Advanced Nursing Practice C157

Advanced Nursing Practice C157.

WQT Task 1
Directions Print

Competency 7004.01.1: Nursing and Interprofessional Standards – The graduate applies the master’s level nursing and interprofessional standards to an organizational change or innovation to improve quality care outcomes.
Competency 7004.01.2: Evaluating and Documenting Innovations – The graduate evaluates an organizational change or innovation as measured against the master’s level nursing and interprofessional standards. Introduction:

Years ago, the role of the nurse was limited and easily described. In today’s world, the nurse’s role is complex and occurs in diverse settings with a broad client population. Often, nurses must combine several professional roles to manage the full range of their responsibilities. Nurses also manage roles that have limited domains of actual authority but large domains of influence (and vice versa). Master’s level nurses are now required to be leaders: whether formally or informally.

For this task, you will select a healthcare organization in your area to analyze and then prepare a consultative change recommendation paper. As part of your analysis, you will interview a nurse leader in the selected organization. Your consultative change recommendation paper should be 7–10 pages and in APA style. Although you are only submitting this paper to WGU as part of your requirement for this course, you should prepare this document as though you would present it to the executive board of the organization you analyzed.

In order to complete this assessment, you must carefully review and closely follow the attached “WQT2 Performance Assessment Guidelines” document.


You are a nursing consultant who has been assigned to analyze a healthcare organization in order to identify a change or improvement needed by the organization. In your analysis, you will use external measures such as HCAHPS scores, patient metrics, community needs, and comparisons to other facilities in area. After your analysis, you will write a consultative change recommendation to present to the executive board of the organization.


Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A.  Write a consultative change recommendation paper (suggested length of 7–10 pages) by doing the following: 1.  Identify the purpose of the consultation and provide a summary of the consultation process. 2.  Describe the organization. 3.  Explain the primary needs of the population served by this organization. 4.  Describe the nurse leader’s role. 5.  Identify the characteristics of the organization. 6.  Recommend an organizational change based on your analysis. a.  Justify how your recommended change addresses the organization’s weaknesses and the community’s needs. b.  Identify a national benchmark of performance and describe a plan to measure the effectiveness of your recommended change.
  B.  Attach the completed “Nurse Leader Interview Verification Form.”
  C.  Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized. File Attachments: 1. Nurse Leader Interview Verification Formlink opens in new window 2. WQT2 Performance Assessment Guidelineslink opens in new window Web Links: 1. The Essentials of Master’s Education in Nursinglink opens in new window 2. WQT Task 1 Rubric (1016)link opens in new window

Advanced Nursing Practice C157





The interview was set with the aim of understanding and highlighting the roles the nurse supervisor plays in the health care system. Besides the knowledge of the responsibility of the nurse supervisor, the interview would also help in identifying the challenges a nurse supervisor faces while discharging their mandate in the health facility.


The consultation was made as an interview with the nurse supervisor in the medical department of the health centre. A two-week appointment schedule had been obtained prior the interview. On the meeting date, the interviewer arrived early before the nurse supervisor came.  The consultation was made at the nurse supervisor’s office. Prior knowledge about the facility was done using the website. Additionally, a questionnaire was obtained to act as a guide during the interview to ensure that only relevant information was obtained.The interviewee was a registered nurse (RN) called Fahid Latif.

The Organisation Analysis


The organisation, in this case, is a hospital that provides most of the health care services that are commonly offered in any hospital. The centre is also located on the outskirts of the town. It is privately owned by a group of doctors who have formed a limited company. Its vision is to provide quality healthcare services to all patients and also in training.  The hospital mission is to a facility providing quality holistic healthcare that is affordable and sustainable to all people seeking its services. The facility is also involved medical research. It has employed over 150 total employees including doctors, nurses, other medical personnel and support staff. It has a bed capacity of 300 in all the departments of the hospital.

The facility has nine units which include surgical, medical, paediatrics and child health, obstetrics and gynaecology, theatre, nursing services, outpatient, pharmacy and administration. It is headed by a medical chief who is a specialised. The chief has a deputy who is the head of clinical services in the health facility. Departmental heads lead the departments. The nursing services manager runs the nursing services in the hospital. It has an administrator who coordinates non-clinical services like accounts, kitchen and transport.

The hospital serves a population of about 5000 people who live in its environs. It is also a referral facility by other small health centres in the area like the clinics both private, faith-based and government owned. The services provided by the facility include surgical services in the theatre, medical services like dialysis, critical care, diagnoses and management of diseases and conditions. The obstetric services like both spontaneous vaginal deliveries and caesarian section modes of deliveries are provided. Gynaecological services like abortion managements of patients and cancer screening are also available. Laboratory services like haematological investigations and biopsies are provided by the facility. The hospital provides radiological services like X-rays, barium swallows, CT scan, bone scans and MRI.


The population that is served by the hospital has a lot of communicable diseases and conditions. Such has been contributed by the low income by the population, which makes it hard to eliminate hygiene related diseases and conditions (Garritano et al. 2016). There are also cases of drug addiction related diseases due to abuse of medications in particular by the youth population from the region. Most of the referral cases are also communicable diseases and a few age related issues like diabetes and hypertension related complications. The hospital also gets referred patients who need critical care since it has an intensive care unit well run and managed.   

