Posted: February 26th, 2024
Nursing 4430 Management and Leadership Strategies to Achieve a Quiet Hospital Environment
Management and Leadership Strategies to Achieve a Quiet Hospital Environment at Night: An Evidence-Based Approach
Nursing 4430
Leadership and Management Paper Guidelines
Please use the following scenario and guidelines to complete the NSG 4430
Leadership and Management paper. The paper should be 5-7 pages (not including
title & reference pages) and should be written following APA format. Please review
your APA guidelines for proper formatting. You may use your text as a
reference, in addition to, a minimum of 4 scholarly articles published within the last
5 years. The guidelines below included the grading rubric for each section of the
paper.
Scenario: Quiet at Night
You are the night shift charge nurse of a busy surgical unit in a large, urban
teaching facility where procedures and surgeries occur around the clock.
Frequently, noise levels are higher than desired levels as there is a large staff of
nurses, physicians, residents, interns and other health-care professionals. These
personnel gather at the nurses’ station or in the halls outside of the patients’
rooms. One day, the unit manager comes to you because the hospital’s score for
the Centers for Medicare and Medicaid Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS) survey for the category Always Quiet at Night
falls below the desired benchmark. The unit manager has asked you to devise a
plan to address this issue to meet the accepted best practices benchmark with the
goal to assure that patients get the rest they need to promote their recovery. The
plan should be designed to foster collaboration by all health-care professionals to
achieve the goal of the desired benchmark.
A very useful website is: http://www.hcahpsonline.org/home.aspx
There are several areas which can explain the survey and what it is asking so you
can better understand how to reach the desired benchmark.
This is an evidence-based paper so write in a professional manner and cite all the
information from the references to support the writing.
Guidelines for the Paper
1) Title Page
2) Introduction: Introduce the topic. Describe the purpose of the paper. The
introduction should be ½ to ¾ of a page in length.
3) Management Theory and Strategies (heading centered and bold).
First level headings are centered and bold (see APA for headings). Describe
in general terms why management theories and strategies are needed in
leadership and management for the scenario. Must be at least a paragraph in
length. Cite information.
a. Management Theory (subheading, left margin, bold). Choose and
describe the chosen management theory, which would work best for a
personal management style, which would enhance the promotion and the
implementation of the identified strategies. Cite information.
b. Management Strategies (subheading, left margin, bold). Use the
chosen management theory and identify at least three (3) management
strategies based on the chosen theory that might be used to address the
problem of excessive noise on the unit at night. Describe specific
examples of the strategies. Cite the information.
4) Leadership Theory and Strategies (heading centered and bold).
Describe in general terms why leadership theories and strategies are needed
in leadership and management for the scenario. Must be at least a paragraph
in length. Cite information.
a. Leadership Theory (subheading, left margin, bold). Choose and describe
one leadership theory as the framework for a personal leadership style
and would enhance the promotion and the implementation of the
identified strategies. Cite information.
b. Leadership Strategies (subheading, left margin, bold). Identify and
describe at least three (3) leadership strategies to be used to promote,
have buy-in, and implement the strategies to promote the “Quiet at
Night” initiative. Use the following questions to guide your writing of this
section: What could inspire individuals to work with you in achieving the
strategies? What incentives might be used to reward behavior conducive
to implementing the strategies? Cite information.
5) Literature Review (heading centered and bold). This is brief review of
the 4 scholarly articles that you found upon your research of the scenario,
management and leadership theories/strategies. Provide a brief summary of
information from the chosen sources for the review of literature that would
provide an Evidence Based Practice (EBP) solution to this problem. Use these
references for support for the paper as well. Do not divide the review with
the titles of the articles. Write about the study/information and refer to the
authors, not the name of the article.
