Discussion: DPI Proposal Corrections

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Discussion: DPI Proposal Corrections julie.childers.gradeddnp_955.10.14.20.docx rubric_dpi_proposal.xlsx How Transformational Leadership Can Affect Staff Satisfaction Submitted by Julie Ann Childers Direct Practice Improvement Project Proposal Doctor of Nursing Practice Grand Canyon University Phoenix, Arizona October 5, 2020 GRAND CANYON UNIVERSITY How Transformational Leadership Can Affect Staff Satisfaction by Julie Ann Childers Proposed October 5, 2020 DPI PROJECT COMMITTEE: Vijayarani Suresh, DNP, NP-BC, Manuscript Chair Barbara McLean, MN, NP-BC, CCNS-BC, CCRN, FCCM, Committee Member v Abstract Rationale/Background: Transformational leadership is a leadership style that can inspire positive changes in those who follow. Transformational leadership is designed to encourage, motivate, include, and model the essential behavior in nursing management. Purpose: The purpose of this quantitative, quasi-experimental Direct Practice Improvement (DPI) project will focus on implementing the transformational leadership style in the Grady Hospital Cardiovascular Service Line Inpatient Bedside Nursing Units (CSLIU) over four weeks. The COVID-19 pandemic brought a surge of patients in hospitals; many nurses feel overwhelmingly stressed by the number of severe cases and the risks that they face by attending to these patients. Added to these tensions is that their nursing managers do not include them in management decisions executed by the organization. Theoretical Framework: Kanter’s Structural Empowerment (SE) theory cite describes how managers or leaders affect staff behaviors to perform their job for this project effectively. Project Method and Design: The job satisfaction will be measured using nursing reports of feeling fulfilled and Using the Global Job Satisfaction (GJS) questionnaire drawn from the Diagnostic Job Survey. Data Results: Identify the population and the sample size. Briefly describe the data analysis approach and statistical tests’ results—state whether the results were statistically significant and include numeric values. Implications: include the abstract with one to two statements describing how your project results directly impacted practice at your site and recommendations for what should be vi done in the future based on the project’s findings. Keywords: Transformational Leadership, management style, nursing, job satisfaction, staff retention, job burnout, Magnet Journey vii Table of Contents Chapter 1: Introduction to Project…………………………………………………………………………….8Discussion: DPI Proposal Corrections Background of Project ………………………………………………………………………………………9 Problem Statement ………………………………………………………………………………………….10 Purpose of Project …………………………………………………………………………………………..11 Clinical Question(s) ……………………………………………………………………………………….12 Advancing Scientific Knowledge ……………………………………………………………………..13 Significance of Project …………………………………………………………………………………….15 The rationale for Methodology …………………………………………………………………………16 Nature of the Project Design …………………………………………………………………………….19 Definition of Terms…………………………………………………………………………………………20 Assumptions, Limitations, Delimitations …………………………………………………………..21 Summary and Organization of the Remainder of the Project ………………………………..25 Chapter 2: Literature Review …………………………………………………………………………………26 Theoretical Foundations……………………………………….. 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Review of the Literature ………………………………………………………………………………….27 Theme 1 ……………………………………………………………………………………………29 Theme 2 ……………………………………………………………………………………………32 Summary ……………………………………………………………………………………………………….33 Chapter 3: Methodology ……………………………………………………………………………………….34 Statement of Problem ………………………………………………………………………………………35 Clinical Question ……………………………………………………………………………………………37 Project Methodology ……………………………………………………………………………………….37 viii Project Design ………………………………………………………………………………………………..38 Population and Sample Selection………………………………………………………………………39 Instrumentation or Sources of Data …………………………………………………………………39 Validity …………………………………………………………………………………………………………41Discussion: DPI Proposal Corrections Reliability………………………………………………………………………………………………………41 Data Collection Procedures………………………………………………………………………………42 Data Analysis Procedures ………………………………………………………………………………..42 Potential Bias and Mitigation……………………………………………………………………………43 Ethical Considerations …………………………………………………………………………………….44 Limitations …………………………………………………………………………………………………….45 Summary ……………………………………………………………………………………………………….45 References …………………………………………………………………………………………………………..54 Appendix A …………………………………………………………………………………………………………57 Appendix B …………………………………………………………………………………………………………60 Appendix C …………………………………………………………………………………………………………60 9 Chapter 1: Introduction to the Project Transformational leadership is a leadership style that can inspire positive changes in those who follow. Transformational leaders are energetic, enthusiastic, and passionate. “Not only are these leaders concerned and involved in the process, but they focus on helping every member of the group succeed as well” (Cherry, 2020). Transformational Leadership (TL) is designed to encourage, motivate, include, and model the essentiaDiscussion: DPI Proposal Corrections l nursing management behavior. It is an aspect of employee management that enables them to think for themselves and become more autonomous (Schwartz et al., 2011). Transformational leaders can motivate their employees to fulfill their goals and mobilize them to perform with self-sufficiency (Choi et al., 2016). Transformational leaders inspire nurses to use their clinical judgment to arrive at the clinical decisions that align with the unit and organizational goals. Studies have shown that nurses, under transformational leaders, have higher morale and are more satisfied with their work (Boamah et al., 2018). Grady Hospital is on the journey toward the magnet, which should encompass transformational leadership throughout the organization. This Direct