3514 final EXAM Flashcards
(120 cards)
1
Q
What is Leadership as Influence (definition)
A
Leadership is the art of influencing others to their maximum performance to accomplish any task, objective or project
2
Q
What is leadership as change
A
leadership is the capacity of individuals to spark the capacity of a human community-people living and working together to bring forth new realities
3
Q
What is leadership as character
A
Leadership is a combination of strategy and character. If you must be without one, be without strategy
4
Q
What is leadership as service
A
Leadership is about service to others and a commitment to developing more servants as leaders. It involves co-creation of a commitment to admission
5
Q
What is leadership as development
A
Before you are a leader, success is all about growing yourself. When you become a leader, success is all about growing others
6
Q
What is autocratic leader
A
DO this, or DO that
Need this in emergency situations, with students
7
Q
What is democratic leader
A
Do this or that, as you see fit group related
8
Q
What is laissez - Faire leadership style
A
What do you think we should do - leave the decision to others
- hands - off approach
9
Q
What is a transactional leader
A
similar to autocratic - help organize current objectives more efficiently
- use reward and punishment, focus on tasks, critical situations
- similar to managers, focus on the day to day operations
10
Q
What is transformational leader and the four elements
A
similar to democratic - work together to achieve goals
– inspiration, visionary, coach, catalyst for change, empowering
- engages peoples to work with to promote organizational goal and performance
FOUR ELEMENTS
– idealized influence (role model, values, beliefs)
–Inspirational motivation (articulating vision, energies)
– Intellectual stimulation (challenge, status quo, challenge other to think creatively, critically and innovatively)
– Individual consideration (demonstrates empathy and a genuine concern for the needs and feelings of others )
11
Q
What is charismatic leader (what is the relation to transformational leader)
A
Personal ability of the leader to inspire - high degree of trust, respect and devotion towards the leader.
- communication, deep, emotional level
- **NOTES can be charismatic and transformational (use personal ability to work toward goal of all but can also be charismatic and non transformational and work toward own personal goals and not of greater good)
12
Q
Define emotional intelligence and what are the 5 main attributes
A
EI - is a core set of competencies for identifying, processing and managing emotions that enable nurse leaders to cope with daily demand in a knowledge, approachable and supportive manner - channel emotion, passion and motivation to mobilize team - coach and create vision for the future
Self-awareness, self-regulation, motivation, empathy, social skills
13
Q
What are the two preferences for general attitude
A
Extraversion – engagement with others and initiating contact with people (assertive, sociables, enthusiastic, various good friends, oral communication, like to be noticed, respond quick
Introversion – inner words, contemplation, respond to contact with others, (calm, reserved, happy alone, do not like being centre of attention, think carefully, absorbed in ideas and thoughts, concentrate deeply cautious when meeting people’s, territorial)
14
Q
What are the two preferences of perception
A
Sensing - preference for perceiving the world through facts, evidence, data, details
Intuition - preference for perceived world through concepts, theories and abstractions
15
Q
What are the two preferences of how a personal processes information
A
Thinking - capacity to decide objectively based on the evidence and applicable principles
Feeling - preference for making decision based on values and effects on people rather than logic
16
Q
What are the two preferences of how a person implements the information that has been processed
A
Judging - preference for living a planned and organized life
Receiving - preference for living spontaneously with many options tin the central world
17
Q
Describe Lewin change theory and a problem with it
A
Unfreezing (change is needed, examine status quo, increase driving force, motivation - initiation & engaging)
Moving (changing 0 take action, make changes, involve peoples, new attitudes/beliefs )
Refreezing ( achieving, make changes permanent, new way, reward desired outcomes, establishment of new attitudes, values and behaviours )
Problem - very simplistic does not account for barriers
18
Q
What are the 8 stages of Kotter change process
A
- Establish a sense of urgency
- form a coalition
- create a new vision
- communicate the vision
- empower others by removing barriers
- create and reward short -term wines
- consolidate, reassess and adjust
- reinforce the changes -
19
Q
Describe Rogers diffusion of innovation model ( the 5 groups)
A
- innovators - risk takers, enjoy new things, spread work
- Early adopters - are KEY bc they bridge the gap to early majority when they see other leaders or people they respect using new innovation they come on board
- Early majority - once come on board late majority follow
- Late majority - vulnerable to peer pressure, also need lots of information before using it
- Laggers - can be hard to reach, wait till new way is mainstream to adopt or sometimes never do
20
Q
What is the complexity science
A
Pattern of relationships within healthcare system - complex interaction of all different parts.
