Running head: SYNTHESIS PAPER 1

Clinical Practicum Synthesis Paper

Stephanie Adamczyk

Ferris State University

SYNTHESIS PAPER 2

Abstract

A clinical practicum was designed and completed in order to gain more knowledge and

experience related to the nurse administrator role. The practicum contained experiences that

furthered the knowledge related to nurse administrators' responsibilities in planning, resource

utilization, collaboration, and evaluation. These experiences included working on the Baby-

Friendly initiative and completing a practicum project. The practicum project was completed

using Kotter's Change Theory. Upon the completion of the practicum an evaluation was

completed to determine the effectiveness of the practicum.

Keywords: nurse administrator, Kotter’s Change Theory, Baby-Friendly, planning,

resource utilization, collaboration, and evaluation.

SYNTHESIS PAPER 3

Clinical Practicum Synthesis Paper

The nursing profession is lacking in the number of leaders needed to well represent nurses

(White Cumming, 2011). As a result, nurses step into leadership roles without proper education

and training, leaving these leaders unable to adequately lead nursing teams (White Cumming,

2011). Sherman and Pross (2010) discuss that current nurse administrators must advocate for

increased training and education related to leadership skills. It is through the final practicum of

my Master's in Nursing Program that I advocated for more experience and education related to

nursing leadership. This practicum allowed me the opportunity to gain more experience related

to important leadership skills such as, planning, resource utilization, collaboration, and

evaluation (American Nurses Association (ANA), 2009). The purpose of this paper will be to

discuss the project completed during the practicum, the leadership skills gained through meeting

practicum goals and objectives, the identification of issues that arose during the practicum and

the management of these issues, and to evaluate my performance during the practicum.

Practicum Project and Kotter's Change Theory

The project portion of this practicum was done by utilizing Kotter's Change Theory.

Kotter developed an eight step change model to help nursing leaders implement change and

avoid resistance to change from staff (Stoller, 2010). The first step of this change model is to

identify an area in need of improvement and communicate to staff members about the need for

change (Kingston, 2013). Once the issue has been identified nurse administrators should identify

key stakeholders and create a team that will help to develop a plan for change. This team will

create objectives and a vision that will be communicated to staff to ensure their understanding of

the upcoming change. The change should be implemented in steps to allow staff members to

adjust to the new process. Nurse administrators should also celebrate short-term wins with staff

SYNTHESIS PAPER 4

members to empower them to keep making necessary changes. Finally, nurse administrators

complete the implementation and evaluate staff performance to determine if the change has been

effective (Kingston, 2013). The following will review how the practicum project was completed

using Kotter's Change Theory.

The project portion of this practicum was completed within the Women's Health and

Infant Services department at Spectrum Health. This department is home to four nursing units,

which provide services to women with special risk pregnancies, women and infants during the

postpartum period, and women's health patients. In addition, Spectrum Health is the largest baby

delivery center in Michigan. With the aid of the Neonatal Intensive Care Unit, this department

helps care for nearly 7,400 babies a year (C. Pries, personal communication, January 13, 2014).

The Women's Health and Infant services department purchased new hearing screen machines in

July 2013 and has experienced an increase in hearing screen failures or referrals since then. As a

result, the department’s leadership team was considering changing their practice related to infant

hearing screens. Initially the hearing screen process called for the department's nursing assistants

to conduct the hearing screen at least 12 hours after birth and before the infant was discharged

from the hospital. If the patient referred their initial screen they would be screened again prior to

discharge. This process was time consuming for the nursing assistants and causing a decrease in

staff satisfaction. Therefore, department leadership was considering outsourcing the hearing

screen process to Pediatrix. Pediatrix provides services to maternal-fetal, newborn, and pediatric

patients nationwide. In addition Pediatrix is one of the leading providers of infant hearing

screens (Pediatrix Medical Group, 2014).

