Purpose

Master’s-prepared advanced practice nurses participate in and demonstrate fair and unbiased interactions within all workplace settings. As a member of the nursing profession, and a leader, you are encouraged to implement strategies that promote and cultivate cultures of civility, regardless of practice setting. The purpose of this assessment is to analyze the issue of incivility and apply best practices to cultivate healthful environments.Course Outcomes

CO 1: Examine roles and competencies of master’s-prepared nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (PO 1-5)

CO 2: Apply concepts of person-centered care to nursing practice situations. (PO 1, 2, 5)

CO 3: Analyze essential skills needed to lead within the context of complex systems (PO 3, 4)Total Points Possible

This assessment is worth 200 points.Due Date

Submit your file(s) by 11:59 p.m. MT Sunday at the end of Week 7.Requirements

Criteria for Content

Reflect on the issue of incivility. Think of an experience in which you were directly involved or witnessed incivility in the workplace. Analyze scholarly literature related to the issue of incivility and strategies for cultivating healthful environments.

1. In a four- to six-page written paper, address the following.
   1. Define and explain the issue of incivility. Use scholarly nursing literature.
   2. Discuss the importance of this issue to nursing. Address the impact of incivility on individuals, microsystem work environments, and the profession of nursing. In this section, use at least three (3) different scholarly nursing literature in-text citations with matching references.
   3. Provide a scenario (real or fictitious) of incivility in a practice setting. What was the impact on the individuals involved? How was the work environment affected?
   4. Describe three strategies for creating a healthful environment. Use scholarly nursing literature to support each strategy.
   5. Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics). Provide two examples of strategies you will implement in your master’s-prepared advanced practice role to cultivate a healthful work environment.
   6. Provide a conclusion. Include a summary on the issue of incivility, strategies to create healthful environments, specialty track, and how you will contribute to cultivating healthful environments in your future professional practice. Include a self-reflection.

Preparing the paper

Submission Requirements

1. Application: Use Microsoft Word 2013™.
2. Length: The paper (excluding the title page and reference page) is at minimum four (4) pages and at maximum six (6) pages.
3. A minimum of four (4) scholarly nursing literature references must be used.
4. Submission: Submit your files: Last name_First initial_Assessment 5_Cultivating Healthful Environments.

Best Practices in Preparing the Project

The following are best practices in preparing this project.

1. Review directions thoroughly.
2. Follow submission requirements.
3. Make sure all elements on the grading rubric are included.
4. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
5. Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
6. Ideas and information that come from scholarly nursing literature must be cited and referenced correctly.
7. A minimum of four (4) scholarly nursing literature references must be used.
8. Abide by CCN academic integrity policy.

Create a 3 page essay paper that discusses Nurse Manager Power. The author playing the role of her boss will assess the case and suggest how she can improve her management skills using literature on management. Case Study Mrs. Jackson is a nurse manager on a coronary care step-down unit. She has a habit of dictating solutions to staff in case of any problem. She is also habitual of degrading her staff publicly and uses a rather a superior attitude. In addition, she also shows more favorable attitude towards some of her staff members and give them relax hours and vacations according to their desire while coerce the other staff members. Also, it has been observed that staff members who confront her are assigned worst hours and shifts and their request to change the shift is usually ignored. Considering this situation, the author has explored the detrimental and optimal behavior for unit functioning followed by observation and suggestion for Mrs. Jackson to improve her management skills. Behavior which is considered detrimental to the unit’s functioning Nurse Managers have is key in the acute care nursing area as it deals with development and retention of staff, with on the whole unit competency. Altogether, the nurse manager has the duty to make sure that the work in the facility is going on smoothly, while ensuring the capability and the competence of the day by day operations of their unit. The attitude that we see in case of Mrs. Jackson is termed as Pseudo-transformational leadership. Pseudo-transformational leaders are those who have narcissist tendencies and self-aggrandizing motives. Judge, LePine and Rich (2006) described narcissism as a grandiose sense of self-importance, which results in fantasies of unlimited success, sense of entitlement, interpersonally exploitative behaviors, lack of empathy, arrogant and haughtiness If nurse manager adopts such behavior, it will create a negative work environment which will affect team functioning and performance as well as workers outcomes. The behaviors that contribute to optimal team functioning within a larger systems environment An environment where workers are treated as assets, there experience and knowledge is acknowledged and they are treated equally with respect leads optimal team functioning. Leadership theories suggest that leaders need to serve as role models and reward and recognize individuals that reflect the values of the organization. The latest leadership style that is being popular almost in organization is transformation leadership. According to Bass and Steidlmeire (1999), to be transformational, leaders must be grounded in moral foundations. Such leaders must exhibit moral character in their concern for self and others, display ethical values embedded in their vision, demonstrate morality in their processes of social and ethical choices, and in all actions in which the leader and followers engage. In a larger system environment, leader should motivate follower, use rewards to encourage and appreciate staff members for their hard work. As, Smith (1998) believed that creative compliments can motivate followers to perform at higher levels (p. 71) Lastly, in order to accomplish all of the key components of their role, it is important for the nurse manager to foster interdisciplinary relationships through effective communication.

