Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

1. Personal and professional accountability
2. Career planning
3. Personal journey disciplines
4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

RUBRICS

 Identification of strengths and weaknesses related to the four content areas listed. 

 Discussion of use of current leadership skills to advocate change in the workplac 

 Reflection on personal goal for leadership growth and development of implementation plan to reach goa 

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Comment 1

Analysis of variance, ANOVA, is a statistical technique used to analyze the variation between two or more groups so as to discover the disparity among the group means. Analysis of variance is used to examine the general variation instead of a specific variation between means. 

The assumptions that involve the use of ANOVA are:

• The population is normally distributed
• The population is mutually exclusive
• All population should have equal variance
• The measurement of the dependent variable is at
  the internal/ratio level
• Each observation of the samples are independent

ANOVA consists of two types of measurements: first, one-way ANOVA and second, two-way ANOVA. The one-way ANOVA is measuring variations among different
groups, comparing two groups or more. The one-way ANOVA is the preferred statistical test when examining two or more groups. An example of using one-way
ANOVA  is the analysis of a particular sport but on different education levels like sophomore, junior, or senior. The two-way ANOVA is used when the variations analysis is comparing a much more complicated pair of groupings. An example of two-way ANOVA could be analyzing the grades of an American senior student to the grades of a student who is studying in America on the exchange student program.

comment2

Analysis of variance refers to the differences between two, three, or more groups. The textbook says two or more groups, while the visual learner says three or more groups (Grove & Cipher, 2017, p. 179); (The Visual Learner, 2018). There are different versions of the analysis of variance (ANOVA) tests but the most basic form, is a one-way ANOVA. The one-way ANOVA has only one dependent variable and one independent variable. The variable is dependent if it is being tested and measured. The independent variable is the variable that is changed to see how it affects the dependent variable. The outcome of the ANOVA provides an F-ratio that is an average of the differences between the groups. There will also be a F-critical value. If the F-critical value is not more than the F-ratio, the null hypothesis would be rejected at the given alpha level.

The test must meet certain guidelines. The distributions of the populations should be very near normal. The variance of the population should be the same. The samples must be quantitative and taken from simple random samples and the samples must not be dependent on one another (The Visual Learner, 2018).

The repeated-measures analysis of variance can be used to measure changes in the dependent variable over extended periods of time.

Post hoc analysis can then be used to find the location of the variance. These tests include the Dunnett test, Newman-Keuls test, the Scheffe test and the Tukey Honestly Significant Difference (HSD) test (Grove & Cipher, 2017).

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Nurses advocate for their patients in many ways and on a daily basis. Many do not realize that by providing care and communicating with patients, they are practicing advocacy. Ways the nurses advocate for patients include; through inter and intrapersonal communication, therapeutic communication, collaboration, socialization, implementation, networking with organizations (specifically those that move to influence legislative change), and identifying health care disparities and health care delivery Grand (Canyon University, 2018).

     We are all put in daily situations in which we advocate for our patients. One that jumps out to me, is a patient who came in as an outpatient and was status post op for a laparoscopic cholecystectomy. The patient came over from PACU into second phase recovery after over an hour and a half in the PACU. Bedside report revealed that the patient was thrashing upon arrival to PACU, pain was not manageable, and the patient’s blood pressure decreased while heart rate increased. The patient was still uncomfortable and thrashing around. I immediately contacted the physician who came to assess the patient. He stood there stating he didn’t know what was wrong or could be wrong with the patient. I, alongside my charge nurse, pushed for an order to draw a stat hemoglobin and hematocrit as I felt the patient was bleeding internally. It took convincing, but there were no further interventions we could do at this time to help this patient. When the H&H came back, it had dropped significantly compared to his preoperative levels the day before and below the norms. The patient was rushed back into the operating room where it was discovered he had ripped his internal stitches due to the thrashing around postoperatively. If it wasn’t for us advocating and pushing for the lab draw, the surgeon may have let the patient discharge where he would have bled a significant amount more. He could have potentially died. An Incident Report Form was completed on this situation.

Reference

Grand Canyon University. (2018). Professional Engagement. Retrieved from

     https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and-science-of-professional-

     practice/v1.1/#/chapter/5

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Comment1

My personal preference for scholarly databases, of those listed by GCU, is the CINAHL Complete. It is described as “the definitive research tool for nursing and allied health professionals with access to the top nursing and allied health journals” (Grand Canyon University, n.d., para 1). I have found that using the CINAHL database has provided me with the most comprehensive articles and information throughout the duration of my career as a nurse. I also tend to utilize the Joanna Briggs Institute EBP alongside the CINAHL database. The Briggs database “is a recognized global leader in evidence-based healthcare resources…[including] evidence summaries, evidence based recommended practices, best practice information sheets, etc…” (Grand Canyon University, n.d., para 3).