Nurse Leader Interviews Summary

Nurse Leader Role

The nurse is the overall supervisor of the medical ward and associated departments. He is responsible for all the nursing officers who are below him in the hierarchy. The main role played is giving directions on how the hospital ward is to be run by the nurses. He is in charge if the shift allocation for the nurses working in the medical department. He is responsible for patient or room allocation to his junior nurses (Joel, 2013). He coordinates nursing rounds in the wards and the patients’ drugs administration by the nurses. He is the person who is in charge of ordering supplies that pertain the nursing services in the particular ward.

He handles discipline issues that can be solved without involving the hospital disciplinary committee. He coordinates patient referral and reviews by other departments. He receives the end of shifts reports concerning all the patients and their conditions (Strudsholm, T., et al. (2016). He receives new policies from the hospital management and the nursing services manager and oversees their implementation. He reports to the nursing services manager about the medical wards.

Characteristics of the Organisation


The hospital has been able to serve the community for which it was intended. There are excellent patient outcomes for both the outpatient and inpatient. There is good working interprofessional relationships. The community around the hospital has appreciated the role played by the hospital in health care delivery among the community members. The workers in the hospital are well treated according to the standards and guidelines recommended by the health department.


There is a shortage of human resource especially nurses, straining the few available nurses. There is also a shortage of specialised nursing officers in the hospital. The lack of the doctors causes additional long waiting time for the patients especially in the accidents and emergency department. It has led to patient complications like death while waiting to be served. The ward does not have properly equipped isolation rooms for patients who need such services (Garritano et al., 2016). Such can lead to nosocomial infections causing long recovery periods stay in the facility. Constraints in financial resource allocations. The allocations sometimes favour individual departments compared to others.

Evidence-Based Practice Activities

Joel (2013) has carried out by the professionals working in the hospitals concerning the quality of services offered in the facility. His findings and recommendations are presented to the hospital management. According to the nurse supervisor, the facility implements most recommendations for the benefit of the patient. There are also few specialised nursing officers who offer quality services to the patients.

Quality Improvement Projects

There have been programmes initiated by the hospital management to train the staff in specialised fields. Such has been boosted by the employees being granted study leaves and also exchange programmes with other institutions with which the organization work with. There are also continuous medical education sessions held on specific days in the various departments to train the medical staff on quality improvements. For example, the facility sets the first Friday of every month for quality improvement. 

Recommendation for Organization Change


There is need to train the nurse leaders to masters levels for better supervision and leadership in the facility.

There is the need to adequately and fair allocation of resources in the departments.


Effective leadership means that the resources allocated to a particular department will be utilised fully and efficiently (Penrod et al., 2016). The nursing master student learns to utilise and such effective leadership skills that would otherwise be unavailable at the bachelor’s level. A nurse who had undergone a master degree will supervise their juniors well and exhibit proper usage of the resources given to manage. They are also able to give the right directions and reports that can be relied on for decision and policy making (Strudsholm et al., 2016).With proper procedures, the facility can offer quality services to the patients who seek treatment. Such will reduce complications like nosocomial infections and death of the patients.

Measurement of Effectiveness

After adopting the recommendations, the facility has then able to meet the minimum specialised number of nurse’s requirements. There are several ways of measuring such effectiveness. According to Joel (2013), the patient outcomes regarding hospital stay can be investigated to know whether the period has decreased. Patient recovery without having nosocomial infections is a good sign that the measurement is useful. Reduction in the patient mortality rate, especially in preventable deaths, also presents an efficient method of measuring effectiveness. (Cashin, et al. 2015). Positive feedback from the patient about the hospital can also show that the measures put in place are helping the facility in its quality service delivery to its clients. According to Garritano., et al. (2016), having proper policies and well-managed hospital wards is a good indication that the recommendations implemented have helped the hospital.


There is the need to consider nursing advanced education and skills advancement for health facilities. Nurses who have specialised skills can offer quality services in their area of specialisation for better patient outcomes (Garritano ., et al. 2016). Such nurses also have managerial and leadership skills that can well utilise for better health facility management. They can give fair and accurate reports concerning their area of the Directorate for better policy and decision making. 

Nurse Leader Interview
Verification Form

Name of nurse leader:             ___Fahid Latif, RN__________________________

Nurse leader’s role:                 ___Nursing Supervisor__________________________

Nurse leader’s email address: _______FahidLatif@gmail.com______________________

Date of the interview:             _________10/25/16____________

I acknowledge that this interview took place on the date indicated above.

Signature of student:  _________Michael Irvin__________________________________


Cashin, Andrew, Thomas Buckley, Judith Donoghue, Marie Heartfield, Julianne Bryce,   Darlene Cox, Donna Waters, Helen Gosby, John Kelly, and Sandra V. Dunn.     “Development of the nurse practitioner standards for practice Australia.”  Policy, Politics, & Nursing Practice (2015): 1527154415584233.

Garritano, N. F., Glazer, G., & Willmarth-Stec, M. (2016). The Doctor of Nursing Practice    Essentials in Action: Using the Essentials to Build a University-wide Automatic     External Defibrillator Program. The Journal for Nurse Practitioners, 12(4),    


Joel, L. A. (2013). Advanced Practice Nursing: Essentials of Role Development. FA Davis.

Penrod, J., Loeb, S. J., Ladonne, R. A., & Martin, L. M. (2016). Empowering Change Agents  

               in Hierarchical Organizations: Participatory Action Research in Prisons. Research  

              in nursing & health, 39(3), 142-153.

Strudsholm, T., Meadows, L. M., Vollman, A. R., Thurston, W. B. E., & Henderson, R.    (2016). Using Mixed Methods to Facilitate Complex, Multiphased Health Research. International Journal of Qualitative Methods, 15(1), 1609406915624579.

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