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3021_FM_i-xxx 16/01/17 3:28 PM Page i NURSING LEADERSHIP AND MANAGEMENT FOR PATIENT SAFETY AND QUALITY CARE 3021_FM_i-xxx 16/01/17 3:28 PM Page ii 3021_FM_i-xxx 16/01/17 3:28 PM Page iii NURSING LEADERSHIP AND MANAGEMENT FOR PATIENT SAFETY AND QUALITY CARE Elizabeth Murray, PhD, RN, CNE Program Director, MSN Nurse Educator Assistant Professor Florida Gulf Coast University School of Nursing Fort Myers, Florida 3021_FM_i-xxx 16/01/17 3:28 PM Page iv F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2017 by F. A. Davis Company Copyright © 2017 by F. A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Senior Acquisitions Editor: Susan Rhyner Developmental Editor: Amy Reeve Content Project Manager: Echo Gerhart Design and Illustration Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Names: Murray, Elizabeth J., author. Title: Nursing leadership and management for patient safety and quality care / Elizabeth J. Murray. Description: Philadelphia : F.A. Davis Company, [2017] | Includes bibliographical references and index. Identifiers: LCCN 2016052944 | ISBN 9780803630215 (alk. paper) Subjects: | MESH: Nursing Care—standards | Nursing Care—organization & administration | Patient Safety—standards | Quality Assurance, Health Care—methods | Leadership | Nurse’s Role Classification: LCC RT89 | NLM WY 100.1 | DDC 610.73068—dc23 LC record available at https://lccn.loc.gov/2016052944 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-3021-5/17 0 + $.25. 3021_FM_i-xxx 16/01/17 3:28 PM Page v Dedication This book is dedicated to my husband, Don, and my daughter, Angel, whose patience and encouragement are unending. Thank you for always supporting me in my professional endeavors and for understanding when I locked myself in “my cave.” This book is also dedicated to Marydelle Polk, my mentor and friend, who shared so much with me and who had a great influence on my development as a faculty member and whom I miss dearly. Finally, this book is dedicated to the hundreds of nurses and nursing students I have taught over the years for inspiring me to actualize my passion for nursing, quality, and patient safety through writing this book. 3021_FM_i-xxx 16/01/17 3:28 PM Page vi 3021_FM_i-xxx 16/01/17 3:28 PM Page vii Epigraph “It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm. It is quite necessary nevertheless to lay down such a principle.” Florence Nightingale, 1863 Notes on Hospitals “The world, more specifically the Hospital world, is in such a hurry, is moving so fast, that it is too easy to slide into bad habits before we are aware.” Florence Nightingale, 1914 Florence Nightingale to Her Nurses vii 3021_FM_i-xxx 16/01/17 3:28 PM Page viii 3021_FM_i-xxx 16/01/17 3:28 PM Page ix Preface In 2000, the Institute of Medicine shocked the health-care community when they reported, in their landmark report, To Err is Human, that approximately 98,000 Americans die each year as a result of preventable adverse events. In response, many patient safety and quality initiatives were launched to make health care safer in the United States and globally. More recently, James (2013) identified evidence suggesting that a more accurate estimate of deaths from preventable errors is 200,000 to 400,000 per year. There is no question that the health-care delivery system is undergoing major changes related to safety and quality. Nurses at all levels and in all settings have been identified as key to transforming health care to a safer, higher-quality, and more effective system. Front-line nurses are being charged with taking leadership and management roles in transforming care at the bedside. Nurse educators must prepare a new generation of nurses to step into these roles as well as manage safe and effective patient care. To that end, this book was written to provide a comprehensive approach to preparing nurses in the critical knowledge, skills, and attitudes in leadership and management needed for the current and future health-care environment. This book is built on the premise that all nurses are leaders and managers regardless of their position or setting in which they work. First-level or front-line nursing leaders and managers are those leading and managing care of a patient or groups of patients at the bedside and clients or groups in the community. This level may also include charge nurses, patient care managers, and supervisors. Second-level nursing leaders and managers are those holding a formal position in the system such as unit manager. Their responsibilities include leading and managing material, economic, and human resources necessary for the care of a group of patients, as well as clients or groups in the community. The third-level nursing leaders and managers are those holding a formal position in the organization such as a director over several units and whose responsibilities are similar to those of the second level manager but encompass a broader scope. The fourth level or executive level includes nursing leaders and managers in positions such as chief nursing officer (CNO) or Vice President of Nursing Services. Their responsibilities include administering nursing units within the mission and goals of the organization. Finally, many nurse leaders and managers hold positions outside direct care delivery such as nurses in academic settings, labor unions, political action groups, health-care coalitions, and consumer advocacy groups. This book provides an evidence-based approach to attaining the necessary knowledge, skills, and attitudes for nursing practice in today’s dynamic health-care environment. It will be beneficial to prelicensure nursing students, RNs returning ix