Improving the infant hearing screen referral rate was identified as the need for change for

the practicum project. Ms. Christina Pries, practicum preceptor and I were identified as the

SYNTHESIS PAPER 5

leaders of this project. The audiology department, department leadership, and department staff

were included in the list of key stakeholders. The plan for this project began through shadow

experiences. I shadowed in the audiology department to identify best practices related to the

infant hearing screen process. I also shadowed nursing assistants in the Women's Health and

Infant services department. Shadow experiences are an informal way for nurse administrators to

evaluate the performance of their staff and determine if there is a need for change or if current

processes are working well (Yee, Needleman, Pearson, & Parkerton, 2011). This allows for

interaction with the staff and for instant feedback that can be used when creating a plan for

change (Yee et al., 2011). These experiences allowed me to identify barriers to completing

hearing screens and to begin formulating a plan for change.

During the shadow experience it became very clear that there is significant variation in

how the hearing screens are done. Therefore, it was determined that a standardization of the

process should be done. Standardization of work helps to ensure that healthcare professionals are

utilizing best practices and providing continuity of care (Bohmer, 2010). By standardizing work

healthcare organizations can improve patient outcomes and decrease costs (Bohmer, 2010). This

standardization would help to ensure that nursing assistants are using the best practices when

completing the infant hearing screen.

Once the standardization was complete approval from key stakeholders was needed. I

attended a leadership meeting to present the standardization to this team first. Collectively we

reviewed the standardization and made changes as needed. Once leadership approved the

standardization I shared the proposed process with the staff at a Shared Leadership meeting. This

allowed me to present the information prior to the actual implementation.

SYNTHESIS PAPER 6

Once the proposed change was introduced to staff members, in-services were scheduled.

The staff in-services included multiple learning techniques to allow for learners to process and

apply the information presented during the in-service (Bluestone et al., 2013). I felt that I should

first discuss why the changes were occurring and then present the standardization. I planned to

go through each step of the standardization and then have the learner repeat the standardization. I

would then provide feedback about their performance. Feedback during in-services is a useful

technique to help clarify the new information and ensure that the learner has a clear

understanding of the information (Bluestone et al., 2013). I also planned to end the in-services

with a quiz to ensure the learners correctly understood the information after it was presented and

we discussed it.

Once in-services were complete I performed audits to determine if the standardization

was becoming part of the department’s culture. When implementing change it is important to

ensure the process has become part of the department's culture. However, ensuring the change

has become part of the department or organization's culture takes time (Kingston, 2013). When

new processes are implemented there will be a need for behavior changes among staff members.

Nurse administrators must observe staff members for the new behaviors. Audits are a beneficial

tool that allows nurse administrators to track and assess the progress of newly implemented

behaviors (Yee et al., 2011). When the majority of staff members are consistently performing

the new behaviors, the new process is considered to be part of the department or organization’s

culture (Carter, Sullivan, Goldsmith, Ulrich, & Smallwood, 2013). While the most of the nursing

assistants demonstrated the new behaviors not all of them did. Therefore, more audits will need

to be completed to ensure the nursing assistants are consistently demonstrating the use of the

standardization process.

SYNTHESIS PAPER 7

Review of Practicum Goals and Objectives

Prior to beginning this practicum a proposal outlining the practicum's goals and

objectives and plan to fulfill them was created. The following will briefly review the practicum's

goals and objectives and identify how they were fulfilled throughout the practicum.

Scope and Standards of Practice 4: Planning

According to the ANA (2009) nurse administrators must be able to develop unique plans

for each situation they are presented with. Nurse administrators must be able to identify a need

for change and create urgency within their organization to make the change. A nurse leader must

be able to identify the key stakeholders and utilize them to create an action plan. Nurse

administrators must be able to work with team members to develop plans to ensure the plan will

work for all stakeholders. While working with a multidisciplinary team, the nurse administrator

must incorporate current trends and research into plans to ensure changes in practice will be

based on the most current information. Once a plan is developed the nurse leader must work with

the multidisciplinary team to implement the plan. Continued attention to the implemented change

is needed to ensure the success of the change and to address unexpected issues.

It is through the practicum project that I gained experience related to planning. With the

aid of my preceptor I was able to identify the infant hearing screen referral rate as a need for

change. I identified the key stakeholders and utilized them throughout the planning process.

