Shared Flashcard Set

Details

Nursing Leadership & Management
Cumulative review for final
122
Management
Undergraduate 2
11/11/2013

Additional Management Flashcards

 


 

Cards

Term
Can a pt w/ influenza B room w/ a pt with neutropenic precautions?
Definition
No, b/c one pt has an infectious disease while the other is highly susceptible to infection.
Term
What should a nurse do if a delegated task is not completed?
Definition
Use "I" statements to the delegated staff member. 
If unfinished task is severe enough, may result in incident report.
Term
What are 3 eg's of good communication techniques?
Definition

"I" statements

time limits

no blaming

positive

SBAR

Term
What is the priority when implementing change?
Definition
People own it and it must be perceived as an improvement
Term
why do ppl resist change?
Definition

it is a natural and expected response

ppl have difficulty accepting change

Term
What are the benefits of the Electronic Health Record (EHR)?
Definition
Info can be shared among medical providers
Term
What is involved in situational leadership?
Definition
Not one best leader, instead effective leadership lies in matching the appropriate style with the level of motivation and task
Term
What is quality improvement?
Definition
a systematic process of organization-wide participation, planning, and implementation of continuance improvement methods
Term
Total Quality Management is made up of these two things?
Definition

Quality Improvement

Performance Improvement

Term
How is quality control measured?
Definition
Predetermined standards
Term
Quality improvement is made up of these 2 things:
Definition

Science (new idea)

Art (out of box-creative ideas-systematically tested to improve pt care)

Term
How is quality control measured?
Definition
Predetermined standards
Term
What is quality assurrance?
Definition
Inspection approach to ensure health care institutions hold to minimum standards of quality pt care
Term
What are the benefits of Quality improvement?
Definition

Discovery of performance issues

Involves staff in implementations and changes

Empowers staff to implement

Improves customers perception

Term
What is F.A.D.E?
Definition

Focus

Analyze

Develop

Execute

Term
What is benchmarking?
Definition
Continual and collaborative discipline of measuring and comparing results of key work processes with those of best perfomers
Term
What are the "Plan-Do-Study-Act" (PDSA) 3 essential questions?
Definition

1. What are we trying to accomplish?

2. How will we know if the change is an improvement?

3. What change can we make that will result in an improvement?

Term
Why is performance and quality measured?
Definition

To determine resource allocation

To organize care delivery

To assess clinician competency

To improve health care delivery processes

Term
What do "outcome audits" indicate?
Definition

Demonstrates quality of care provided

How the pt's health status changed as a result of the intervention

Determines if managed care

Term
What is formal leadership?
Definition
An appointed position
Term
What are leadership characteristics?
Definition

Integrity

Sociability

Flexibility

Guiding vision

Passion

Intelligence

Self-confidence

Determination

Caring

Respectability

Trustworthiness

Term
What are some leadership values?
Definition

Enthusiastic

Supportive and knowledgable

Visible and responsive

Has high standards and expectations

Values education and professional development Demonstrates power in an organization

Communicates openly

Term
What is autocratic leadership?
Definition

Democratic leadership;

involves participatory leadership with authority delegated to others;

participation

Term
What is Laissez-faire leadership?
Definition

Passive and permissive

Leader defers decision making

Term
What is the Transformational Theory?
Definition

- Leaders motivate others to behave in accordance to mutual values and empowers others to contribute

- Described as a process where leaders and followers raise one another to higher levels of motivation and morality

- Leaders are identified as charge agents, are courageous, believe in ppl, are value-driven, are life-long learners, and have the ability to deal with complexity

Term
What 3 factors involve Organization of Health Care?
Definition

1. Structure: resources or structures needed to deliver quality care

 

2. Process: quality activities, procedures, tasks, and processes performed w/in the health care structure

 

3. Outcome: pt satisfaction, good health and functional ability, and absence of health-acquired infections and morbidity

Term
What are the foundations of primary care?
Definition

1st contact

Longitudinality

Comprehensiveness

Coordination

Continuous

Term
What are 2 Prospective Payment Systems?
Definition

RVU: Relative value unit

DRG: Diagnosis related group

PCS: Pt classification system

Term
What do High-Performance Organizations do for their employees?
Definition

- Bring out the best in ppl and produce sustainable high performance over time

- Pay close attn to the dynamics of the workplace

- Are known for having high quality-of-work environments

Term
What are the Goals of the Magnet Program?
Definition

- "Empowering their nurses" w/ AUTONOMY and feel they have a say in an organization

