question

a process for measuring products, practices, and services against best performing organizations; allows nurse managers to compare staffing and plans across like units or organizations

answer

benchmarking

question

measurement tool used to determine the nursing workload for a specific patient or group of patients over a specific period

answer

patient classification system (PCS)

question

the measure of nursing workload generated for each patient

answer

patient acuity

question

measures the work commitment of a full time employee; the unit's forecasted workload is used to calculate the number of FTEs needed for the unit's staffing plan wich may comprise full-time and part-time employees; a conversion of hours to a standard base of one person working so many hours per day, so many days per week, and so many weeks per year

answer

full-time equivalent

question

FES is the most popular patient classification sytem in use because of it's ability to project needs for individual patients and groups of patients; used to determine each patient's acuity rating, depending on hospital policy, several times through out the day; uses units of measure that equate to nursing time

answer

Factor Evaluation System

question

considered subjective and descriptive and is based on diagnostic related groups (DRGs-a grouping of similar patients with similar diseases or conditions); used less frequently than FES Advantage: reduction of the RN's duty of completing the acuity rating on each patient throughout the day Disadvantages: DRGs do not capture all of the patient's needs because the medical diagnosis alone does not adjust for differences in patients; there is a lack of ongoing measure of the actual nursing work required by individual patients; and there is a lack of ongoing data to monitor the accuracy of the pre-assigned nursing care requirements;

answer

Prototype Evaluation System

question

Total nursing hours worked by nursing staff in a 24 hour period divided by the patient census at the end of that 24 hour period.

answer

Nursing Hours Per Patient Day

question

primary concerns include patient acuity, volume of patients, state licensing standards, needs and experience of the staff, the environmental layout of the unit, the organization's mission, philosophy and policies

answer

Scheduling

question

when the nurse manager develops the schedule separate from other units within the hospital

answer

decentralized scheduling

question

done by staffing coordination

answer

centralized scheduling

question

method used to provide care to patients Goals: 1)Deliver nursing care effectively and efficiently to patients 2)Nurse manager must ensure to achieve both patient and nurse satisfaction as an outcome measure 3)Should enhance communication between staff and the inter-professional healthcare team 4)Must meet the mission, vision, values, and goals of the hospital or healthcare organization

answer

nursing care delivery model

question

model of care delivery in which one nurse provides total care for an individual patient during an entire work period; oldest model commonly seen on hospital units where the nurse will provide patient centered, comprehensive, continuous, and holistic care to several assigned patients during his/her shift (ICU setting)

answer

case method/total patient care model

question

a method of providing patient care by which each licensed and unlicensed staff member performs specific tasks for a large group of patients (may be seen during a mass casualty event)

answer

functional nursing model

question

a small group of licensed and unlicensed personnel, with a team leader, responsible for providing patient care to a group of patients

answer

team nursing model

question

a model of patient care delivery whereby one registered nurse functions autonomously as the patient's main nurse throughout the entire hospital stay

answer

primary nursing

question

the process of a nurse coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes; patient focused and outcome oriented

answer

nursing case management

question

a component of care MAP that is specific to diagnosis-related group reimbursement; the purpose is to ensure patients are discharged before insurance reimbursement is eliminated

answer

critical path/critical pathway

question

outline the expected clinical course and outcomes for a specific patient type; generally outline the normal course of patient care, and the patient's progress is measured against expected outcomes

answer

clinical pathway

question

anything that alters a patient's progress through a normal care path

answer

variance

question

a corporate culture emphasizing customer satisfaction, innovation, and employee involvement in quality improvement activities; often used interchangeably with total quality management, continuous quality management, quality improvement, and performance improvement

answer

quality management (QM)

question

systematic process to improve outcomes; based on customer needs; proactive approach; responsibility of all; "doing the right thing;" continuous process

answer

quality improvement

question

a process that focuses on the clinical aspects of a provider's care, often in response to an identified problem; inspection approach to ensure that minimum standards of care existed in health care institutions

