HQS 620 Review Figure 2.1 “The Five Steps of the Nursing Process” and Figure 2.2 “The Five Phases of Project Management” in Chapter 2 of the textbook
HQS 620 Review Figure 2.1 The Five Steps of the Nursing Process and Figure 2.2 The Five Phases of Project Management in Chapter 2 of the textbook
The first phase of Project management in figure 2.2 which design and initiate project correlates or aligns with nursing process’ first and second steps which is the assessment and diagnosis. The design and initiation phase involve defining the goals or aims of the project. It requires gathering of the current processes, finding what is lacking in the process, the constraints involve in initiating the project like resources (people and monetary), and time (Overgaard, 2010). These details must be clearly defined before proceeding to the next phase which is developing a project plan which aligns with nursing process’ outcomes plan. During planning, all process changes must be made transparent to all the stakeholders for buy-in, participation or commitment to ensure successful implementation of the project. Everyone involved must know what are expected of them and how they can deliver it. The next phase will be Implement the project which aligns with implement care plan. This phase involves the carrying out of the plan changes. Everyone involves must perform what they must do accordingly to achieve the goals of the project. They must also have updates or access on the development or how the project is performing or progressing. Everyone involved in the project must do they share in seeing in what aspect they can still help. The phases monitoring and controlling the project along with the closing aligns with the evaluation step of nursing process. In these phases, the project changes implemented are being checked and feedbacks are sought to be able to correct what needs to be along the way. It can also be an opportunity to at least have an idea as to whether the project will have a positive outcome or not. In these phases as well, finalization of the project is set. Implementation strategies which were effective will be included in the process and those identified issues identified along the way, will be studied, and given corrective measures to address it, to have a fully successful and planned project.
One notable example is prevention of fall. To initiate a project on fall prevention, gathering data on the current preventive measures must be taken (design and initiation phase while assessment and diagnosis in nursing process) and determine the sources of fall from previous incidents to identify if there are gaps as well as the resources needed for the project. Then, goes the planning where meeting with stakeholders must be done. Everyone implementing the project must know their respective roles and how to do it (like putting every patient in VMU is Morse fall score is greater than 45). Next will be implementation which involves the actuality of the project to determine if everyone is performing what they are expected to. Feedbacks from everyone is welcome so necessary corrections can be added or change if fall preventive measures seems not working well (this is the monitoring and controlling phase). Lastly, the closing where the outcome of the project will be determined as whether it will be integrated to the current process of needs further revisions or not to be included at all.
Overgaard, Penny Morgan BSN, RN, FAHCEP Get the keys to successful project management, Nursing Management (Springhouse): June 2010 – Volume 41 – Issue 6 – p 53-54 doi: 10.1097/01.NUMA.0000381744.25529.e
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As discussed by in our textbook, “Implementation science involves increased use of theoretical approaches to provide better understanding and explanation of how and why an implementation succeeds or fails” (Sipes, 2019). For nurses to provide appropriate care of patients the nursing process is the approached looked at to assess the patient, identify what care is needed for diagnosis, planning of care, care plan implementation and evaluate the expected outcomes for the plan. Project management uses theoretical approaches as well with the design of the project, and the finalization of the project, implementation of the plan, monitor and control the project then the project is closed to evaluate what can be learned from the project. Project management is a process of working with a project where nursing process is working with patients (Sipes, 2019).
The article Lavoi-Tremblay, Aubry, Richer & Cry discuss how the Project Manager Office (PMO) support manager in the transformation of the project and help harmonize processes for the facility (2018). This describing just what nurse do in the support of patients using nursing process. The nurse supports the patient navigate the healthcare system and coordinates the care of multiple providers and services to ensure patients needs are met. Another key concept I felt that Lavoi-Tremblay, Aubry, Richer and Cry (2018) discuss is the need for the project manager to listen to the front-line staff throughout the project planning and implementation. Like the importance for the patient to have a voice in the care they receive, project managers need to listen to front-line staff to ensure all the projects needs are identified and met. The understanding and training of the nursing process for nurses prepare them for project management process in the implementation of projects.