Through the shadow experiences I was able to collect information related to best practices and

incorporate that information into the plan. Once a plan was developed, key stakeholders

reviewed the plan prior to implementing the change. Once the plan was implemented I aided in

the evaluation process to determine if the plan was effective. This experience allowed me to

become more confident in my planning and implementing skills. I now have a better

SYNTHESIS PAPER 8

understanding of all the steps necessary to successfully implement change in a healthcare

organization.

Scope and Standards of Practice 12: Collaboration

Nurse administrators are responsible for the day-to-day operations, quality of care

delivered, and goal attainment for their area of practice (ANA, 2009). By collaborating with all

levels of nursing staff, interdisciplinary teams, executive leaders and other key stakeholders,

nurse administrators are able to create, implement, and evaluate plans that help them to fulfill

these responsibilities (ANA, 2009). When nurse administrators feel comfortable working with

nursing staff, interdisciplinary teams, and executive leaders they are more satisfied in their work,

remain in their leadership position, and play a more vital role in the decision making process

(Abraham, 2011). Therefore, it was important that this practicum included opportunities

that allowed me to gain experience related to collaboration.

I was able to gain experience related to collaboration through the completion of the

practicum project. This project required me to work with a variety of organizational staff in order

to complete the project. These individuals included clinical staff, staff from the audiology

department, technical support from the hearing screen machines, equipment managers, and the

leadership team. Through my interaction with these people I gained confidence in my ability to

communicate effectively with a multidisciplinary team. This experience will be a great benefit in

future leadership roles. I will have a greater knowledge of communicating with individuals from

different departments that I may not be familiar with.

Scope and Standards of Practice 14: Resource Utilization

According to the ANA (2009) nurse administrators should find innovative solutions to

utilize resources. Resources should be utilized in a way that maximizes safety, efficiency,

SYNTHESIS PAPER 9

financial responsibility, and quality. The manner in which resources are utilized should also be

evaluated to ensure that current processes are the most efficient and effective way to provide

patient care.

It is important for nurse administrators to have a clear understanding of resource

utilization. This knowledge is necessary to effectively lead in healthcare organizations. Through

the completion of the practicum project I was able to gain experience and knowledge related to

resource utilization. The hearing screen project allowed me to evaluate a current process that was

not utilizing resources to the fullest. By creating a plan and implementing it I was able make

improvements in how resources were being utilized.

I also gained experience related to resource utilization by working on the Baby-Friendly

initiative. Baby-Friendly is a designation that is granted to healthcare organizations that promote

and support breastfeeding and mother-baby skin to skin interactions (Schoenfelder et al., 2013).

In order to receive this designation healthcare organizations must create and implement a

breastfeeding and skin to skin policy. This policy should include the promotion of education

related to the benefits of breastfeeding, facilitate breastfeeding within one hour of birth, stress the

importance of keeping newborns in the room with mothers after birth, and promote skin to skin

interactions during the hospital stay. Healthcare organizations should also provide discharge

information related to support with breastfeeding once discharged from the hospital and educate

families that they should not use formula or pacifiers while breastfeeding . Healthcare

organizations are also responsible for providing staff with education so that they can effectively

provide patients with the care and education laid out in the policy (Schoenfelder et al., 2013).

In order, to receive the Baby-Friendly designation, Spectrum Health has implemented a

breastfeeding policy and several new initiatives to support breastfeeding.   As part of the

SYNTHESIS PAPER 10

implementation of Baby Friendly patient audits need to be completed. Audits are an effective

tool for ensuring that staff members are making the required changes and have the tools

necessary to complete the change (Semenic, Childerhose, Lauziere, & Groleau, 2012). Audits

also allow for leadership to provide feedback about staff performance (Semenic et al., 2012). By

completing patient audits I was able to help ensure that resources were being utilized effectively

and that the quality of care was meeting the standards of the Baby-Friendly initiative.