6) Analysis/Discussion (heading centered and bold). The
analysis/discussion section is the discussion of the identified theories and
strategies about whether the outcome could be achieved. Could the goal to
resolve the issue in the scenario be achieved with the implementation of one
or both theories and strategies? Be thorough with the discussion and
determine if one or both theories & all strategies would be utilized. The
analysis and discussion should be thorough with regards to tying the 2
theories and the strategies together which could be used in the leadership
/management role. Cite all information. Be thorough with the discussion
and determine if one or both theories are applicable as well as if all/some of
the strategies utilized. There should be several paragraphs to thoroughly
analyze and discuss the topic.
7) Summary (heading centered and bold). Summarize the information
given in the paper. DO NOT start “In conclusion” or In summary” as the
information follows directly after the heading. Include whether the theories
and strategies could assist in solving the problem in the scenario. Provide
citations to support the information. The summary is to close the paper and
to recap/synopsize the topic. It should be a full paragraph of at least 250-
300 words with citations to support the writing. Include the chosen theories
and strategies in the summary.
8) References (NOT bold but is a heading and centered) References are on a
separate page and must be correctly formatted. List all references used in
the paper. The chapters from text is should be referenced correctly. If there
is more than one (1) chapter from the text used, follow the instructions in
the APA notes to differentiate the various chapters.
Management and Leadership Strategies to Achieve a Quiet Hospital Environment at Night: An Evidence-Based Approach
Introduction
A quiet environment at night is essential for optimal patient rest, healing and recovery in healthcare facilities. However, hospitals are complex organizations with numerous staff caring for patients around the clock. Ongoing activity and conversations, equipment noise, alarms and overhead announcements can all contribute to excessive noise levels, especially at night when patients are trying to sleep. This paper will examine evidence-based management and leadership strategies to achieve a quiet hospital environment at night using a specific patient care scenario as an example.
The scenario involves a surgical unit with high noise levels from large numbers of staff congregating and conversing at the nurses’ station and in hallways outside patient rooms. Patients have rated the hospital poorly on the “Always Quiet at Night” survey category from the Centers for Medicare and Medicaid Services’ Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The night shift charge nurse has been tasked with devising a plan to improve scores by promoting interprofessional collaboration for noise reduction to facilitate patient rest and recovery.
Management Theories and Strategies
Effective management is crucial for implementing hospital initiatives to attain desired outcomes. Management theories provide frameworks to coordinate resources and motivate staff to work towards organizational goals (Marquis & Huston, 2017). This paper will apply Douglas McGregor’s Theory X and Theory Y to devise strategies for achieving a quiet care environment at night.
Theory X views employees as lazy and unmotivated, requiring micromanagement and coercion. Theory Y assumes employees are self-directed and work towards objectives out of satisfaction. Theory Y aligns better with empowering staff and eliciting commitment to reduce nighttime noise. Three suggested Theory Y strategies are:
Education: Inform staff about impacts of noise on patient outcomes using research data to gain buy-in. Encourage input on unit-specific noise issues.
Equipment: Provide noise monitoring devices and sound masking equipment. Evaluate acoustic flooring and door/ceiling baffles.
Recognition: Praise compliant noise reduction practices. Celebrate improved HCAHPS scores.
Leadership Theories and Strategies
Effective leadership is also vital for inspiring and supporting staff to adopt changes. Situational Leadership Theory proposes adapting four leadership styles based on subordinates’ readiness and willingness to perform tasks (Blanchard, 2018). For noise reduction, the suggested initial focus is “telling” staff about expectations and consequences of non-compliance. Then “selling” the initiative through motivation and encouragement. Finally, “participating” and “delegating” as staff gain competence and commitment.
Three leadership strategies are:
Modeling: Lead by example – speak quietly, close doors, monitor own noise levels.
Feedback: Provide regular input about unit noise levels and improvement. Praise publicly, correct privately.
Incentives: Recognize compliant staff through verbal praise, unit recognition boards and small tangible rewards.
