question

Who developed a theory that provides nurse leaders with tools to become effective change agents?

answer

Kurt Lewin

question

The nurse leader should identify the _______ forces prior to attempting to implement change.

answer

restraining

question

True of False: Change should be immediately implemented if the need for change has been identified.

answer

False

question

You are the nurse manager of a medical surgical unit that is in need of a change in staffing rotation patterns. which will lead to major changes in how the unit is staffed. According to Lewin's Change Theory, what forces are in play to enact these changes?

answer

Driving Force

question

A single parent raising two children and relying on public transportation, is determined to become a registered nurse. What are the restraining forces in this situation?

answer

Relying on public transport Being a single mother Stress of being away from children

question

The unit manager of a medical surgical unit is transitioning the unit to electronic charting. According to Lewin's model, which of the following roles describes you as the change agent?

answer

The unfreezer

question

The oncology unit has recently experienced a higher than normal patient census, which is requiring that nurses pick up an additional patient. The hospital CFO has indicated that there are no additional funds available to hire additional full-time nurses. As such, the unit manager anticipates some behavioral responses by the stakeholders of change (nursing staff) within the unfreezing phase. What are some possible behavioral responses?

answer

Anger Withdrawal Discontentment

question

The charge nurse of a step down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the Movement stage can be more successful if certain things are considered by the change agent.

answer

Include all stakeholders Set target dates Implement the change

question

Which of the following is not included in the contemporary change process?

answer

Evaluation

question

Select the classic change strategies that nurse leaders use to apply the change process.

answer

Rational-Empirical Normative-Reeducative Power-Coercive Strategy

question

The nurse leader should not only understand the change process but also understand how to adapt to various methods in order to become an effective change agent int their organizations.

answer

True

question

A nurse manager notices that supply carts are unorganized and could use some attention. What strategy can the manager use to help implement change in this area?

answer

Encourage input from subordinates for potential options

question

The nurse manager for a medical surgical unit is implementing change in unit procedures as it relates to patient discharge. During the fourth phase of change known as action, the manager should incorporate the major component known as:

answer

Communication

question

A nurse manager is assigned to a new unit due to issues of administrative mismanagement, which had resulted in staff becoming disillusioned as to the mission of the unit. As the unit manager, you are expected to develop new policies for the staff to follow. What is one of the greatest factors that may contribute to resistance of change on this unit?

answer

Lack of trust

question

A nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. After working in the new hospital for a month, the nurse leader believes it would be a great idea to brighten the rooms with a lighter paint job, obtain newer hospital beds and curtains, and hang some fun artwork. However, the nurse leader doesn't want to be perceived as a threat to the team. How could these ideas be presented to minimize resistance?

answer

- Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea - Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics. - Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data with the idea to the team if the experiment was successful

question

A nurse leader is thinking about approaching their manager with a new idea. To be properly prepared, the nurse leader should recognize this as a natural and unexpected response to change.

answer

Resistance

question

What is the role of the change agent?

answer

Seeks to lead or create change

question

The nurse leader is a change agent and needs to identify factors that lead to resistance of change. Identify factors of resistance:

answer

Poor timing Fear of loss of control Lack of trust Person energy needed Comfort with the current way of completing goals or tasks

question

True of False: It is important for nurse leaders to establish a trusting relationship with those involved in the change process.

answer

True

question

As the nursing manager of a unit, which key steps should be performed before implementing a change effort?

answer

Encourage input from team members who would be impacted by the change. Investigate the magnitude and complexity of the intended change. Use a roadmap as a guide to complete the change

question

A few months ago, a new nurse leader at a hospital discovered via EBP that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of the planning stage?

answer

Anticipating resistance to the change by less tech savvy staff. Determining the scope of the change of the project, a schedule for its implementation, and a budget to submit to administration for approval.

question

A nursing staff member who is on a unit committee to bring about a planned change is currently in the integrating phase of change. What activities are associated with the integrating phase?

answer

Assessing how well the new process is accepted and becoming the new norm. Assessing how well the change is working against an established measurement for success.

question

A nurse leader is working in the ER when a patient presents with a deep head laceration requiring immediate suturing. The nurse leader went to the medical supply area for antibacterial ointments, gloves, and bandages. However, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. The next morning, the nurse leader began to ask team members if they had any input regarding the organization of medical supplies, and then began to brainstorm a few different ideas, such as rearranging the supplies and relabeling items. What is the next stage of change the nurse leader should address?

answer

Plan

question

Last month, two nursing units were merged to save on staffing costs. The nursing manager is now inquiring among the staff about how the change is working and if any barriers remain. What stage of change is this?

answer

Plan Design Integrate

question

True of False: All people and organizational units that will be affected by a planned change should be included in the planning.

answer

TRUE

question

What is the effect on a nurse who experiences a disconnection between personal and organizational values?

answer

Intrapersonal conflict and burnout

question

Which of the following delineates the set of values and beliefs of an organization's goals and guides the development of the philosophy statement?

answer

Purpose or mission statement

question

A newly employed nurse is reviewing the organizational chart of the facility, observing that there is a shared governance. What type of organizational chart does the nurse recognize the facility follows?

answer

Matrix

question

The chief nursing officer (CNO) at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. This CNO is part of what type of organization?

answer

Flat

question

The mission of the acute care facility is "We are dedicated to creating a healthy community, one person at a time" What nursing leadership activities would correlate with that mission?

