Leadership & Management in Nursing

APPLICATION OF RESEARCH IN NURSING

Role of research in Nursing

• By polit and beck (2006)

“Systematic inquiry designed to develop knowledge about issues of importance to nurses, including
nursing practice, nursing education, and nursing administration.”

Importance of research in Nursing

1. Important tool for the continual development of a relevant body of knowledge in nursing.

2. Generates information from nursing investigations which help define the unique role of nursing
as a profession.

3. Professional accountability of nurses to their clients is demonstrated when nurses incorporate

research evidence into their clinical decisions.

4. Facilitates evaluation of the efficacy of nurses’ practice which may articulate their role in the
delivery of health services.

5. With research, costly trial-and-error and even unsafe interventions are avoided.

6. Research may allow nurses to make more informed decisions as each phase of the nursing
process is clarified through research.

7. 7. Research also enables nurses to understand a particular nursing situation about which little is
known.

8. Fills the gaps in knowledge and practice

9. Provides basis for professionalism and professional accountability

10. Improves standards of nursing education

11. Discovering new measures of nursing practice

12. Molds attitudes, competencies and skills

13. Meeting the changing societal needs

TYPES OF RESEARCH
Client Satisfaction

 Enhance knowledge and leadership regarding safety.

• Identify and learn from errors.

• Set performance standards and expectations for safety.

• Implement safety systems within health-care organizations.

How can nurses improve patient satisfaction?

• Effective communication

• patients believe that key competencies for nursing staff include “correct behavior and attitude,
composure, making time for patients, and listening and having empathy.” 

• Communicate clearly with empathy

Sit with patient

—Where nurses sit with patients during each shift—

Can positively impact patient perception of nurse communication and boost overall satisfaction
rates.

Prioritize teamwork

- Where staff work together to provide care

Advocate for adequate staffing levels

• Proper staffing and patient-to-nurse ratios are essential in fostering higher patient satisfaction
levels—research in the Journal Health Affairs  found that in a hospital setting, each additional
patient per nurse was correlated to a 1.44 percent decrease in the number of patients who
would definitely recommend the facility

Monitoring and improving customer satisfaction has always been a very important factor for driving
business forward and it’s become an important issue in the medical world as well. The main reason for
this is that providing patients with the best possible care is very important in the modern healthcare
industry.Https://www.Smartsurvey.Co.Uk/blog/importance-of-conducting-patient-satisfaction-surveys

Benefit of patient survey

By building up a picture of patient experiences, you will be able to improve the level of healthcare you
can offer and adopt a patient-centric approach to achieve improved satisfaction.

• Awareness of opening times

• The process of making an appointment

• Checking in for an appointment

 • Waiting time

• Comfort of the waiting room

• Paying the bill

• Support and information

 Follow-up reminders

Six Aims for Improving Quality in Health Care

• Health care should be:

1. Safe

2. Effective

3. Patient-centered

4. Timely

5. Efficient

6. Equitable

Action Research in Healthcare

Action research in healthcare is a practical guide to using research for improving practice in
healthcare contexts.

As an increasingly popular method of inquiry, action research is widely used in healthcare to

investigate professional practice and patients' experience while simultaneously:

• introducing innovations

• planning, actioning and evaluating new ideas

• seeking to improve patient care

• working collaboratively.

• Action research is a form of investigation designed for use by teachers to attempt to solve
problems and improve professional practices in their own classrooms.

• It involves systematic observations and data collection which can be then used by the
practitioner-researcher in reflection, decision making and the development of more effective
classroom strategies.

- Parsons and Brown (2002)

 • a natural part of teaching

• Teachers are continually observing students, collecting data and changing practices to improve
student learning and the classroom and school environment.

• Action research provides a framework that guides the energies of teachers toward a better
understanding of why, when, and how students become better learners.

