ATI Comprehensive- Management

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Concepts of Management
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Define Leadership.
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A way of behaving that influences others to respond, not because they have to, but because they want to. Leaders help others to identify and focus on goals and the achievement of them. Leadership is a personal interaction that focuses on the personal development of the members of the group.
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Name the 6 essential components of leadership.
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Knowledge Self-awareness Communication Energy Goals Actions
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What are the nursing interventions for Leadership.
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All nurses will need leadership skills to manage other nurses, assistive personnel, and clients. It is essential to the nursing role to identify and implement effective leadership practices.
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Define Management.
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A problem-oriented process with a focus on the activities needed to achieve a goal; Supplying the structure, resources, and direction for the activities of the group. Management involves personal interaction, but the focus is on the group’s process. The most effective managers are also effective leaders.
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Name the 5 phases of the management process.
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Planning Organizing Staffing Directing Controlling
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Name the 3 different Management Styles.
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Autocratic Laissez-faire Democratic
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What are the nursing interventions involved in Management?
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Nurses should learn management skills and identify their own personal leadership styles. Nurses should know the difference between being an autocratic and democratic leader. The most effective management style in a health care enviroment is the democratic leader who uses an interdisciplinary approach to encourage open communication and collaboration, which will promote individual autonomy and accountability.
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Determine the Leadership Style: A nurse manager does not participate, but delegates the staff scheduling to the nurses on the unit.
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Laissez-Faire
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Determine the Leadership Style: A nurse manager allows the staff nurses to participate in trial use of new IV pumps and contribute input when choosing a new product.
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Democratic
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Determine the Leadership Style: A nurse manager makes a decision for the staff to wear blue scrubs without consulting the staff nurses.
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Autocratic
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Determine the Leadership Style: A nurse manager allows the staff to choose which holiday they would prefer to take off b efore completing the work schedule.
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Democratic
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Determine the Leadership Style: A nurse instructs the staff nurses to “work out the problem between yourselves” when a conflict arises between two nurses.
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Laissez-Faire
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Determine the Leadership Style: A nurse manger changes the policy regarding sterile dressing changes and directs the staff to follow the new procedure.
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Autocratic
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Define Communication.
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Involves sending, recieving, and interpreting written, face-to-face, and nonverbal information between at least two people.
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Name the 8 Functional Components of Communication.
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Referent Sender Message Channel Reciever Enviroment Feedback Interpersonal Variables
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Define Therapeutic Communication.
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The purposeful use of communication to build and maintain helping relationships with clients’ families, and significant others. Therapeutic communication is client-centered, purposeful, planned, and goal directed.
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Name the 12 Effective Communication Skills and Techniques
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Active Listening Open-ended Questions Clarifying Techniques Offering general leads, broad opening statements Showing acceptance and recognition Focus Asking questions Giving information Presenting reality Summarizing Offering self Touch
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Name the appropriate Nursing Interventions for Communication.
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Effective communication requires commitment, effort, focus , and cooperation, especially when dealing with complex clinical clinical issues and people who have diverse backrounds and perspectives. It is essential to understand and use effective communication skills to successfully manage others.
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Define Conflict.
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Arises when there are two opposing veiws, feelings, expectations, or other divergent issues. It can occur within an individual, between individuals, or between groups and organizations. Conflict can be managed.
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Name 4 Sources of Conflict.
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1. Lack of resources and/or economics. 2. Differences in values, feelings, beliefs, backrounds, goals, economic values, and professional values. 3. Struggles for power or influence. 4. Sexual harrassment.
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What is the optimal goal of the different types of Conflict Management Strategies?
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Creating a Win-Win solution for all involved.
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Name the 6 Different types of Conflict Management Strategies.
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1. Avoiding 2. Cooperating/accomidating 3. Compromising 4. Competing 5. Collaborating 6. Smoothing
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What are the appropriate Nursing Interventions for Conflict?
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A nurse manager’s role is to identify the source of conflict, understand the issues that have developed, and worktoward conflict resolution while maintaining positive regard for each individual. It is essential to address the person with whom there is a conflict before going to superiors (use chain of command). The most important conflict strategy involves collaboration that results in a win-win solution for everyone.
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Power Vs. Influence
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Define SBAR.
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A communication model used in conflict resolution that incorporates the *Situation* , *Background* , *Assessment* , and *Recommendation* to improve communication between clinicians.
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Define Power.
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Ability, strength, and capacity to do something.
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Define Influence.
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Control over people and their actions.
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Name the 5 types of Power.