- examine interrelationship of the emotional, physiological, spiritual, cultural, social and other partners influencing each individuals reality at any given point
21
Q
What is positive deviance (the 5 steps)
A
Focus on individuals and strategies that are successful rather than what is going wrong - expands on practise and strengths within the environment without additional resources
Define, Determine, Discover, Design, and Monitor
22
Q
What is self - awareness / reflexivity
A
self awareness is an ongoing interpersonal relational, extra-personal and contextual process of becoming aware of ones physical and psychological traits, emotional states and feelings and meaningful life patterns, actions, beliefs and preconceived ideas
23
Q
What are the 4 components of awareness/ reflexivity
A
Intrapersonal - focusing on your personal self and examining personal thoughts influence of historical, cultural, social understanding of self and family values
Relational – allows oneself to analyze oneself in relation to other people and examine own thoughts and feelings with that of others
Extrapersonal - expands beyond self and focuses on the analysis of the internal and external environment
Multi-dimensional - recognizes the influence of social, environment, culture and political factor on self-awareness
24
Q
Describe intrapersonal VS interpersonal self-awareness
A
Intrapersonal – what are my own historical, sociopolitical, material, economic, physical and linguistic contexts. How do these influence my identity, values and beliefs, attitude and behaviours. How are my contexts influencing the way I relate to others
Interpersonal – how do i relate to others form different cultures. What stereotypes do I attach to others and what am I assuming about them and why. What knowledge supports and challenges my assumptions. What contexts may be influencing how others relate to me.
25
What are the 4 Johari Window types of self
Open self - information about you that both you & others know
Blind self - information about you that you don't see about others know
Hidden self - information that you know but others don't
Unknown self - information about you that neither you nor others know
26
What are the 4 self-awareness archetypes
Seekers - low internal and low external self awareness - don't know who they are, or what they stand for
introspector - high internal but low external -
Pleasers - low internal but high external - focus on appearing certain way
Aware- high internal and external - know who they are and value others opinions
27
What are the components of maslows motivation theory
28
What is work motivation and what are sources
Intensity and persistence of an employee's work-related behaviours. Drive
Sources : workplace characteristics, workplace conditions, personal characteristic, individual priorities, internal psychological states, and characteristics of good team
29
What is work engagement
Opposite of burnout - refers to positive feelings of enthusiasm dedication towards ones work
30
What are factors that increase self- efficacy
- - Actual performance (success of task)
- - Vicarious experience (observing others)
- - verbal persuasion / coaching
- - Psychological feedback
31
What are competencies for a successful team
- -Conflict resolution, group norms, problem solving
- - roles - role bending, role overlap
- - communication, decision making skills, goal setting and performance management skills
- - planning and task coordination, co-location
32
What are the stages of group process
Forming (establish ground rules)
Storming (start to communicate feelings, still see as individual)
Norming ( feel part of team, can achieve work together)
Performing ( team works in open/trusting environment, flexible)
Adjourning (team conducts assessment of year, plan for transition out of roles, recognize group members contributions)
33
what are the 5 responses to conflict
```
Competition : win-lose
Accommodation - win -lose
Compromise - lose-lose
Avoidance : lose-lose
Collaboration : win-win
```
34
What is difference between vertical and horizontal bullying
Vertical -- Violence between a person with more power than another (manager to staff, clinical supervisor to student)
Horizontal -- Hostile and aggressive behaviours by individual or group members towards another member (ex. rumours)
35
What is difference between overt and covert bullying
Overt : Name calling, intimidating, criticism, blaming, put downs, gossiping
Covert: Eye rolling, ignoring, refusing to help, excluding, sabotaging, speaking different language, shunning, unfair patient assignments
More nonverbal
36
What characteristics are often seen in bully and receiver
Bully – often perceived as powerful, low self-worth, impulsive, reactive
Receiver - low perceived power, low self esteem, submissive, insecure, (race or gender play a role)
37
Why don't staff always report bullying
- - Fear of retribution, belief nothing will change