- A. Christine miller (2007)

Five Phases of Action Research

• 1. Selecting an area or focus identifying an area of interest focus on students look at both
immediate and cumulative effects

• 2. Collecting data collect existing archival data use additional multiple data sources collect data
regularly promote collective ownership of data monitor data collection

• 3. Organizing data count instances, events, and artifacts display data in tables and charts
arrange data by classroom, grade level, and school organize for analysis

• 4. Analyzing and interpreting data analyze and question the data as a professional collective
decide what can be celebrated and what needs attention determine priority area(s) for action

• 4.5 studying the professional literature identify professional literature that relates to or
matches the interest gather research reports, research syntheses, articles, videotapes,
etc. Analyze and interpret these materials for understanding and action determine the
most promising actions

• 5. Taking action combine data analysis with that from professional literature select best options
for action craft short- and long-term action plans implement some actions immediately assess
implementation of selected actions
 Traditional Research Action Research

Purpose To draw conclusions. Focus is on To make decisions. Focus is on the

advancing knowledge in the field. improvement of educational practice.
Insights may be generalized to other Limited generalizability
settings.
Context Theory: Hypotheses/research questions Practice: Research questions derive from
derive from more general theoretical practice. Theory plays secondary role.
propositions.
Data Analysis Rigorous statistical analysis. Focus on practical, not statistical
significance

Sampling Random or representative sample. Students with whom they work.

Mc Millan, J. H. & Wergin. J. F. (1998).

"Understanding and Evaluating Educational
Feasibility study

• A feasibility study is simply an assessment of the practicality of a proposed project plan or

method. This is done by analyzing technical, economic, legal, operational and time feasibility
factors.

• The study tries to determine whether the project is technically and financially feasible, i.E., Is it
technically or financially viable? Financially feasible, in this context, means whether the project
is feasible within the estimated cost.

Training and needs analysis

• Process in which the company identifies training and development needs of its employees so
that they can do their job effectively. It involves a complete analysis of training needs required
at various levels of the organisation.

Evaluation studies

• focus on measurements (numeric or descriptive, but usually the former) of social inputs,

outputs and processes: it typically studies change. At their most basic, evaluations replicate
classic scientific experimental methods (experiments).

Continuing Professional development

• A profession based on the criteria that a profession must have; a systematic body of knowledge
that provides the framework for the profession’s practice, standardized formal higher
education, commitment to providing a service that benefits individuals and the community

Philippine core values of nurses

1. Love of god Romans 15:1 — "We who are strong have an

obligation to bear with the failings of the weak,

and not to please ourselves."

2. Caring as the core nursing

a. Compassion

b. Competence

c. Confidence

d. Conscience

e. Commitment

3. Love of people
 a. Respect for the dignity of each person (creed, color, gender and political affiliation)

4. Love of country

a. Patriotism

b. Preservation and enrichment of the environment and culture heritage

Philippine Qualification framework (PQF)

• Describes the levels of educational qualifications, the official recognition of a person's learning
achievements. It also sets the standards for qualification outcomes which are the knowledge or
skills gained by students after undergoing a certain learning or educational program.

Objectives

“The Philippine qualifications framework (PQF) is hereby established with the following objectives:

1) to adopt national standards and levels for outcomes of education;

2) to support the development and maintenance of pathways and equivalencies which, provide access
to qualifications and assist people to move easily ...

3) to align PQF with international qualifications framework to support the local and international
mobility of workers through the increased recognition of the value and comparability of Philippine
qualifications.

Learning standards

• DepEd, TESDA and CHED shall make detailed descriptors of each qualification level based on
learning standards in basic education, competency standards or training regulations, and the
policies and standards of higher education academic programs. They shall jointly implement
national pilot programs to determine its relevance and applicability in all levels of education.

• Based on the standards of the PQF, graduates of the BSN program are expected to achieve a
specific level of knowledge, skills and values, application and degree of independence
Level Knowledge, Skills and Application Degree of
Values Independence

6 Broad and coherent Professional/creative Independent and/or in

knowledge and skills on work in a specialized teams of related field
basic clinical nursing area of clinical nursing with minimal
practice and research practice, research supervision
for professional, and/or further study.
creative and lifelong
learning
PNLE Coverage

• NURSING PRACTICE - 1: Community health nursing

• NURSING PRACTICE - 2: Care of healthy/ at risk mother and child

• NURSING PRACTICE - 3: Care of clients with physiologic and psychosocial Alterations (part A)

• NURSING PRACTICE - 4: Care of clients with physiologic and psychosocial alterations (part B)
 • NURSING PRACTICE - 5: Care of clients with physiologic and psychosocial alterations (part C)

Career Development
Career planning
Following skills as desirable in job candidates:

• Oral and written communication skills

• Responsibility and accountability

• Integrity

• Interpersonal skills

• Proficiency in field of study/technical competence

• Teamwork ability

• Willingness to work hard

• Leadership abilities

• Motivation, initiative, and flexibility

• Critical thinking and analytical skills

• Self-discipline

• Organizational skills

“Tips for Career Development:

• Know yourself

• Seek out mentors and wise people

• Be a risk taker

• Understand the business of health care

• ■ Involve yourself in community and professional organizations

• ■ Network

• ■ Understand diversity

• ■ Be an effective communicator

• ■ Set short- and long-term goals, and strive continually to achieve them.

