students. Phase 5: Ensure the role and responsibility of the change agent is clearly understood Clearly identify as many of the problems as possible to fix prior to going â€Å"live† with the program. Ensure that everyone that works with this change will have technical backup and support. Confirm that there will be a representative from the company to answer any and all questions. Phase 6: Maintain the change through communication, feedback, and group coordination There will be evaluation forms for managers and students to provide feedback. Users will be surveyed to evaluate any changes that may be needed to support their teaching/learning needs. The evaluation will be an ongoing process. As problems arise, there will be a representative available on site or by telephone to assist any users. Phase 7: Gradually remove the change agent At the initial phase of the project, there will be a representative on site to help anyone who is having trouble accessing or understanding how to navigate the new laboratory software. After the first six or eight weeks, the physical presence of the software company will no longer be on site but, there will always be twenty-four hour telephone support (Lippitt, Watson, Westley, 1958). Plan for Change After careful research, by a chosen committee, a specific software program will be bought by the college. The college is currently looking into the software called â€Å"The Digital Clinical Experienceâ„ ¢Ã¢â‚¬  made by Shadow Health. Farmer (2014) states that there are over four hundred colleges and universities that are currently using this type of software in their nursing programs. The article goes on to state that the Shadow Health’s program â€Å"is broken down into ten modules, each of which correlate with a body system students study in class† (Farmer, 2014, para. 10). The acquisition committee has a chairwomen that will contact the software developer and set up a demonstration of the product. The committee members will have the opportunity to talk to one of the four hundred present user sites and observe the software in action. Once the decision has been made to purchase this program, the training will begin. Phase I will be the technical part of installing and updating any computer equipment that the school has. Phase II will be educating and training the instructors and â€Å"Super Users†. Phase III will be educating the students and remaining faculty. Phase IV Take the program â€Å"live† and start assigning lessons within the software website. There will be follow up meetings and suggestion boxes to evaluate the staff and students feedback in using this new system. The staff and students need to feel like their suggestions and feedback will make a difference in promoting advanced learning. The amount of money it will take to update, install, and train faculty and students will be added into the cost of tuition. The research committee has evaluated the cost and have estimated that the increase in semester cost will be two-hundred and fifty dollars per student. There will be opportunities for students to reduce this cost by applying for grants and/or financial aid. Evaluation As with any change, it will take time and dedication for staff and students to get used to the new software and work within an online environment. There will be an initial survey for students and faculty prior to starting the online learning lab project. After the software has been up and running for six months, a follow up survey will be given to evaluate the student’s and staff’s perception of the learning quality provided by the software. The students should be aware that there will always be technical support available to them and that instructors will be reasonable regarding grades and assignment within this initial new setting. The students should be contacted, by the instructor, via email numerous times throughout the semester and asked if they are experiencing any issues or concerns with the new software (O’Neil, Fisher, Rietschel, 2014, p. 134). The continuous evaluation process will allow the college to work with the software developers to custom fit the needs of the college. References Farmer, R. (October, 2014) Virtual patient teaches nursing students lessons in real-life care. Nurse.com. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=2014141009007#.VFvjrvnF8mvAssets/ 092014_SpaceCoastBusinessMagazine_FlCTWWinners.pdf Jersey College. (2014). About us: Accreditation and licensing. Retrieved from http://www.jerseycollege.edu/about/accreditation-licensing/ Joint Commission. (2014) Sentinel event data: root causes by event type 1995–2Q2014. Retrieved from http://www.jointcommission.org/assets/1/18/General_Information_1995-2Q_2014.pdf Lippitt, R., Watson, J. Westley, B. (1958). The dynamics of planned change. New York: Harcourt Brace. O’Neil, C., Fisher, C., Rietschel, M. (2014). Developing online learning environments in nursing education (3rd Ed.). New York: Springer. Shadow Health. (2014). Health assessment software. Retrieved from http://www.shadowhealth.com/health-assessment.html The Center for Allied Health Nursing Education. (January, 2012). Faculty guidelines for practicum experiences. United States Department of Health and Human Resources (HHS). (2014). Faculty development: Integrated technology into nursing education and practice (INTEP). Retrieved from http://bhpr.hrsa.gov/nursing/grants/itnep.html Appendix A ORGANIZATIONAL STRUCTURE OF JERSEY COLLEGE Admission Advisors `Education Coordinator Financial Aid Planner Career Services AdvisorProgram Administrator Media Services and LibrarianNursing Faculty Administrative AssistantProgram Administrator Registrar Nursing Faculty Academic Affairs Coordinator The Center for Allied Health Nursing Education. (January, 2012, p. 14)

