Professional Nursing Leadership and Management Capstone Project ** Professional Capstone Project Guidelines: 6-10 pages, excluding cover page and reference page. APA format, Times New Roman 12-font. Double spaced, 0.5-inch margins at the top, bottom, left, and right. A minimum of 5 references within 5 years with internal citation. No more than 6 direct quotes from sources and no more than 2 sentences per quote. Refer to Grading Rubric for guidance. I. Cover Page II. Abstract III. Body A. Analyze the roles of the professional nurse within the health care delivery system while caring for a specific patient. 1. Assignments 2. Delegation 3. Collaboration 4. Advocacy B. Apply the principles of management of care while caring for the patient. 1. Priorities of care 2. Teaching (develop a teaching plan) 3. Analyze the orders include cost effective safety and evidence-based practice. 4. Analyze the referrals. How do they address the treatment plan? 5. Legal and Ethical issues • Ethical dilemmas • Legal rights • Advance directives • Confidentiality • Informed consent C. Analyze the factors impacting the patient and healthcare. 1. Look at the Performance Improvement on the unit? How did this impact your client? 2. How does case management effect your client? 3. How is the care provided cost effective? 4. What are the environmental factors to keep your client’s information confidential? 5. What kind of information technology is being used? D. Analyze the plan of care to determine if it provides safe, competent and compassionate care. 1. Was continuity of care provided? How? 2. How did you provide safe, competent and compassionate care for this client? E. Assess your own leadership qualities and evaluate your own ability to be an adaptable leader. IV. Conclusion V. Reference Page Capstone Project Paper Rubric Criteria All components complete and in correct format. • 12 font Times New Roman • Plain paper • No grammatical or spelling errors • Follow APA throughout the paper, use the following link for reference https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_i ntroduction.html Title Page • Title • Student’s Name • School Name & Program • Course Number & Name • Instructor Name • Assignment Due Date Body of the Paper Pick a client that you are caring for at the clinical site. In this paper you will analyze the following: A. Analyze the roles of the professional nurse within a health care delivery system. a. Address assignments (How were assignments made?) b. Address delegation (What was delegated and to who? Was the delegation appropriate?) c. Address collaboration (Who are the members of this client’s team? How did they work together? Any conflicts? If so, how were they resolved?) d. How did you (or the nurse) advocate for the client? Possible Points Points Earned 5 20 B. Apply principles of leadership and management utilizing a systematic problem-solving process and critical thinking skills to plan care for clients and their families. a. Address priorities when caring for the client b. Teaching (Develop a teaching plan for this client) c. Orders- Analyze the orders for this client. Look at cost effectiveness and safety. How are the orders helping the client get better? d. Referrals (What referrals were made? If none what referrals could be made?) e. Legal and Ethical i. Ethical dilemmas. If there were none, identify potential ethical dilemmas. ii. What is the client’s legal rights? Are there any issues affecting the client? iii. Does the client have an advance directive? When would a client need one? How would you assist the client is making one? iv. Examine the client’s rights. Are they being met? v. Confidentiality? How is this being maintained? vi. Informed consent. Did the client provide it? C. Examine the factors impacting nursing and healthcare. a. Look at the Performance Improvement on the unit. What Performance Improvement Plan is the unit working on? How does this impact your client’s care? b. How does case management effect your client? c. What is being done for cost effective care? d. How was the client’s information kept confidential? e. Information technology. What technology was used? D. Analyze the plan of care to determine if it provided safe, competent and compassionate care. a. Was continuity of care provided? (Look at the hand off, documentation, follow-up) b. How did you provide safe competent and compassionate care for this client? E. References (minimum of 5) 25 20 25 5
 

Professional Nursing Leadership and Management

Abstract

            The intensive care unit is among the most emotionally and physically challenging environments to work in the healthcare sector. Nurses are tasked with various roles in specific domains, including delegation, collaboration, and advocacy. Furthermore, health practitioners must abide by the principles of care management, which entail developing teaching plans, ensuring cost-effectiveness, and adhering to ethics while respecting the patient's legal rights. Various performance improvement initiatives are undertaken to improve the quality of care for ICU patients through factors such as improved technology. Finally, the continuity of care before ICU admission and after discharge is imperative to improving the final health outcomes. The following report details the nursing care management given to a 53-year-old male involved in a fatal road accident and was immediately admitted to the ICU in our medical facility.

Professional Nursing Leadership and Management

            The intensive care unit provides medical assistance to patients that are perceived as critically ill. The following is a comprehensive report of my experience as a Professional Registered Nurse in the ICU department of a medical organization. The patient was a 53-year-old male who had suffered fatal injuries in a road accident. The patient arrived at the hospital unconscious and was immediately admitted to the ICU. The report covers the nursing leadership and management concepts that saw the successful recuperation of the client.