answer

quality assurance

question

1) Establish a clear and defined aim or purpose 2) Reviewing the literature 3) Examining current resources to facilitate quality improvement 4) Mapping the current processes 5) Analyzing the root causes 6) Selecting appropriate tools for process analysis 7) Selecting measures and metrics (baseline and outcomes) 8) Conducting a rapid cyclical review of the plan, data, interventions, and outcomes

answer

8 Common steps of Quality Improvement

question

measuring organizational performance against standards from regulatory/accrediting organizations

answer

regulatory requirements

question

Plan Do Study Act/Plan Do Check Study Act

answer

PDSA/PDCSA

question

define the objective, questions, and predictions; plan data collection to answer the questions: who? what? where? when?; devise a plant to address the problem

answer

Plan

question

identifying the steps in a plan; carry out the plan; collect the data; begin analysis of the data--implementation

answer

Do

question

complete the analysis of the data; check: compare data to predictions; summarize what was learned

answer

Study

question

plan the next cycle; decide whether the change can be implemented; examine outcomes; consider modifications for initiating the cycle again for refinement of the process; continue seeking improvements

answer

Act

question

method for sharing work with others; takes the major steps in the improvement methodology and visually outlines the progression of each step; can be displayed on a chart in a high traffic area of the organization to inform other staff of the improvement efforts underway

answer

storyboard

question

time series data; allows a quality improvement team to see change in quality over time; time series chart used to look for trends, shifts, and unusual data

answer

dashboards

question

freedom from accidental injury (patient stay free of complications and expected outcomes reached)

answer

safety

question

the outgrowth of the larger organization culture and emphasizes the deeper assumptions and values of the organization toward safety

answer

safety culture

question

the shared perception of employes about the importance of safety within the organization

answer

safety climate

question

the failure of a planned action to be completed as intended (error of execution) or the use of the wrong plan to achieve an aim (error in planning); directly related to outcomes

answer

error

question

type of incident that is non-compliant with procedure, or making a mistake such as not assuring the correct identification of the patient before administering the medication

answer

active error

question

condition involves problems within the system; may lie dormant within the system for a long time; pose the greatest threat to safety in a complex system

answer

latent error

question

an injury resulting from medical intervention; not due to the patient's underlying condition

answer

adverse event

question

avoidable complications that prevent patients from receiving full potential benefit of a service (patient receives a med that is not prescribed & conflicts w/his allergies causing anaphylaxis)

answer

misuse

question

the potential for harm from the provision of a service that exceeds the possible benefit

answer

overuse

question

recognition that an event occurred that might have led to an adverse event

answer

near miss

question

an event that had a negative patient outcome (unexpected death, serious physical or psychological injury, or serious risk)

answer

sentinel event

question

the process used to identify all possible causes of a sentinel event and all appropriate risk-reduction strategies; an in-depth analysis of an error to asses the event & identify causes & possible solutions

answer

root cause analysis

question

a blame free environment in which staff can practice & openly discuss potential errors or near-misses as well as actual errors---just culture: No shame No Blame

answer

culture of safety

question

culture where staff are willing to come forward with information about errors so everyone can learn from mistakes; the culture recognizes the need for accountability & at times disciplinary action

answer

just culture

question

organizational structure-encourage accountability; maximize communication; communicate and focus priorities at all levels

answer

Patient Safety: Principles in Action in an Organization

question

clearly communicate expected standards of care; encourage followers to be actively involved in the QI process

answer

Patient Safety: Leadership Roles

question

Establish a clear-cut measurable standards of care and determine the most appropriate method for measuring if those standards have been met; keeps abreast of current government and licensing regulations that affect QI; determines discrepancies between care provided and hospital/unit standards and seeks further information regarding why standards were not met

answer

Patient Safety: Management Functions

question

serves to provide a safe and effective environment for patients, visitors & employees while averting/decreasing loss to the organization Focus: identification, analysis, treatment, and evaluation of actual or potential hazards

answer

risk management

question

loss prevention and reduction, claims management, financial risk, risk regulatory and accreditation compliance

answer

Responsibilities of risk management

question

a method to analyze reliability problems proactively to avoid negative outcomes; risk management tool; proactive identification and risk reduction

answer

Failure Mode & Effect Analysis (FMEA)

question

a graphical representation of a process, depicting inputs, outputs and units of activity; represents the entire process, allowing analysis and optimization of workflow