Scope and Standards of Practice 6: Evaluation

Nurse administrators must be able to implement change and monitor it to ensure its

success in the healthcare environment. Evaluation should be a done throughout the

implementation process to determine what is working and what needs to improve (Kingston,

2013). By doing this it allows the project stakeholders to address issues as they arise and create

action plans quickly to resolve barriers to implementing the change (Schaffer, Sandau, &

Diedrick, 2012).

By completing the hearing screen project I was able to implement a change and then

evaluate the new process to determine if the change had a positive influence on the infant hearing

screen referall rate. I completed the evlaution phase by shadowing nursing assistants to

determine if they were able to carry out the new hearing screen process. This also allowed me to

provide feedback to help nursing assistants improve the process. I also monitored the hearing

screen referall rate. The referall rate was 5.5% prior to starting the implementation phase and

decreased to 4.2% after implementation was complete. The evlauation phase will need to

continue to ensure the new process has become part of the departments' culture and to ensure that

the new process continues to decrease the referall rate.

SYNTHESIS PAPER 11

Management of Practicum Challenges and Ethical Implications

Leach and McFarland (2014) define leadership development as professional development

that improves the effectiveness of leadership skills. Leaders often learn the most valuable skills

through experiences. Challenging experiences allow leaders to handle a situation and then reflect

on how it went. This reflection will allow the leader to determine how they would handle it in the

future, allowing them to become more effective leaders. Issues arose throughout this practicum

that required me to revise me expectations and create a new plan. However, these issues acted as

a valauble learning tool and allowed me to gain further knowledge related to leadership. The

following will review issuses from the practicum experience, the ethical implications, and the

management of these issues.

Budgetary Concerns

When planning for the project portion of this practicum I anticipated evaluating the

current hearing screen process and determining if the process could be improved or if the process

should be outsourced to Pediatrix. Determining if the process should be outsourced would have

provided me with more experience related to budgeting and finances. However, due to budgetary

concerns outsourcing the hearing screen process was no longer a financially viable option

because it would be a loss of revenue for the organization.

According to the ANA (2009) nursing leaders must be able to optimize fiscal resources to

ensure that patients are receiving safe, quality, and up-to-date care in their area of practice.

However, fiscal resource management is becoming more difficult as health care costs continue to

increase and reimbursements for services decrease (Gurtner, 2014). This is causing health care

organizations to make budgetary cuts which may negatively affect the quality of care that

patients are receiving (Gurtner, 2014). This causes an ethical dilemma for nursing administrators

SYNTHESIS PAPER 12

who are being forced to improve patient outcomes with fewer staff members and less financial

resources (ANA, 2009). Nurse administrators must work to create solutions that will improve

patient outcomes with the resources available to them (ANA, 2009). Therefore, it is important

for nurse administrators to have a strong understanding of their fiscal resources and how they are

distributed throughout their area of practice.

This experience allowed me to observe that even when a change may benefit the quality

of care being delivered to patients it might not be the best option for the organization. Therefore,

it is important for nurse administrators to have a strong understanding of their resources to

improve the quality of care within their means. While outsourcing was not an option, improving

the current process with current resources was. This allowed me to recognize that it is important

to effectively communicate with staff members when there is a need for change. When staff

members have an understanding of why the change needs to occur they are more willing to

implement the change and improve the quality of care they are delivering (Heuston & Wolf,

2011). This expereince will allow me to better create action plans and implement change in the

future.

Staff Feedback

While administering staff in-services, I received feedback that staff members felt they

were not learning anything new. According to Whitehead, Weiss, and Tappen (2010) when

implementing change nurse administrators must be prepared for resistance and to answer

difficult questions from their staff. Staff members will want to know when the change will occur

and why the change is happening. Staff members also want to know how the change will benefit

them or make more work for them. When answering these questions it is important to answer

clearly and concisely, to ensure that the necessary information is heard. It is also important for

SYNTHESIS PAPER 13

staff members to feel that their questions and concerns are valued by the leadership team. Staff

members who feel that their opinions matter tend to be more engaged in the performance

improvement process and helping to ensure that new action plans succeed (Shriberg & Shriberg,

2011).

