Response one: Nurse managers and leaders contribute to the reengineering of health care by creating teams that are diverse, talented, educated, well-trained, and inspired. Managers and leaders can demonstrate a commitment to the values and vision of an organization and create an environment of well-engaged nurses and other collaborating staff. Providing opportunities for funding of research and resources to keep up-to-date training, education, and technology have been shown to improve patient safety, satisfaction, and quality of care (Sherman, 2014). It is also important for managers and leaders to be risk-takers and be strong enough to address negative behavior or poor work quality. By stepping out of the comfort zone, leaders and managers can create and foster an environment that inspires progress and advancements through a team that is always looking to make things better (Helbig, 2018). Having the mindset and value of continuous improvement keeps employees well-engaged and goal-driven. Focusing on empowerment as opposed to direction can instill a sense of trust and value in employees. It is also important to create a diverse environment that values cultural-differences and various viewpoints as having different perspectives and experiences can also create positive change. Employees should be allowed time to brainstorm ideas and develop approaches. Measures should also be taken to research what has worked in the past and how to best research or test new approaches. ReferencesHelbig, J. (2018). Reengineering health care management. In Nursing leadership & management: Leading and serving. [Academic Web Service]. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadershi...Sherman, R. (2014). Nurse work engagement. Retrieved from https://www.emergingrnleader.com/nurse-work-engage...Response two : Nurses make up a very large part of any healthcare organization and have the ability and responsibility to influence healthcare delivery systems (Helbig, 2019). A few ways in which nurses have the ability to reengineer healthcare can be found in culture, policy, and workflow.Policy influence is seen when nurses show their patient outcomes and patient satisfaction scores. Nurses have direct impacts on outcomes and patient satisfaction. When outcomes and satisfaction is high, nurses will have a strong voice at impacting new policies. When these two factors are low, nurses can help shape new policies to bolster each. The Institute of Medicine’s 2011 report realized this and called for leadership in nursing to shape and improve the quality of healthcare (Helbig, 2019).Workflow can impact a healthcare organization immensely. Good workflow patterns will show efficiency and nursing is the backbone of workflow in any healthcare organization (Helbig, 2019). Efficient nursing workflow will translate into reliable, consistent, safe, and compliant healthcare (Helbig, 2019).Culture is an area that can define an organization. We all have probably worked in areas with negative or positive cultures and the difference can be readily felt and seen. Culture in our textbook has been deemed the “heart of a successful organization” (Helbig, 2019). Nurses should be selective in job hunting to find an organization that shows strong support of nursing, such as a magnet designated institution. A culture that supports nurses through education, appreciation, recognition, and communication will benefit huge rewards from nurses that feel empowered and engaged (Helbig, 2019). Some of these rewards will be seen in patient satisfaction scores which can translate into payment benefits with the Centers for Medicare and Medicaid Services (Helbig, 2019). Overall, it is always in an organizations best interests to keep nurses empowered and appreciated and nurses should not forget the voice they truly have to influence this type of workforce.ReferenceHelbig, J., (2019). Reengineering health care management. Nursing Leadership & Management: Leading and Serving. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/#/chapter/5RESPONSE THREE: Continuous quality improvement “is based on the notion that there is always opportunity for improvement” (Helbig, 2018). No matter what kind of health care, there is room for improvement. Our facility just recently put together an intensive care unit (ICU) committee. The hope is to improve the education, skill, workflow, equipment and resources in the ICU. We currently have a two bed ICU. There are minimal staff who are able to work in the ICU. We often times have to transfer patients to another facility when they need to be admitted to the ICU because we don’t have enough staff that are trained to care for these patients. With this committee we are utilizing our trained staff to train other members how to become efficient and knowledgeable in caring for ICU patients. We are setting up skills stations to teach staff how to monitor critically ill patients. There are skills stations on starting and monitoring medications that will often be given to ICU patients. The ICU equipment has been set up for teaching purposes and staff are being given orientation in the ICU so they know where the equipment is, what it is for and how to use it. There are educational resources that are well laid out in the ICU so that the staff can have quick reference guides. There are phone numbers to ICU doctors and nurses readily available so that they have resources to call if or when they have questions. It is our hope that we will be able to successfully train enough staff so that we will decrease the number of critically ill patients that need to be transferred. If we are successful, this will allow more patients who doctor at our facility and who want to stay at our facility and close to home to be able to do so while still receiving excellent care from trained nursing staff. Our ICU manager is the head of the committee but has given the handful of nurses in the committee permission to choose which staff we think would be a good addition to the ICU and start training them. “Quality improvement strategy aims to promote health and health care centered on the needs of patients, families, and communities, and incorporate evidence-based results in clinical medicine, public health, and health care delivery using collaboration to improve care” (Helbig, 2018). We have had an increase of patient’s voice how difficult it is for them to be so far away from home when they are transferred to a different facility. It is our hope that we can train enough staff at our facility to be able to accommodate the requests of our patients and continue to provide excellent care for them.Reference:Helbig J. (2018). Organizational Culture and Values. Nursing Leadership and Management: Leading and Serving. Retrieved from http://lc.gcumedia.com/nrs451un/nursing-leadership...RESPONSE FOUR : Continuous quality improvement (CQI) in healthcare is important to identify problems, and develop new processes. Part of CQI is to implement, monitor, and study nursing processes to ensure safe, efficient, and effective patient care. According CDC (2010), catheter-associated urinary tract infections (CAUTI) account for more than 30% of healthcare-associated infections. CAUTI is responsible for increased morbidity, mortality, hospital cost, and length of stay. CAUTI can be easily prevented when nurses follow improved guidelines established by CQI. (CDC, 2010)At the job, CQI is applied in various health issues. For example, the CQI team implemented the reliable care plan that requires all Foley catheters to be monitored by 2 nurses. Two nurses are required to review the patients chart for information that leads to a reason for the catheter. If alternative methods are appropriate, have they been attempted? All catheter placements must have a doctors’ order, and be reviewed every 24 hours for necessity. Also, two nurses must be present at the bedside during a Foley insertion. Latex allergies are assessed, all supplies are reviewed, and one nurse uses sterile technique while the other observes for any breeches in sterility. This is helpful to prevent infection if in the middle of the procedure the insertion nurse needs any supplies or assistance. Once the Foley is in, the observing nurse does the charting on the insertion; this is also helpful to ensure accurate documentation. ReferenceCDC, 2010. Healthcare infection control practices advisory committee, Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/hicpac/CAUTI_fastFacts.html