Provide your rationale, identifying specific characteristics of effective managers and leaders. (Note: Do not identify these individuals by name, position, or location.)

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Think of the managers you have reported to thus far in your career. Now consider the people you have worked with or know of that you would consider leaders. Based on these experiences, what would you surmise about the responsibilities of managers and leaders and about the distinctions between these two categories in health care settings?

This week’s Learning Resources classify management and leadership (which are often confused in everyday discussion) and explain their significance for health care organizations. As you advance professionally, it is critical to understand the distinctions between management and leadership and how you can apply this knowledge for increasing effectiveness in your workplace.

To prepare:

·        Review the information in the Learning Resources.

·        Conduct additional research on your own and select at least two current, credible sources that contribute to your understanding of management and leadership.

·        Reflect on how the roles of management and leadership differ in supporting the organization to set and achieve goals.

·        Drawing upon specific examples from a current or previous practice setting, bring to mind someone who seemed to be a leader but not a manager and someone who seemed to be a manager but not a leader (generally speaking, or within a specific circumstance). Be prepared to support your assessment with specific behavioral descriptions found in the literature.

 

On the Week 8 Discussion Board, 1 page, APA format

1.      an analysis of how management and leadership roles differ in terms of supporting an organization to set and achieve goals.

2.      In addition, post  descriptions of an individual who demonstrates leadership behaviors but not management behaviors and an individual who demonstrates management behaviors but not leadership behaviors.

3.      Provide your rationale, identifying specific characteristics of effective managers and leaders. (Note: Do not identify these individuals by name, position, or location.)

 

 

Course readings

·        Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

o   Review Chapters 2 and 3

Note: Many of the articles in this week’s Required Readings are foundational in the leadership and management literature. The concepts presented in these early articles still apply to today’s workplace.

·        Jennings, B. M., Scalzi, C. C., Rodgers, J. D., & Keane, A. (2007). Differentiating nursing leadership and management competencies. Nursing Outlook, 55(4), 169–175.
Retrieved from the Walden Library databases.

In this foundational article, Jennings explores the similarities and differences between leadership and management competencies. The research implies that there is a growing ambiguity between the competencies required in nursing that must be addressed.

·        Keys, Y. (2014). Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers. Journal of nursing management, 22(1), 97-105.doiI: 10.1111/jonm.12198

Abstract excerpt: The aim of this study identifies elements of professional success, and personal and professional fulfilment as defined by Generation X Nurse Managers.

·        Leach, L. S., & McFarland, P. (2014). Assessing the Professional Development Needs of Experienced Nurse Executive Leaders. Journal of Nursing Administration, 44(1), 51-62. doi: 10.1097/NNA.0000000000000021

Abstract excerpt: The objective of this study was to identify the professional development topics that senior nurse leaders believe are important to their advancement and success. Visionary leadership, leading complexity, and effective teams were the highest ranked leadership topics. Leading change, advancing health: The future of nursing, healthy work environments, and healthcare reform were also highly ranked topics.

·        Marker, D. (2010). Leadership or management? Management Quarterly, 51(2), 31–34.
Retrieved from the Walden Library databases.

This article defines what leadership and management are and explains differences between the concepts. According to Marker, managers are associated with position and power, while leadership is associated with position, guidance, and communication.

·        Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014). Transformational leadership practices of nurse leaders in professional nursing associations. Journal of Nursing Administration, 44(4), 201-206.doi: 10.1097/NNA.0000000000000044

Abstract excerpt: To build transformational frontline nurse leaders, organizations should balance formal leadership training programs with advanced degree attainment to encourage leaders to envision and challenge the future.

·        Stoddart, K., Bugge, C., Shepherd, A., & Farquharson, B. (2014). The new clinical leadership role of senior charge nurses: a mixed methods study of their views and experience. Journal of Nursing Management, 22(1), 49-59.DOI: 10.1111/jonm.12008

Abstract excerpt: The aim of this study was to investigate the experience and views of senior charge nurses in relation to the implementation of a national clinical leadership policy.

·        Yi, H. H., & Yi, Y. J. (2014). Influence of Leader-Member exchange quality of head nurses and clinical nurses on organizational commitment and job satisfaction in clinical nurses. Journal of Korean Academy of Nursing Administration, 20(2), 195-205.

Abstract excerpt: The purpose was to identify the influence the quality of head and clinical nurses’ LMX (Leader-Member Exchange) on job satisfaction and organizational commitment.