sterilization Essays -- essays research papers fc

  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  The only way to ensure that sterilization has occurred is to use the biological monitoring methods. This is because these are the only tests done which show whether or not actual microbial life has been killed. Biological methods are the only ones which are recommended by the CDC (Centers for Disease Control and Prevention), the AAMI (Association for the Advancement of Medical Instrumentation), the AMA (American Medical Association), OSHA, and OSAP (Office Safety and Asepsis Procedures Foundation)   Ã‚  Ã‚  Ã‚  Ã‚  Biological monitoring is basically evaluating a sterilization process by rendering highly resistant bacterial spores biologically inert. The highly resistant bacterial spores used varies depending on what kind of sterilizer was used. For example Bacillus stearothermophilus spores for steam and chemical vapor sterilizers, Bacillus subtilis spores for dry heat and ethylene oxide sterilizers. These specific Bacillus spores are used because they are more resistant, and present in greater numbers than are the common microbial contaminants found on patient care equipment. If it is proven that these spores have been killed, it is strongly implied that other potential pathogens in the load have also been killed.   Ã‚  Ã‚  Ã‚  Ã‚  In this method, living spores which are resistant to whichever sterilizing agent is being tested are prepared in either a self contained system, such as dry sp...

Describe and Evaluate Milgrams Agency Theory

Milgram’s agency theory basically states that you the state of mind you are in determines if you’re obedient or not. He argued that normally we operate in the autonomous state, where you assert control over yourself and what we do. An example of this is when faced with danger, most people will turn away to try and avoid conflict. Even if you decide not to walk away, this is still the autonomous state because you’re deciding what to do. There is also the agentic state which says you are subconsciously acting as an agent to some authority figure and that you do what they tell you because you feel as if you are an agent of that person.An example of this would be during the trial of Nazi’s Adolf Eichmann said, â€Å"I was just following orders to kill Jews†. This clearly illustrates that he only did what he did, followed orders, because he was told to and he felt like an agent to Adolf Hitler. Milgram also posed the idea of something called moral strain . This is when you obey an order although it goes against your morals, you feel that what you are doing is wrong but you have no choice. An example of this is in the study of obedience carried out by Milgram.The participants objected to shocking learners by saying that they wouldn’t do it and consistently standing up to avoid it, but still carried on anyway. The first strength to Milgram’s study is that his theory has practical application. Practical application means it can be applied to explain real life behaviours. An example of this is during the trial of Nazi’s Adolf Eichmann, he said, â€Å"I was just following orders to kill Jews†. This shows he was in the Agentic State because he saw himself as an agent of Hitler when helping him to complete the Final Solution.Another advantage is that in Milgram’s study of obedience the study had experimental validity. This is when the experiment is carried out so well that the participants believe that it is real. One participant, Fred Pozi, showed physical signs of distress indicating that he thought he was actually harming a man. He stood up multiple times during the experiment, was holding his head in his hands and was nervous laughing throughout the experiment. This indicates moral strain because he did carry out what the researcher asked, but this behaviour clearly shows that he was under stress and unhappy with what he had been asked to do.There is also evidence to support this theory which serves as a strength. In his theory of obedience Milgram found that 65% of participants went to 450 volts and 100% went to 300 volts. From this he concluded that American men would obey an authority figure even if they harmed a stranger. As the participants obeyed the authority figure it shows that they were acting as agents to help the researcher with his study, this illustrates the agentic state. On the other hand there are disadvantages to Milgram’s study as well, for example; Mil gram’s study lacked ecological validity.Ecological validity is when the study takes place in an environment that is familiar to the participants. The experiment took place in a lab and Fred Pozi, a plumber, would be more comfortable in a house or bathroom. As he was not in his natural environment his behaviour might have changed because of it. This will therefore reduce validity because he would not be behaving in a natural way. Another disadvantage to Milgram’s study is that he deceived his participants. He did not tell them what the study was actually researching and there for broke ethics.However he did perform a full debriefing at the end of the study which rectified the problem. There is an alternative theory to the Agency Theory called, The Social Powers theory. The Social Powers theory states that authority figures use reward power to gain obedience. Reward power is when an authority figure uses a reward to get the person to obey. For instance when a parent says if you do your homework you can go to your friends house. The Social Powers theory says it is power and not the mental state of someone that leads to obedience, Milgram’s theory is incomplete.

Life of Butch Cassidy essays

Life of Butch Cassidy essays Born Robert Leroy Parker in Beaver, Utah, on Apr. 13, 1866, Cassidy was the oldest of 13 children and had no formal education. Cassidy became a cowboy while still in his teens when he met Mike Cassidy, adopting Cassidy's name after he joined him in rustling cattle in Utah and Colorado. He joined a gang every one later called the wild bunch who over they years would take over $15,000,00 from banks, trains and other robberies. After a robbery he tried to make an honest living by being a ranch hand but later met up with some old friends named Bill and Tom McCarty and tried to rob a train but after the guard refused to open the safe they left the train alone and left with no money. Later he met up with them again and robbed the Denver First National Bank of over $20,000 Tom McCarty approached the bank president that day and stated: "Excuse me, sir, but I just overheard a plot to rob this bank." The bank president nervously asked: "Lord! How did you learn of this plot? McCarty said, I planed it raising his gun "Put up your hands." Being only captured once and let out on Jan 19,1896 he went back to his hide out in a bank robbery butch's friends Bill McCarty and his brother Fred McCarty had been shot to pieces while trying to rob the bank in Delta, ColoOn the night of November 6, 1908, Butch and Sundance arrived in the town of San Vicente. They were looking for a place to stay and were directed to the home of Bonifacio Casaola. The room that Butch and Sundance were given had one doorway that opened up into a walled patio, no windows and no back door. After guiding the two outlaws, the local man who directed Butch and Sundance to Casaola's home, alerted four local soldiers that two strangers were in town. The soldiers gathered their rifles and ammunition and headed for the house. The soldiers entered the patio at the same time Butch was coming out of the doorway. Butch drew his gun and fired, hitting one o...