answer

flowcharts

question

a process that protects a nurse from employer retaliation & licensure sanction when a nurse makes a good faith request for peer review of an assignment or conduct the nurse is requested to perform and that the nurse believes could result in violation of the NPA or Board rules; must be invoked prior to engaging in conduct or assignment

answer

safe harbor act

question

personal freedom, right to choose: informed consent, progressive discipline with employees, HN decision about unit operations, staff decisions regarding patient care

answer

autonomy

question

promote good, doing good to others; consists of mercy, kindness & charity deed; taking actions to benefit & promote the welfare of people; doing good; help prevent or remove harms or improve situation of others: educating community about STD prevention; progressive discipline; encouraging pt to stop smoking

answer

beneficence

question

do no harm; correlates to beneficence; obligated not to harm anyone-intentionally refraining from actions that harm a patient; principle most helpful when balanced against beneficence--risk of treatment (harm) must be understood in light of the potential benefits, benefits outweigh burdens: stopping ineffective treatment

answer

non-maleficence

question

fairness, treating people equally and without prejudice

answer

justice

question

allowing a person to make a decision for another; deliberate overriding of patient's opportunity to exercise autonomy b/c of perceived obligation of beneficence: mandatory flu vaccine, not giving bad information about a terminal diagnosis

answer

paternalism

question

truth: informing family of sentinel event or error; completing incident report for a near miss

answer

veracity

question

keeping one's promise: maintaining staff vacation request, keeping promise made to patient/family

answer

fidelity

question

highest ethical principle; acknowledges rights of the individual to make decisions and live by the decisions; patient centered focus

answer

respect for others

question

-gather data & identify conflicting moral claims -identify key participant -determine moral perspective and phase of moral development of key participants -determine desired outcomes -identify options -act on the choice -evaluate outcomes of the action

answer

Ethical Decision-Making Framework

question

groups of persons who provide structure and guidelines for potential healthcare problems, serve as an open forum for discussion, and function as patient advocates; provide education, policy and guideline recommendations, and case review

answer

ethical committees

question

a type of distress that occurs when faced with situations in which two ethical principles compete, such as when the nurse is balancing the patient's autonomy issues with attempting to do what the nurse knows is in the patient's best interest

answer

moral distress

question

technology (when to use, stop using, or who can use); cost containment; Patient's rights; staffing issues; impaired nurses; confidentiality; refusal of treatment...

answer

ethical issues encountered in practice

question

lack of diversity in healthcare's leadership and workforce; systems of care poorly designed to meet the needs of diverse patient populations; poor communication between providers and patient of different racial, ethnic, or cultural backgrounds; lack of education regarding cultural proficiency; lack of evaluation regarding cultural proficiency

answer

barriers to cultural competence

question

theory explicitly focused on the close relationships of culture and care on well-being, health, illness, and death; it is holistic and multidimensional, generic (emic, folk) and professional (etic) care has a specifically designed research method (ethnonursing); care is the essence of nursing, and culturally based care is essential for well-being, health, growth, and survival and for facing handicaps or death

answer

Cultural Care Theory

question

eliminates the cultures of others

answer

cultural destructiveness

question

trivialize other cultures and make other cultures appear to be wrong

answer

cultural incapacity

question

do not see or acknowledge the culture of others

answer

cultural blindness

question

increasing awareness of what you do, do not know about working in diverse settings

answer

cultural precompetence

question

including values, beliefs, and attitudes that are new or different from your culture to render effective nursing care

answer

cultural competence

question

lifelong learning of cultural groups to create a socially just democracy

answer

cultural proficiency

question

refers to maintaining several different cultures simultaneously

answer

multiculturalism

question

refers to mediating between two cultures (one's own and another)

answer

cross-culturalism

question

denotes bridging significant differences in cultural practices

answer

transculturalism

question

the values and behaviors that contribute to the unique social and psychological environment of an organization; a shared value system developed over time that guides members to problem solve, adapt to the external environment, and manage relationships; the values and behaviors that contribute t the unique social and psychological environment of an organization

answer

organizational culture

question

process by which a person becomes a competent participant in the dominant culture

