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Change within the healthcare setting is inevitable and as a nurse leader understanding how change occurs and strategically determining the change process or model needed to best suit the needs of the change is a valuable skill to possess.  In this situation a change is needed surrounding the current organizational structure at a facility.  This situation indicates that there is an in-proportionate number of leaders to staff creating a “top heavy” environment where multiple people are in charge of a single unit(s).  This type of a change consists of organizational restructuring and can create threats to decision-making strategies, including information flow, relationships, and priority setting (Spiers, Lo, Hofmeyer, & Cummings, 2016).  Restructuring the organizational structure will create a feelings of uncertainty among staff and this type of change should be mapped out and well communicated to ensure a smooth transition.  With a top heavy scenario the goal of the organizational restructuring is to ultimately create a more streamlined and direct line of authority, eliminate any duplicate leaders and flatten out the line to reduce the expense.  

The three change models discussed could theoretically all be used in this scenario however the one I opted to implement is the PDSA model of change.  This scenario requires a rapid change in organizational structure and Kotter and Roger’s are by design a more slow measured change process.  This organizational restructure requires a plan of action which is restructuring the leadership or reducing the number of leaders within each unit/department.  The plan is then implemented by restructuring leadership or by eliminating excessive leadership in order to create a more direct line of authority and lessen the redundancy of leaders.  If a alteration of the plan is needed upon further eval then the cycle continues.  Flattening out the leadership or reducing the number of leaders is difficult but must be done in a precise manner, enacted upon evaluated and then adjusted if needed.  Kotter and Rogers change models could be applied here but in my opinion the PDSA model and the quick four cycle process works best to implement a rapid change in leadership that is needed in this scenario.  

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n this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

NO PLAGIARISM

MUST INCLUDE PLAGIARISM CHECK

PLEASE FOLLOW ATTACHED RUBRIC AND MUST ADHERE TO WORD COUNT

Hi, I need a paper to cover these areas:

This week you have taught a predetermined group of community members something new. Not only was it something new, but it was something you worked really hard to create!! PLEASE UPLOAD A COPY OF YOUR POWER POINT NOTES. Now , let’s talk about your presentation.

-What did you learn about providing a health promotion presentation?

-If you had to tell someone else how to do a presentation, what helpful advice would you give?

-What are you most proud of?

-What would you do better next time?

-Looking at your classmates’ presentations, which one makes an impression on you and why?

To support your work, use your course and text readings and also use resources from the University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA Style website through the APA icon below. 

TASK

Post your initial response to one of the two topics below.

Topic 2

Based on the development of therapeutic nurse-patient relationships:

• Explain the continuum of boundaries of the nurse-patient relationship. 
• Describe the negative results of boundary crossing in the nurse-patient relationship.

Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook.

Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

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