The title of this assignment is Leadership Project Paper.

It was completed in
NUR 4144 Professional Role Development: Servant Leadership. The specific program
outcome that this assignment demonstrates is Program Outcome #3 - Integrate servant
leadership into nursing practice to promote global health. The purpose of this assignment was
to discuss with a nursing units quality improvement (QI) representative, nurse manager, or staff
nurse what quality improvement projects are being performed on his/her specific unit and select
a QI project to complete this assignment and develop a paper addressing how you would
implement the quality improvement project as a nurse manager utilizing the four domains of
leadership (heart, head, hands, and habits) as discussed in Lead like Jesus textbook and the five
practices of exemplary leadership (model the way, inspire a shared vision, challenge the process,
enable others to act, and encourage the heart) as discussed in Student Leadership Practices
Workbook. This assignment exemplified Program Outcome #3 because it required that I think as
a servant leader and creatively search for quality improvement projects to better nursing practice.
Also, this assignment required me to discuss how I would apply the QI project using servant
leadership principles.

LEADERSHIP PROJECT

Leadership Project Paper

David Krukiel
Bon Secours Memorial College of Nursing

LEADERSHIP PROJECT

As a nurse manager, patient safety is a priority concern for hospitalized patients.

According to the Joint Commission, fall reduction has been identified as a national priority for
hospitals, and the National Patient Safety Goal 09.02.01 requires hospitals to reduce the harm
related to falls. Also, the Centers for Medicare and Medicaid Services has recognized falls
among the list of hospital-acquired conditions (Murphy, 2013). Nurse managers must utilize
quality improvement efforts to reduce falls in order improve patient safety and quality care. The
quality improvement project addressed in this paper is the use of mobility/activity circles in an
effort to reduce falls. This quality improvement project was developed by the health networks
multidisciplinary fall prevention team. The team reviewed fall data and current literature to
determine that the medical renal unit had a greater than average number of falls. As a result, the
team discussed with the nurse manager ways to prevent falls on the unit. It was decided to use
mobility/activity circles in an attempt to reduce the number of falls. Mobility/activity circles are
laminated circles that display visual cues such as the patients mobility mode and use of assistive
devices, such as if the patient uses a bedpan or how does the patient ambulate (Murphy, 2013).
The purpose of this paper is to discuss how I would implement this quality improvement project
as a nurse manager utilizing the four domains of leadership discussed in Lead like Jesus and the
five practices of exemplary leadership as discussed in Student Leadership Practices Workbook.
Effective leadership starts in the heart (Blanchard & Hodges, 2005). In order to lead with
my heart and implement this quality improvement project I would exert confidence around my
peers and motivate them for success. I would empathize with them and allow them to express
their concerns about the project and encourage open discussion of creative ways to implement
the project. Also, I would forgive them for failure to prevent previous falls and acknowledge that
I am part of the system that has failed to reduce falls. Ultimately, leading with my heart I would

LEADERSHIP PROJECT

actively listen to my peers and their feelings while offering reassurance and positive feedback
regarding the project. Leading with my head, I would be aware of my values and beliefs
regarding my leadership style. I would review the project and the mobility/activity circles with
my staff, patients, and families to determine if it can be an effective fall reduction intervention. I
would promote a future vision of reduced falls with my staff and set goals for each of my staff
members. My staff and I would keep track of the goals set to see if they are achieved. Also, I
would seek a multidisciplinary approach in reducing falls. According to Ohde et al. (2012) and
Wexler et al. (2011), a quality improvement approach that involves and educates healthcare staff
at multiple levels (multidisciplinary) is effective at reducing falls. Leading with my hands, I
would create the mobility/activity circles and place them outside the patient rooms. I would
write goals for my staff and provide educational handouts regarding the project. I would call
other healthcare employees and managers from multiple units to include them in the project. In
addition, I would ensure that the purpose of the project is clear among all of my staff members
and coach them to reach their goals. Staff compliance is critical to success of fall prevention
programs (Ohde et al., 2012). Leading with my habits, I would pray that the project is successful,
and the number of falls is reduced. I would participate in the project with my staff members and
portray confidence that the project could be successful. Also, I would self-reflect on the project.
In addition, I would be honest with my staff and others throughout the trial of the project.
In order to Model the Way, I would set a positive example by clarifying my values and
standards regarding the project. I would participate in the project with my staff members, and
remain committed to their needs and the needs of the project. I would ensure the project is
executed appropriately. Also, I would spend time with my staff and provide them my full
attention by being actively available. In addition, I would stand up for my beliefs and the beliefs

