question

management

answer

process of planning, organizing, directing, and coordinating the work within an organization -formal positions of power and authority

question

leadership

answer

ability to inspire others to achieve a desired outcome

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authoritative leadership style

answer

makes decisions for group motivates by coercion communication occurs down the chain of command work output by staff is usually high-good for crisis situations and bureaucratic settings

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democratic leadership style

answer

includes the group when decisions are made motivates by supporting staff achievements communication occurs up and down chain of command good when cooperation and collaboration are necessary

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laissez-faire

answer

makes very few decisions and does little planning motivation is largely the responsibility of individual staff members communication occurs up and chain of command and between group members work output is low unless informal leader evolves from the group effective with professional employees

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characteristics of leaders

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initiative inspiration energy positive attitude communication skills respect problem solving & critical thinking skills

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transformational leaders

answer

empower followers to assume responsibility for a communal vision and personal development is a secondary outcome

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transactional leaders

answer

focus on immediate problems, maintaining the status quo and using rewards to motivate followers

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emotional intelligence

answer

ability of an individual to perceive and manage emotions of self and others

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Characteristics of managers

answer

hold formal position of power and authority possess clinical expertise network with members of the team coach subordinates make decisions about organization function, including resources, budget, hiring, and firing

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5 major management functions

answer

planning organizing staffing directing controlling

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Maslows

answer

physiological > safety and security > love and belonging > self-esteem > self-actualization

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Assigning

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process of transferring authority, accountability, and responsibility of client care to another member of the HC team

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delegating

answer

process of transferring the authority and responsibility to another team member to complete a task while retaining accountability

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supervising

answer

process of directing, monitoring, and evaluating the performance of tasks by another member of the HC team

question

Assignment factors

answer

client factors -condition of client and level of care needed -specific care needs -need for special precautions -procedures requiring a significant time commitment health care team factors -knowledge and skill level -amount of supervision necessary -staffing mix -nurse to client ratio -experience with similar clients -familiarity of staff member with unit

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Who can an RN delegate to?

answer

other RN's, LPN's, and UAP

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What can RN's not delegate?

answer

the nursing process client education tasks that require clinical judgment (for those that are not also RN's)

question

Factors to consider when delegating

answer

predictability of outcome potential for harm complexity of care need for problem solving and innovation level of interaction with client

question

Considerations for selecting appropriate delegatee

answer

education, training, experience knowledge and skill level to perform task level of critical thinking required ability to communicate with others as it pertains to the task demonstrated competence delegate's culture agency policies and procedures and licensing legislation (state nurse practice acts)

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Tasks that can be delegated to LPN

answer

monitoring client findings reinforcement of client teaching from a standard care plan trach care suctioning checking NG tube patency administering enteral feeds urinary catheterization medication administration (excluding IV)

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Tasks that can be delegated to UAP

answer

ADL's -bathing -grooming -dressing -toileting -ambulating -feeding (w/o swallowing precautions) -positioning specimen collection intake and output vital signs (on stable clients)

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5 rights of delegation

answer

right task right circumstance right person right direction/communication right supervision/evaluation

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Benner 5 stages of nursing ability

answer

novice (students or brand new) advanced beginner competent (nurse for 2-3 yrs) proficient expert

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quality improvement

answer

process used to identify and resolve performance deficiencies

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quality improvement process begins with?

answer

identification of standards and outcome indicators based on evidence -outcome/clinical indicators: reflect desired client outcomes related to the standard under review -structure indicators: reflect the setting in which care is being provided and the available human and material resources -process indicators: reflect how client care is provided -benchmarks: goals that are set to determine at what level the outcome indicators should be met

question

steps in QI process

answer

standard is developed and approved standards are made available to employees quality issues are identified an interprofessional team is developed to review the issue the current state of structure and process related to the issue is analyzed

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root cause analysis

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done to critically assess all factors that influence an issue when a benchmark is not met -investigates the consequences and possible causes -analyzes possible causes and relationships -determines additional influences at each level of relationship -determines the root cause/s

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steps in progressive discipline

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-informal reprimand -written warning -employee placed on suspension -employee termination

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intrapersonal conflict

answer

occurs within a person

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interpersonal conflict

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occurs between 2 or more people

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intergroup conflict

answer

occurs between two more more groups of individuals, departments, or organizations

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grievance

answer

wrong perceived by an employee based on a feeling of unfair treatment that is considered grounds for a formal complaint

question

decision making styles

answer

decisive: team uses a minimum amount of data and generates one option flexible: the team uses a limited amount of data and generates several option hierarchical-team uses a large amount of data and generates one option integrative-team uses a large amount of data and generates several options