These databases, and those listed in the GCU Library are far superior to using Google Scholar or a general internet search. The databases listed above are first and foremost, medical specific. The information obtained in a search on either database will reveal only articles and information related in a medical aspect. Secondly, the use of traditional search engines, like Google Scholar, does not allow for the user to apply as detailed specificity to the search as could be in a database search. This in turn results in a “grab bag” of results that make it difficult to determine what is accurate information and what is not (LibGuides, 2018, para 5). Lastly, the use of databases remains consistent; meaning that standard web searches and results found on those websites can change without notice. This leaves room for error and for a loss of content to occur; you may not see the same information twice with a Google Scholar search (LibGuides, 2018, para 6)

comment2

The first one that I found helpful in aiding my research is the CINAHL database.  There are more than 4 dozen nursing specialties that are covered in the journals on their engine.  It provided you with the most current practices, continuing education and evidence base best practices (Grand Canyon University, n.d).  Secondly, the Joanna Briggs Institute will also help me in finding scholar information to support my EBP proposal.  It offers the best evidence base practices and systematic reviews.  These two databases are better than google scholar articles because it has been researched by specialist and proven before publication.  Articles that are found on google scholar or internet may not reliable because they can be written from opinions.  Since being a student at GCU, I have also found the databases to be valid, the peer review articles have reliable sources and have been thoroughly researched.  By also filtering it to what you are looking for, you can also find the most current practices.

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Comment1

The scientific management theory was first described by Frederick Taylor in the early nineteen hundreds. Frederick Taylor published The Principles of Scientific Management which described how the application of scientific management applied to workers will greatly improve productivity. Scientific management calls for making tasks that are being performed easier and simplifying the tasks and training the workers on those specific tasks to be performed to the best of their abilities. Taylor stated his published work, “The principal object of management should be to secure the maximum prosperity for the employer, coupled with the maximum prosperity for each employee. The words ‘maximum prosperity’ are used, in their broad sense, to mean not only large dividends for the company or owner, but the development of every branch of the business to its highest state of excellence, so that the prosperity may be permanent”  (Caramela, 2018).

One of the things our hospital is inefficient with is individualizing every single care plan. Our team does good but we have frequent fall outs.  Individualized care plans are just that individualized. Not everyone will have the same interventions. The leaders and the education department had meet with many nurses to see how we can make individualized care plans more easier and help the nurses focus more on them. Feedback was provided from all nurses and leaders took that in for the ultimate decision.  The leaders took the information back to the chief nursing officer who ultimately made the final decision.

Commet2

A prominent name in scientific management is Frederick Taylor who in 1914 wrote a book called The Principles of Scientific Management which primarily sought to improve the level of cooperation between management and the labor force so that profits could be maximized but so could the personal development of the workers (Huber, 2014). However, there are faults in this theory with one of them being the worker often feels undervalued (Huber, 2014). One of the most frequently complained about routines in healthcare is the broken algorithm used to determine staff to patient ratios. In our PCU we can have up to acuity 5 patients. Usually I will have 3-4 acuity 3 patients or some combination of acuity 3’s and 4’s. Our ICU is acuity 5 and above. At most you can only have two level 5’s or one level 6 or 7. Level 8-10 are 2-3 nurses per patient and they are reserved for very sick patients such as those on ECMO. It seems the staffing office can never get it right when it comes to the number of nurses we are going to need and we are always either short-staffed or overstaffed. Another routine which seems could with a bit of tuning is the EPIC EMR system. This system has a great idea but there are many short-fallings in a system developed back in 1979. Finally, I would say that a routine in the healthcare field in general which is inefficient mainly is the billing department. I cannot be the only person that has been double billed, told that our insurance doesn’t cover something that it does cover, or some other terrifying mistake made. The situation is a problem in many ways and could do with a considerable tune-up. We have several examples of participative decision-making in my workplace and the first starts with every employee my department. We are primarily a democratic department and decisions which would affect the department are usually put to the vote via surveys, emails, and polls. We are also a unionized hospital and therefore have a relatively significant influence on decisions. A second example of participative decision making is the various committees that are comprised of all sorts of staff that seek to analyze, brainstorm, and implement policies and procedures in the hospital that can affect patient care. T

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