Discussion

Review Appendix A, Sections I–V in Finkelman (2016).

1. Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies. Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.
2. In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?
3. Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences

====250 words, APA, double spaced.

reference: Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Boston, MA: Pearson.

1. Clinical Practice Knowledge
   • Maintain knowledge of current nursing practice and the roles and functions of patient care team members
   • Articulate patient care standards as published by JCAHO [Joint Commission], CMS, and professional nursing literature
   • Understand, articulate, and ensure compliance with the State Nurse Practice Act, State Board of Nursing regulations, regulatory agency standards, and policies of the organization
   • Ensure that written organization clinical policies and procedures are reviewed and updated in accordance with evidence-based practice
   • Role model lifelong learning, including clinical subjects such as disease processes, pharmaceuticals, and clinical technology
2. Delivery Models/Work Design
   • Maintain current knowledge of patient care delivery systems and innovations
   • Articulate various delivery systems and patient care models and the advantages/ disadvantages of each
   • Serve as change agent when patient care work/workflow is redesigned
   • Determine when new delivery models are appropriate, and then envision and develop them
3. Health Care Economics
   • Articulate federal and state payment systems and regulations, as well as private insurance issues, which affect organization’s finances
   • Understand and articulate individual organization’s payer mix, CMI, and benchmark database
4. Health Care Policy
   • Articulate federal and state laws and regulations that affect the provision of patient care, e.g., tort reform, malpractice/negligence, reimbursement
   • Participate in the legislative process concerning health care through membership in professional organization and personal contact with public officials
   • Educate patient care team members on the legislative and regulatory processes and methods for influencing both
   • Interpret impact of state and federal legislation on nursing and health care organizations
5. Governance
   • Articulate the role of the governing body of the organization in the following areas:
     • Fiduciary responsibilities
     • Credentialing
     • Performance management
   • Represent patient care issues to the governing body
   • Participate in strategic planning and quality initiatives with the governing body
   • Interact with and educate the organization’s board members regarding health care and the value of nursing care
   • Represent nursing at the organization’s board meetings
6. Evidence-Based Practice/Outcome Measurement
   • Interpret information from research
   • Utilize research findings for the establishment of standards, practices, and patient care models in the organization
   • Disseminate research findings to patient care team members
   • Participate in studies that provide outcome measurements
   • Allocate nursing resources based on measurement of patient acuity/care needed
7. Patient Safety
   • Support the development and implementation of an organization-wide patient safety program
   • Design safe clinical systems, processes, policies, and procedures
   • Monitor clinical activities to identify both expected and unexpected risks
   • Support a non-punitive reporting environment and a reward system for reporting unsafe practices
   • Support safety surveys, responding and acting on safety recommendations
   • Ensure staff is clinically competent and trained on their role in patient safety
   • Articulate and take action to support the JCAHO National Patient Safety Goals
8. Utilization/Case Management
   • Articulate organization for the criteria model adopted by the organization
   • Communicate key points of the model to a variety of audiences (nursing, financial, medical staff)
   • Involve physicians in on-going utilization management practices
   • Design continuum of care options for managing patient throughput (long term care units, urgent care centers, admission/discharge units, etc.)
9. Quality Improvement/Metrics
   • Articulate the organization’s QI program and goals
   • Determine patient care quality improvement goals and objectives
   • Define metrics as related to process improvement
   • Explain and utilize metrics as a unit of measure for any process
   • Articulate the link between metrics and goals
   • Articulate the link between organization metrics and national quality initiatives/metrics
   • Target outcomes that are evidence-based (comparison data benchmarking)
   • Define quality metrics by
     • Identifying the problem/process
     • Measuring success at improving specific areas of patient care
     • Analyzing the root causes or variation from quality standards
     • Improving the process with the evidence
     • Controlling solutions and sustaining success
10. Risk Management
    • Identify areas of risk/liability
    • Ensure staff is educated on risk management and compliance issues
    • Develop systems which encourage/require prompt reporting of potential liability by staff at all levels
    • Envision and take action to correct identified areas of potential liability

III. Leadership

1. Personal and Professional Accountability
   • Create an environment that facilitates the team to initiate actions that produce results
   • Hold self and others accountable for actions and outcomes
   • Create an environment in which others are setting expectations and holding each other accountable
   • Answer for the results of one’s own behaviors and actions
2. Career Planning
   • Develop own career plan and measure progress according to that plan
   • Coach others in developing their own career plans
   • Create an environment in which professional and personal growth is an expectation
3. Ethics
   • Articulate the application of ethical principles to operations
   • Integrate high ethical standards and core values into everyday work activities
   • Create an environment that has a reputation for high ethical standards
4. Evidence-Based Clinical and Management Practice
   • Advocate use of documented best practices
   • Teach and mentor others to routinely utilize evidence based data and research
5. Advocacy
   • Role model the perspective that patient care is the core of the organization’s work
   • Assure that the clinical perspective is included in organizational decisions
   • Ensure that nurses are actively involved in decisions that affect their practice
6. Active Membership in Professional Organizations
   • Participate in at least one professional organization
   • Support and encourage others to participate in a professional organization