Practice Improvement (DPI) project will focus on implementing the transformational leadership style in the Grady Hospital Cardiovascular Service Line Inpatient Bedside Nursing Units (CSLIU). Once transformational leadership approaches are implemented, an increase in nurses’ job satisfaction is expected to be seen. The nurses will then become enthusiastic and engage with the unit and organizational goals that call for more patient care quality and accountability. This will lead to increased longevity in the CSLIU. The project manager will employ a quantitative quasi-experimental project to determine if TL can influence bedside nurses’ staff satisfaction. The project manager will 10 collect data from the participants using paper questionnaires and online surveys through a quasi-experimental design. The project participants include 50 full-time bedside nurses who have been employed at the CSLIU for at least six months. Theoretical Framework Model Kanter’s Structural Empowerment (SE) theory describes how managers or leaders affect staff behaviors to perform their job effectively and efficiently. Transformational leaders can get tasks or projects accomplished by providing access to four essential organizational components: resources, opportunities, support, and education. The features, along with opportunities to learn and develop, empowers the staff. The availability of resources means the team will have the funding, time, education, and tools required to do their job (Kanter, 1993). Opportunities consist of incentives, challenges, job position/status, value, and compensation that enhance the workers’ abilities and skills. Leadership support involves the instructions and responses given by supervisors, managers, and peers. Discussion: DPI Proposal Corrections According to (Kanter, 1979), “when the situations are structured so that employees feel empowered, the organization benefits in terms of improved employee attitudes and increased organizational effectiveness”. Many adverse patient outcomes (APO’s) have occurred due to an inappropriate work environment and the absence of productive and operative leadership. According to (Aiken et al., 2002), toxic work environments and a shortage of nursing staff are the critical factors of APOs. This research measured different APOs measured by nurses, including patient falls, medication errors, hospital-acquired infections, skin breakdown, and patient death. “The nursing-rated quality of healthcare offers the most relevant yet distinctive information about patient outcomes because the nursing staff is concerned virtually at every stage of the patient’s health care, which builds their perception and 11 provides valuable information. Nursing-measured quality of care related to impartial hospital quality indicators, such as the patient’s satisfaction, failure to rescue, and the death rates, offer that the nursing-assessed patients’ outcomes and the real ones are interlinked” (Aiken et al., 2002). Background of the Project The CSLIU lost over 50% of their bedside staff during the time of April-August of 2020. There were various reasons for voluntary separation, but the question remains; could leadership have played a role in retaining some nursing staff? Leadership is a process of interpersonal interaction that encourages people to work voluntarily toward a high individual or group job performance. It is a process of guiding employees towards the accomplishment of the company’s goals. In the nursing profession, leadership entails assisting nurses in providing the best quality of care to their patients (Cordo & HillRodriguez, 2017). Project managers have shown that leadership plays a significant role in ascertaining nurses’ satisfaction in their posts (Asif et al., 2019). This is supported by the study of de Moura et al. (2017), which discusses the quality of leadership shown by nursing managers at work that can significantly influence the level of dissatisfaction and burnout that nurses feel as they try to deliver competent and compassionate nursing care to their patients. Because of nursing leadership’s importance, many studies have been conducted to determine how transformational leadership helps uplift nurses. Specifically, the research of Guo et al. (2016) states that there is a considerable difference between nurse retention rates among nurses who have inspiring leaders and those who do not. This shows that historically, the need for TL in nursing practice has been identified for years. At present, the need for transformational leaders is still an issue in the nursing field. Discussion: DPI Proposal Corrections Explain why.According to Kleinman (2004), there is a high correlation between 12 quality nursing leadership and hospital staff retention rates. Specifically, nurse shortage becomes a significant problem in medical institutions as nurses are dissatisfied with their work shift from one medical facility to another. Aside from nurse shortage and extended hours at work, many nurses experience low morale because they are underpaid, overworked, and not feel empowered. According to Talaee et al. (2020), now that the COVID-19 pandemic has brought a surge of patients in hospitals, many nurses feel overwhelmingly stressed by the number of severe cases and their risks by attending to these patients. Added to these tensions is that their nursing managers do not include them in the unit’s management decisions. This can lead to job dissatisfaction, an unhealthy or toxic work environment, and decreased quality and safe patient care. Without transformational leaders to guide nurses in their jobs, burnout and low morale will ensue. This project aims to determine whether TL can improve nurses’ work environment and improve job satisfaction at Grady Hospital CSLIU. Studies have shown that nurses can be motivated to exemplify compassionate and competent nursing care once they are under the guidance of nursing leaders who genuinely care for their staff (Krepia et al., 2018). With this knowledge, the project manager tries