Capstone Project Milestone 2: Design for Change Proposal Guidelines PURPOSE You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program. COURSE OUTCOMES This assignment enables the student to meet the following course outcomes. • CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO #1) • CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO #2) DUE DATE Milestone 2 consists of the proposal for your Design for Change Capstone Project. Submit this assignment to the Dropbox by the end of Week 4. POINTS Milestone 2 is worth 225 points. DIRECTIONS 1. Create a proposal for your Design for Change Capstone Project. Open the NR451_Milestone2_Design_Proposal_ template in Course Resources to create your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice. 2. The format for this proposal will be a paper following the Publication manual of APA 6th edition. 3. The paper is to be four- to six-pages excluding the Title page and Reference page. 4. As you organize your information and evidence, include the following topics. a. Introduction:Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution. b. Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members. c. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change. d. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings. e. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan. 5. Citations and Referencesmust be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites. 6. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change. Your title here This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper. Change Model Overview In this first paragraph, provide an overview of the ACE Star model Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the ACE Star model EBP Process. Define the Scope of the EBP Restate your practice issue. Why is this a problem? Give basic statistics and information to back the scope of the problem at your facility/work area. How does this problem impact healthcare on a broader scale? Stakeholders You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse, etc.). Determine Responsibility of Team Members Why are the members chosen important to your project? What are their roles? Evidence Conduct internal/external search for evidence. What type of evidence did you find in addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position statements? Clinical Practice Guidelines? Briefly discuss the strength of this research. This is not where you describe the results of your studies. This is done in the following steps. Summarize the Evidence In this section, you need to synthesize the information from the systematic review article. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use?Be sure and cite all of your references, in proper APA format, from any and all articles into this one paragraph. Develop Recommendations for ChangeBased on Evidence What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program. Translation Action Plan You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study? What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results. Process, Outcomes Evaluation and Reporting What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders? Identify Next Steps How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent? Disseminate Findings How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)? Conclusion Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the five points of the ACE Star change model EBP process and ways to maintain the change plan.

Remember: need 2 assignments 40 per each, plagiarism free, on time.

Final Paper

The final assignment for this course is a Final Paper. The purpose of the Final Paper is for you to culminate the learning achieved in the course by applying your knowledge in the field of health care ethics and medical law through the analysis of an actual case regarding an ethical dilemma.

Focus of the Final Paper

Review the three scenarios below. Choose one of them and address the questions asked within your selected scenario in the form of a written analysis.

Scenario No. 1: HIPAA Privacy Rule

Case Study:Imagine that you are the privacy officer for a small town hospital. You receive a report that there is a breach of privacy. You are informed that a 15-year-old girl is received at the emergency with an emergency labor. The baby is delivered in the emergency room as there is no time to move the patient to the obstetrics (OB) department. In addition to the emergency delivery, the baby is born with multiple medical problems. Once the mother and baby are moved to obstetrics and neonate, care is given to both.

