Discussion Question1: Shared Governance

Discussion Question1: Shared Governance

Discussion Question1: Shared Governance

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Week 3 – Assignment 1 Discussion Discussion Question 1: Shared Governance Structure and the CNO During the 1980s, nursing and healthcare were suffering from challenges of an acute nursing shortage, rampant nurse turnover, and issues with nurse retention. In the mid-1980s, shared governance was instituted to incentivize and empower nurses. Shared governance is an innovative organizational model promoting staff control and autonomy over nursing practice in areas that were previously controlled by managers. The concept of shared governance may be a challenge to understand because it is not uniformly applied or operationalized and because of the great diversity in shared governance models. Nurses working in organizations with shared governance models are more empowered and have higher levels of satisfaction in their roles. Using the readings for the week, the South University Online Library, and the Internet, respond to the following: Compare the roles of the CNO and nursing directors or managers in a shared governance structure. What steps can the CNO take to enable smooth operations in such a structure? Identify two challenges CNOs face when working with a shared governance structure. Compare and contrast a model of shared governance with an authoritarian or autocratic CNO. Examine the role of the CNO in working to set parameters for nurses in a shared governance structure. Comment on the postings of at least two peers. Evaluation Criteria: Compared the roles of the CNO and nursing directors or managers in a shared governance structure. Listed steps the CNO can take to enable smooth operations in such a structure. Identified two challenges CNOs face when working with a shared governance structure. Compared and contrasted a model of shared governance with an authoritarian or autocratic CNO. Examined the role of the CNO in working to set parameters for nurses in a shared governance structure. Justified your answers with appropriate research and reasoning. Commented on the postings of at least two peers. DQ2 Discussion Question 2: Staff Concerns and the CNO Often, gossip mills and rumors tend to circulate very quickly throughout healthcare organizations even though everything is supposed to be confidential. Good and bad news travel quickly; one of the greatest challenges the CNO or vice president for patient care services (VPPCS) faces is to control and share information with the staff members so that they receive the same message in the same way at the same time. Using the readings for the week, the South University Online Library, and the Internet, respond to the following: What role does the CNO or VPPCS play in addressing the concerns of the entire staff in nursing town-hall meetings? Why is this role important? Provide an example of a need for the CNO or VPPCS to schedule an entire staff town-hall meeting. How can the CNO or VPPCS minimize gossip and information via the “grapevine” before an entire staff town-hall meeting? How would you craft an agenda and circulate it for a town-hall meeting? How can the CNO or VPPCS integrate the use of electronic and social media into addressing staff concerns in twenty-first-century healthcare organizations? Comment on the postings of at least two peers. Evaluation Criteria: Described the role of the CNO or VPPCS in addressing the concerns of the entire staff in nursing town-hall meetings, and explained the importance of this role. Provided an example of a need for the CNO or VPPCS to schedule an entire staff town-hall meeting. Suggested ways in which the CNO or VPPCS can minimize gossip and information via the “grapevine” before an entire staff town-hall meeting. Explained how you would craft an agenda and circulate it for a town-hall meeting. Recommended ways in which the CNO or VPCSS can integrate the use of electronic and social media into addressing staff concerns in twenty-first-century healthcare organizations. Justified your answers with appropriate research and reasoning. Commented on the postings of at least two peers.

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As the unit director for the emergency department and part of an ad hoc interdisciplinary committee formed to address rise in medication errors it is important to include all stakeholders to combat this issue system-wide. Ultimately, stakeholders are known as our consumers or patients, however, we must take into consideration the stakeholders of the organization; CNO, nurse manager, pharmacist technicians, nurses, pharmacists, IT and any member of the team that has access to medication rooms. Stakeholders are not chosen by the organization, but rather stakeholders choose to have a stake in the organization’s decision making (Marquis & Houston, 2017). It is essential to include all members of the organization because each individual has their own vision and view toward their approach to medication administration, medication verification, and the technology used to do so.

I’ve worked in both adult health and currently in the pediatric arena; one major difference to reducing medication errors between specialties is highly regarding diabetes and insulin and anticoagulants. To compare the two fields, in the pediatric field our medication administration is calculated weight based and in specific the sliding scale protocol is based on caloric intake per meal. Each syringe of medication is drawn and sent via tube from pharmacy, nurses are never to draw up units from vials. This extra precaution and safety measure (although medication checks are still necessary and double RN checked) is put in place to reduce complications relating to insulin administration. Medication errors often times occur when layers of defense are not implemented correctly, when teamwork is strong on a unit and resources are available, most often another team member may catch the error before it occurs, the Swiss Cheese Model illustrates exactly that (Aebersold & Kalisch, 2016).

As different roles gather to overcome the medication error prevention ad hoc, we must look into organizational culture and organizational climate. Organization culture is known as the total of an organization’s values, language, traditions customs and certain aspects of the organization that is not open for change (Marquis & Houston, 2017). With that being said, the team will utilize effective, respectful communication and transparency throughout the process. Approaching medication errors with the intention to learn from mistakes and find the “swiss cheese” effect is essential in all departments involved. In short, the organizational culture can be specific to one organization, including unique ways of thinking and behavior. On the other hand, organizational climate is how the organization is perceived. One employee may perceive the organization in a positive light whereas another may not. Leadership and management can influence their employee’s perception of the unit or organization as a whole, influencing perceptions through effective communication, leadership style, culture of safety and transparency. Forming a workplace culture where in the event of medical errors occur, we must empower our nurses, respiratory therapists, pharmacy techs and others to share the occurrences. Sharing events that crossed the Swiss Cheese Model which draws attention to the organizational efforts in reducing disparities, not necessarily the individual involved.

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