Running head: LEADERSHIP PROJECT

Leadership Project
Sarah M. Brockman
NUR 4144 Professional Role Development: Servant Leadership
April 4, 2016

On my honor, I have neither given nor received aid on this assignment, and I pledge that I am in
compliance with the BSMCON Honor System. Sarah M. Brockman

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Leadership Project

The purpose of this paper is to discuss how a nurse manager would implement a current
quality improvement (QI) project focusing on bedside shift reporting within an acute care
nursing unit. Implementation will be guided utilizing the four domains of leadership (heart,
head, hands, and habits) as well as the five practices of exemplary leadership (model the way,
inspire a shared vision, challenge the process, enable others to act, and encourage the heart).
The unit for the quality improvement project is a busy medical-surgical unit with a variety of
clinical issues. Bedside shift reporting (BSR) improves patient safety and nurse accountability.
Shift reports held at the bedside can improve patient satisfaction with nursing communication
while building trust and facilitating teamwork. Many patients want to be more involved in their
care, including health status, medical plan and progress towards their goals. I believe the
implementation of bedside shift reporting will facilitate patient-centered care and improve team
communication, producing positive patient outcomes and greater patient, and nurse, satisfaction.
Four Leadership Domains
Heart
Blanchard and Hodges (2005) explain how the journey of a servant leader begins in the
internal domain of the heart. As the nurse manager, I must first ask myself, Am I a servant
leader or a self-serving leader? Motivations from the heart and intent for change teach us to
become a servant leader like Jesus. Implementation of the quality improvement project on my
unit will require me to successfully plan for positive and negative feedback, by actively listening
to the perspectives of my nursing staff and team members. As I embrace the characteristics of
the heart domain, I will lead with humility, alleviating any fear towards change by encouraging
and motivating my team, while being open and accepting of concerns. I am confident that a QI

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project focused on bedside shift reporting can positively affect patients, their families, and
nursing staff, facilitating patient- and family-centered care.
Head
While the heart of a servant leader is primarily focused on internal motivation, the head
incorporates motivation with ones beliefs and theories about leading. The two parts to servant
leadership, as describe by Blanchard and Hodges (2005) include: a vision, which sets the course
and the destination, and implementation which focuses on doing things right. As a nurse manager
leading with my head, I will establish a vision for the QI project that aligns with the mission and
values of the unit and the hospital system. A compelling vision tells people who they are, where
they are going, and what will guide their journey (Blanchard & Hodges, 2005, p.113). By
communicating the purpose, vision for the future, and values of the QI project, I will be able to
engage my team, establish goals, and begin implementation.
Hands
As a nurse manager utilizing the hands domain of servant leadership, I will serve as a role
model for my team by providing clear directions, setting goals, and providing feedback to
encourage success. I will establish open forums, discussions, and collect surveys to actively
listen and understand staff opinions of bedside shift reporting. An instructional video that focuses
on using SBAR during bedside shift reporting will be made for use in training. My role as nurse
manager using this domain is to act as a performance coach. Blanchard and Hodges (2005)
explain how people who are praised for producing good results feel good about themselves and
continue to be successful. As a leader utilizing this domain, I will encourage team members to
take a leadership role in the project, building on his/her own skills and talents.
Habits

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The final leadership domain, habits, is a way to new ones daily commitment as a servant leader.
Implementation of bedside shift reporting involves management of team members, committees,
meetings, and processes, requiring one to stay focused and on track towards the common goal
and vision. Blanchard and Hodges (2005) explains how Jesus stayed on track with His mission
by applying five key habits: solitude, prayer, scripture, accepting and responding to Gods
unconditional love, and supportive relationships. I will utilize these habits through reflection,
prayer for strength and guidance, and by seeking supportive relationships. By adopting Jesuss
habits, he will serve as my role model for leadership.
Five Exemplary Leadership Practices
Model the Way
When a leader models the way for their team, they are setting an example through their
actions. Leaders clarify personal values while affirming shared values. Leaders earn credibility
by putting their values into action and living by the same standards and principles they expect
from others (Kouzes & Posner, 2013, p. 13). As a nurse manager leading a QI project, I will be
aware of my own words and actions to ensure they consistently align. I will be the example,
serving as a role model for professional behavior, by attending forums and discussions, actively
listening, and participating in bedside shift reports.
Inspire a Shared Vision
As a servant leader, I will inspire a shared vision by truly believing in the positives that can
come from bedside shift reporting. I will educate my staff on the benefits and improved
relationships that result from this practice change. I will seek support from other departments, to
encourage collaboration, and share success stories. A kick-off event to begin bedside shift
reporting on my unit will encourage staff buy-in and participation. By inspiring a shared

