208 study guide Flashcards
What are the 4 principles of scientific management?
- Traditional ways of doing work need to be replaced with scientific methods
- Workers hired, trained, and promoted based on their unique competence and abilities
- Workers view how they “Fit” into an organizations goals. Financial incentives
- Relationship between workers and managers should be cooperative and interdependent, share work
5 Management functions
Planning
Organization
Command
COordination
Control
What did Max Weber discover?
Bureaucracy
*need to provide more rules, regulations, structure within organization to increase efficiceny
What is PLANNING
determining philosophy, goals, objectives, policies, procedures and rules
Carry out long and short term goals
Fiscal course of action
What is ORGANIZING
Establish a structure to carry out plans
Understanding and using power appropriately
What is STAFFING
Recruiting, hiring, orienting staff
Scheduling, team building
What is DIRECTING
HR responsibilities
Motivating, managing conflict, delegating,
What is CONTROLLING
Performance appraisals, quality control, legal and ethical control, fiscal accountablity
What is X and Y Theory?
X theory mgmrs believe their employees are lazy, need constant supervision., and are indifferent to organizational needs
Y theroy mgmrs believe their workers enjoy their work, are self motivated and willing to work to meet personal and organizational needs
Theory Z
Conscious decision making, fitting employees to their jobs, job security, slower promotions, lifetime employment, holistic concern for workers
What is the Hawthorne effect?
people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will contuinue to warrant the attention
Characteristics of a leader?
Obtain power through influence
variety of roles
May or may not be part of formal organization
focus on group process, info gathering, feedback and empowering others
emphasize interpersonal relationships
direct willing followers
have goals that may or may not reflect those of organization
What is authoritaruan leadership
Strong control over a group
Motivated by coercion
Commands
Communication flows downward
Criticism
*well defines group actions that are predictable giving members security. Productivity high but creativity self motivation is reduced. / Found in large bureaucracies like armed forces
What is democratic leadership
Less control
Economic and ego are used to motivate
Directed through suggestions and guidance
Communication up and down
Criticism is constructive
*Seek input from followers and include in decision making. Employees feel valued. Promotoes growth in individual workers. Takes more time to make decisions
What is Laissez-faire leadership
Hands off approach
Permissive
Little or no direction
Does not criticize
group decided
*Frustrating, group disinterest can occur. When all members are motivated can result in creativitiy. Good when brainstorming is needed.
What is the great man theory of leadership
asserts that some people were born to lead, others were born to be led
* great leaders will arise when the situation demands
What are 6 fatal leadership flaws?
- Inability to motivate
- Not self developing / asking for feedback
- Poor team work
- Failure to develop others
- Lack of communication
- Lack of positive relationships with others
What is situational / contingency theory?
Style varies based on individuals involved.
No one leadership style is ideal for every situation
What is interactional leadership?
Leader behavior is generally determined by the relationship between leaders personality and specific situation
Issues affecting 21st century leaders?
Growing older adult population
Health care reform
Reduction in reimbursement
Commerical insurance
Pay for performance
AI advancement
Focus on externally regulated safety and customer focused care
What challenges must leader managers face?
Focus on the business of healthcare
Constantly learn new roles and develop new skills
health care worker shortages, unionization, eliminate mandatory overtime
Strenght based leadership?
focuses on development or empowerment of strengths as opposed to weakness or areas of needed growth
Servant leadership
put serving others as number one priority
Qualities of a servant leader
- listen and understand
- open mind/no judgement
- deal with complex issues
- honestly sharing critical challenges
- Clear on goals
- Be a servant, helper and teacher first
- Think before reaction
- Words choosen carefully
- Use foresight and intuition
- See big picture
Level 5 leadership
Level 1: highly capable individual
Level 2: Contributing team member
Level 3: Competent manager
Level 4: Effective leader
Level 5: Great leader
Principle agent theory?
When one person can make decisions on behalf of another person.
*Issues of moral hazard and conflicts of interest
What is emotional intellegance?
Ability to percieve, understand and control ones own emotions as well as others
- Appraising and expressing emotions in self and others
- Regulating emotions in self and others
- Using emotions in adaptive ways
Human capital
Collective skills, knowledge, or other tangible assess of individuals that can be used to create economic value for employees, their employers and their community
Social capital
Social relationship and networks, based on reciprocity and trust, that facilitate mutually benefical coordiantion and cooperation
Authentic leadership
that to lead, leaders must be true to themselves and their values and act accordingly.