- Promote quality in the milieu that supports professional nursing practice

- Identify excellence in the delivery of nursing services to pt's

- Provide mechanisms for dissemination of the best practices in nursing services

Term
What are the Essential of Magnetism?
Definition

- Good nurse-physician relationship

- Support for education

- Concern for pt paramount

- Opportunities to work w/ other competent nurses

- Nurse autonomy and accountability

- Supportive nurse manager/supervisor

- Control over nursing practice and the practice env't

- Adequate nurse staffing

Term
What are the Forces of Magnetism?
Definition

- AUTONOMY

- Professional development

- Community and hospital

- Nurses as teachers

- Image of nursing

- Interdisciplinary relationships

Term
What are the benefits of Magnet Designation?
Definition

- Improved quality pt outcomes:

incr'd pt satisfaction

decr'd pt morbidity and mortality

 

- Enhanced organizational culture:

incr'd respect for nurses and

shared decision making

Term

What is confidentiality?

 

Definition
The act of limiting disclosure of private matters
Term
What is privacy?
Definition
The rights of an individual to keep info about themself from being disclosed to anyone
Term
What is security?
Definition
To control access and protect information
Term

What is ECONOMICS?

 

Definition

The study of how scarce resources are allotted among possible uses to make appropriate choices among increasingly scarce resources

- Based on 3 premises: scarcity, choice, and preference

Term

Cost Analysis


- What is a BUDGET?

Definition

A plan that provides formal quantitative expression to acquiring and distributing funds for 1 YEAR

- generally based on spending from PREVIOUS years

Term

Fundamental Costs

- What are Direct costs?

Definition
Costs directly r/to unit and care expenses
Term
What are INDIRECT COSTS?
Definition

Facility costs

- water, heat, electricity

Term
What are examples of FIXED costs?
Definition

Taxes

Insurance

Mortgage

Term
What are examples of VARIABLE COSTS?
Definition

Day-to-day costs

- if census is low, you will have low laundry costs

Term

Money=Mission

What is the MISSION STATEMENT?

Definition
The PURPOSE of the business
Term

What is the VISION STATEMENT?

(hint: what is seen down the road)

Definition
The LONG-RANGE goals for the business
Term
What is the STRATEGIC PLAN?
Definition
It identifies how the business or unit will achieve it's vision and get it's goals developed
Term

Prospective Payment System (PPS)

Medicare

Definition

Medicare Part A: pays for hospital, DRG

 

Medicare Part B: pays for Dr office visits, RVU

Term

Managed Care

 

 

What are HMOs?

(hint: Have Money for me?)

Definition

Began in an attempt to provide cost-efficient and quality care

 

HMOs are FOR-PROFIT BROKERAGE businesses and have resulted in complex structures and processes to deliver health care

Term

What is Population-Based Health Care Practice?

 

Definition
Development, provision, and evaluation of multi-disciplinary health care services to population groups experiencing increasing health risks or disparities, in partnership with HC consumers and community, to improve the health of the community and its diverse population groups
Term
What are HEALTH RISK FACTORS?
Definition

Variables that incr or decr the probability of illness or death

 

- Variables such as smoking; those that you can change (modifiable)

Term
What are HEALTH DISPARITIES?
Definition
Differences in health system access and quality of care for different racial, ethnic, and socioeconomic population groups that persist across settings, clinical areas, age, gender, geography, and health needs and disabilities
Term
What are some causes of health care disparities?
Definition

- Inadequate housing

- Unsafe neighborhoods

- Lack of employment

- Lack of educational opportunites

- Inadequacy of health care

- Lack of health insurance

- Less access to primary care providers

Term
What are goals of population-based health care?
Definition

- Reduce health care delivery costs

- Improve access to health care services

- Reduce health disparities among different population groups

Term

Models of Population-Based care

 

Traditional Models

Definition

- Start w/ public health and community health agencies working in partnership to carry out community assessment

- Priorities identified and plan developed and implanted

- Evaluation conducted after plan implemented

Term
The right of the RN to delegate duties and give directions to unlicensed assistive personnel places the RN in a position of...
Definition
AUTHORITY
Term
What is an assignment?
Definition

Distribution of work ea staff member is responsible for performing as a condition of employment. 

