Chamberlain School of Nursing
NR447 RN Collaborative Healthcare
Introduction
My first SMART goal is to become an effective leader in conflict resolution with a nurse in the Operating Room who is consistently tardy. My second goal is to learn the organization’s Time Out policy and educate nurses and other care providers to achieve100% compliance. I chose these goals because of the urgency of the issues involved. We have organizational policies requiring timeliness and violations thereof negatively affect team productivity and morale. Policies prescribe appropriate disciplinary actions for violations with the goal of deterring unprofessional behaviors. Meanwhile, wrong-site surgery causes unnecessary suffering to patients. However, such events are preventable through adherence to the time-out policy.
Goal 1: Leadership Development
The goal is to conduct effective coaching sessions with a nurse who will be placed on probation for consistent tardiness. Achieving this involves a review of organizational policy, seeking assistance from the Human Resources Department, and meeting with the nurse in question to initiate corrective action. Daily evaluations of the nurse’s progress will be done and decisions will be made about her status after four months of probation.
Peer-Reviewed Article
Brown et al. (2011) conducted a phenomenological study on the experiences of and responses to conflict by health care professionals working in teams. The main themes were sources of conflict and hindrances to and strategies for resolution. The findings constitute knowledge that will help me achieve effectiveness in resolving conflicts. Knowing the source of conflict and the barriers therein will help me determine the appropriate strategy of addressing it. The idea of establishing a conflict resolution protocol is also worth considering as having one in the workplace provides appropriate guidance to individuals when addressing conflict. Direct and open communication, showing humility and respect, and openness to solutions, on the other hand, enable dialogue that helps in conflict resolution.
Credible Website
The website of the Office of Human Resources Development at the University of Wisconsin provides useful conflict management tools and resources. It provides instructional videos on dealing with conflict, listening skills, and sources of power (OHRD, 2012). It also provides links to courses on the topic and self-assessment tools on personality and conflict styles. Miscellaneous links lead to resources on intercultural communication, non-violent communication, group process facilitation, and problem solving. The tools and resource will assist me in developing conflict resolution skills and self-awareness that permits reflection and improvement. The site provides a perspective from the field of human resource development that can be applied in a health care environment.
Informational Expert
I interviewed our HR officer about the topic and her openness in sharing information made the encounter very informative. She commended me for overcoming the fear of “rocking the boat.” She noted that when people respond to conflict through passive avoidance, it can prevent emotional discomfort but will prove counterproductive because unresolved conflict creates a communication breakdown that hinders collaboration leading to poor outcomes. Particular to confronting staff on policy violations, she said it is important to use constructive feedback. She recommended focusing on the behavior and not the person, as well as describing the behavior and stating observations rather than judgments or inferences. She further added that keeping a balance between positive and negative feedbacks will give an accurate picture of performance. Overall, my resource person provided invaluable and practical advice on attaining my goal.
Goal 2: Organizational Planning
My aim is to prevent wrong-site surgery by attaining full compliance with the time-out policy within four months. I will review our current policy, and The Joint Commission and AORN standards. I will also develop and implement educational activities pertaining to the importance of compliance with the policy at the level of the surgical steering committee and the staff nurses. I will monitor for adherence and provide periodic feedback to the staff.
Peer-Reviewed Article
In an integrative review of the literature, Conrardy, Brenek & Myers (2010) investigated the state of knowledge on the Joint Commission’s Universal Protocol in different facilities. They found gaps in the process of implementation with some areas a cause for concern. However, trends show that successful implementation requires several components, namely the active participation of patients and staff, use of multidisciplinary and team-based approach, full support from management, and active communication aimed at creating healthy work environments. This article supports my strategy in eliciting compliance with the time-out policy. It also points to the necessity of conducting a needs assessment to establish gaps in staff’s knowledge and skills that are barriers to compliance. In this manner, appropriate educational activities can be developed and implemented.
Credible Website
The AORN website provides a toolkit on correct site surgery. It includes a reference on best practices, as well as steps in promoting patient identification, marking of surgical sites, and time out (AORN, 2014). There are also samples of templates for policy and checklists. Meanwhile, the frequently asked questions section provides updated information on the most relevant questions that health care professionals have about the Universal Protocol. The tools and resources are helpful as guides in determining what needs to be improved in current unit practices in order to achieve compliance. Further, the template assists in the technical aspect of developing our OR policy and checklist. The FAQ prepares me for possible staff inquiries about the time-out procedure.
Informational Expert
I approached our quality and process improvement officer about my second goal. The information he shared were highly relevant. He related the need to ascertain the barriers to compliance so that appropriate tactics can be employed to change individual behaviors and attitudes. He suggested that I consider using motivational strategies because knowledge and skills may not translate automatically into the desired behaviors. Recognizing team and individual efforts to comply is a form of positive reinforcement. Monitoring daily performance through rounds and weekly or monthly performance through the dashboard also serves as the impetus to enhance performance. Based on his experience, successful change can be attained by involving the patients. Often, patient and family awareness of clinical policies helps establish a stronger sense of accountability among clinicians in preventing adverse events.
Summary
The information obtained from various sources highlight the importance of analyzing conflict and noncompliance to determine the barriers. Doing so ensures that actions taken are appropriate. In addition, having a proactive rather than passive stance to workplace issues leads to improvement. A multidisciplinary and team approach is best when resolving conflicts and eliciting compliance with policies. Positive communication employed in constructive feedback, staff education, and motivation promotes collaboration that makes change possible. Involving all stakeholders, including patients, further engenders accountability. On my part, self-awareness will help me determine my style of dealing with issues and what skills and attitudes I need to further develop to enhance my effectiveness.
References
Association of Perioperative Registered Nurses (2014). Correct site surgery toolkit. Retrieved from http://www.aorn.org/Secondary.aspx?id=20846
Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T.R., & Kasperski, M.J. (2011). Conflict on interprofessional primary health are teams – can it be resolved? Journal of Interprofessional Care, 25(1), 4-10. doi: 10.3109/13561820.2010.497750.
Conrardy, J.A., Brenek, B., & Myers, S. (2010). Determining the state of knowledge for implementing the Universal Protocol recommendations: An integrative review of the literature. AORN Journal, 92(2), 194-207. doi: 10.1016/j.aorn.2009.12.031.
Office of Human Resource Development – University of Wisconsin (2012). Fully prepared to manage: Conflict resolution resources. Retrieved from https://www.ohrd.wisc.edu/home/HideATab/FullyPreparedtoManage/ConflictResolut ion/Resources/tabid/160/Default.aspx
