Running Head: LEADERSHIP PROJECT

Mary Wright
Leadership Quality Improvement Paper
4144 Professional Role Development: Servant Leadership
March 30, 2015
Tomeka Dowling, RN, MS

2
Introduction:
Along the list of many requirements that composes a nurse managers job
description, quality improvement projects are one of them. In the labor and delivery
department there are various projects that can be implemented. Hand hygiene is not only
an important factor in labor and delivery and dealing with newborns immature immune
systems but it is an important factor in all areas of nursing. Along with the numerous
things nurses have to remember throughout the course of a shift, hand washing or the use
of hand gel antiseptic is one of the most important things to for health care workers to
incorporate in their care to stop the spread of infection. The way a nurse manager
introduces and implements a quality improvement project can be done in various
different ways incorporating diverse leadership characteristics.
Heart:
Implementing a hand hygiene quality improvement program using your heart as a
manager, usually involves listening to others feeling about the new project, staying
humble, and appealing to their emotions. By appealing to the heart, it is important for the
nurse manager to get his or her nurses to out themselves in the patients shoes. With all of
the organisms found in the hospital, patients have a 5-10% chance of obtaining an
infection during their hospital stay (Abdella, N., et al., 2013). Being the nurse manager, is
it important to relay this information to your employees to let them know the significance
of hospital inquired infections and the threat they have not only to the patients but to their
families and themselves as well.
Head:

3
As a nurse manager, one must use their head to create new policies so that his or
her unit stays up to breast with the newest evidence based practice. To implement hand
hygiene, a nurse manager should make sure the unit has ample education on these
policies. Also, nurse managers should make sure their employees are washing their hands
properly by having seminars. It is important to note to proper way to wash hands, which
many nurses forget after years of practice. According to Mathur, one should remove
jewelry and rinse hands with warm water (2010). It is also important to turn the sink
handle off with a wrist or elbow (Mathur, 2010). Using ones hands a nurse manager
should do all of these things to prevent the spread of infection.
Hands:
The nurse manager should create training programs for their employees to make
sure they understand the importance of hand hygiene. It would also be valuable to make
memos and place reminders around the unit to prompt nurses to wash their hands at the
right time. The six times it is vital to make sure nurses wash their hands to prevent the
spread of infection is before touching a patient, before touching a site on the patient
vulnerable to infection like a wound or catheter, before a clean or aseptic task, after body
fluid exposure, after touching a patient, and after touching a patients surroundings (The
Importance, 2014). The nurse manger could create a simple slogan like Remember your
3 Bs and 3 As, the 3 Bs for the three befores and the three As for the three afters.
By using their hands as an external domain, a nurse manager can help prevent the spread
of infection on the unit.
Habits:

4
Another important external domain of leadership includes the habits of a leader.
These external domains will determine if others will follow the manager as a leader.
These habits should include praying, seeking counsel, and having solitary moments
during times of stress. Implementing new policies and requiring nurses and staff to attend
training classes for proper hand hygiene could possibly create stress on a unit. A nurse
manager can also encourage the staff to study scripture and have involvement in
supportive relationships (Blanchard, K. & Hodges, P., 2005).
Model the Way:
For a manger to be a strong leader, they must model the way for the unit. They
can do this by making sure they themselves know the proper policies incase a staff
member asks them about it, making sure they follow through on the policies, and
following the rules. A nurse manger can do this by using three effective ways of keeping
their hands clean: soap and water, alcohol-based hand rubs, and chlorhexidine-based hand
rubs (Kapil, R., Bhavsar, H., & Madan, M., 2015). These methods are available in most
health care facilities and have different positives. Nurse mangers can also attend in
services on hand hygiene as well as publicly making a point to wash their hands in front
of staff.
Inspire a Shared Vision:
The vision of a unit is where leaders can start and inspire others to act. A nurse
manager can do this by reinforcing policies and getting people to believe in them. Having
staff meeting on new policies and when new products are on the unit can do inspiring this
vision. If there is any infection on the unit, it would be helpful to have a root-cause
analysis to find out where the started will help inspire the vision. Having a vision of no