- Is consistent w/ the staff member's job position and job description, legal scope of practice, education and experience

Term
What is competence?
Definition

Is built upon knowledge gained in a nursing education program

- orientation to specific settings

- experiences of implementing nursing

Term
What is supervision?
Definition
The provision of guidance or direction
Term
What are the responsiblities of RNs as health team members?
Definition
-Teach and demonstrate how to perform a task rather than telling how it should be done
Term
What are factors to consider prior to delegation?
Definition

1. Potential for harm

2. Complexity of the task

3. Amount of problem solving and innovation required

4. Unpredictability of outcome

5. Level of pt interaction

Term
What are RN responsibilities?
Definition

1. Analyze data

2. Comprehensive assmt

3. Formulating nursing diagnoses

4. Plan, implement and evaluate nursing care

5. Pt education

Term
What are responsibilites of the LPN?
Definition

1. Provide care to stable pt's w/ predictable outcomes

2. Ongoing assmt AFTER initial assmt is done

3. Data collection, foley insertion, pass meds, suctioning, all PCT duties

Term
Who are stakeholders?
Definition
Any person, group or organization that has vested interest in a program or project
Term
What is shared governance?
Definition
Organizational framework in leadership that fosters autonomous decision making and professional nursing practice
Term
How should a nurse prioritize the use of time?
Definition

1. Understand the big picture

 

2. Do first things first:

LIFE-THREATENING,

SAFETY,

PAIN

 

3. Activities essential to POC

Term
What are time wasters?
Definition

Procrastination and inability to delegate

- management by crisis

- Complaining

Term
What are productive hours?
Definition
When you are actually doing pt care
Term
What are non-productive hours?
Definition
Mandatory skills labs, meetings
Term
What are considerations for staffing?
Definition
Nurse-intensive activities need to be supported by work shift
Term
What are some barriers to communication?
Definition
Use of language, anger, and illiteracy
Term
What is assertiveness?
Definition
A way to communicate that allows ppl to express themselves in direct, honest and appropriate ways that do not infringe on another person's rights
Term
How do you diffuse an aggressive attack?
Definition

Repeat the aggressors key points

Rephrase the statements

Put the aggressive threat back to the aggressor

Term
What is the definition of a team?
Definition
A small # of ppl w/ complementary skills committed to a common purpose, performance goals, and approach for which they are mutually accountable
Term
What are the advantages of teamwork?
Definition
Improves interpersonal relationships, job satisfaction and equalizes power
Term
What are qualities of effective team members?
Definition

Taking full responsibility for one's own actions, decisions, and behavior

- developing a personal sense of purpose, mission and professional goals

Term
What is group think?
Definition
Occurs when a desire for harmony and consensus overrides member's rational efforts to appraise the situation
Term
How long is the statute of limitations in Kansas?
Definition
2 years
Term
What laws affect pt care?
Definition

Pt self-determination act

Good Samaritan Laws

HIPPA

Term
Pt's have the right to refuse care
Definition
Pt self-determination act
Term
States in which it's MANDATORY to stop if someone is in medical need...
Definition
VT, MN, LA
Term
Advanced Directives
Definition
To communicate a pt's wishes regarding end-of-life care should the client be incapacitated
Term
What to do when pt leaving AMA...
Definition
Pt has autonomy and right to leave unless deemed incompetent or will do harm to others
Term

Can a Living Will be changed? 

Under what circumstances?

Definition
Yes, if the pt is competent
Term
What is a Living Will?
Definition
A legal doc that expresses the pt's wishes regarding medical tx in the event the pt becomes incapacitated
Term
What is the Good Samaritan Law?
Definition
HC providers are protected from potential liability if they volunteer their nursing skills away from the workplace, provided that actions do not harm or injure persons
Term
Can DPOA revise a living will?
Definition
NO
Term

T or F? 

The KS State Board of Nursing is set up to implement or enforce the State Nurse Practice Act

Definition
True
Term
This defines what the functions of nursing shall be and sets standards for licensure
Definition
Nurse Practice Act
Term
The board of Registered Nurses protects who and how?
Definition
Citizens;
it monitors RN educational standards, disciplines RN's and RN licensing
Term

T or F?

The guidelines for practice change year to year?