According to ANA (2010) it is nurses’ ethical responsibility to question current and new

practices in healthcare. Nurses should ensure that their practice allows them to provide safe and

quality care to their patients. Nurses can aid in the improvement of current process by

formulating recommendations that will improve the process. Therefore, the feedback I received

was the nursing assistants’ ethical responsibility to question the new process and ensure that it

was the right thing to do for their patients.

After reflecting on the in-services and the information I was presenting I decided to

revise how I worded things and stress the importance of providing me with feedback and

questions. By doing this the remaining in-services were much more successful. I received several

questions about the hearing screen machines and the change in the process. I was not able to

answer all the questions on the spot but reinforced to the nursing assistants that I would seek out

answers and send the information to all nursing assistants. At the completion of the in-services I

addressed every question that I received and sent the information to all staff members. While I

was disappointed at first with the feedback I received it turned out to be beneficial to the

implementation process. If I had not revised the in-services I would not have received the

questions from the nursing assistants. These questions helped me to ensure that the nursing

assistants had the correct information to improve the hearing screen process. This was a valuable

lesson that even negative staff feedback can be used constructively.

SYNTHESIS PAPER 14

Practicum Evaluation

In addition, to evaluating the outcome of the hearing screen project I evaluated my

performance throughout the practicum. Reflecting on one's performance is an important practice

for nursing professionals because it allows for professionals to continue growing personally and

professionally. Reflection allows them to continuously learn, integrate what is learned on the job

with their personal beliefs, and encourage individuals to continue to grow and discover

themselves (Asselin & Fain, 2013). Reflecting on my performance allowed for me to determine

that my leadership skills and knowledge have grown through this practicum. I gained confidence

related to collaboration and planning and implementing change. I feel that I also gained

expereince with project management and making adjustments to the project to ensure its

completion and success. These skills will allow me to continue to grow as a leader and become

an effective nurse administrator (See Appendix A for completed self evaluation form).

According to Whitehead et al. (2010) all professionals need feedback to determine their

effectiveness. Both positive and negative feedback is valuable. Positive feedback allows

professionals to have an understanding of skills that they perform well. Negative feedback

illustrates the areas in need of improvement. Therefore, I met with my preceptor and asked her to

complete an evaluation form. The feedback I received was positive and beneficial. Overall, she

felt I performed well and met my objectives for the practicum. She felt that I had the potential to

become a nurse administrator and would improve with more experience. This feedback helped to

assure me that I am on the right track. I will continue to seek new opportunities that will allow

me to continue to grow s a leader (See Appendix B for completed preceptor evaluation form).

SYNTHESIS PAPER 15

Conclusion

Nurse leaders are often given leadership roles without first having the necessary training

and skills to be an effective leader. Nurse leaders must advocate for education and experiences

that will allow them to develop the skills needed to effectively lead the nursing profession. By

completing this clinical practicum I advocated for myself and gained valauble experience and

knowledge related to the nurse administrator's role and responsibilities. By completing the

practicum project I gained knowledge related to planning by creating a plan, implementing the

change, and evaluating the success of the plan. By creating this plan I developed skills related to

collaboration. Implementing change requires nurse administrators to work with

multidisciplinary teams to ensure the success of change. This project encouraged me to work

with individuals from multiple departments, allowing me to gain confidence in my ability to

collaborate. By participating in the project practicum and the Baby-Friendly initiative I furthered

my knowledge of resource utilization. I was able to evaluate whether resources were being used

effectively and proposed changes based on my findings. Finally, I gained more knowledge

related to evaluation by evaluating the outcomes of the hearing screen project and by evaluating

my performance throughout the practicum. I gained much knowledge and experience through

this practicum and will be better prepared for future nurse administrator roles.

SYNTHESIS PAPER 16

References

Abraham, D. J. (2011). Developing nurse leaders a program enhancing staff nurse leadership

skills and professionalism. Nursing Administration Quarterly, 34(4), 306-312.

doi:10.1097/NAQ.0b013e31822ecc6e

American Nurses Association (2009). Nursing administration: Scope and standards of practice.

