Advanced Practice Leadership Paper From an Ethic of Care

Strategic leadership in nursing is essential in eliminating the Ventilator-Associated Pneumonia (VAP) as a nosocomial infection among in-hospital patient, as well as the general job satisfaction of the nurses and the clinicians (Hugonnet, Uckay, & Pitet, 2007). There is need to understand the scenarios and the possible mechanisms that will lead to efficient healthcare delivery to the required standards (Advanced Nursing Practice, 2007). This paper will discuss a strategic approach to relationship-centered and patient-centered care on organizational and leadership behaviors, which will reduce the prevalence of Ventilator-Associated Pneumonia (VAP) as a nosocomial infection among in-hospital patients.

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Description of the Selected Change Model for Quality Improvement Proposal

Change Theory

A strategic leadership in medical services entails the process of identifying the shortcomings in the healthcare services within the selected facilities and making of necessary changes. The structural modifications are meant for the mitigation of the challenges such as in-hospital acquired infections as well as improving the existing situation by considering quality and ethics (White, 2012). Nevertheless, strategies intended for social integration can be essential for the process of developing a more secure working environment in nursing for leaders and workers. Developing the practitioners regarding their skills and capabilities creates a scenario that favors quality development and value addition. Knowledge about the challenges faced in the professional field is essential because it helps in building mechanisms for the eradication of the cropping shortcomings.

It is essential to recognize how the Kurt Lewin Change Theory applies in the process of implementing the strategic leadership in nursing aimed at decreasing the prevalence in nosocomial infections such as the VAP, as well as improvement of quality. The problem of incompetence among nurses is due to the rooted culture of prevalent unethical behaviors enhanced by internal and external factors. The first step of change is referred to as the unfreezing state (Lewin, 1947). Although the administration recognizes the need to mitigate the shortcomings associated with patient safety and outcomes, there is resistance to new methods that will bring change. For example, nurses may find it difficult to embrace supervision and job rotation to improve quality of patient outcomes. The prevalence of VAP is associated with a lack of quality approach to treatment procedures and patient care. The introduction of quality of service check during in-hospital period will be a challenging process for the medical practitioners. The process of reducing the nosocomial infections requires the attention and commitment of nurses to the code of conduct and oath of service. Nurses may find it difficult to accept measures meant to improve nurse to patient relationship. However, with constant training and supervision, the nurses will gradually adhere to the internal changes.

The unfreezing state will not last long because of the need to improve the quality of health care for patients. The process of embracing the necessary transformations is called the moving change state. For example, training meant to remind the nurses of the disinfection procedures will assist the practitioners to reduce the patient-to-patient infections. Through increased number of nurses, the effect of short staffing will be controlled and the patients will receive adequate attention. A sustainable and effective nurse to patient ratio will reduce the rate of VAP among the in-hospital patients. However, there exists the tendency of practitioners going back to the old culture and practices whenever sustainable measures are not incorporated in the change through a process called refreezing (Lewin, 1947). For example, when the process of supervision is not consistent, then there exists the tendency of the caregivers neglecting some procedures that are essential for quality patient outcomes. Nevertheless, the process of formulating a strategic approach to nursing leadership involves awareness and a succinct analysis of the rationale for change agents and systems (Burnes, 2004). Once the problems and causes associated with prevalence of VAP have been identified, then the selected goals of change and options will define the implementation criterion. Besides, it is necessary to create a stable culture that will allow sustainable redefined changes to improve in-hospital patient safety and general outcomes.

Non-interprofessional Behavior

There are a number of non-interprofessional behaviors, which contribute to the prevalence of nosocomial infections in hospitals such as the VAP. Incivility involves the personal edification while disregarding the perception of others in a working environment. Practitioners are bound to increase their knowledge and experience based on their interaction with other and valuing their opinions. Besides, mobbing entails emotional abuse through practices meant to intimidate and individual. Cases of professionals intentionally being hostile when dealing with colleagues are on the rise. Such occurrences are traumatizing especially when the victims are attacked in public with prevalence in a learning environment for nurses (Ozturk, Sokmen, Yilmaz, & Cilingir, 2008). Stalking also has been witnessed whenever individuals follow the activities of their workmates without their consent to acquire information that may be considered as private in some circumstances. All the above behaviors limit possibility for growth and expertise in nursing since they encourage the formation of groups not meant for positive development that compromise quality of services.