Definition
True
Term

Intentional Tort

 

Definition
A legal wrongdoing against a person or property
Term
Criminal Law
Definition
This law is "beyond a reasonable doubt"
Term

Civil Law

 

Definition
This law is "more likely than not" in malpractice cases
Term
Name two types of intentional torts...
Definition

Assault

Battery

False Imprisonment

Invasion of Privacy

Lack of informed consent

Defamation of character

Term

Professional Negligence (Malpractice)

OR

Unintentional Tort

Definition

The failure to act as a reasonably prudent nurse w/ similar education and experience in the same of similar circumstances thereby causing harm to a pt

 

*Just "following the Dr's orders" is NOT a defense for malpractice.  Nurses have an independent responsibility so...ALWAYS question orders that are not clear

Term
What are the 4 elements of professional negligence?
Definition

Duty

Breach of Duty

Injury/Damage

Causation of Injury

Term
If you actually care about your pt, you are (More) or (Less) likely to be sued?
Definition
Less Likely
Term

T or F?

You file an incident report in a pt's medical chart?

Definition
False
Term
Who is responsible for filling out an incident report?
Definition

Staff member who witnessed the incident

or

the first person on the scene

Term
A medication was given to the wrong pt with NO HARM.  Which Standard of Care Level Incident is this?
Definition
Level 2
Term
Heparin drip found infusing 2 hours after it was ordered to be D/C'd; NO signs of bleeding were noted.  Which SOC level of incident was this?
Definition
Level 3
Term
Which levels of incidents do you report to the KSBN?
Definition
Levels 3 and 4
Term

When is it appropriate for the RN to not delegate pt care?

 

Definition
For an UNSTABLE pt
Term

T or F?

If there is NOT an order for a DNR, the nurse is to start chest compressions EVEN when the family requests NO attempt be made to save the pt...

Definition
True
Term
Fear of mistakes, job loss, and not being valued are part of...
Definition
Resistance to CHANGE
Term
What kind of witness testifies to what any "reasonable and prudent" nurse would do?
Definition
An EXPERT WITNESS
Term
What actions do you take to recognize your staff?
Definition
Positive Feedback
Term
What is an important factor in survival for organizations in the 21st century?
Definition
Quality Improvement
Term
Everyone wants to be...
Definition
VALUED
Term
When communicating with pts, it's helpful to set...
Definition
Time Limits.  This will help manage your duties.
Term

Roles of RN

- Directly responsible and accountable for provision of nursing care

Definition

- Analyze data

- Comprehensive assmt

- Formulate nursing dx

- Plan, implement and evaluate nursing care

Term

Roles of NAP

- Trained to perform certain duties

Definition

-Baths, feed, toilet, ambulate

- Expected to doc and report info r/to these activities

- CANNOT be assigned to assess or eval responses to Tx

 

* RN has incr'd scope of liability when tasks delegated to AP

Term

Responsibilities of the LVN/LPN

(ATI pg 31)

 

Definition

- Provides care to STABLE pt's with PREDICTABLE OUTCOMES

 

-CANNOT complete INITIAL pt ASSMT

- Provides ONGOING ASSMT AFTER INITIAL ASSMT made

Term
Factors for the RN to consider BEFORE delegation:
Definition

- Potential for harm

- complexity of task

- amt of prob solving and innovation req'd

- unpredictability of outcome

- level of pt interaction

Term
5 Rights of Delegation
Definition

Right:

- task

- circumstance

- person

- direction/communication

-supervision

Term

Prioritizing Time:

 

1st Things First


Assess upon introduction

 

 

Definition

#1 Life-Threatening

-ABC's

 

#2 Safety

-protect from infection and falls

Term

Priority TRAPS the nurse should AVOID:

 

Definition

- Doing whatever hits first

- taking the path of least resistance

- responding to squeaky wheel

- completing tasks by default

- relying on misguided inspiration

Term

Legal Issues in Nursing

(Kay's Presentation)

 

The PRIMARY purpose of law and legislation is to:

Definition
Protect the pt AND the nurse
Term
Informed Consent
Definition
The pt giving consent must COMPREHEND
Term
The nurse's role with informed consent is to:
Definition

Witness the signature and ensure that the pt:

- is informed

-understands

-signs correctly

-questions are answered

-is compentent, A&O, no drugs

 

*BATTERY if consent signed w/o understanding

Term
The Board of Nursing protects ...
Definition

Citizens

 

 

Term

T or F

 

All laws are fluid and subject to change

Definition

True

 

* follow P&P per institution

Term

Levels of Incidents R/to Standard of Care (SOC)

 

Levels 1-4

Definition

Level 1 - SOC met and NO harm done

 

Level 2 - SOC met with LOW RISK or NO reasonable probabily of injury

 

Level 3 - SOC NOT MET w/ injury

 

Level 4 - Actual harm occurs and grounds for disciplinary action

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