The Roles of the Professional Nurse

Assignments

            Professional nurses working within the Intensive Care Unit (ICU) are tasked with various assignments related to improving the patient's overall wellbeing in a critical condition. The most significant assignment I was assigned as an RPN entailed monitoring and accurately detailing records of the ICU patient. I was expected to regularly observe the patient's records to identify any patterns that may assist the physician in providing adequate care (Scholtz et al., 2016). Furthermore, it was my responsibility to record any symptoms and changes displayed by the patient while in the ICU and report the findings to the physician. Additionally, I was required to order, construe, and appraise diagnostic tests that are imperative in identifying and evaluating the patient's condition.

Delegation

            The delegation of duties by the nurse is based on the needs and conditions of the patient. It accounts for the stability of the patient, the potential for harm, and the intricacy of delegated tasks. Professional nurses working within the ICU can delegate duties to unlicensed assistant personnel (UAP) by allocating direct and indirect patient care activities (Scholtz et al., 2016). While in the ICU, I worked with a nursing student placed on an internship in our facility. The direct care patient activities that I delegated to the student included collecting specimens, recording the patient's daily weight, repositioning the client, and assisting him with daily hygiene.

On the other hand, I delegated indirect activities, including delivering meal trays, updating unit logbooks, cleaning equipment, and making the bed. While delegating roles, it is essential to follow various allocation conventions. First, only the right tasks were passed on, and they were assigned under the right circumstances. The registered nurse must only delegate functions that fall within the UAPs purview and that such activities are only given when the patient's condition is not prone to fluctuation (Scholtz et al., 2016). I also ensured that I regularly supervised and evaluating the UAP and made modifications where deemed necessary. The delegation process was appropriate since the nursing student was aware of the universal nursing principles crucial to improving health outcomes.

Collaboration

            Several members were involved in taking care of the severely ill hospitalized patient. The ICU team comprised various members, including the lead physician, respiratory therapist, nutritionist, clinical pharmacist and psychologist, me as the registered professional nurse, and a nursing intern (Scholtz et al., 2016). It is worth noting that the ICU environment is physically and emotionally challenging and hence the need for optimum collaboration to obtain the best outcomes. While working with the team members, we made information sharing our utmost priority to ease the decision-making process.

Advocacy

            Patient advocacy is an imperative role tasked to nurses within their care practice. While working with the ICU patient, I demonstrated patient advocacy by providing the patient's family with information concerning cost savings. The patient in question was not aware that the medical facility accepted various insurance alternatives. Nonetheless, I made it my responsibility to avail the patient's family with a list of accepted insurance and assisted them in making the right decision to accomplish cost saving. Furthermore, I demonstrated patient advocacy by helping the patient to make informed decisions.

Principles of Leadership and Management

Priorities of Care

            The Society of Critical Care Medicine emphasizes prioritizing critically ill patients into the ICU based on the anticipated probability of benefit. The patient, in this case, was involved in a fatal accident. As such, the lead physician and I found it necessary to admit the patient into the ICU as this was the only place where he would receive appropriate care. The second priority of care involved effective communication. As a registered nurse, I ensured that the patient's family was informed about the patient's condition and were constantly elucidated about the treatment type prescribed for the patient and any side effects associated with certain medications (Estella, 2018). Finally, I created an individual plan of care for the patient detailing his medical information and providing recommendations for the best prescription and treatment plan.

Teaching Plan

            Upon admission into the ICU, the patient was unconscious, and as such, no teaching would be done at the time. Nonetheless, after the patient underwent surgery and began recuperation, developing a teaching plan that entailed elucidating the patient about the necessities of wound care was essential. The teaching plan utilized for the patient education segment is presented below.

Orders Analysis

The orders prescribed for the patient are indeed appropriate. After the accident, the patient had lost much blood, and it was necessary to recommend ICU blood glucose treatment protocol before transfusion commenced. This prescription is cost-effective as almost all medical insurers cover it. Since the patient was deemed to be of high risk upon admission, a bilateral sequential compression device was recommended as well as hemodynamic monitoring. The machines used for the sedation and operation processes are also safe for use and have been certified. The antibiotic orders are helping the patient get better through the reduction of pain, while the physiotherapy recommendation is imperative in assisting the patient to walk.

Referrals

            Although no referrals were made for the patient, several referrals may be made in similar circumstances. First, referral should be done when the physician feels that they need a specialist's opinion. This is done to acquire alternative ideas regarding a particular diagnosis. Referrals may also be done when the doctor realizes that the patient will have a better relationship with another physician. Some patients may not always see eye-to-eye with their doctors, and when no solution is attainable, it may be necessary to refer the patient to another physician (Rees et al., 2020). Finally, referrals may occur because of patient access concerns such as location and appointment availability.