Thought leadership
Applies to a person who is recognized among their peers for innovative ideas and who demonstrates the confidence to promote these ideas
Agile leadership
Ability to think in many ways so they can be flexible, adaptable, and fast in decision making
*listen deeply and ask powerful questions
Quantum leadership
Leaders must work together with subodinated to identify common goals, exploit opportunities and empower staff to make decisions.
Why is there a transition from industrial age to relationship aged leadership?
Changing workfoce dynamics - employees are seeking meaningful work, work-life balance, personal growth
Increased focus on collaborationa dn innovation
Technological advancement
Benefit of learning with case studies?
More interactive learning
Development of clinical decision making skills
Benefit of simulation
Opportunities for problem solving that have no risk to patients
Provide insight to a learners decision ,making based on priority setting, timeliness of action and patient outcomes
Problem based learning
Problem solving in a group
helps develop critical thinking skills
Heuristics
Trial and error methods
Mental shortcuts
Provide more of an immediate solution
SWOT?
Strengths
weakness
Opportunities
Threats
Intuitive decision making models?
Gut feeling
Integrated ethical problem solving model?
DETERMINE - whether ethical issue
IDENTIFY - Key values and principles involved
RANK - values/principles most relevant
DEVELOP - action plan
IMPLEMENT - your plan
REFLECT- on outcome
Critical elements in decision making
Define objectives
Gather data
Take the time
Use evidence based approach
Gather alternatives
Think logically
Choose and act
Confirmation bias
Tendency to search for and favor info that confirms our beliefs while simultaneously ignoring or devaluing info that contradicts our beliefs
What is evidence based approach
Approach has been reviewed by experts in the field using accepted standrs of research
PICO
Patient population
intervention
Comparison
Outcome
Overgeneralizing
When one believes that because “A” has a particular characteristic that every other A also has that characteristic
Influences that affects ones decision making?
Sex
Values
Life expierence
Individual preference
Difference between Right and Left brained thinking?
RIght brained - nonverbal ideation and creativity. More emotional. big picture
Left brained - Processing language, logic and numbers. analytical thinker, facts, organized and detailed.
Economic man
Decisions made in rational manner
Decision maker has complete knowledge of problem
All possible alternatives considered
Rational system of ordering alternatives
Decisions are selected to maximize utility
Administrative man
Decisions made are “good enough”
Complete knowledge is not possible; knowledge always fragmented
Alernatives impossible to predict accurately
SOme alternatives considered
Final choice made to satisfy rather than maximizing
DECISION MAKING TOOLS
GRID
PAYOFF TABLES
DECISION TREE
CONSEQUENCE TABLE
LOGIC MODEL
PERT
GRID - visually examine alternatives
**PAYOFF TABLES ** - Cost-profit-volume relationship
**DECISION TREE ** -
**CONSEQUENCE TABLE ** - shows how various alternatives create different consequnces
LOGIC MODEL - pictures of how programs are intended to operate. Resources, processes and desired outcomes and what relationship between all 3 looks like
PERT - determing timing of decisions
What is Ethics?
Systematic study of what a persons conduct and actions should be regarding self, other human beings and environment. Justification of what is right or good.
Moral distress
Occurs when individual knows the right thing to do but organizational constraints make it difficult to take right course of action
*WItnessing inadequate pain relief bc provider fails to order adequate meds
Moral uncertainity
When an individual is unsure which moral principles or values apply and even what moral problem is
Moral outrage
WHen a person withnesses a immoral act of another but feels powerless to stop it
What is Duty based reasoning?
Ethical framework stating that some decisions must be made because one has a duty to do something or refrain from doing something
What is intuitionist framework
Allows the decision maker to review each ethical problem or issue on a case-by-case basis, comparing the relative weights of the goals, duties and rights. The weighing is determined by intuition - what decision maker belives is right
Autonomy / Self determination
Freedom of choice or accepting the responsibility for ones choice
When is self determination not a choice for patients?
When an individuals decisional capacity is in question
What is paternalism?
When one person assumes the authority to decide for another
*this limits freedom of choice so only justified to prevent a person from doing harm
What is the ethical principle of Justice?
That equals should be treated equally and that unequals shoudl be treated according to their differences
What are the ethical principles?