Résumé

• Résumé is your personal data sheet and a way of marketing yourself.

Essentials of a Résumé

• The standard résumé is organized by categories:

• by clearly stating your personal information

 • job objective

• work experience

• education and work skills

• Memberships

 Honors, and special skills

chronological résumé:

• lists work experiences in order of time, with the most recent experience listed first.

• This style is useful in showing stable employment without gaps or many job changes.

• The objective and qualifications are listed at the top

functional résumé

• also lists work experience but in order of importance to your job objective.

• List the most important work-related experience first.

• This is a useful format when you have gaps in employment or lack direct experience related to
your objective.

combination résumé

• is a popular format, listing work experience directly related to the position but in a chronological
order.

Membership in professional nursing organization

1. PNA

The Philippine Nurses Association is a professional organization in the Philippines established to

promote the holistic welfare of nurses and to prepare them to be globally-competitive.

• List of professional organization and associations of nurses in the Philippines:

• YNAP Young Nurses Association of the Philippines inc

• SCVNPP Society of Cardiovascular Nurse Practitioners of the Philippines

• RENAP Renal Nurses Association of the Philippines

• PSECN Philippine Society of Emergency Care Nurses

• PONA Philippine Oncology Nurses Association

 • PHICNA Philippine Infection Control Nurses Association

• ORNAP Operating-room Nurses of the Philippines

• OHNAP Occupational Health Nurses Association of the Philippines

• NLGNP National League of Government Nurses of the Philippines

• NICUNAP NICU Nurses Association of the Philippines

• NARS Nagkakaisang Narses sa Adhikaing Reporma sa Kalusugan ng Sambayanan

• MNAP Mlitary Nurses Association of the Philippines

• MCNAP Maternal and Child Nurses Association of the Philippines

• IAAPI INFJ Alumni Association of the Philippines inc

• GNCF Graduate Nurses Christian Fellowship

• GNAP Gerontology Nurses Association of the Philippines

• CNGP Catholic Nurses Guild of the Philippines

• CCNAPI Critical Care Nurses Association of the Philippines inc

• APDNPP Association of Private Duty Nurse Practitioners of the Philippines

• ANSAP Association of Nursing Service Administrators of the Philippines

Succession planning

Strategies that are readily available to staff members at all levels

- to provide healthcare organizations with an adequate supply of qualified internal leadership

candidates

- The primary component of successful succession planning programs is senior leader- ship
support (bargininere, franco, & wallace, 2013)

- The development of internal talent requires planning and contributes to maintaining corporate
knowledge and improved employee morale

- Current and projected nursing shortages highlight the need for ongoing succession planning
strategies designed to address future nursing leadership gaps (Carriere, Muise, Cummings, &
Newburn-Cook, 2009)

- Cooperation among healthcare facilities and academic institutions in creating succession

planning programs is recommended (Griffith, 2012).

Basic Clinical Career Ladder

Clinical/Staff Nurse I (beginner/novice)

 - ▪  Experience and Education
▪ Current state licensure with less than 1 year of experience.

- ▪  Description

- ▪  Needs close supervision.

- ▪  Performs basic nursing skills/routine patient care.

- ▪  Begins to develop patient assessment skills/communication skills.

Clinical/Staff Nurse II (advanced beginner)

• ▪  Experience and Education

• ▪  Current state licensure with more than 1 year of experience.

• ▪  BSN with more than 6 months of experience.

• ▪  MSN without experience

• ▪  Description

• ▪  Demonstrates unsupervised competency using the nursing process.

• ▪  Can plan and organize in terms of short-range and long-range goals.

• ▪  Demonstrates direction in actions.

• ▪  Accepts leadership responsibility readily.

• ▪  Demonstrates well-developed communication skills.

• ▪  Shares ideas and knowledge with peers.

• Clinical/Staff Nurse IV (proficient)

• ▪  Experience and Education

• ▪  Current licensure with 3 years of clinical experience and pursuit of BSN.

• ▪  BSN with more than 2 years of experience.

• ▪  MSN with more than 1 year of experience.