Legal and Ethical Issues

            An ethical issue that may be faced by a nurse working in critical care is the end-of-life decision. Some patients may request assisted suicide, while their families may not support this. Registered nurses are faced with challenges regarding advising patients and their families about end-of-life decisions (Miller, 2018). Among the patient's legal rights include informed consent and confidentiality. The patient must be made aware of all procedures necessary for recuperation and has the right to have his information kept private. The client, in this case, did not have an advanced directive. Nonetheless, a client would need one in matters of life-sustaining treatments by asserting what types of medication they would or would not want to undergo if they are later unable to make their wishes known (Miller, 2018). The client would also wish to clarify their will. In such a case, I would assist the patient by proposing that they find a lawyer.

            The patient's rights are also being met. For instance, he is treated with respect by all members of the ICU department. His safety is our topmost concern by ensuring that he received the correct dosages at the right time and in the appropriate manner. Furthermore, the patient's health information is kept private and accessible only to those health practitioners directly involved in providing care for the patient. Upon admission, the patient's wife provided informed consent regarding the operation.

Factors Impacting Nursing and Healthcare

            The ICU unit in the medical facility is working towards improving the effectiveness of bedside rounds. The ICU department has developed a strictly adhered timetable, which provides timelines for physicians and nurses to make bedside rounds within the facility. This improvement plan is beneficial to my patient because I can efficiently deliver patient-centered care through bedside rounds (Baker et al., 2021). Case management also affects my patient because his treatment plan entails advocacy, education, service facilitation, communication, and the identification of appropriate service resources (Baker et al., 2021). The case manager, for instance, assisted the patient's family to identify applicable insurance providers to ensure cost-effectiveness. The client's information was kept confidential by recording it in the hospital's database system under his unique identification. Passwords are used to protect patient information in the facility and are only accessible to designated hospital staff.

Plan of Care Analysis

            Since the patient's admission to the hospital facility, continuity of care was provided. For instance, patient monitoring was based on frequent observations and regular measurements of regular variables such as temperature and blood pressure. The registered nurse or the UAP mainly conducts these procedures. It is essential to monitor the patient's condition regularly to discover any deterioration. The continuity of care was also achieved by administering lower sedative levels as the patient's health improved (McManus, 2020). I also referred the patient to a therapist who would assist him in regaining his motor senses. As a result of the accident, the patient has broken multiple ribs and fractured his leg. He needed help to recapture his muscular strength and hence the referral to a physiotherapist. Before his release from the ICU, all team members working with the client were summoned by the lead physician to discuss his post-ICU treatment. After his release, communication with him and his family was prioritized (McManus, 2020). It allowed them to ask any questions while also sharing any experiences they may have while the patient recuperates from their home.

            While working as an RNP with the patient, I ensured that he received safe, competent, and passionate healthcare. Firstly, I ensured that I regularly monitored the patient's vitals that the UAP recorded. At certain times, I confirmed that I was present to ensure that the UAP accurately recorded all measurements. The strategy is imperative in ensuring that the medication prescribed by the lead physician is in line with the patient's conditions and is vital in reducing medical errors (Jakimowicz et al., 2018). I also ensured that I kept patient information secure by keeping the medical facility's database password a secret. I displayed competency by offering patient education regarding wound care to ensure that no complications arose out of wound infections. Finally, I depicted passionate care by always being kind and warm towards the patient. I did not allow my emotions to interfere with the relationship I had developed with him. Maintaining a positive environment with the client is effective for improving health outcomes.

Personal Leadership Appraisal

            Through an analysis of my leadership qualities, I can attest that I am an adaptable leader. Firstly, I am an emotionally intelligent leader. While dealing with people, I realize that I have to consider their perspectives and feelings before deciding. I also emphasize with individuals based on their personal experiences. Furthermore, I possess optimism as a part of my leadership qualities. It is effective in the hospital setting as it is always recommended to maintain positivity while dealing with patients. As a leader, I would always advise my subordinates to keep a positive mindset in all processes. Finally, I have flexible thinking, and I am always open to recommendations. This is important in the workplace because listening to different perspectives is imperative in realizing the best alternative.

Conclusion

            This report has focused on the nursing leadership and management concepts that saw the successful recuperation of a 53 years old patient admitted to the ICU after a fatal road accident. The paper has provided a comprehensive review of the registered professional nurse's roles in specific domains, including delegation, collaboration, and advocacy, among others. Furthermore, the principles of management in critical care and the factors impacting patient and healthcare, such as case management and performance improvement, have been discussed. Finally, a personal perspective on safe, competent, and compassionate care has been provided.