answer

acculturation

question

choosing to change role expectations and/or role performance

answer

role development

question

a gap between role expectations and role performance

answer

role discrepancy

question

stage at which a person has learned behaviors that maintain a role so thoroughly that the person performs them without consciously considering them; energy once spent on establishing these behaviors can be redirected to other goals

answer

role internalization

question

resolving conflicting expectations about personal management performance through communication

answer

role negotiation

question

the subjective feeling of discomfort experienced as a result of role stress, may manifest through increased frustration, heightened emotional awareness, or emotional fragility to situations

answer

role strain

question

a social condition in which role demands are conflicting irritating, or impossible to fulfill

answer

role stress

question

the process of unlearning an old role and learning a new role; transforming one's identity from being an individual contributor as a staff nurse to being a leader as a nurse manager

answer

role transition

question

an acronym used to identify the components of a role: responsibilities, opportunities, lines of communication, expectations, and support

answer

ROLES

question

measures patterns of decision making used when processing information about the world & self; profile places emphasis upon thinking, not behaving

answer

Hartman Value Profile

question

similar to honeymoon phase

answer

role exploration

question

Role preview Role Acceptance Role Discrepancy Role Development Role Internalization Unexpected Role Transition

answer

Role transition Process

question

a process in which an individual is assessed by a variety of people in order to provide a broader perspective; nurses asked to evaluate their peers need orientation to the process and to the specific tool being used

answer

360 Degree Feedback

question

programs encouraging nurses to earn promotion, gain recognition, and to increase pay by meeting specific requirements

answer

clinical ladder

question

a set of related common-sense skills that helps you use your time in the most effective and productive way possible; the use of tools, techniques, strategies, and follow-up systems to control wasted time and to ensure that the time invested in activities leads toward achieving a desired, high priority goal

answer

time management

question

more is achieved than with an emphasis on task completion; determine long-term goals, then break them down into achievable outcomes that are the steps toward those goals; flexibility

answer

outcome orientation (time management)

question

the relative effectiveness of the effort (20% effort for 80% outcome results); the importance of outcome vs process orientation; the value of organizing how time is currently being used

answer

main time management concepts

question

1st priority: a life-threatening or potentially life-threatening occurrence 2nd priority: activities essential to safety (life saving medications, assisting others with lifting) 3rd priority: activities essential to the plan of care (symptom management, other medications)

answer

establishing priorities

question

Process of synthesizing, discriminating, and using research-generated knowledge to make an impact or change in existing practices

answer

research utilization

question

integration of individual clinical expertise, built from practice, with the best available evidence from systematic research applied to practice

answer

evidence-based practice

question

originally formed to address research issues in primary care, PBRNs are increasingly being used in large healthcare organizations having the capability of integrating systems across multiple practice sites; practice-based research networks in nursing exists for primary care, community nursing centers, and school nursing

answer

practice based research network

question

approaches that integrate the use of evidence into patient care; the science of how research is best translated into practice

answer

translating research into practice (TRIP)

question

Patient population Intervention/interest area Comparison Outcome Time

answer

Asking the right question: PICOT format

question

constraining healthcare costs; reducing geographic variability; improving quality; promoting consumer-directed healthcare; making health coverage decision

answer

impact of EBP (positive)

question

statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options

answer

clinical practice guidelines

question

evolves from values of impartiality and objectivity at a systems or governmental level and founded on principles of fairness, equity, respect for self and human dignity, and tolerance; fair treatment regardless of economic status, race, ethnicity, age, citizenship, disability, or sexual orientation; values are reflected in policies--fairness in policy implementation Fair distribution of benefits and burdens among members of a society

answer

social justice

question

based on the principle that the benefits & burdens of a society should be distributed among its members according to the members' individual efforts & abilities

answer

market justice

question

Safe healthcare Timely healthcare Effective healthcare Efficient healthcare Equitable healthcare Patient-centered healthcare

answer

IOM 6 Aims STEEEP

question

a mechanism for achieving professional practice through group decision making; activities undertaken by a group of people with a common interest

answer

collective action

question

flat type of organizational structure with decision making decentralized; democratic, egalitarian; shared decision making and accountability

