As you plan, develop, implement and evaluate your nursing practicum project, reflect on how this project and your graduate education have prepared you to meet the growing needs of healthcare and the diverse populations we serve.

This week you will address Essential II: Organizational Systems and Leadership.

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Recognizes that organizational and systems leadership are critical to the

promotion of high quality and safe patient care. Leadership skills are

needed that emphasize ethical and critical decision making, effective

working relationships, and a systems-perspective.


Organizational and systems leadership are critical to the promotion of high quality and

safe patient care. Leadership skills are needed that emphasize ethical and critical decision

making. The master’s-prepared nurse’s knowledge and skills in these areas are consistent

with nursing and healthcare goals to eliminate health disparities and to promote

excellence in practice. Master’s-level practice includes direct care and a

focus on the systems that provide care and serve the needs of a panel of patients, a

defined population, or community.

To be effective, graduates must demonstrate leadership by initiating and

maintaining effective working relationships using mutually respectful communication

and collaboration within interprofessional teams, demonstrating skills in care

coordination, delegation, and initiating conflict resolution strategies. The master’s prepared

nurse provides and coordinates comprehensive care for patients–individuals,

families, groups, and communities–in multiple and varied settings. Using information

from numerous sources, these nurses navigate the patient through the healthcare system

and assume accountability for quality outcomes. Skills essential to leadership include

communication, collaboration, negotiation, delegation, and coordination.

Master’s-prepared nurses are members and leaders of healthcare teams that deliver a

variety of services. These graduates bring a unique blend of knowledge, judgment, skills,

and caring to the team. As a leader and partner with other health professionals, these

nurses seek collaboration and consultation with other providers as necessary in the

design, coordination, and evaluation of patient care outcomes.

In an environment with ongoing changes in the organization and financing of health care,

all master’s-prepared nurses must have a keen understanding of healthcare

policy, organization, and financing. This content aims to prepare a graduate

to provide quality, cost-effective care, participate in the implementation of care, and assume a leadership role in managing human, fiscal, and physical healthcare

resources. Program graduates understand the economies of care, business principles, and

how to work within and affect change in systems.

The master’s-prepared nurse must analyze the impact of systems on patient outcomes, including analyzing error rates. These nurses will be prepared with knowledge

and expertise in assessing organizations, identifying systems’ issues, and facilitating

organization-wide changes in practice delivery. Master’s-prepared nurses must use effective interdisciplinary communication skills to work across departments

to identify opportunities and design and test systems and programs to improve

care. In addition, nurse practice at this level requires an understanding of complexity

theory and systems thinking and the business and financial acumen needed for the

analysis of practice quality and costs.

Sample Content

• Leadership, including theory, leadership styles, contemporary approaches, and

strategies (organizing, managing, delegating, supervising, collaborating, coordinating)

• Data-driven decision-making based on an ethical framework to promote culturally

responsive, quality patient care in a variety of settings, including creative and imaginative

strategies in problem-solving

• Communication–both interpersonal and organizational–including elements and

channels, models, and barriers

• Conflict, including conflict resolution, mediation, negotiation, and managing conflict

• Change theory and social change theories

• Systems theory and complexity science

• Healthcare systems and organizational relationships (e.g., finance, organizational

structure, and delivery of care, including mission/vision/philosophy and values)

• Healthcare finance, including budgeting, cost/benefit analysis, variance analysis, and


• Operations research (e.g., queuing theory, supply chain management, and systems

designs in health care)

• Teams and teamwork, including team leadership, building effective tea

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