answer

Notifying nursing staff of an upcoming CEU seminar on healthy eating for low-income families. Mentoring a nursing student who is interested in introducing smoking cessation to patients and patient families without being preachy. Reviewing health care provider orders to guarantee the nursing staff is appropriately carrying them out.

question

A nurse leader has an idea for changing the intake flow in the ER to leverage more of the nursing staff. The leader knows that if they could implement the idea as a pilot program, they could prove its effectiveness and then use it in all the ERs in the region. The nurse leader is frustrated, however, because in order to implement even a pilot of the idea, a proposal must be submitted to the ER Supervisor with a start to finish scenario that details not only the process but also the risks, liabilities, and cost estimates. If the supervisor approves, the proposal would then be sent to the Chief Nursing Officer, who would then send it to the Administrator and Board of Directors for review and approval. Which of these factors are influencing the nurse leader's ability to implement the pilot program?

answer

Organizational Structure

question

A nurse on a busy medical surgical unit must delegate some care assignments to an experienced nursing assistant. What factors does the nurse consider prior to delegating the care to the nursing assistant?

answer

State or national standards

question

Planning

answer

All planning involves choice: a necessity to choose from among alternatives. Definition: deciding in advance what to do; who is to do it; and how, when, and where it is to be done. Therefore, all planning involves choosing among alternatives.

question

Planning (implications)

answer

a proactive and deliberate process that reduces risk and uncertainty.

question

Leadership characteristics required for planning:

answer

Flexibility and Energy

question

Unlike the 20-year strategic plans of the 1960s and 1970s, most long-term _____ today find it difficult to look even 5 years in the future.

answer

planners

question

Proactive Planning

answer

is dynamic, and adaptation is considered to be a key requirement because the environment changes so frequently.

question

Managers who are uninformed about the legal, political, economic, and social factors affecting health care make______ errors that may have disastrous implications for their professional development and the financial viability of the organization.

answer

planning

question

Strategic planning typically examines

answer

an organization's purpose, mission, philosophy, and goals in the context of its external environment.

question

An organization will never be greater than

answer

the vision that guides it.

question

An organization must truly believe and act on its

answer

mission statement; otherwise, the statement has no value.

question

A working philosophy

answer

is evident in a department's decisions, in its priorities, and in its accomplishments.

question

When a nurse experiences cognitive dissonance between personal and organizational values, the result may be

answer

intrapersonal conflict and burnout.

question

It is unrealistic for managers to accept a position under the assumption that they can change

answer

organization's philosophy to more closely match their personal philosophy.

question

Although goals may direct and maintain the behavior of an organization, there are several dangers in using

answer

goal evaluation as the primary means of assessing organizational effectiveness.

question

Today, most health-care organizations find themselves undergoing continual change directed

answer

organizational restructuring, quality improvement, and employee retention.

question

Change should be implemented only for

answer

good reasons.

question

Change agents must be

answer

patient and open to new opportunities during refreezing, as complex change takes time and several different attempts may be needed before desired outcomes are achieved.

question

The forces that push the system toward change are

answer

driving forces

question

the forces that pull the system away from change are called

answer

restraining forces

question

Because change disrupts the homeostasis or balance of the group

answer

resistance should always be expected.

question

Whenever possible, all those who may be affected by a change should be

answer

involved in planning for that change.

question

It is critical that managers not

answer

view change as a threat

question

CAS theory suggests that the relationship between elements and agents within any system is

answer

nonlinear and that these elements are constantly in play to change the environment or outcome

question

Chaos theory is really about

answer

finding the underlying order in apparently random data

question

Power-Coercive Strategy:

answer

features the application of power by legitimate authority, economic sanctions, or political clout of the change agent

question

Normative-Reeducative

answer

strategies use group norms and peer pressure to socialize and influence people so that change will occur

question

Rational-Empirical

answer

gives current research as evidence to support the change

question

Stages of Change

answer

Precontemplation Contemplation Preparation Action Maintenance

question

Unfreezing

answer

occurs when the change agent convinces members of the group to change or when guilt, anxiety, or concern can be elicited

question

Refreezing

answer

the change agent assists in stabilizing the system change so that it becomes integrated into the status quo

question

Organizational Philosophy

answer

provides the basis for developing nursing philosophies at the unit level and for nursing service as a whole

question

Nursing service philosophy

answer

should address fundamental beliefs about nursing and nursing care; the quality, quantity, and scope of nursing services; and how nursing specifically will meet organizational goals

question

Unit philosophy

answer

adapted from the nursing service philosophy, specifies how nursing care provided on the unit will correspond with nursing service and organizational goals.

question

Vision Statements

answer

are used to describe future goals or aims of an organization.

question

Mission Statement

answer

a brief statement (typically no more than three or four sentences) identifying the reason that an organization exists

question

Strategic planners using a balanced scorecard develop

answer

metrics (performance measurement indicators), collect data, and analyze that data from four organizational perspectives: financial, customers, internal business processes (or simply processes), and learning and growth

question

Long-range or strategic plans

answer

time span and complexity or comprehensiveness. Generally, complex organizational plans that involve a long period (usually 3 to 7 years) are referred to as

question

Reactive planning

answer

occurs after a problem exists. Because there is dissatisfaction with the current situation, planning efforts are directed at returning the organization to a previous, more comfortable state

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