• ▪  Description

• ▪  Demonstrates specialized knowledge and skills.

• ▪  Continues professional education.

• ▪  Assumes leadership/supervisory responsibility.

• ▪  Recognizes and adjusts to situations that vary from the norm.

• ▪  Delegates responsibility appropriately.

 • ▪  Uses wide range of alternatives in solving problems.

• Clinical/Staff Nurse V (expert)

• ▪ Experience and Education

• ▪  MSN with more than 2 years of appropriate clinical experience.

• ▪  BSN required with more than 3 years of experience; pursuing MSN.

• ▪ Description

• ▪  Demonstrates expertise in clinical practice.

• ▪  Assumes/delegates personnel and management responsibility.

Formal education

• School/institutions

• Hierarchical structure

• Uniform/ full time and proper

• Subject oriented

• Certification/degrees

non-formal education

• Very long process

• Learning form experience

• Learning from home

• Learning form environment

• Learning form work

Professional advocacy

• Professional counselor advocacy involves taking action to promote the profession, with an

emphasis on removing or minimizing barriers to counselors' ability to provide services

Filipino management styles

• 1. Pakiramdaman -

• A passive style of leadership, with subordinates doing work that is not too little or too
much to play safe. This is because this style does not provide workers with guidance
required to give them sense of initiative

• 2. takutan
 • Leadership that puts the responsibility on the manager who relies on oppression,
conceit, and hostility

• Professionalism

• Social distance between leaders and subbordinates

3. Kulit

• A superior closely observes and controls the work of their subordinates by checking
every detail of the assignment

• Results in lack of freedom

4. patsamba-tsamba

* Has no goals, objectives, and direct instructions

*Trial and error leaving success or failure to fate

Opportunities for Entrepreneurial Nursing Practice

• Entrepreneurship is defined as “The institutionalization or the development of something in

order to provide benefits to the individuals and society” (andrade et al., 2015)

• is also defined as the fact that the entrepreneurs take risks, look for the opportunities, cover the
entire Process of innovation (arslan and şener, 2012; başar et al., 2015).

Entrepreneur

• “person who organizes and manages a business undertaking, assuming the risk for the sake of
profit” -Merriam-Webster, 2005

Accdg. to European Commission (2006) “entrepreneurship represents the ability of an individual to

transform opinions into action. It involves creativity, innovation and risk taking in addition to the ability
to plan and manage projects to reach the objectives.”

Business Plan

• 1. Executive Summary

• 2. business description

• 2. Market analysis strength

• 4. Weakness, opportunities, threats (SWOT)

• 5. organization management

• 6. sales strategies
Strength

• Relevant work experience

• advanced education

• product knowledge

• good communication and people skills

• computer skills

• self-managed learning skills

• flexibility

Weakness

• Ineffective communication and people skills

• inflexibility

• Lack of interest in further education

• difficulty adapting to change

 • inability to see health care as a business

Opportunities

• Expanding markets in health care

• new applications of technology

• new products and diversification

• increasing at-risk populations

• nursing shortage

Threats

• Increased competition among health-care facilities

• changes in government regulation

Intrapreneurship

• Is acting like an entrepreneur within an established company

• Creating a new business or venture within an organization

• Sometimes that business becomes a new section, or department, or even a subsidiary spinoff

Entrepreneur Intrapreneurs

• is a person who doesn’t work for anyone is an individual who works within the company or
and runs one’s own business or company. an organization and act as a leader of one’s
For good or bad, he has complete startup business. Intrapreneurs usually have his
autonomy and responsibility of his team or group of people working for him of
company. his product or service which may be different
from the company’s main line of business

Basics of entrepreneurship

• Strategic planning

• Continuous quality improvement

• Business plan development

• Marketing

• Management information systems

 • Leadership

• financial management

Terms common to entrepreneurship

1. Innovator - A person who introduces new methods, ideas, or products

2. Nurse Innovator - Working to improve outcomes and the patient experience by reimagining and
redesigning healthcare and developing innovative models of care

3. Networking – meeting people for a purpose of establishing links or contacts to further a goal

4. Networking – interacting and engaging with people for mutual benefit.

5. 5. Mentor – a role model who will agree to give counsel and act as a sounding board for
potential career plans and activities, invaluable source, particularly of new business venture or
even at the beginning of nursing career support of new RN

6. Marketing – Let the potential users know about a product’s existence and advantages

Process or technique of promoting, selling and distributing a product or service

career survivalist

• A career survivalist or resilient individual focuses on the person, not the position.

