Change Initiative

Respond to your colleagues and explain how your leadership strengths identified in the Clifton Strengths Finder could improve upon the change initiative processes they describe. Be specific. Use your Resources to support your response.


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Within the last year, we went through implemented changes in the steps of our surgical count. During surgery, the surgical technologist and circulating nurse must ensure counts are correct four countable items and instruments, when appropriate, before closure of the last skin layer. There was a near event of an unintentionally retained item and following this, there was an actual unintentionally retained item occurrence that drove management into a frenzy. Surgical counts are extremely important in surgery. In ensures patient safety and reduces incidences of surgical complications (Kertesz, 2020).

           After the incident, a strict counting protocol was set in place for both instrumentation and countable good. While it makes perfectly good sense to account for all instrument in our surgical pans, it is unrealistic with certain surgical procedures have pans that contain well over 300 pieces. Management tried to implement a protocol to count all items in surgical pans and on start times were delayed, teams grew frustrated, and in general this protocol was ill-fitted for certain surgical procedures. In addition, a doctor who was no longer in practice came to the facility to offer a course over the count of surgical sponges. I clearly remember there was a lot of confusion and we all felt misunderstood as to why these changes did not fit well in every surgical case.

           Strategic planning entails assessment of the environment, developing implementation strategies, planning their implementation, and planning evaluation. Goals, missions and values, a summary and background of the institution will help align course outcomes and objectives (Harper, 2018). Leaders and managers are a critical part of strategic planning. My strengths in the Clifton Strengths Finder were achiever, learner, harmony, positivity, and input. An achiever seeks to get things accomplished. A learner seeks new knowledge to have the most current information to help practice. A harmonious individual seeks to ensure a harmonious working environment for higher employee satisfaction which ultimately reflects on patient outcomes. Positivity is a quality than can rub off on staff. The Input theme is extremely important as it falls nicely within the evaluation necessities of program evaluation which ultimately determine outcomes.

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           I do believe this initiative was poorly implement and there was not a follow up on the subject. One of the five competencies is that leaders influence policy to achieve positive health outcomes. Leading educators serve as mentors. Education leaders seek the most up do date healthcare information to help implement that into practice. Leaders are strong advocates for a healthy work environment to enhance patient and staff safety. Finally, leaders in education focus on building strong relationship and communication with colleagues and stakeholders in order to help positively influence patient outcomes. Our leaders tried to ensure communication; however, it was not fully achieved. People in my shift were some of the last to be aware of changes because we work weekends. Increased efforts to ensure everyone is informed could have been more helpful. Our leaders did mentor is in the new policies and created mandatory information sessions to attend. They ensured we got breaks when needed to attend. Our educator did present us with the most up-to-date evidence-based practices. Leaders did not ask us for input before the implementation of the new counting policy which really threw everyone off. Additionally, we did not believe there was that big of an issue and the sudden impact of these changes really made the usual flow run a lot less smooth.

           Receiving input from staff who work in the operating room can be extremely beneficial. A thorough environmental assessment could have helped identify why there was an item that was not accounted for. Leaders in education have a lot of roles to play alongside a very big contribution to the future of nursing and patient outcomes (Harper, 2017).


Harper, M. G. (2018). Strategic management. In D. L. Huber (Ed.), Leadership and nursing care management (6th ed., pp. 216–224). St. Louis, MO: Elsevier, Inc.

Harper, M. G., Maloney, P., & Shinners, J. (2017). Looking Back and Looking Forward Through the Lens of the Nursing Professional Development: Scope and Standards of Practice, 3rd Edition. Journal for Nurses in Professional Development33(6), 329–332.

Kertesz, L., Cordella, C. M., Nadera, N. M., Nelson, P. E., Kahil, M., Shim, S.-H., & Holtzman, J. S. (2020). No Surgical Items Left Behind: A Multidisciplinary Approach to the Surgical Count Process. Journal of Radiology Nursing39(1), 57–62.



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