Topic is Effects of hand hygiene in the hospital, Article choice is very important, therefore:Articles used for this assignment cannot be used for the other assignments. The selected articles should be original research studies. Review articles, concept analysis, meta-analysis, meta-synthesis, integrative review, and systemic review articles should not be used.Mixed-methods studies should not be used.should be in APA format

Please read the peers discussions and respond to them APA format with referenceDiscussion 1Nurse Managers and Leaders play a vital role in the reengineering of health care. Advocating for legislation to ensure the safety of the work environment and for procedures which enhance patient care and outcomes is important in reengineering health care. A manager and a nurse leader also needs to ensure that staff are practicing with in their scope of responsibilities , which requires updating unit polices/procedures and requiring continuing education to ensure nurses are performing their duties that in line with updated guidelines . Additionally, w hen change is needed, it’s the responsibility of managers/leaders to ensure changes are implemented within a reasonable amount of time. Change that takes place in too rapid a period may create too much anxiety and allow for numerous errors. Some of the ways Nurse Managers reenginer the health care system is by using ethical and professional decision making to protect the rights of patients and employees. They also ensure a legal environment. Nurse managers should keep up with the legal aspects in health care. This is very important because being legally knowledgable protects patients, employees and the organization as a whole. Nurse managers need to be cognizant of the environment in which they function in order to anticipate the need for change. References Huber, D. (2014). Leadership and Nursing Care Management, 5th Edition. [ Pageburstl ]. Retrieved from https://pageburstls.elsevier.com/#/books/978145574...Discussion 2In the reengineering of healthcare, the nurse manger isresponsible for creating safe, healthy environments that support the work ofthe health care team and contribute to patient engagement. The role isinfluential in creating a professional environment and fostering a culturewhere interdisciplinary team members are able to contribute to optimal patientoutcomes and grow professionally,” the American Organization of NurseExecutives said.Nurse managers need strong communication and leadershipskills. They should be adept at coordinating resources and personnel andmeeting goals and objectives. They must be effective leaders who can strike abalance between working with the nursing staff and the healthcare facilityadministrators.The Agency for Healthcare Research and Quality, a branch ofthe U.S. Department of Health and Human Services, said nurse managers arechange agents. They work with staff to find and implement useful changes toimprove patient wellness and safety outcomes. Nurse managers also implementregulatory guidelines for patient safety set by state and federal agencies,such as the U.S. Centers for Disease Control and Prevention, the JointCommission, and Centers for Medicare & Medicaid Services. They have to makesure the staff is educated on care standards and can implement them as needed.Reference:The Roles of a Nurse Manager: Leading the nursing professioninto the future. (2017, May 24). Retrieved fromhttps://onlinenursing.duq.edu/blog/roles-nurse-man...Discussion 3In this era of modern technology, the health care organizations and hospitals have started adopting the innovative and creative management strategies in order to improve the health care processes with the support of the leaders or managers (Birken et al.). The business activities in hospitals are affected by a large number of internal and external factors. The hospitals are currently evaluating the trends in the health care environment as the external factor come to bear in luxuries. The role of a nurse manager or leader in health care involves the care of both internal and external factors. It is a tough position as the nurse leader plays a significant role in keeping the health management processes in motion. The nurse manager unites the health care team in order to provide well centered and reengineered health care services to the patients. There are many characteristics that allow the nurse leaders to play a significant role in the reengineering of health care. One of the characteristics is the ethical decision making which means that the nurse managers should use the ethical and legal professional codes in order to implement policies and take care of the rights of the patients and employees working the health care areas. Also, the nurse leaders or manager should keep the legal aspects up to date in the field of health care. It involves reinforcing laws and legislation as required in the health care system. It is very vital in health care as being legally aware assists in protecting patients, employees and organizations. Apart from the ethical decision making and legislation, the advocacy also plays an important role in nursing management and staff. Many times the nursing roles find themselves in a position to advocate for others which can involve providing other people with the information and data which strengthens them to make their own decisions and acting in the place of another person who cannot advocate for their own. The advocacy is based on decision making rather than making decision for others. In addition to this, changing management is an important aspect related to the role of nurses in reengineering of health care. In this era, change happens very quickly as compared to the old days. Sometimes it happens so quickly that it becomes difficult to analyze the series of changes i.e. which change has finished and which change has begun. The nurse leaders analyze the need for a change, create opportunities and a shared vision, communicate and involve people, develop structures that support the change and reinforce the change (Kodama, and Fukahori). The leaders also solve the conflicts and crisis that may occur in the successful implementation of the required change. Leaders play a significant role in shaping up the organization culture and satisfy the customers in association with the latest advancements in the required field. The nurse manager or leaders are required to learn and adapt the new technologies continuously in order to play a vital role in the reengineering of health care. It improves the quality management processes of the internal environment of the organizations which ultimately becomes a strong point. Thus, the outcomes should be analyzed and evaluated clearly in order to improve the workflows and the business procedures that take