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The purpose of this paper is to review the recent literature assessing various leadership skills for hospital nurses. Increasing numbers of individual studies have been conducted on nursing leadership topics in the past five years. Four separate articles, related to four predetermined leadership skill goals are reviewed. Nursing data bases were the primary source for the information.

Databases Searched and Search Terms Used

To examine recent literature on leadership in nursing, a variety of articles were viewed. Databases searched included CINAHL, PubMed and Academic Search Premier. A search was performed using the key words: leadership, staffing, risk assessment and joint commission. Current literature from 2006 through 2011 was searched and only in English language publications. Through these articles, knowledge toward completion of the leadership plan will be discussed.

Literature Review of Four Articles

Smart Goal One                                                                               

The recruitment committee alongside with the HR is involved at this point. The specific goals here are to interrogate the process of recruiting and retaining of the Registered Nurses dealing with high risk fall challenges. There are several factors that attempt to explain why Registered Nurses decide to take up an offered job and whether to keep at the facility for a long time after being employed. Amongst others, factors that affect recruitment consist of the facility's salary, reputation, status, autonomy and union. On the other hand, factors affecting retention comprise practice autonomy, decision making inclusion, training on the risk of falling, respect of workers by management, knowhow of the intervention strategies, shifts worked and work load. As it can be seen, there are some concerns that overlap between the Registered Nurses being recruited and at the time the Registered Nurses considering remaining at their places of work. In fact, taking into consideration the factors that draw Registered Nurses and then make their employment come true must be considered if a health facility is to get and retain nursing staff that is adequate. In line with the above statement, Meyer et al. (2009) related a standardized fall risk evaluation tool and clinical judgment of nurses with the judgment of nurses alone. Meyer et al. indicate that patients’ falling is still the most common unpleasant incident reported in acute health care centers and frequently led in mortality, fear of falling and morbidity. The authors indicate that a bulk of the best fall reduction or prevention intervention evidence is found with community long-term care and dwelling elderly. A number of extra interventions has been incorporated in this research including training of staff on the risk of falling, family and patient education, toileting prior to medication of pain, safety huddle, fall tool boxes, as well as, automatic identification of high-risk fall.  

Retention is as well a key challenge because once Registered Nurses are recruited and formally hired, the health facility engages in the way to engage them. Leaders, on the other hand, must embrace fall risk tool in identifying hospitalized elderly patients at risk of falling. Things such as feelings have sovereignty over their professional practice deliberations that Registered Nurses make part of the process of decision making at the individual level, that they get ongoing education and they have workloads that are reasonable, that they have scheduling that is flexible and that they get competitive pay etc. influence the decision of Registered Nurses to leave or stay at their employment places.

 In support of the above statement, Harrington et al. (2010) assert that the fall risk tool helps team leaders in identifying hospitalized grown-up patients at risk of falling. Based on the available information, two fall-risk tools can found to be the most accurate –STRATIFY and MFS. Some tools targeted for incorporation and inclusion in the meta-analysis were found that they did not have adequate research publications to be included. The authors conclude that the use of the STRATIFY and MFS by the nursing team leadership is best for utilization in clinical practice in order to identify elderly patients who are at risk for falls. Furthermore, with expectations like those established above, senior leadership at all the facility levels must endeavor to satisfy the fundamental prospects of the employees they hire. In fact, success of the hospitals in satisfying such expectations differs widely.

Smart Goal Two         

The specific goals at this point lie in the leaders’ ability to manage nursing teams. The nursing workforce of today comprises of nursing leaders and staff from four varied generational groups. Generational diversity, comprising differences of workforce in attitudes, work habits, expectations and beliefs have always proven challenging for health care leaders. Normally, members of the team from varied disciplines bring an exceptional set of skills. It is as well imperative to understand that skills overlap. In fact, understanding the education and skills of various members of the team contributes to respect. In addition, understanding other health professionals in terms of skills, members of the team can as well refer clients properly to other professionals. Even though, at times, there is a disagreement due to the language and expectations create confusion, it is noteworthy to recognize that members of professionals are trained in a culture that is in line with professional behaviors, beliefs, values and common language.

Leadership and membership roles are inseparable and entail an emphasis on functions of roles and not on a particular set of discipline or personality traits. In addition, success entails the efficient use of total resources of a team. Even though one or more persons may have an official designation as a leader of a group, the effective employment of resources means that every member of the team needs to share responsibility for formal and informal leadership. Since nurses belong to an interdisciplinary team, it means that functions of membership and leadership are viewed as synonymous. This is based on the fact that all members in the team have a responsibility in seeing the team attain its objectives and goals; every member of the team has the duty to assist the team progress. In support of this, ICSI (2010) leadership of an organization needs to spot and assist an interdisciplinary prevention team consisting of clinical and non-clinical employees to run the fall prevention program. In addition, the team should incorporate at least a clinician who has some information regarding education in prevention of falls.

According to ICSI, leadership of an organization needs to invest in systems that encourage ongoing evaluation, learning and enhancement of the prevention program. In addition, ICSI indicates that the analysis must report on the validity or effectiveness of screening of falls and intervention effectiveness applied to the falls screened at risk. Chapman, Bachand and Hyrkas (2011) report on a research undertaken to test the feasibility, specificity and sensitivity of fall risk assessment tools. They assert that sensitivity and specificity of the instruments are key aspects to embody when choosing an instrument. Nonetheless, strategies to educate the workforce and to mediate suitably are equally imperative for an institution undertaking an upbeat position in reducing the risk of falls. The authors conclude by indicating that it is vital for leaders to test instruments in specific populations and their own organizations.

 Summary

This paper has explored the developmental plans in leadership. Specifically it has discussed the recruitment and retention of nurses in the context of high risk patients and also team leadership in terms of interdisciplinary prevention teams. Under retention and recruitment, knowledge in high risk fall challenges was the key factor even though there were other general factors. In the leadership context, it was concluded that leaders must test instruments in specific populations before implementing them.

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