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1. Reward 2. Coercive 3. Legitimate 4. Referent 5. Expert
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Describe Reward Power.
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The ability to control resources.
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Describe Coercive Power.
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The ability to inflict aversive outcomes or punishment.
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Describe Legitimate Power.
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Based on one’s position.
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Describe Referent Power.
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Based on attractive characteristics.
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Describe Expert Power.
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Based on expertise or knowledge.
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Name the 5 types of Influence Tactics.
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1. Ingratiation 2. Conformity pressure 3. Foot-in-the-door 4. Door-in-the-face 5. Guilt
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Describe Ingratiation, as an Influence tactic..
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The ability to manipulate others through flattery and style.
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Describe conformity pressure, as an Influence tactic..
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The pressure to conform to the group; this pressure increases as group size increases to greater than six, or as a familiarity with the topic decreases.
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Describe Foot-in-the-door, as an Influence tactic..
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A small request followed by a larger request.
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Describe Door-in-the-face, as an Influence tactic..
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A large request that is intended to be denied, followed by a smaller request that is intended to be granted.
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Describe Guilt, as an Influence tactic.
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The practice of inducing guilt before making a request; granting the request reduces the feeling of guilt.
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What is the appropriate Nursing Intervention for Power and Influence?
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The power of influence is aimed at accomplishing well-defined goals, preferrably as a cohesive team.
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Team Building
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Define Team Building.
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Activities or effort intended to unify people into a team to more effectively accomplish the overall objectives and mission of the organization.
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Name the 8 components of Team Building.
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1. Clear Expectations 2. Context 3. Commitment 4. Competence 5. Collaboration 6. Communication 7. Creativity 8. Consequences.
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Describe Clear expectations, as a compenent of team building.
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Expectations should be clearly defined and communicated to members of the team.
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Describe Context, as a compenent of team building.
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Members should understand why they are participating on the team.
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Describe Commitment, as a compenent of team building.
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Members should feel valued, excited, and challenged, and should be commited to the success of the team.
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Describe Competence, as a compenent of team building.
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Team should feel like it has the resources, strategies, and support it needs to meet its goals.
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Describe Collaboration, as a compenent of team building.
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Rules of conduct should be followed for conflict resolution and cooperative decision-making.
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Define Communication, as a compenent of team building.
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There should be clear, honest, and respectful dialogue between team members.
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Define Creativity, as a compenent of team building.
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New and innovative ideas should be encouraged and welcomed.
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Define Consequences, as a compenent of team building.
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Contibutions and success should be recognized and rewarded.
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Name 4 Nursing Interventions for Team Building.
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1. Foster a culture that values collaboration and cooperation. 2. Communicate that teamwork is expected. 3. Publicly celebrate team success. 5. Bring a sense of play and fun to the team.
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Continuity of Care
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Define Continuity of Care
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Focuses on the experience of the client as the client moves through the health care sustem; guiding the client through this experience requres coordination, integration, collaboration, and facilitation of all the events along the continuum.
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Name the 7 Roles of the Nurse in Continuity of Care.
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1. Faciliate the continuity of care provided. 2. Act as a liason and be a client advocate. 3. Complete admission, transfer, discharge, and post discharge. 4. Initiate, revise, and evaluate the plan of care. 5. Report the Client’s status. 6. Coordinate discharge planning. 7. Facilitate referrals and use of community resources.
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Quality
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Total Quality Improvement Model AKA?
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Continuous Quality Improvement
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Continuous Quality Improvement AKA?
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Total Quality Improvement Model
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Define Total Quality Improvement Model/Continuous Quality Improvement.
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A philosophy that doing the right thing,the right way, the first time, with problem prevention planning (non reactive problem-solving) leads to quality outcomes.
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Performance Improvement AKA?
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Quality Improvement (or) Quality Control
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Quality Control AKA?
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Quality Improvement (or) Performance Improvement
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Quality Improvement AKA?
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Quality Control (or) Performance Improvement
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Define Performance Improvement/ Quality Control/ Quality Improvement.
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The Process used to identify and resolve performance deficiencies focused on assessment of outcomes to improve delivery of quality of care. All employees are involved in this process.
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Name the 13 steps in the performance improvement process.
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1. A standard is developed and approved by facility commitee. 2. Standards are made available to employees by way of policies and procedures. 3. Quality issues are identified by staff, management, or risk management department. 4. An interdisciplinary team is developed to review the issue. 5. The current state of structure and process related to the issue is analyzed. 6. Datta collection methods are determined. 7. Quantitative methods. 8. Audits. 9. Data is collected, analyzed, ajnd compared with the established benchmark. 10. If the benchmark is not met, possible influencing factors are determined. A root cause analysis may be done. 11. Potential solutions or corrective actions are analyzed and one is selected for implementation. 12. Educational or corrective action is implemented. 13. The issue is reevaluated at a pre-established time to determine the efficacy of the solution or corrective action.