to determine if TL can increase employees’ morale and enhance job satisfaction in Grady Hospital CSLIU. Problem Statement Leaders’ quality of leadership style and quality plays a vital role in helping a unit and organization reach its goals. The most present traits in influential leaders include excellent communication skills, accountability, competence, and compassion (Nielsen et al., 2009). However, the problem arises when employees are guided by leaders who do not exemplify the previous sentence’s traits. According to Rushton and Pappas (2020), the lack of transformational leaders in institutions leads to a workforce that is not inspired 13 and motivated to execute their jobs well. In the nursing field, leaders who do not lead effectively with their nurses fail to determine how to direct them towards optimum effectiveness. Additionally, nursing leaders who do not show accountability for their actions can breed nurses who do not act responsibly to care for their patients (Schwartz et al., 2011).Discussion: DPI Proposal Corrections Finally, leaders who are poor at communicating with their nurses do not motivate them, leading to job dissatisfaction, burnout, and high attrition rates. The research mentioned above shows that TL’s implementation in the nursing field may be a critical factor in increasing nurses’ job satisfaction in their respective workplaces. It is unknown if or to what degree the implementation of TL would affect job satisfaction for Cardiovascular Service Line Bedside Nurses. While literature shows leadership can be the root cause of an unhealthy or toxic work environment, it is not known in Grady Hospital CSLIU if TL can influence job satisfaction or job burnout. Further, it is not known how or to what extent TL will affect staff retention either. Purpose of the Project Transformational leadership refers to a leadership approach that results in a significant change in the staff. Under a transformational leader’s guidance, a positive change is expected to develop among their people (Suratno et al., 2018). Transformational leaders can inspire their followers to perform well in their work. Additionally, they can motivate them to fulfill both their personal and professional objectives. Because of acting as role models to their subordinates, transformational leaders are emulated by their people and regarded as someone who shows the most outstanding work efficiency. In the nursing field, transformational leaders are essential because they can guide their nurses towards offering empathetic and competent nursing 14 care to their wards (Asif et al., 2019). Furthermore, transformational nursing leaders enable their nurses to look beyond their struggles and become more satisfied with their ability to care for patients in physical or emotional pain. As such, their nurses become happy with their jobs and are more inspired to execute their tasks. The purpose of this quantitative project is to determine if or to what degree the implementation of transformational leadership would impact job satisfaction when compared to job dissatisfaction or job burnout among the CSLIU nurses in Atlanta, Georgia, over four weeks. Additionally, the purpose of this quality improvement project is to determine the degree to which the implementation of transformational leadership impacts job satisfaction of the bedside nurses when compared to patient care among cardiovascular service line patients in an acute inpatient care setting in Atlanta, Georgia, over four weeks. Through an online survey and a questionnaire that the participants will answer, the project manager will understand how transformational leadership plays a role in job satisfaction that the bedside nurses at Grady Hospital CSLIU have. Discussion: DPI Proposal Corrections Clinical Question Bedside nurses are nurses who deliver immediate and direct care to their patients. Research has shown that having competent and compassionate bedside nurses is essential in ensuring the best quality nursing care delivery to patients. However, the problem lies with the level of job dissatisfaction that bedside nurses experience in their work. Among Grady Hospital Cardiovascular Service Line Inpatient Units Bedside Nursing Staff, does transformational leadership impact job satisfaction and job burnout influencing staff retention rates over four weeks? Research which research , not clear has shown that bedside nurses’ level of dissatisfaction has been associated with inadequate nurse staffing, low compensation packages, long hours of work per shift, and the lack of training 15 provided by their leaders. Specifically, their nursing managers’ lack of sufficient training is detrimental to their ability to provide adequate care to their patients. Moreover, bedside nurses feel dissatisfied with their job whenever they must work for long hours because of nurse shortages in the medical facilities that they work in (McAllen et al., 2018). Being exposed to overfatigue and burnout may adversely affect their ability to show compassionate care to their patients. Transformational leadership is an effective way of helping nurses feel motivated to deliver competent care to their patients. Studies have shown that nurses guided by transformational leaders have a positive mindset about their patient care goals. Additionally, nurses with transformational leaders are more satisfied with their jobs because their leaders know how to listen to their concerns, compromise, and alleviate their issues in the best way possible (Boamah et al., 2018). Because nurses feel essential in the institution, they are more motivated to attend to their patients’ needs. They execute their jobs well and supply empathetic care to their patients and their families and relatives 16 (Peng & Tseng, 2019). They interact with them, respectively, and educate them about important information about the patient’s illnesses needed to prevent complications. Sp … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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