(9)
Autonomy
Beneficence
Nonmaleficence
Paternalism
Unity
Justice
Veracity
Fidelity
Confidentiality
What is confidentiality?
The obligation to obsere the privacy of another and to hold certain information in strict confidence is a basic ethical principle and a foundation of both medical and nursing ethics
What is MORAL decision making model?
**Massage the dilemma: **Collect data
Outline options: Identify alternatives & analyze
Review criteria & resolve: Weigh options
Affirm position and act: Develop strategy
Look back: Evaluate
When to use the MORAL decision making model?
When clarifying ethical problems that result from conflicting obligations
What is an ethics committee?
Interprofessional and organized to consciouslt and reflectively consider significant and often difficult or amniguous value issues related to patient care or organizational activities
What is the nurse practice Act?
Law and legislation to protect patient and nurse
Defines scope of acceptable practoce and to protect individual rights
What kind of law is the nursing practice act?
Statues - laws that govern
What are the 4 sources of law?
Constitution - highest law in US
Statues - laws that govern
Administrative agences - rules/regulations est by agencies
**Court decisions **- Interpret statues
Types of laws and courts?
Criminal - beyond a measurable doubt / jail & fines
Civial - based on preponderance of evidence - individual sues for money / Fines
Administrative - Clear and convincing standard - sued by state or agency / loss of licensure
Stare decisis?
“To let the decision stand”
Uses precedents as a guide for decision making
Res judicata?
“Thing or matter settled by judgement”
Applies when competent court has decided a legal dispute and no further appeals are possible/ keeps same parties from retrying same issue
Elements required for Professional Negligence or malpractice?
- Standard of care must be established
- Must be shown that standard was violated
- Nurse must have knowledge that not meeting standard could result in harm
- Failure to meeting standard must have potential to injure patient
- Actual patient injury
How can nurses reduce the risk of malpractice claims?
- Practice within scope
- Observe policies
- Use evidence based practice
- Put pts right and welfare first
- Be aware of laws
- Practice within area of competence
- Continue education
Respondant superior
applies when an employee causes damages or injuries while working on behalf of their employer
Incident report or adverse event form?
Records of unusual or unexpected incidents that occur during a clients treatment
Tort
Legal wrongs committed against a person or property, that render the person who commite them liable for damages in a civil action
Unintential tort
Professional negligence
Intential tort
Direct invasion of someones legal rights
Assult
Conduct that makes a person feel fearful and produces a reasonable apprehension of harm
Battery
Is an intential and wrongful physical contact wtih a person that entail an injury or offensive touching
False imprisionment
Use of physical restraints
Defamation
Communicating to a 3rd party false information that damages a persons reputation
Libel
When defamation is written, printed or broadcast
Slander
When defamation is spoken
Who can give informed consent?
- A competent adult
- Legal guardian or power of attorney
- Emancipated or married minor
- Mature minor
- Parent of minor child
- a court order
The person giving consent must fully understand?
- the procedure
- The risks
- Expected outcomes
- Expected complications
- Alternatives available
What are pts right to access their medical records?
Methods for retreiving records vary by state
Written request and pay clerical cost
Inspect during business hours
What is the patient self determination act
Education to staff and patients on issues regarding treatment on end-of-life issues
**Advanced directive **- written instructions regarding end of life care
Durable power of attorney / heath care proxy -
What is the good samaritan law
suggests that healthcare providers are typically protected from potential liability if they volunteer their nursing skills away from workplace if actions are not grossly negligent and if healthcare worker does not exceed tehir training or scope
HIPPA
Health Insurance Portability and Accountability Act
Unauthorized release of information or photographs in medical records
Title VII
Overt or subtle discrimination is prohibited by VII
What is the difference between professional licensure and institutional licensure?
Professional - Individual nurse meets necessary standards of training, granted by state, NCLEX and education, allows to practice within scope in jurisdiction
Institutional - Promotes healthcare facility , governmental agencies specific to healthcare facilities (State health dept/joint commission), req is meeting standrds for safety,
Actions nurse should take when being investigated by board of nursing?
- Dont ignore notification
- Dont unnecessarily share news with friends/colleagues
- Read employee handbooks,contracts, policy
- Consider an attorney
- HIre expierenced attorney
- Consider anything you put in writing
- Contact malpractice insurance provider
- Do not violate HIPPA, do not alter medical records
- Be prepared for a lengthy investigation