Transformational verses Transactional Leadership

A transformational form of leadership will encourage nurses and clinicians to embrace effectiveness. The effective approach to duty will lead to the achievement of job satisfaction as well as improvement of patient safety and general medical outcomes. A strategic nursing leadership will reduce the prevalence of the VAP through the facilitated measures. The set methodologies will shield the culture being established from the effect of power, politics, and poor policies that threaten the process of improving the quality levels (Marshall, 2011). For example, facilities that operate based on a succinctly defined culture are bound to realize improved performance through the set methodologies that encourage anticipatory guidance (Nelson et al., 2011). Worth noting is the increased practices among nurses that are considered a lack of leadership and concern for acceptable behavior. Non-interprofessional behaviors are affecting the nature of care being delivered. However, transformational leadership will lead to improved outcomes that are matching the expectations of professionalism (Felblinger, 2009). It is essential to witness the positive changes in the moral considerations of healthcare workers that are according to the ethical requirements. On the other hand, transactional leadership plays a vital role in nurse performance through work motivations. The transactional form of leadership in nursing encourages individual competence, which will improve patient outcomes and reduce VAP in-hospital cases.

Presentation of Selected Change Model for Quality Improvement Analysis

Expected Outcomes

It is important to recognize the advantages of strategic leadership and management during the nursing change and transformation. Nursing leadership will enhance organizational and systems within the health facilities for quality improvement for better patient outcomes and interprofessional integration. Strategic management in nursing will lead to an environment and mechanisms that will encourage settling of all the matters that are affecting the integration meant for personal and professional growth. Such undertakings will allow the moral support as well as the setting example for the nurses to emulate. Effective leadership in nursing will support conflict settlement through effective communication. The process will entail the sole purpose of eliminating the current wrangles and establishing measures that will reduce the reoccurrence of non-interpersonal behaviors. Therefore, this strategy will support conflict resolution from a preventive point of view as the most efficient mechanisms for nursing leadership if amalgamated with reconciliation (Wright, 2008).

Besides, through strategic management of nursing practices a technology transformation will be witnessed. Facilities will employ information technology that will encourage transformational changes in healthcare. The process of using technology-based systems ensures that the patient outcomes and safety associated with Ventilator-Associated Pneumonia are improved. Technology encourages the incorporation of new knowledge into the daily duties. Technology enhances the monitoring of patients in sensitive care as well as the management of the hospital information systems. The communication within the healthcare systems is improved through effective leadership and management structures (American Association of Colleges of Nursing, 2006).

Moreover, collaboration will assist in the outcomes of patients while in hospital and the population expectations regarding healthcare. Teamwork will encourage assist in solving complex issues. The fundamental aspect of strategic leadership in nursing will encourage the understanding of the ethical position of the respective duties. When solving the conflicts that arise due to the VAP dilemma in ethics in is essential to recognize the Ethics of Care and the Ethics of Justice. The two facets of a dilemma in service delivery are worth noting before decisions are made because of the nature of each perspective (Sorbello, 2008). There is difficulty when defining what is right or wrong in an ethical dilemma. However, the way the practitioner respond to each factor in such a scenario will determine the extent of the consequences that will emanate from the activities and the actions of nurses and clinicians (Simola, Barling & Turner, 2010). Strategic leadership will encourage nurses to make decisions concerning Ventilator-Associated Pneumonia based on how they value the need for quality of life. It is important to recognize also how power affects the understanding of the patients safety requirements (Beall, 2007).

Role of DNP-Prepared Nurses on Expected Outcomes

It is essential to recognize that the DNP-prepared nurses play a critical role in enhancing the expected outcomes among patients to prevent Ventilator-Associated Pneumonia as a nosocomial infection. The nurses are competent to ensure that the strategy incorporates the future expectations of the populations concerning healthcare delivery based on conducted researches. The leadership change will encourage accountability that calls for the efforts of the DNP-prepared nurses in encouraging obedience and implementation of policies and skills during management and care for patients. When the nurses monitor budgets then the financial development initiatives will be implemented within the margin of the available funds (American Association of Colleges of Nursing, 2006). Strategic leadership will be enhanced by the DNP-prepared nurses through an organizational approach to the external factors to establishment an environment that will encourages professional growth and development. Moreover, the DNP-prepared nurses will encourage effective communication that is essential for best quality services, inter-professional relationship, and improved in-hospital patient safety.

Moreover, the DNP-prepared nurses will encourage the process of technology adoption due to the skills acquired through the vigorous...