hudson river essays

hudson river essays The Hudson River and PCB Pollution The Hudson River is a body of water that stretches for 315 miles from the Adirondack Mountains to the Battery in Manhattan, reaching its deepest point of 216 feet in the Highlands near Constitution Island and West Point and reaches its widest point of 3 miles across at Havestraw. This river is one of the most beautiful and scenic of the Tri-State area. Unfortunately, it happens to be New Yorks most polluted river. The river has been influenced upon since the early 1600s, when Englishman Henry Hudson commanded the Dutch ship Half Moon on an exploration of the river, certain that he had discovered a trade route to China. It soon dawned that this was no Atlantic-to-Pacific passage but an Edenlike place of awesome potential-a river valley teeming with prospect and spirit that was worth fighting for. In the centuries that followed, the fight for the river and its commerce never stopped, and still continues to the present. Then during the Industrial Revol ution, with the advent of hulking manufacturing plants on the riverbanks, everything changed. The river became a sewer, cut off from the people around it by the electrification of the railroads. The 1825 completion of the Erie Canal instantly opened trade to the Midwest by linking Troy to Buffalo and established the Hudson River as the major commerce channel for New York City. Tycoons transformed the landscape in New York and across the country with the railroad, and the Hudson River valley became a hotbed for iron mining, limestone quarrying and clear-cutting. Toward the 19th century, when dynamite blasting was reducing the face of the Palisades to rubble, conservationists became alarmed that something was being lost to progress. In 1900, New York and New Jersey established the Palisades Interstate Park Commission to preserve the cliffs from further quarrying. Although conservation efforts continued into the 20th century, there was no progress ...

Find a sidedraft carburetor with labelled with it's part list for a Assignment

Find a sidedraft carburetor with labelled with it's part list for a car ,, and find 3 positive & 3 negative aspects of the down draft carburetor - Assignment Example The fundamental issue with acquiring the best execution utilizing a carburetor is that it cannot screen the air to fuel proportion for every individual barrel. In the event that there was a carburetor for every barrel, this would not be an issue. So with a carburetor, the best fuel to air proportion for every chamber is approximated for the best execution (Leffingwell, 2012). Nevertheless, carburetors do last more than fuel infusion systems and are supported in engine sports. Carburetors are additionally much less complex to introduce than fuel infusion systems, because there are no electrical segments or return lines to the fuel tank. The carburetor is presently substantially less costly than the electronic fuel infusion systems. Negatively, at a low speed, the mixture supplied by a side-draft Carburetor is weak to the point that it wont light appropriately and for its advancement, at such conditions some course of action in the carburetor is obliged to be made. The working of side-draft carburetor is influenced by changes of barometrical weight (Gunnell, 2011). Carburetors utilized as a part of the airship are to be given height control as the rich mixture is unnecessarily accessible, because of less thickness of the air. In addition, the working of side-draft carburetor is influenced by changes of environmental temperature. In the event that the setting is carried out in winter season, it will be found to give excessively rich mixture in the late spring. This happens because of less thickness of air with the ascent of temperature to a grater degree than the thickness of fuel (Gunnell, 2007). It gives the best possible mixture at stand out motor speed and burden, in this way, suitable just for motors running at steady speed build or diminishing ,the amount of fuel issuing out will change and not match the speed of air moving through the venturi

THE ECONO,Y AND MONOPOLIES Essay Example | Topics and Well Written Essays - 250 words

THE ECONO,Y AND MONOPOLIES - Essay Example Monopoly is a concept that strides under macroeconomics. In addition, it is a situation when there is a single seller in the market who acts like the godfather of all products; it means that only the seller may alter prices of the products according to his own intentions. Below mentioned are three reasons (Allison, 2009) in which monopoly would not be efficient: There has been a consensus many times practically that a government intervenes in the decision making of the country in economic activities like monopoly. United States (US) is one of those economies that used antitrust policies to stop a monopoly from occurring. There are several companies that faced problems here in the US and the name of Microsoft is one of them, largest company of software development in the country. The government of the US took several actions against the company to restrict their quota of manufacturing products in order not to build monopolistic stance within the economy. Apart from that, Microsoft was obliged to disclose everything in front of the public before the making and launching of any product in order to minimize the effects of monopoly to comply with the standards and to be in contact with the economic consequences with the country of