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Running head: JOURNAL

LEADERSHIP JOURNAL

Ashlee Knoll

Ferris State University

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JOURNAL
Leadership Journal

Implementing process improvement projects in any organization is associated with a

variety of challenges and limitations as well as exciting triumphs. My project is focusing on the

specimen labeling process in the Emergency Department at Ascension St. Mary’s in effort to

decrease mislabeling events. The purpose of this leadership journal is to reflect on the progress

of my project up to this point. I will correlate my progress thus far in relation to some of the

American Nurses Association (ANA) Scope and Standards of Practice in Nursing. I will focus

specifically on standard 1 assessment, standard 12 regarding education, and standard 16 focusing

on resource utilization.

Standard 1: Assessment

When assessing patients nurses use a head to toe approach in hopes to not overlook

something important. When reviewing a policy or process, I believe the same approach is

necessary. By assessing the specimen labeling process from start to finish I was better able to

understand where the breakdowns in continuity were occurring. To properly assess the process,

the input of the nursing staff that will be impacted must be considered. One of the things I

learned during my assessment of specimen labeling is that several events were occurring because

students were completing the labeling. This realization prompted a rule for students, in every

department, to not be allowed to apply the labels on specimens. We still encourage them to draw

the labs and to do so properly, but the nurse should be at the bedside with them and is

responsible to adhere the labels to the specimen tubes. The openness of other departments to

allow me to assess the issues has been very beneficial for me to assess the process. As much as I

want to determine the root cause of mislabeling events and impact positive change, it cannot be

overlooked that human error is inevitable.

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Standard 12: Education

Before nurses can be held accountable for their adherence to a new policy or procedure,

they first must be properly educated on the process. To complete staff education I created a

trifold presentation board with examples of common mislabeling issues. Also included on this

board were simple, easy to follow instructions to help ensure compliance. I was able to present

this information to the nursing staff of the emergency department on all shifts and then place the

presentation board in their break room for continued review. To maintain awareness of the issue,

specimen mislabeling events are monitored daily as part of the morning unit huddles. The

tracking tool as also presented to the staff to help establish ownership of the process. The annual

mandatory education module was also evaluated with the education department to accurately

reflect the specifics of the specimen labeling process that are being implemented. This module is

assigned to the emergency department staff and will be pushed out to all of nursing as well. The

ANA nursing standard of education (2015) states that “The registered nurse seeks knowledge

and competence that reflects current nursing practice and promotes futuristic thinking. The staff

members I have educated have been very open to the process change. They understand the

importance and safety issues that are associated with specimen mislabeling events. Walker

(2016) explains that regardless of the setting, the nurse’s primary commitment is to the patient.

The continued presence of the education material has also created opportunities for further

education for new associates or students. The education of new associates that have started has

proven to be a barrier for this process as now I am relying on their preceptors to teach them how

to appropriately label their specimens.

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Standard 16: Resource Utilization

Understanding and successfully utilizing the available resources in any organization is

something that occurs over time. When creating the team for this project, I was in a fortunate

position to understand who would be beneficial to include based on previous teams that I have

participated. I have a strong rapport with several of them so despite their busy work schedules,

they have been willing to collaborate with me with the shared hope to impact patient safety.

Holtschneider (2016) discusses how the prior focus of education and learning environments have

focused on nursing but should continue to expand to encompass the entire healthcare team. I

need to continue to improve on effectively leading a team meeting. Although I come to the

meeting prepared with what I think will be necessary, I have encountered issues that I feel I

should have thought out more in depth prior to our meeting. However, the team members are

very accessible if I need anything or have any questions and encourage me to call to not hinder

progress.

Conclusion

So far I have truly enjoyed implementing the phases of my project. I have not

encountered the reluctant behavior from the nursing staff that I anticipated as a possible

constraint initially. During this leadership journal I have discussed some of the aspects of my

project that are going well, and some that have posed opportunities for improvement. I have

related my progress to the ANA scope and standards of nursing specifically focusing on

assessment, education, and resource utilization. It has been reaffirming to review the scope and

standards of nursing practice and reflect back on the interactions I have had with the nurses of

Ascension St. Mary’s who are truly striving to provide excellent patient care.
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References

American Nurses Association. (2015). Nursing: Scope and Standards of Practice (Third ed.).

Silver Spring, MD: Author.

Holtschneider, M. E. (2017). Expanding the Fidelity of Standardized Patients in Simulation by

Incorporating Wearable Technology. Journal for Nurses in Professional

Development, 33(6), 320-321. doi:10.1097/NND.0000000000000391

Walker, S. Y. (2016, July). Due process in nursing education. Teaching and Learning in

Nursing, 11(3), 126-127. doi:10.1016/j.teln.2016.03.005