Silver Spring, MD: American Nurses Association.

American Nurses Association (2010). Nursing: Scope and standards of practice. (2nd ed.).

Silver Spring, MD: American Nurses Association.

Asselin, M. E., & Fain, J. A. (2013). Effect of reflective practice education on self-reflection,

insight, and reflective thinking among experienced nurses. Journal for Nurses in

Professional Development, 29(3), 111-119. doi:10.1097/NND.0b013e318291c0cc

Bluestone, J., Johnson, P., Fullerton, J., Carr, C., Alderman, J., & BonTempo, J. (2013).

Effective in-service training design and delivery: Evidence from an integrative review.

Human Resources for Health, 11(51). Retrieved from

http://www.biomedcentral.com/content/pdf/1478-4491-11-51.pdf

Bohmer, R. (2010). Harvard Business Review. Fixing healthcare on the front lines, 88(4), 62-69.

Retrieved from

http://ocvets4pets.com/archive23/Fixing_Health_Care_on_the_Front_Lines_-

_Harvard_Business_Review.pdf

Carter, L., Sullivan, R. L., Goldsmith, M., Ulrich, D., & Smallwood, N. (Eds.). (2013). The

change champion's field guide: Strategies and tools for leading change in your

organization (2nd ed.). Wiley.

SYNTHESIS PAPER 17

Gurtner, S. (2014). Making the right decisions about new technologies: A perspective on criteria

and preferences in hospitals. Health Care Management Review, 39(3), 245-254.

doi:10.1097/HMR.0b013e3182993b91

Heuston, M. M., & Wolf, G. (2011). Transformational leadership skills of successful nurse

managers. JONA: Journal of Nursing Administration, 41(6), 248-251.

doi:10.1097/NNA.0b013e31821c4620

Kingston, M. B. (2013). The System Chief Nursing Officer: An Evolving Role. Nurse Leader,

11(3), 27-29. doi:10.1016/j.mnl.2013.03.004

Leach, L. S., & McFarland, P. (2014). Assessing the professional development needs of

experienced nurse executive leaders. JONA: The Journal of Nursing Administration,

44(1), 51-62. doi:10.1097/NNA.0000000000000021

Pediatrix Medical Group (2014). About Pediatrix. Retrieved from

http://www.pediatrix.com/body.cfm?id=48&oTopID=517

Schaffer, M. S., Sandau, K. E., & Diedrick, L. (2012). Evidence-based practice models for

organizational change: overview. Journal of Advanced Nursing, 69(5), 1197-1209.

doi:10.1111/j.1365-2648.2012.06122.x

Schoenfelder, S. L., Wych, S., Willows, C. A., Harrington, J., Kaufer, K., & Becker, A. B.

(2013). Engaging Chicago hospitals in the baby-friendly hospital initiative. Maternal and

Child Health Journal, 17(9), 1712-1717. doi:10.1007/s10995-012-1144-2

Semenic, S., Childerhose, J. E., Lauziere, J., & Groleau, D. (2012). Barriers, facilitators, and

recommendations related to implementing the baby-friendly initiative (BFI): An

integrative review. Journal of Human Lactation, 28(3), 317-334.

doi:10.1177/0890334412445195

SYNTHESIS PAPER 18

Sherman, R., & Pross, E. (2010). Growing future nurse leaders to build and sustain healthy work

environments at the unit level. The Online Journal of Issues in Nursing, 15(1).

doi:10.3912/OJIN.Vol15No01Man01

Shriberg, D., & Shriberg, A. (2011). Practicing leadership: Principles and applications. Hoboken,

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White Cumming, J. C. (2011). The nurse reinvestment act of 2002 and nursing shortage in

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Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of Nursing Leadership and

Management (5 ed.). Philadelphia, PA: F.A. Davis Company.