The OB nurse who took care of the mother and baby completes her shift, and she goes home to her own daughter to have a talk with her. She sits her daughter down and pleads with the girl to tell her if she ever has any problems, especially when it comes to pregnancy. The nurse tells her daughter the story about the young patient who delivered that evening, and she accidentally mentions the patient’s name. The patient’s name is one of those odd names that immediately triggers the nurse’s daughter to relay that she knows the patient. The mother/nurse, realizing that she made a big mistake by mentioning the patient’s name, pleads with her daughter not to say anything. Needless to say, word shoots through the four high schools in the town the next day.

The nurse returns to work the following evening, and she contacts you to hand in her badge and keys, stating that she knows she made a mistake by breaching the young patient’s privacy and she knows she is going to be fired. In addition to the breach of the obstetrics nurse, you learn that the patient hid her pregnancy from her family, and to make matters worse, her aunt and mother are both nurses at the hospital. You know both of these nurses on a professional and personal level.

Scenario No. 1 HIPAA Privacy Rule Project Assignment:

Research the HIPAA Privacy Rule here:

• U.S. Department of Health and Human Services. (2013).Health Information Privacy.Retrieved fromhttp://www.hhs.gov/hipaa/for-professionals/privacy/guidance/introduction/index.html

Then, perform additional research regarding the HIPAA Privacy Rule and prepare your Final Paper by analyzing the issues through these questions in regards to the above scenario:

• Analyze the specific requirements needed to perform this investigation.
• Identify whether this incident was an actual breach of privacy according to the HIPAA law.
• Examine the differences and similarities between the hospital’s stance and HIPAA as to whether the nurse should be fired from her job.
• Explain why you would fire or not fire the nurse immediately or whether you would put her on administrative leave awaiting the details of the investigation.

Scenario No. 2: DNR

Project Assignment:Review your State Government’s website and search for its official Do Not Resuscitate (DNR) Form. Along with the form will be information and instructions regarding the form. In addition, research three area hospitals to determine if they provide separate DNR forms. Then, perform additional research regarding DNR and prepare your Final Paper by analyzing the issues through these steps:

• Analyze the requirements of your State Government’s DNR.
• Identify the requirements of the three hospital’s DNRs.
• Examine the differences and similarities between the state’s and the three hospital’s DNR requirements, and address the following questions:
• What are they?
• Which one should you follow?
• Explain how a DNR is applied if a patient is under hospice care and EMTs are called.

Scenario No. 3: Institutional Code of Ethics

Project Assignment:Codes of ethics are standards that outline how individuals or groups of people are to act. The healthcare/medical community has its own code of ethics, which is outlined in the American Medical Association’s Code of Medical Ethics. Review the following:

• AMA’s Code of Medical Ethics here:
• American Medical Association. (2013).AMA’s code of medical ethics.Retrieved fromhttp://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page.

• Three local or regional hospitals’ codes of ethics.
• Various scholarly research on healthcare codes of ethics (at least seven additional sources).

Then, prepare your Final Paper by analyzing the issues through these steps:

• Analyze the specific requirements of a code of ethics.
• Identify three critical elements of the AMA’s code that you believe are most important.
• Examine the differences and similarities between the AMA’s Code of Medical Ethics requirements and the code requirements of the three hospitals that you researched.
• Explain why certain individuals and/or groups (please name these) should follow a hospital’s code of ethics.

Writing the Final Paper

The Final Paper:

• Must be eight to ten double-spaced pages in length, excluding title and reference pates, and formatted according to APA style as outlined in the Ashford Writing Center.
• Must include a title page with the following:

· Title of paper

· Student’s name

· Course name and number

· Instructor’s name

· Date submitted

• Must begin with an introductory paragraph that has a succinct thesis statement.
• Must address the topic of the paper with critical thought.
• Must end with a conclusion that reaffirms your thesis.
• Must use at least eight scholarly sources that were published within the past five years, including a minimum of four from academic journals found in the Ashford University Library.
• Must document all sources in APA style, as outlined in the Ashford Writing Center.
• Must include a separate reference page, formatted according to APA style as outlined in the Ashford Writin