Lavoie-Tremblay, M. , Aubry, M. , Richer, M. & CYR, G. (2018). A Health Care Project Management Office’s Strategies for Continual Change and Continuous Improvement. The Health Care Manager, 37 (1), 4-10. doi: 10.1097/HCM.0000000000000185.
Sipes, C., PhD, , CNS, , APRN, , PMP, , RN-BC, , NEA-BC, , & FAAN, . (2019). <i>Project management for the advanced practice nurse</i> (2nd ed.). Springer Publishing Company
The following is a summary of the five steps of the nursing process and the five phases of project management.
Steps of the Nursing Process:
1. Assessment of patient; patient interview re. physical, mental, spiritual; health hx., family hx., this is the phase w/greatest patient interaction.
2. Dx. Phase; list of dx. options (differential dx.), describe the problem and possible further problems for pt., Nursing Outcome Classification.
3. Plan chosen, choose from diff dx., rate symptoms vs. risk factors, set goal and process.
4. Implementation, achievable outcomes started, monitor outcomes, inform patient re. process and following steps, may need much of the time.
5. Evaluate re. goals set, pt. condition better, or stabilized, or deteriorated, if poor result, restart process and goal setting.
Steps of Healthcare Project Management
1. Design and initiate project; define goals, write down detail, list of stakeholders.
2. Scope of project, written plan, budget prepared, roles of stakeholders, positive influencing of stakeholders, and identifying resistance factors.
3. Resources supplied and managed, work towards goals, review periodically and rectify.
4. Watch costs, monitor procedures, guide plan, prevent problems.
5. Review and present goal achievements, obtain approval of results, document results, and review for new goals.
Comparing and contrasting each of these parts is important for nurses and professionals in healthcare.
Step one: In each case evaluation of the situation is initially done to define goals of treatment or a single project. The nursing process is confined to one person, whereas project management deals with a spectrum of persons (stakeholders). I, personally, recall this step whenever in the hospital ER or in a rehabilitation facility.
Step two: Evaluation of the facts, in each case, results in a plan of action. In the nursing profession, the Nursing Outcomes classification (NOC) is applied, and a 5-point Likert Scale is set for patient diagnosis and outcome for treatment. The University of Iowa College of Nursing provides an expanded commentary on NOC at the Center for Nursing Classification and Clinical Effectiveness. It may be reached at http://www.nursing.uiowa.edu/cncce/facts.
In project management, a detailed written proposal and action plan is set. Interviewing stakeholders and persuading them of the value of the project is essential. As is true in the nursing process, defining the problem is basic.
Step three: After a decision is reached concerning a specific patient diagnosis, plans are organized. This procedure is applied in both the nursing process and project management. Periodic written (EHR) entries in the record of a patient or the project are done so that careful review of conditions is possible and sensible. I recall applying this approach in dental records so that the team members understood exactly the purpose and process applied in any patient situation. Those notes are detailed and specific. (When major restorative procedures were finished and patient approval attained, I kept all physical models and items for implant cases for future reference. As patients moved to other locations and needed follow-up care in another office, I could give them the details as requested.) Redirecting the process is often needed in project management, and usually not during the nursing process. This assumes a good patient outcome. Occasionally, poor patient outcomes occur, and attention is quickly applied. Patient emergencies must be attended to right away. Mechanical monitoring is set up as the patient is first seen in stage one.
Step four is associated with following results and implementing course changes, as needed. Plans may work, or they may need considerable revisions. Every patient is special and needs redirected care if problems occur. The same is true in a project, but a larger number of stakeholders may be involved. This is especially true of the project often.
Step five involves the completion of patient care or a project. Stepping back to review results helps with record keeping and may lead to a new project. Hopefully, a patient does not return for follow-up care. This is an important concept related to my purpose in obtaining the certification.
Strait, C. L. (2006). It’s All in the Technique! Information Management Journal, 40(2), 41–46.
Haifen Lin, Mengya Chen, & Jingqin Su. (2017). How are management innovations successfully implemented? An organizational routines perspective. Journal of Organizational Change Management, 30(4), 456–486. https://doi-org.lopes.idm.oclc.org/10.1108/JOCM-07-2016-012