place inside a health care organization. Work Cited Birken, Sarah A et al. "Uncovering Middle Managers' Role In Healthcare Innovation Implementation". Implementation Science, vol 7, no. 1, 2012. Springer Nature, doi:10.1186/1748-5908-7-28. Accessed 28 June 2018. Kodama, Yoshimi, and Hiroki Fukahori. "Nurse Managers’ Attributes To Promote Change In Their Wards: A Qualitative Study". Nursing Open, vol 4, no. 4, 2017, pp. 209-217. Wiley, doi:10.1002/nop2.87. Accessed 28 June 2018.Discussion 4The role of a nurse manager is a tough position. As a leader you play a vital part in advancing and keeping the healthcare system in motion. The nurse manager initiates & unites the health care team to deliver a patient centered, well engineered health care system. According to Grand Canyon University (????) there are several characteristics/scenarios that allow the nurse manager to play a vital role in reengineering the health care system: Ethical decision making-Nurse managers use both ethical and professional codes to protect the rights of patients and employees. Managers take in account ethical and professional codes when making decisions. Legal environment-Nurse managers should keep up to date with the legal aspects in health are. This is important because being legally knowledgeable protects patients, staff members and organizations. Advocating-Nurse managers play a vital role in advancing for patients and staff. There are situations in which the nurse manager needs to step in and advocate for patients and staff. Change-Managers and leaders help initiate change in the fast paced world of healthcare. They find new approaches in healthcare based on evidence based practice to allow the hospital to administer the best quality of care. Conflict resolution-In situations in which there is conflict between team members, patients or even managers, leaders step in to advocate and defuse the situation. This allows for a safe work place environment for staff and patients. Communication during high stress-Leaders prepare team members for crisis situations. Through providing information, teamwork and preparation. For example, during a disaster, leaders guide team members to appropriate stations and keep staff calm and proactive. Reference Grand Canyon University (NRS-451V Lecture 5. Retrieved July 1, 2018 from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?operation=home&token=D9MGLcmh277D%2bRsjON6WUcn%2bTpW%2bj%2fwGDgWfsc4QZ%2bpV3H0m%2fZ9CAo%2f7JJkoBVre&classId=2146760#/learningPlatform/loudBooks/loudbooks.html?currentTopicname=Organizational%20Culture%20and%20Values&viewPage=past&operation=innerPage&topicMaterialId=ec0ec62b-fc64-4116-8c49-ef1b90d4d739&contentId=e0dbfc00-b214-4c77-85d5-9f299b901e72& Birken, S., Lee, S., Weiner, B. (2012, April) 3 Uncovering middle managers’ role in healthcare innovation implementation. Retrieved July 1, 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC33724...Discussion 5Nurse managers and leaders are not receiving enough attention in health services research, yet they play a crucial role in healthcare re-engineering and implementation of health care policies. They are involved in revising and changing organizational structures and redesigning of the functioning systems in place. The primary focus in making a change is to analyze the outcome of patient care from the consumers perspective and maximize productivity through proper alteration of established systems (Huber, 2013). Nurse leaders and managers focus on methods that would enhance patient-centered care, teamwork, and collaboration, evidence-based practice. They would use their background and current evidence-based research to improve patient outcome. System failures are the root-cause of higher mortality rates and efforts should be made to address these issues. In an interview, Jim Collins, a professional business analyst, explains how institutions fall from excellent performance to good to mediocre to dangerous and even disastrous. He uses an analogy of the early stages of diseases to describe how organizations look healthy on the outside but are falling apart on the inside. (Cone, 2002) The chief problem with these issues is that most institutions are in denial of their systemic weakness that contributes to medical errors. It is the responsibility of nurse managers and leaders to bring these systemic issues to the organization and find solutions that would optimize the delivery of adequate patient care. Furthermore, nurse leaders should fully understand their scope of practice and create autonomous roles that would impact and change the health care system. Reference: Cone, J. (2002). Built to be great: T+D talks with Jim Collins about what it takes to go from good to great. T+D, (8). 22.Huber, D. (10/2013). Leadership and Nursing Care Management, 5th Edition [VitalSource Bookshelf version]. Retrieved from https://bookshelf.vitalsource.com/books/9781455740...Discussion 6The role that the nurse manager or leader plays in the reengineering of health care is that they help organizations reorder priorities, help provide more cost-effective care, and increase value to patients. Reengineering assists in redesigning administrative functions, clinical services, and caregiving programs to improve health status (Edens, 2005). Reengineering is a necessary skill of health care organizations if they want to succeed in the future.As changes in nursing occur continuously, negotiation skills of leaders and managers are needed to handle downsizing, mergers and restructuring. Nurse leaders and manager need to anticipate and be ready for change.Edens, P., (2005). Workplace Reengineering, Reorganization, and Redesign. Retrieved July 1, 2018, from http://www.medscape.com/perspective/medscapecritic…

1- Locate a peer-reviewed journal article through the Saudi Digital Library. This article will describe a healthcare quality improvement that occurred within an organization. In this discussion, you willExamine the quality improvement that occurred, including the background and the process changes.Explain the challenges in adopting these changes and outline the key issues that need to be considered when implementing the process of change for this decision.Describe how this quality improvement effort aligns with Saudi Vision 2030. 2- Discuss the importance of leadership in the implementation of the electronic health record from the perspective of meeting the end-user’s functional needs from that system. How does this help a healthcare organization in KSA meet their business and clinical intelligence needs?In developing your initial response, be sure to draw from, explore, and cite credible reference materials. In responding to your classmates’ posts, you are encouraged to examine their opinions, offering supporting and/or opposing views.&