NR 718 Week 5 Stakeholder Analysis Example

Stakeholder Analysis for Kilograms-Only Pediatric Weights: Who Controls What, Who Gains and Loses, and the Two Quiet Vetoes

Student Name

College of Nursing, Chamberlain University

NR 718: Topics in Advanced Practice Leadership I

Instructor Name

Month Day, Year

Stakeholder Analysis for Kilograms-Only Pediatric Weights: Who Controls What, Who Gains and Loses, and the Two Quiet Vetoes

Start Where the Work Changes

The analysis starts with the people whose routine actually changes, not with the leaders above them. The change puts every child on a scale set to kilograms and the result into a field that rejects pounds, ahead of any dose calculated by weight, in a 26-bed community emergency department that sees about 6,460 pediatric visits a year. The routine changes for triage nurses first, then for registration staff who sometimes weigh children, parents who are used to pounds, and paramedics who report weights in pounds at handoff. Leaders and technical owners come after them in this analysis because they control the conditions, not the act. The change itself follows national guidance on pediatric readiness (Remick et al., 2018), so the stakeholder question is how it will be adopted, not whether it should be.

The Map

Table 1

Stakeholders for Kilograms-Only Pediatric Weights

Note. Note. Influence means power over whether the change happens and lasts; interest means how much the change matters to the party.

Placement, With Reasons

The day triage nurses sit high in influence because nothing happens unless they weigh each child, but only medium in interest because the safety reports have not felt personal; most were caught by pharmacists. The night charge nurse sits high on both: the informal leader of triage practice and the person most affected by how the change is introduced, given past friction with the educator. The nurse manager is high on both because the manager owns the metric the change would worsen. The information technology analyst is high in influence and low in interest, which is the most dangerous combination in the table.

Name What Is Lost

Three parties lose something real. The triage nurses lose time, about two to three minutes per child, which on a busy evening with eight children waiting is more than twenty minutes of triage capacity. The night charge nurse loses some control over how triage runs, since the change sets a rule that was previously a judgment. And the analyst loses queue position for other requests. Pretending these losses away would make the analysis less useful; the engagement plan below offers something specific against each.

The Quiet Vetoes

Two parties have no formal say and complete practical control. The biomedical technician can lock the scales, and can also unlock them when someone complains that a scale is broken because it no longer shows pounds; if that happens quietly on a weekend, the change reverses without anyone deciding it should. The analyst can build the field in six hours or leave it in the queue for ten weeks, and no one outside the team would notice the difference. Neither will oppose the change openly. Both could end it by doing nothing. Resistance of this kind, passive and unannounced, is often more decisive than open objection (Kotter, 2012).

The Party Without a Voice in the Room

One group appears in no meeting: the children themselves, and especially children with special health care needs who cannot stand on a scale. For them the change means being lifted onto a chair scale that cannot currently be locked, or onto an infant scale they have outgrown, and for some the honest answer at triage will still be a recent clinic weight from their records. Their parents are often the most experienced people in the room on how to weigh their child safely. The plan therefore treats these families as advisors rather than as a group to be informed: the unit's family advisory council will be asked how weighing should work for children who use wheelchairs, before the chair scale is replaced and before the rule allowing a recorded weight from the past 30 days is written.

Engagement Fitted to Each Party

Engagement differs by quadrant. The night charge nurse and the nurse manager, high on both measures, are engaged as partners: the night charge nurse helps design the triage workflow before anything is announced, and the manager agrees the metric change. The analyst and the biomedical technician, high in influence but low in interest, are kept satisfied with precise requests and a sponsor's name on each: a ticket listing the exact scale settings, and a priority request for the field from the manager rather than the educator. The day triage nurses are consulted through the one-week trial, whose timing results they see before rollout. Low-influence parties are kept informed: a card for travel nurses, a plain sentence for parents and a note to paramedic crews through the regional coordinator. Matching the form of engagement to each party's position is the main use of a stakeholder map (Northouse, 2019).

What the Map Changes

The analysis changes the order of the plan. The first two conversations are now with the night charge nurse and the biomedical technician, not with the staff meeting. And the field request goes to the manager to send, because the educator's name on it would place it at the back of the queue.

References

Kotter, J. P. (2012). Leading change. Harvard Business Review Press.

Northouse, P. G. (2019). Leadership: Theory and practice (8th ed.). SAGE Publications.

Remick, K., Gausche-Hill, M., Joseph, M. M., Brown, K., Snow, S. K., Wright, J. L., American Academy of Pediatrics Committee on Pediatric Emergency Medicine and Section on Surgery, American College of Emergency Physicians Pediatric Emergency Medicine Committee, & Emergency Nurses Association Pediatric Committee. (2018). Pediatric readiness in the emergency department. Pediatrics, 142(5), Article e20182459. https://doi.org/10.1542/peds.2018-2459