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vision, I will motivate individuals to begin implementation of this QI project, leading to

increased patient safety, improved nurse communication, and facilitation of teamwork.
Challenge the Process
As a leader challenging the process, I will search for opportunities to innovate, grow, and
improve upon the practices of my unit. Giving patient report away from the bedside can lead to
a breakdown in communication and effective communication is essential for maintaining a safe
and trusting environment for patients. Giving report at the bedside allows a patient and their
family to be involved in their care. This QI project is an innovative way to improve upon patient
safety and communication.
Enable Others to Act
Kouzes & Posner (2005) state leaders foster collaboration by building trust and facilitating
relationships (p. 14). These collaborative relationships enable processes to function effectively.
It is necessary to utilize this leadership practice, as I know I will not be able to make the change
to bedside shift reports occur on my own. I will teach other members of the team to become
leaders, encouraging them to take on tasks and projects. As we share responsibilities, actively
listen to concerns, and celebrate successes, team confidence will grow, and members will be
empowered to continue the process change.
Encourage the Heart
Utilizing the leadership practice of encourage the heart will help to build a sense of
community among the unit. As explained by Kouzes & Posner, (2013) it is necessary for leaders
to recognize contributions and celebrate the victories. Successfully implementing a QI project is
not an easy task, and the work and effort that goes into the project should be celebrated. Words
of encouragement are motivating, inspiring members to keep hope and the drive to succeed alive.

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As nurse manager and project leader it is my duty to recognize a job well done by rewarding
efforts and celebrating accomplishments.
Professional Practice Implications
Bedside shift reporting has many professional practice implications. Two implications
identified by the research include improved nursing accountability and the facilitation of
teamwork. A literature review by Vines, Dupler, Van Son and Guido (2014) found that nurses
who utilize bedside shift handoff reported reduced errors in communication among staff,
promoted accountability, and enhanced teamwork, collaboration, and respect for one another.
During bedside shift report, nurses are able to visualize the patient, quickly verify fluid rates,
vital signs, and the status of the patients environment or room. If errors in communication are
made, they can be corrected in a timely and efficient manner. Bedside shift report facilitates
patient-centered care and is an effective communication tool for the shift change process.

Outcomes Evaluation
Improved patient safety and satisfaction with nursing communication are two positive
outcomes seen from incorporating bedside shift reporting. Patients who have experienced
bedside shift handoffs report feeling safer as they are able to give input to their plan of care
(Maxson, Derby, Wrobleski, & Foss, 2012). Bedside shift report gives patients the opportunity
to hear and participate in the exchange of information, allowing for continuity of care. HCAHPS
surveys have verified the lack of communication that can occur between nurses and patients.
Vines et al. (2014) explains, bedside report can contribute to an increase in satisfaction and
HCAHPS communication scores, as it assists in keeping patients informed and involved in their
plan of care (p. 168).

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Evaluation of the effectiveness of bedside shift reporting can also impact patient-and familycentered care. In a study by Salani (2015), the use of bedside reporting in a pediatric critical care
unit promoted family-centered care. Implementation of BSR showed an increase in engagement
scores and family satisfaction scores. Bedside report can allow nursing staff to recognize the
care contributions of family members when they are include in shift reports (Salani, 2015).
Bedside shift reports engage the patients family, allowing for better communication and
improved patient- and family-centered care.

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References

Blanchard, K. & Hodges, P. (2005). Lead like Jesus. Nashville, TN: Thomas Nelson.
Kouzes, J. M., & Posner, B. Z. (2013). The Student Leadership Challenge: Student Workbook
and Personal Leadership Journal. San Francisco: Jossey-Bass.
Maxson, P.M., Derby, K.M., Wrobleski, D.M., & Foss, D.M. (2012). Bedside nurse-to-nurse
handoff promotes patient safety. Medsurg Nursing, 21(3), 140-145. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/2286643
Salani, D. (2015). Implementation of shift report at the bedside to promote patient-and familycentered care in a pediatric critical care unit. Journal for Nurses in Professional
Development, 31(2), 81-86. doi:10.1097/NND.0000000000000128
Vines, M.M, Dupler, A.E., Van Son, C.R., & Guido, G.W. (2014). Improving client and nurse
satisfaction through the utilization of bedside report. Journal for Nurses in Professional
Development, 30(4), 166-173. doi:10.1097/NND.0000000000000057