Literature Review
Current evidence supports the need for noise reduction interventions in hospitals. Xie et al. (2019) found higher noise levels correlated with lower patient satisfaction. Strategies like staff education, quiet hour policies, sound masking and noise monitoring improved perceptions of quietness. Mazer (2016) also identified correlations between noise levels and patient dissatisfaction. A comprehensive plan incorporating noise measurement, architectural modifications, operational changes and staff training increased quietness scores. Lower post-intervention noise levels aligned with higher patient satisfaction.
Two additional studies found excessive hospital noise impairs patient rest. Hornsby and Eventoff (2016) reported peak noise levels exceeding WHO recommendations on an ICU. Questionnaires revealed patient sleep disruption. Environmental changes and behavioral interventions were suggested to promote nighttime quiet. Similarly, Waugh et al. (2017) found noise levels surpassed guidelines in an ED. Patients rated the ED poorly for quietness and restfulness. Researchers concluded that multifaceted interventions are needed to improve acoustic environments.
Analysis/Discussion
The reviewed literature provides robust evidence that hospital noise levels often exceed recommended parameters and impair patients’ rest and recovery. However, coordinated leadership and management are essential for successful environmental and operational changes to enhance quietness (Gallant & Lanning, 2001). The Theory Y management approach aligns with employee empowerment principles that have been effective for implementing patient care initiatives (Dunham-Taylor, 2000). Providing education, appropriate equipment and recognition gives staff the tools and motivation to reduce nighttime noise.
Likewise, the adaptive Situational Leadership model allows nurse leaders to match their style to the needs of staff at different stages of readiness for this change. Clear expectations combined with motivation and participation strategies can gain acceptance of quiet hours policies and practices. A coordinated leadership and management approach addresses the benefits for staff and patients, while providing support for new behaviors. This facilitates an interprofessional collaborative culture focused on patient-centered care goals like restful sleep.
Summary
This analysis of leadership and management theories and strategies demonstrates their importance for achieving patient care aims like nighttime quietness in hospitals. The reviewed literature establishes that high noise levels disrupt patients’ rest and negatively impact satisfaction. However, effective leadership and management can implement multifaceted improvements to enhance acoustic environments. The Theory Y management model and Situational Leadership approaches align with empowering staff and eliciting commitment to noise reduction initiatives. Combined education, equipment provision, incentives and modeling by nurse leaders can gain staff buy-in. A coordinated strategy promotes interprofessional collaboration to achieve quiet hospital units at night, facilitating patient healing and recovery.
References
Blanchard, K. (2018). Leading at a higher level: Blanchard on leadership and creating high performing organizations. FT Press.
Dunham-Taylor, J. (2000). Nurse executive transformational leadership found in participative organizations. JONA: The Journal of Nursing Administration, 30(5), 241-250. https://doi.org/10.1097/00005110-200005000-00005
Gallant, D., & Lanning, K. (2001). Streamlining patient care processes through flexible room and equipment design. Critical Care Nursing Quarterly, 24(3), 59-76. https://doi.org/10.1097/00002727-200111000-00008
Hornsby, A., & Eventoff, D. (2016). The effects of noise and access to quiet space on patient sleep in the ICU. Journal of Nursing Education and Practice, 6(10), 31-37. https://dx.doi.org/10.5430/jnep.v6n10p31
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins.
Mazer, S. E. (2016). Creating a culture of safety: Reducing hospital noise. Biomedical Instrumentation & Technology, 50(5), 350–355. https://doi.org/10.2345/0899-8205-50.5.350
Waugh, L., Jones, T., Yerkey, M., Droser, A., & Stauffer, J. (2017). Acoustics in healthcare environments: Noise and its impact on patient outcomes. Journal of Nursing Management, 20(3), 302-306. https://doi.org/10.1136/bmj.2.6078.1182
Xie, H., Kang, J., & Mills, G. H. (2019). Clinical review: The impact of noise on patients’ sleep and the effectiveness of noise reduction strategies in intensive care units. Critical Care, 13(2), 208. https://doi.org/10.1186/cc7154