Leadership and Management Test 2

question

benchmarking
answer

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
question

patient classification system (PCS)
answer

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

patient acuity
answer

the measure of nursing workload generated for each patient
question

full-time equivalent
answer

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
question

Factor Evaluation System
answer

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
question

Prototype Evaluation System
answer

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;
question

Nursing Hours Per Patient Day
answer

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.
question

Scheduling
answer

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
question

decentralized scheduling
answer

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

centralized scheduling
answer

done by staffing coordination
question

nursing care delivery model
answer

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
question

case method/total patient care model
answer

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)
question

functional nursing model
answer

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)
question

team nursing model
answer

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

primary nursing
answer

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

nursing case management
answer

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
question

critical path/critical pathway
answer

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
question

clinical pathway
answer

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
question

variance
answer

anything that alters a patient’s progress through a normal care path
question

quality management (QM)
answer

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
question

quality improvement
answer

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

quality assurance
answer

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
question

8 Common steps of Quality Improvement
answer

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
question

regulatory requirements
answer

measuring organizational performance against standards from regulatory/accrediting organizations
question

PDSA/PDCSA
answer

Plan Do Study Act/Plan Do Check Study Act
question

Plan
answer

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

Do
answer

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

Study
answer

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

Act
answer

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
question

storyboard
answer

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
question

dashboards
answer

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
question

safety
answer

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

safety culture
answer

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

safety climate
answer

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

error
answer

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
question

active error
answer

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
question

latent error
answer

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
question

adverse event
answer

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

misuse
answer

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)
question

overuse
answer

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

near miss
answer

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

sentinel event
answer

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

root cause analysis
answer

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
question

culture of safety
answer

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
question

just culture
answer

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
question

Patient Safety: Principles in Action in an Organization
answer

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

Patient Safety: Leadership Roles
answer

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

Patient Safety: Management Functions
answer

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
question

risk management
answer

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
question

Responsibilities of risk management
answer

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

Failure Mode & Effect Analysis (FMEA)
answer

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

flowcharts
answer

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

safe harbor act
answer

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
question

autonomy
answer

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

beneficence
answer

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
question

non-maleficence
answer

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
question

justice
answer

fairness, treating people equally and without prejudice
question

paternalism
answer

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
question

veracity
answer

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

fidelity
answer

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

respect for others
answer

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

Ethical Decision-Making Framework
answer

-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
question

ethical committees
answer

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
question

moral distress
answer

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
question

ethical issues encountered in practice
answer

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

barriers to cultural competence
answer

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
question

Cultural Care Theory
answer

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
question

cultural destructiveness
answer

eliminates the cultures of others
question

cultural incapacity
answer

trivialize other cultures and make other cultures appear to be wrong
question

cultural blindness
answer

do not see or acknowledge the culture of others
question

cultural precompetence
answer

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

cultural competence
answer

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

cultural proficiency
answer

lifelong learning of cultural groups to create a socially just democracy
question

multiculturalism
answer

refers to maintaining several different cultures simultaneously
question

cross-culturalism
answer

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

transculturalism
answer

denotes bridging significant differences in cultural practices
question

organizational culture
answer

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
question

acculturation
answer

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

role development
answer

choosing to change role expectations and/or role performance
question

role discrepancy
answer

a gap between role expectations and role performance
question

role internalization
answer

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
question

role negotiation
answer

resolving conflicting expectations about personal management performance through communication
question

role strain
answer

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
question

role stress
answer

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

role transition
answer

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
question

ROLES
answer

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

Hartman Value Profile
answer

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

role exploration
answer

similar to honeymoon phase
question

Role transition Process
answer

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

360 Degree Feedback
answer

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
question

clinical ladder
answer

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

time management
answer

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
question

outcome orientation (time management)
answer

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
question

main time management concepts
answer

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
question

establishing priorities
answer

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)
question

research utilization
answer

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

evidence-based practice
answer

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

practice based research network
answer

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
question

translating research into practice (TRIP)
answer

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

Asking the right question: PICOT format
answer

Patient population Intervention/interest area Comparison Outcome Time
question

impact of EBP (positive)
answer

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

clinical practice guidelines
answer

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
question

social justice
answer

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
question

market justice
answer

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

IOM 6 Aims STEEEP
answer

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

collective action
answer

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

shared governance
answer

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

workplace advocacy
answer

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
question

collective bargaining
answer

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
question

Magnet Status
answer

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
question

budget
answer

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

cost
answer

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
question

capitation
answer

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
question

revenue
answer

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

profit
answer

an excess of revenues over expenses and obligations;
question

budget variance
answer

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

operating budget
answer

a financial plan for day to day activities of an organization
question

capital budget
answer

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
question

cash budget
answer

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

regulatory organization
answer

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
question

informatics
answer

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
question

focus of nursing informatics
answer

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
question

clinical information system (CIS)
answer

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
question

biomedical technology
answer

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
question

information technology
answer

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

knowledge technology
answer

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

PLEASED
answer

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
question

Ten C’s for evaluation of internet sources
answer

Content Credibility Critical thinking Copyright Citation Continuity Censorship Connectivity Comparability Context
question

power
answer

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

personal power
answer

based on one’s reputation and credibility
question

expert power
answer

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

position power
answer

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

perceived power
answer

results from one’s reputation as a powerful person
question

information power
answer

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

connection power
answer

gained by association with people who have links to powerful people
question

empowerment
answer

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
question

politics
answer

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

Get instant access to
all materials

Become a Member