answer

shared governance

question

refers to acting on or in behalf of another who is unable to act for himself or herself to effect change about workplace conditions; activities aimed at addressing nursing challenges faced by nurses in their practice setting

answer

workplace advocacy

question

mechanism for settling labor disputes by negotiation between the employer and representatives of the employees; process which organized employees participate w/their employers in decisions about their pay, hours of work, & other terms and conditions of employment

answer

collective bargaining

question

only national designation built on and evolving through research; this program is designed to acknowledge nursing excellence; designed for healthcare organizations to achieve recognition of excellent nursing care through a self-nominating, self-appraisal process

answer

Magnet Status

question

detailed financial plan, stated in dollar, for carrying out the activities of an organization wants to accomplish within a specific period

answer

budget

question

the amount spend on something; national healthcare costs are a function of the price and utilization of healthcare services; a healthcare provider's costs are the expenses involved in providing goods or services

answer

cost

question

a reimbursement method in which healthcare providers are paid a per-person-per-year (or month) fee for providing specified services over a period of time

answer

capitation

question

money earned by an organization for providing goods or services (before expenses are deducted)

answer

revenue

question

an excess of revenues over expenses and obligations;

answer

profit

question

change in expected revenue or change in expected expense may be due to changes in price, volume, acuity, and wage

answer

budget variance

question

a financial plan for day to day activities of an organization

answer

operating budget

question

budget for purchasing major capital items, such as equipment or a physical plant, with a useful life greater than 1 year and exceeding a minimum cost set by the organization

answer

capital budget

question

a plan for an organization's cash receipts and disbursement, how bills are paid month to month

answer

cash budget

question

set standards for the operation of healthcare organizations, ensure compliance with federal and state regulations developed by governmental administrative agencies, and investigate and make judgements regarding complaints brought by consumers of the services and the public

answer

regulatory organization

question

the use of knowledge technology; nursing science, computer science and information science; identifying, collecting, processing, and managing data and information; supporting nursing practice, administration, education, research, and the expansion of nursing knowledge

answer

informatics

question

handling information in nursing practice; making sure nurses' needs are taken into consideration when automated systems are designed and purchased; developing processes to help bedside nurses manage patient data at the bedside; teaching other nurses about information resources & tools; testing information systems

answer

focus of nursing informatics

question

a collection of software programs and associated hardware that supports the entry, retrieval, update, and analysis of patient care information and associated clinical information related to patient care; primarily a computer system

answer

clinical information system (CIS)

question

the technological devices and systems that relate to biologic and medical sciences; involves the equipment in the clinical for diagnosis, physiologic monitoring, testing, or administering therapies to patients

answer

biomedical technology

question

the use of computer hardware and software to process data into information to solve problems

answer

information technology

question

the use of expert and decision support systems to assist in making decisions about patient care delivery; provide clinical decision support

answer

knowledge technology

question

Purpose for which the site was created Links and their accuracy and reliability Editorial or site content: accuracy, bias, comprehensiveness, currency Author: credentials, expertise Site: design, navigability, ease of use Ethics: disclosure of author, sponsor, site purpose Date: is information current, updated regularly

answer

PLEASED

question

Content Credibility Critical thinking Copyright Citation Continuity Censorship Connectivity Comparability Context

answer

Ten C's for evaluation of internet sources

question

the ability to influence others in the effort to achieve goals; ability to create, get and/or use resources to achieve one's goals

answer

power

question

based on one's reputation and credibility

answer

personal power

question

results from the knowledge and skills one possesses that are needed by others

answer

expert power

question

possessed by virtue of one's position within an organization or status within a group

answer

position power

question

results from one's reputation as a powerful person

answer

perceived power

question

stems from one's possession of selected information that is needed by others

answer

information power

question

gained by association with people who have links to powerful people

answer

connection power

question

sharing of power and control with the expectation that people are responsible for themselves; also, the process by which we facilitate the participation of others in decision making within an environment in which power is equally distributed

answer

empowerment

question

a process of human interaction within organizations; predominantly a process by which people use a variety of methods to achieve their goals; involves some level of competition, negotiation, and/or collaboration

answer

politics

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