LEADERSHIP PROJECT

of my staff. I would Inspire a Shared Vision by clarifying the purpose of the project and
including all staff members. I would encourage my staff to envision a future on the unit with a
reduced number of falls. I would enlist all staff to develop this future vision. Throughout the
project, I would reinforce this vision to motivate my staff and promote the success of the project.
To Challenge the Process, I would look at the current fall reduction interventions in place and try
to determine why our fall rate is high. I would search for opportunities with my staff to reduce
the number of falls, and experiment with different fall reduction methods. Also, I would study
the outcomes of the mobility/activity circles to determine if it was effective in reducing falls. I
would Enable Others to Act by encouraging open communication and collaboration between
myself and all staff members. I would promote trust between my staff members and encourage
them to openly discuss their opinions and feelings regarding the project. I would strengthen
others by making all staff members equally important when collaborating on the fall prevention
project. According to Colon-Emeric et al. (2013), staff perceptions of communication quality,
and staff participation in decision-making were successful attributes of fall prevention programs.
There are numerous ways I would Encourage the Heart in implementing this quality
improvement project. I would recognize all staffs contributions to the project and provide them
with positive feedback. I would promote a positive environment where everyones opinion is
valued. Also, I would celebrate reaching goals with my staff members and reinforce the
importance of the group. I would encourage staff members to keep pushing towards the goal and
continue beyond the goal to improve patient care and improve patient outcomes.
The mobility/activity circles in an effort to reduce falls has numerous professional
practice implications. Falls are a serious patient safety concern among hospitalized patients, and
many falls result in harm. This is a burden on the healthcare system and results in billions of

LEADERSHIP PROJECT

dollars of healthcare expenses that could be prevented (Centers for Disease Control and
Prevention, 2015). Fall prevention programs could save the healthcare system billions of dollars
by improving patient safety and preventing harm from falls. According to Murphy (2013), the
mobility circles promoted patient safety, teamwork, patient satisfaction, and multidisciplinary
communication. Therefore, mobility circles may be effective in reducing falls in a variety of
healthcare settings and hospital units. Also, this quality improvement project may offer insight
into other evidence-based practices that may be utilized to reduce falls and can be used as a
guideline for other studies. It is clear that fall prevention programs are successful in reducing
falls and fall reduction programs should be implemented nationwide in all healthcare settings. In
addition, the mobility circle project may provide data that helps improve other existing fall
prevention programs.
The outcomes evaluation of this quality improvement project can be determined by
looking at the number of falls on the unit. Falls would be looked at before the start of the project
and following the project. The project would be considered effective if there was a significant
reduction in the number of falls. Also, it is important to evaluate the patients and staff members
perception of the project. I would provide surveys to patients, families, and staff members that
participated in the project and evaluate their responses. I would use their responses to determine
if this project could be utilized long-term to reduce falls or if changes needed to be made to the
project. If the project was not successful, I would use the project and survey responses to
develop a new fall prevention program.

Ultimately, this project has the potential to

improve the outcomes of the patients on the nursing unit. Preventing falls reduces the risk of
injury during hospitalization. Fall prevention allows individuals to maintain their functional
independence and avoid harm. Furthermore, patient safety is a priority when provide safe

LEADERSHIP PROJECT
quality patient-centered care, so it is imperative falls are prevented to maintain the physical
integrity of patients and promote optimal health outcomes.

LEADERSHIP PROJECT

8
References

Blanchard, K. & Hodges, P. (2005). Lead like Jesus. Nashville, TN: Thomas Nelson.
Centers for Disease Control and Prevention. (2015). Cost of falls among older adults. CDC.
Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html
Colon-Emeric, C.S., McConnell, E., Pinheiro, S.O., Corazzini, K., Porter, K., Earp, K.M.,
Landerman, L., Beales, J., Lipscomb, J., Hancock, K., & Anderson, R.A. (2013).
CONNECT for better fall prevention in nursing homes: Results from a pilot intervention
study. Journal of the American Geriatrics Society, 61, 2150-2159. doi: 10.1111/jgs.12550
Murphy, B. (2013). Mobility/activity circles: A quality improvement effort to reduce falls.
MEDSURG Nursing, 22(6), 265-269. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/24600932
Ohde, S., Terai, M., Oizumi, A., Takahashi, O., Deshpande, G.A., Takekata, M., Ishikawa, R., &
Fukui, T. (2012). The effectiveness of a multidisciplinary QI activity for accidental fall
prevention: Staff compliance is critical. BMC Health Services Research, 12(197), 1-7.
doi: 10.118611472-6963-12-197