• Be engaged Your career belongs to you. Define your values and determine what motivates
you.

• Be the lookout for opportunities to break from the status quo

• Opportunities for nurses are growing every day

The following are career survivalist strategies (morgan, 2013):

• ■ Stay informed

• Health care is dynamic and changing daily.

• Go out there, stay informed, and start thinking about your options for riding the waves
of change

• ■ Learn for employability

• Take personal responsibility for your career success

• Continue to be a “work in progress”

• Employability in health care today means learning technology tools, job-specific

technical skills, and people
 • Skills such as the ability to negotiate, coach, work in interprofessional teams, and make
presentations.

• ■ Plan for your financial future

• Ask yourself, “how can I spend less, earn more, and manage better?”

• people make job decisions based on financial decisions, which makes them feel trapped
instead of secure.

• Develop multiple options

• The career survivalist looks at multiple options constantly. Moving up is only one option

• Being aware of emerging trends in nursing, adjacent fields, lateral moves, and special
projects presents other options.

• Build a safety net

• Networking is extremely important to the career survivalist

• Joining professional organizations, taking time to build long-term nursing relationships,

and getting to know other career survivalists will make your career path more enjoyable
and successful.

Understanding Filipino values

• Filipinos are generally friendly and harmony-seeking

• Family is the most important of all

• Other values:

• honor

• group harmony

• diplomacy

• good behavior

• public esteem

• courtesy

• tolerance

• good manners

Teleconferencing

the use of telecommunication devices to hold discussions between participants in different locations.

E-Health
 • Is an emerging field in the intersection of medical informatics, public health and business,
referring to health services and information delivered or enhanced through the internet and
related technologies.

Characteristics

1. Efficiency

• One of the assurances of e-health is to upturn efficiency in health care, thus reducing costs

• One potential way of decreasing costs would be by dodging duplicative or avoidable diagnostic
or therapeutic intermediations, through improved communication potentials between health
care institutions, and patient participation.

2. Improving the quality of care

• Increasing efficiency implicates not only decreasing costs but at the identical time improving
quality of services.

• E-health may improve the quality of health care by allowing comparisons between diverse
providers

• (focus on quality assurance, aiming patient streams to the finest quality suppliers)

3. Evidence-based

• E-health interventions must be evidence-based in the sense that their value and competence
should not be presumed but proven by laborious scientific assessment.

4. Empowerment of consumers and patients

• By making the knowledge base of medicine and personal electronic records easily available to
users over the internet, e-health unseals new opportunities for patient-centered medicine and
facilitates evidence-based patient choice.

5. Encouragement

• provides encouragement for a new link between the patient and health expert, towards a true
corporation, where choices are made mutually

6. Education of physicians through online sources (ongoing medical education) and consumers
(health education, personalized preventive information for consumers)

7. Enabling information discussion and communication in a consistent way between health care

institutions

8. Extending

• E-health extends opportunity of health care further than its conservative boundaries.

• This is meant in both a topographical sense along within a conceptual sense.

 • E-health also facilitates consumers to effortlessly achieve health services online from
international providers. These facilities can range from simple advice/suggestions to more
compound intermediations or medications.

9. Ethics

• E-health includes new forms of patient-physician communication, poses new challenges, and
pressures to ethical issues

For example: online professional practice, informed consent, privacy and equity issues.

10. Equity

• To make health care further justifiable is one of the assurances of e-health, but at the same time
there is a substantial risk that e-health might expand the gap between the “haves” and “have-
nots”.

• E-health is and should be equitably accessible to all the people, irrespective of their age, race,
gender, ethnicity etc.

• People, whose economic conditions are poor, people who lack skills, and access to computers
and networks, cannot use computers efficiently. As a result, these patient populations (which
would truly value the utmost from health information) are those who are the least expected to
benefit from developments in information technology, except political trials ensure equitable
access wholly. The digital gap presently runs between rural vs. Urban inhabitants, rich vs. Poor,
young vs. Old, male vs. Female people, and among the neglected/rare vs. Common illnesses.

Social media

• Opportunity for electronic communication

• A powerful adjunct to other communication strategies when used appropriately

• Nurses can connect with other nurses worldwide and share information

• Can follow professional organizations, an excellent source of continuing education

• Source of health care informations (following hashtags)