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centralized hierarchy

answer

nurses at top of organizational chart make most of the decisions

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decentralized hierarchy

answer

staff nurses who provide client care are included in the decision making process

question

behavioral change strategies

answer

rational-empirical: uses factual information to support change, used when resistance is minimal normative reeducative: manager focuses on interpersonal relationships to promote change power-coercive: the manager uses rewards to promote change, used when resistance to change is high

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veteran 1925-1942

answer

support status quo accept authority appreciate hierarchy loyal to employer

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baby boomer 1943-1960

answer

accept authority workaholics some struggle with technology loyal to employer

question

generation X 1961-1980

answer

adapts easily to change personal life and family are important proficient with technology makes frequent job changes

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generation Y 1981-2000

answer

optimistic and self-confident value achievement technology is a way of life at ease with cultural diversity

question

roles in case management

answer

coordinate care facilitate continuity of care improve efficiency of care and utilization of resources enhancing quality of care provided limiting unnecessary costs and lengthy stays advocating for client and family

question

advocacy

answer

ensuring clients are properly informed, rights are respected, and that they are receiving the proper level of care

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informed consent should include

answer

reason the treatment or procedure is needed how the treatment or procedure will benefit the client risks if the client proceeds risks if the client rejects other options

question

individuals who can grant consent for another person

answer

parent of a minor legal guardian court specified representative spouse of closest available individual who has durable power of attorney for HC (emancipated minors can provide for themselves)

question

Client role in informed consent

answer

client must: give it voluntarily be competent and of legal age or be emancipated receive sufficient information to make a decision based on an informed understanding of what is expected

question

nurse role in informed consent

answer

witness ensure the provider gave the necessary info ensure the client understood and is competent have the client sign notify provider if client has more questions or does not understand documenting: reinforcement of info originally given by provider, questions from client were forwarded to provider, use of an interpreter

question

advance directive

answer

communicates clients wishes regarding end of life care if client cannot do so 2 components: living will & durable power of attorney

question

living will

answer

legal document expressing the clients wishes regarding medical tx in the event the client becomes incapacitated and is facing end of life issues

question

durable POA

answer

legal document designates a HC proxy, who is an individual authorized to make HC decisions for a client who is unable to do so

question

DNR or AND orders

answer

provider administers them after consultation

question

unintentional torts

answer

negligence malpractice (professional negligence)

question

quasi-intentional torts

answer

breach of confidentiality defamation of character

question

intentional torts

answer

assault: conduct of one person makes the other person fearful and apprehensive (ex: threats) battery: intentional and wrongful physical conduct with a person that involves injury or offensive contact false imprisonment: restraining or confining against a persons will

question

Malpractice/professional negligence

answer

failure of a person with professional training to act in a reasonable and prudent manner

question

5 elements to prove negligence

answer

1. duty to provide care as defined by a standard (care that should be given) 2. Breach of duty by failure to meet standard (failure to give care that should have been given) 3. Forseeability of harm (knowing that failing to give the proper standard of care may cause harm to the client) 4. Breach of duty has potential to cause harm (failing to meet standard had potential to cause harm-relationship must be provable) 5. harm occurs

question

autonomy

answer

ability of client to make personal decisions, even when those decisions may not be in the clients own best interest

question

beneficence

answer

care that is in the best interest of the client (benefits them)

question

fidelity

answer

keeping your promise

question

justice

answer

fair treatment and use of resources

question

nonmaleficence

answer

do no harm

question

veracity

answer

telling the truth

question

Uniform determination of Death Act UDDA 2 criteria

answer

-irreversible cessation of circulator and respiratory function OR -irreversible cessation of all functions of the entire brain including brain stem

question

QSEN 6 core competencies

answer

safety patient centered care evidence based practice informatics quality improvement teamwork and collaboration

question

Rules of restraints

answer

provider must prescript based on face to face assessment if emergency: nurse can apply restraints but must get prescription within I hr prescription must be re-written q 24 hrs. prescription must state: reason for restraint, type, location, length of allowable use, behaviors warranting restraint q 2 hours assess: circulation, sensation, mobility

question

RACE for fire safety

answer

R-rescue A-alarm C-contain E-extinguish

question

PASS for extinguisher use

answer

P-pull A-aim S-squeeze S-sweep

question

incident reports

answer

should be completed by person who identifies an event occurred should be completed within 24 hours considered confidential and are not shared with client DO NOT PLACE in health care record or mention in record just describe the incident itself in the record description should be: objective, contain actions taken, assessment and treatment forward report to risk management dept.

question

INFO to include in incident report

answer

patients name and hospital number date,time, location of incident factual description witnesses corrective actions taken detail of medications or equipment involved

question

Discharge of clients in a disaster

answer

ambulatory clients requiring minimal care go first clients requiring assistance are next clients who are unstable or require nursing care should not be discharged

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