Time Management, Conflict
Resolution, and Quality
Improvement in Nursing
Practice
Felicia Pendleton, MSN, RN, FNP-C
Learning Outcomes
At the completion of this learning module,
the student will:
1.
2.
3.
4.
5.
6.
Discuss time management strategies.
Discuss the relationship of conflict to
management of nursing care.
Discuss five conflict resolution methods.
Describe the stages and phases of
planned change.
Identify principles and strategies in
initiating change.
Describe the essential activities of a
quality improvement program.
Issues in Nursing Practice
Professional Nursing Practice:
 Client and Client Care
 Safe Practice
Involves:
 Critical Thinking
 Time Management
 Conflict Resolution
 Quality Improvement
Demands of Nursing Practice
The current status of healthcare
organizations, trying to do more
with less, has led to demands
(stressors) being placed on care
providers and care managers
Stress and Time Management

Stress –


decreases productivity
leads to poor use of time

Time Management –

method to reduce stress
preventive action to reduce elements of
stress in nurse’s life

Time Management
The ability to spend your time on
the things that matter to you and
your organization
Time Management
Strategies





Goal Setting
Setting Priorities
Organization
Time Tools
Managing Information
Relationship of Conflict to
Management of Nursing Care

Stressors in the Healthcare environment:
*Increased
demands
*Limited and aging workforce
*Decrease in resources
*Increased acuity
*Increased underinsured client population

Management of nursing care:
*Stressors affect staff members and contribute to
conflict in the workplace
*Nurse managers must learn to deal with conflict and
try to resolve it effectively
Conflict Resolution
Conflict Resolution Methods





Avoiding
Accommodating
Competing
Compromising
Collaborating
Stages and Phases of
Change
Linear Change: Planned Change Theories
Havelock’s (1973) six-stage model,
Lippit, Watson, and Westley’s (1958) sevenphases model, and
Roger’s (1995) five-stage - Innovation-Decision
Process
Nonlinear Change: Chaos Theory
Change

Barriers – factors that hinder the
change process

Facilitators – factors that
expedite the change process
Effective Change

Force of facilitators outweigh
force of barriers

Reduce barriers and support or
enhance facilitators
Stages of Planned Change

Unfreezing

Experiencing the Change

Refreezing
Six Stages of Planned Change
(Havelock, 1973)






Building a relationship
Diagnosing the problem
Acquiring relevant resources
Choosing the solution
Gaining acceptance
Stabilizing the innovation and
generating self-renewal
Seven Phases of Planned Change
(Lippitt, Watson, & Westley, 1958)







Client system becomes aware of the
change
Relationship is developed between
client system and change agent
Change problem is identified
Change goals are set and options for
achievement are explored
Plan for change is implemented
Change is accepted and stabilized
Change entities redefine their
relationships
Innovation-Decision Process –
Five Stages (Rogers, 1995)





Knowledge
Persuasion
Decision
Implementation
Confirmation
Effective Management Practices
for Instituting Change





Managing change process actively
Balancing tension between efficiency
and reliability
Creating a learning environment
Creating and sustaining trust
Involving the staff in decision-making
Principles and Strategies in
Initiating Change
Change Management: Five Functions





Planning (includes assessment)
Organizing
Implementing
Evaluating
Seeking feedback
Quality Improvement (QI)



Goal – improve quality
Focus – prevention of errors
Major Tasks –





Review nursing activities
Innovation
Staff development
Quality Team – multidisciplinary
Outcomes – set with input from staff
and patients
Essential Activities of QI
Major steps in QI process:



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
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Identify needs
Assemble a multidisciplinary team
Collect data
Establish measurable outcomes
Select and implement plan to meet
outcomes
Evaluate plan and outcomes
Reference
Yoder-Wise, P.S. (2007). Leading and managing in
nursing (4th ed.). Philadelphia, PA: Mosby Elsevier.