 

 

    Construct the appropriate two by two tables using the data given above. Be sure to label the cells and margins.

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1.       A cohort study was undertaken to examine the association between high lipid level and coronary heart disease (CHD). Participants were classified as having either a high lipid level (exposed) or a low or normal lipid level (unexposed). Because age is associated with both lipid level and risk of heart disease, age was considered a potential confounder or effect modifier and the age of each subject was recorded. The following data describes the study participants: Overall, there were 11,000 young participants and 9,000 old participants. Of the 4,000 young participants with high lipid levels, 20 of them developed CHD. Of the 6,000 old participants with high lipid levels, 200 of them developed CHD. In the unexposed, 18 young and 65 old participants developed CHD.

·         Construct the appropriate two by two tables using the data given above. Be sure to label the cells and margins.

·         Calculate the appropriate crude ratio measure of association combining the data for young and old individuals.

·         Now, perform a stratified analysis and calculate the appropriate stratum-specific ratio measures of association. What are they?

·         Do the data provide evidence of effect measure modification on the ratio scale? Justify your answer.

 

 

Question 2

Consider each of the following scenarios and state whether or not the variable in question is a confounder, and why.

·         A study of the risk of pulmonary hypertension among women who take diet drugs to lose weight. The crude relative risk of pulmonary hypertension comparing diet drug users to non-users is 17.0 and the age adjusted relative risk is 5.0. Is age a confounder in this study?

·         A cohort study of liver cancer among alcoholics. Incidence rates of liver cancer among alcoholic men are compared to a group of non-alcoholic men. Is gender a confounder in this study?

·         A case-control study of the risk of beer consumption and oral cancer among men. In this study, cigarette smoking is associated with beer consumption and is a risk factor for oral cancer among both beer drinkers and nondrinkers. Is cigarette smoking a confounder in this study?

 

 

Question 3

The association between cellular telephone use and the risk of brain cancer was investigated in a case-control study. The study included 475 cases and 400 controls and the following results were seen:

Cases Controls
Cellular Phone User Yes 270 200
No 205 200
Total 475 400

·         Calculate the odds ratio based on these data.

·         The p value for this odds ratio is 0.06. State your interpretation of this p-value.

Gender was considered a potential confounder and effect measure modifier in this study. The data were stratified into males and females in order to assess these issues.

Males Females
Cases Controls Cases Controls
Cellular Phone User Yes 242 150 Yes 28 50
No 100 50 No 105 150

·         Calculate the stratum-specific odds ratios.

·         Is gender a confounder in this study?  Briefly justify your answer.

 

·         Is gender an effect measure modifier in this study? Briefly justify your answer.

, describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.

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The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To prepare:

·        Review the Bazzano et al. and Mayhew articles in the Learning Resources. Reflect on situations in which children should be prescribed drugs for off-label use.

·        Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

Post 1 page APA format

1.      an explanation of circumstances under which children should be prescribed drugs for off-label use.

2.      Then, describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.

3.      Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

 

Readings

·        Bazzano, A. T, Mangione-Smith, R., Schonlau, M., Suttorp, M. J., & Brook, R. H. (2009). Off-label prescribing to children in the United States outpatient setting. Academic Pediatrics, 9(2), 81–88.
Retrieved from Walden Library databases.

This study examines the frequency of off-label prescribing to children and explores factors that impact off-label prescribing.

 

·        Mayhew, M. (2009). Off-label prescribing. The Journal for Nurse Practitioners, 5(2), 122–123.
Retrieved from the Walden Library databases.

This article reviews the prevalence of off-label prescribing, including its benefits and risks. It also explores issues regarding the safety of off-label prescribing and when it is unavoidable.

Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?

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When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.

To prepare:

·        Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.

·        Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

o   Mammogram

o   Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds)

o   Prostate-specific antigen (PSA) test

o   Dix-Hallpike test

o   Body-mass index (BMI) using waist circumference for adults

·        Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

·        Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?

·        Are there any controversies or issues related to any of these tests or tools?

·        Consider any ethical dilemmas that could arise by using these tests or tools.

Post 1 page paper APA format a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

 

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

o   Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

·        Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o   Appendices A–E (pp. 225–236)

·        Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163.
Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

·        Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150.
Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

·        Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.
Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions.

·        Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.
Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test.

Optional Resources

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 3, “The Physical Screening Examination”

o   Chapter 17, “Principles of Diagnostic Testing