5
hospital inquired infections for their patients will be helpful. This goal will be important
so that staff can have something to aim for.
Challenge the Process:
A nurse manager can do a couple things to challenge the process. One thing
would be to ask the staff what they could learn from their mistakes. It is important for
nurse managers to get the staff to take risks (Kouznes, & Pozner, 2013). This could
include encouraging those who usually dont attend new policy meetings to attend those
about hand hygiene and bring the information back to the unit. Also, by developing skills
to teach others new policies and procedures is another great way for managers to
challenge to process. All in all, challenging the process can be uncomfortable at times but
it is important for the staff to grow and learn together.
Enable Others to Act:
Being a nurse manager implementing a new hand hygiene project, one must be
able to get people to participate in the change. One of the most important things behind a
successful unit is teamwork the relationships between the staff members there. By
fostering these cooperative relationships, a nurse manager will have a better change of
their quality improvement project working (Kouznes, & Pozner, 2013). For hand hygiene,
a nurse manager could allow the staff members to work together creating different hand
hygiene officers to make sure the other staff washes their hands. Not only would it be
something everyone could learn from, it can foster relationships and allow everyone to
work together as a team. This teamwork is especially important on a labor and delivery
unit since things can change so quickly and it is important for everyone to come together
when they need to.

6
Encourage the Heart
As nurse manager can encourage the heart while implementing a hand hygiene
project by celebrating the accomplishments of others while praising their efforts. The
manager can do this by making recognition boards for those who have completed their
certifications classes or their online classes that correlate with hand hygiene. This will
show the staff that the manager appreciates their efforts to help reduce infection on the
unit. By praising these efforts, others will see this too and it will persuade them to finish
these classes.
Professional Practice Implications
A product was developed to better observe hand hygiene techniques used by
health care professionals. A Targeted Solutions Tool also known as TST is available to
organizations accredited through the Joint Commission (Cantrell, S, 2015). The system
uses real time analysis to track if hand hygiene is used going in and out of rooms.
Developing this on a hospital unit will help staff not only remember to wash their hands
going in and out of rooms from physically seeing the device but it will help them
remember because they know there will be a report going to their manager. Basically, if
an employee uses the soap or hand gel dispensers the system tracks during a single shift.
Another important factor for hand hygiene is artificial fingernails. By starting a campaign
on a labor and delivery unit for all the nurses to have their natural nails less than of an
inch long, it will help with the spread of infection. In 2002 the CDC and HICPAC
suggested for all health care professionals to not have artificial nails (Mathur P., 2011).
Both quality improvement ideas would help with hand hygiene and the spread of
infection on a labor and delivery unit.

7
Outcomes:
Using the TST system has been shown more effective than peer observation
methods due to compliance being falsely identified (Cantrell, S., 2015). After this study,
hand hygiene compliance was shown to increase and risk for infection decrease. If
implemented on a labor and delivery unit, this system would improve compliance as well
as educe infection for infants and mothers alike. After health care professionals were
required to remove their artificial nails, Gram-negative and candidal infections reduced
(Mathur, P., 2011). If this quality improvement campaign was started on a labor and
delivery unit, it would help spread of infection.
Conclusion:
All in all, hand hygiene is important on any unit although on a labor and delivery
unit were infants with immature immune systems are born every day it is even more
important. These infants dont have the immunity adults do which puts them at a higher
risk for developing infection.

8
Reference:
Abdella, N., Tefera, M., Eredie, A., Landers, T., Malefia, Y., & Alene, K. (2014). Hand
Hygiene compliance and associated factors among health care providers in
Gondar University Hospital, Gondar, Noth West Ethiopia. BMC Public Health,
14(96).
Blanchard, K. & Hodges, P. (2005). Lead like Jesus. Nashville, TN: Thomas Nelson.
Cantrell, S. (2015). Hand hygiene, like germs should be ever-present. Healthcare
Purchasing News, 18-22. Retrieved March 10, 2015, from
http://www.hpnonline.com/inside/2015-03/1503-IP-HHSurveillance.html
Kapil, R., Bhavsar, H., & Madan, M. (2015). Hand Hygiene in reducing transient flora on
the hands of healthcare workers: An educational intervention. Indian Journal of
Medical Microbiology, 33(1).
Kouzes, J. M., & Posner, B. Z. (2013). The Student Leadership Challenge: Student
Workbook and Personal Leadership Journal. San Francisco: Jossey-Bass
Mathua, P. (2011). Hand Hygiene: Back to the basics of infection control. Indian J Med
Res, 134.
The importance of hand hygiene in preventing the spread of infection. (2014). JCN
Learning Zone, 28, 2.