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Within the performance improvement process, if the benchmard is not met, possible influencing factors are determined and a root analysis may be done. Describe a root analysis.
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1. Investigates the consequences and possible causes. 2. Analyzes the possible cuases and relationships that may exist. 3. Determines additional influences at each level of relationship. 4. Determines the root cause or causes.
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Variance/ Incident/ Occurence Reports
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Define a Variance or Incident.
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A Variance or Incident is an event that occurs outside the usual expected normal events or activities of the client’s stay, unit functioning, or organizational processes.
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What are the appropriate Nursing Interventions for Variance/ Incident/ Occurence Reports?
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Incident or variance reports are not intended to point blame, just document the facts. There purpose is to identify situations or system issuese that contributed to the occurrence and to engage strategies to prevent reoccurance or to correct the situation. Generally, the report is confidential communication and cannot be subpoenaed. However, if it is inadvertently disclosed, it can be subpoenoed. The report should not be placed in the chart.
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Name the 10 Reportable Incidents.
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1. Client Injury 2. Unanticipated client death 3. Malfunction of equipment 4. Unanticipated adverse reactions 5. Inability to meet client needs–system problem, order problem, lack of qualified staff, or client/family refusal of care. 6. Unethical, illegal, or incompetent practice. 7. Client/ family complaint about care. 8. Toxic spills, fires, and/or other enviromental emergencies. 9. Violent behavior by the client/ family. 10. Loss of property.
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Resource Management
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Name the 2 different types of Health Care Reimbursement Methods.
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1. Retrospective vs. Prospective Payment 2. Health Maintenance Organizations
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Name the 3 different types of budgets.
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1. Personnel Budget 2. Operating Budget 3. Capital Budget
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What does a Personnel Budget consist of?
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Worked time and benifit time.
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What does a Operating Budget consist of?
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Electricity, Maintenance, and Supplies
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What does a Capital Budget consist of?
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Buildings or Major Equipment
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Name the 4 steps of the Budget Process.
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1. Planning 2. Preparation 3. Modification and approval 4. Monitoring
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What occurs during the Planning step of the Budget Process?
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Assess what the needs are.
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What occurs during the Preparation step of the Budgeting Process?
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Develop a plan (time frame).
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What occurs during the Modification and Approval step of the Budgeting Process?
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Implement (ongoing monitoring and analysis)
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What occurs during the Monitoring step of the Budgeting Process?
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Evaluate (revise and modify as needed)
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What is the appropriate Nursing Intervention for Resource Management?
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A nurse manager must be aware of ecomonic issues in health care. Budgeting terms are fundamental to understanding the financial management of facilities. The more information available to the nurse, the better the decisions and input into long-range planning for the facility.
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Case Management
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Define Case Management.
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Case management is a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual’s health needs through communication and available rescources to promote quality, cost-effective outcomes.
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What is the appropriate Nursing Intervention for Case Management?
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A nurse’s role in case management is to coordinate services that respond to the hierarchy of the client’s individual needs. This system provides care that minimizes fragmentation and maximizes holistic individualized client care.
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Consultation and Referral
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Define Consultation.
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A professional provides expert advice in a particular area and determines what treatment or services the client requires.
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Give two examples of Consultation.
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1. An orthopedic surgeon for a client with a hip fracture. 2. A psychiatrist for a client whose risk for suicide must be assessed.
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What is the appropriate Nursing Intervention for Consultation?
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Notify the primary care provider of the client’s needs, provide the consultant with pertinent information, include consultant’s information into the plan of care, and facilitate coordination with other health care with other health care providers in order to protect the client from conflicting and potentially dangerous prescriptions.
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Define Referal.
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A formal request for a special service by another care provider so that the client can access the care identified by the primary care provider or consultant. The intervention becomes that specialist’s responsibility, but the nurse continues to be responsibile for monitoring the client’s response and progress.
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Give examples of Inpatient Referrals.
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Physical therapy Wound Care Nurse
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Give examples of a referral outside the facility.
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Hospice.
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What is the appropriate Nursing Intervention for Consulations and Referrals?
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The processes of consultation and referral are integral for effective use of services along the continuum, and they estabilsh collaboration with the interdisciplinary team. The nurse should support the client/family with appropriate consultation and referral to contacts in the community.

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