Yee, T., Needleman, J., Pearson, M., & Parkerton, P. (2011). Nurse manager perceptions of the

impact of process improvements by nurses. Journal of Nursing Care Quality, 26(3), 226-

235. doi:10.1097/NCQ.0b013e318213a607

SYNTHESIS PAPER 19

Appendix A

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Appendix B

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Bibliography

Abraham, D. J. (2011). Developing nurse leaders a program enhancing staff nurse leadership

skills and professionalism. Nursing Administration Quarterly, 34(4), 306-312.

doi:10.1097/NAQ.0b013e31822ecc6e

American Nurses Association (2009). Nursing administration: Scope and standards of practice.

Silver Spring, MD: American Nurses Association.

American Nurses Association (2010). Nursing: Scope and standards of practice. (2nd ed.).

Silver Spring, MD: American Nurses Association.

Asselin, M. E., & Fain, J. A. (2013). Effect of reflective practice education on self-reflection,

insight, and reflective thinking among experienced nurses. Journal for Nurses in

Professional Development, 29(3), 111-119. doi:10.1097/NND.0b013e318291c0cc

Bluestone, J., Johnson, P., Fullerton, J., Carr, C., Alderman, J., & BonTempo, J. (2013).

Effective in-service training design and delivery: Evidence from an integrative review.

Human Resources for Health, 11(51). Retrieved from

http://www.biomedcentral.com/content/pdf/1478-4491-11-51.pdf

Bohmer, R. (2010). Harvard Business Review. Fixing healthcare on the front lines, 88(4), 62-69.

Retrieved from http://ocvets4pets.com/archive23/Fixing_Health_Care_on_

the_Front_Lines_-_Harvard_Business_Review.pdf

Carter, L., Sullivan, R. L., Goldsmith, M., Ulrich, D., & Smallwood, N. (Eds.). (2013). The

change champion's field guide: Strategies and tools for leading change in your

organization (2nd ed.). Wiley.

Grohar-Murray, M. E., & Langan, J. (Eds.). (2011). Leadership and management in nursing (4th

ed.). Upper Saddle, NJ: Pearson.

SYNTHESIS PAPER 25

Gurtner, S. (2014). Making the right decisions about new technologies: A perspective on criteria

and preferences in hospitals. Health Care Management Review, 39(3), 245-254.

doi:10.1097/HMR.0b013e3182993b91

Heuston, M. M., & Wolf, G. (2011). Transformational leadership skills of successful nurse

managers. JONA: Journal of Nursing Administration, 41(6), 248-251.

doi:10.1097/NNA.0b013e31821c4620

Kingston, M. B. (2013). The System Chief Nursing Officer: An Evolving Role. Nurse Leader,

11(3), 27-29. doi:10.1016/j.mnl.2013.03.004

Leach, L. S., & McFarland, P. (2014). Assessing the professional development needs of

experienced nurse executive leaders. JONA: The Journal of Nursing Administration,

44(1), 51-62. doi:10.1097/NNA.0000000000000021

Maragh, K. A. (2011). The nurse leader as change agent and role model: Thoughts of a new

nurse manager. Nurse Leader, 9(3), 39-42. doi:10.1016/j.mnl/2010.09.007

Pediatrix Medical Group (2014). About Pediatrix. Retrieved from

http://www.pediatrix.com/body.cfm?id=48&oTopID=517

Ponti, M. D. (2011). Why change fails. Nurse Leaders, 9(4), 41-43.

doi:10.1016/j.mnl/2011.05.004

Rickbeil, P., & Simones, J. (2012). Overcoming barriers to implementing evidence-based

practice: A collaboration between academics and practice. Journal for Nurses in Staff

Development, 28(2), 53-56. doi:10.1097/NND.0b013e31824b4141

Schaffer, M. S., Sandau, K. E., & Diedrick, L. (2012). Evidence-based practice models for

organizational change: Overview. Journal of Advanced Nursing, 69(5), 1197-1209.

doi:10.1111/j.1365-2648.2012.06122.x

SYNTHESIS PAPER 26

Schoenfelder, S. L., Wych, S., Willows, C. A., Harrington, J., Kaufer, K., & Becker, A. B.

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