- - Not recognizing behaviour as bullying, unfamiliarity with reporting procedure, labelled as complainer
- -career prospects
- - Manager is friends with bully, staff want to fit in
38
Where should you focus energy/intervention for resolving bullying
focus intervention at peer group rather than at individual bullies & victims to mobilize team members - look at units with positive cultures, new patterns to shift culture - bullies loose power
39
What are factors or things seen in healthy work environment related to nursing
Nurse have more autonomy, more in control of decision making
Collaboration, support from co-worker and supervisors
Effective leadership
Manageable workload
Work together support
40
What is organizational empowerment / workplace
Organizational efforts that generate individual empowerment among members and organizational effectiveness needed for goal achievement
Workplace empowerment has been shown to be an important precursor of employees positive relationships with their work, thereby improving job satisfaction and enhancing organizational commitment
41
What are Kanters 4 organizational structures
Access to information
--- Having knowledge of recognition decisions policies goals
----Technical knowledge, expertise, sense of purpose for employees
----Enhanced employee's ability to make decisions that contribute to organizational goals
Access to support
-----Includes feedback, guidance received from superiors, peers, subordinates, emotional support, helpful advice, assistance
Access to resources needed to do the job
-----Ability of individuals to access the material money, supplies time and equipment required to accomplish organizational goal
Opportunities to learn and grow
------Opportunities for mobility and growth, access to achieving professional development to increase knowledge and skills
42
What is burnout and what is something it leads to within an organization
Burnout is psychological syndrome of exhaustion, and inefficiency, emotional exhaustion - depleted of emotional resources
Linked to lower job satisfaction, turnover, and patient outcomes
Burnout related to all of maslow's needs - a lack of any can contribute
Turnover - employees leaving organization - can be stress or burnout
-----Costly to organization increase workload of training nurses, poor staffing linked to decreased patient outcomes
43
What is the importance of organizational culture
Culture promotes outcomes that are either beneficial or harmful to the organisation, impact on productivity, commitment and morale
Strong culture with shared assumptions values and beliefs may increase organisational commitment or not
Innovative culture is needed for innovation, and adaptive culture is needed to respond to changing conditions
44
What are the three aspects of culture (values, habits, beliefs)
Beliefs - unexamined taken for granted assumptions
Values - exposed strategies, goals & justification
Habits - observable patterns of interaction
NOTE
Personal values and attitudes less visible but can be talked about
Cultural values and assumptions - usually not bible are rarely talked about
45
What are the steps in changing organizational culture
Leaders together with local peoples closest to the work or challenge, identify a shared need or a desired change
With support from a leader, local peoples generate a purpose, desires outcomes a plan for action research, and implement their own plan
Hidden positive practices are discovered, new approaches are invented and local peoples see results for themselves
Successful practices are adapted to local conditions, spread via informal social networks, and sustained (and owned) by local groups
46
What are liberating structures
Liberating structures provide strategies to identity new patterns of working together, make sustainable change need to change how people interact with one another
Tap into collective intelligence and creativity and unleashing the power of self-organization
Generate purpose, outcomes, plan of action, identify partners, generate ideas, positive practices discovered, new approaches created, easy to implement, doesn't cost lots of money
Focus on habits to spark change - versus conventional change effort focus on values
47
What are 8 types of liberating structures
```
Impromtu
1-2-4-ALL
Heard, seen, respected
Discovery & action dialogues
TRIZ (innovative problem solving)
What, So What, Now What
15% solution
Design team
```
48
What is the impromptu network
Rapidly share challenges and expectations and build new connections
Generate energy and start a meeting through having focus on what they want to improve
What challenge do you bring, what to hope to get, and give
Allows for ideas and commitment to be generated
49
1-2-4-ALL
Conversing in cycles, self-reflection, pairs & small groups
50
What is Heard,Seen, Respected structure
Improves listening and empathy,people are invited to tell a story about a time where they did not feel heard, seen or respected - listeners can interrupt and ask question (what else etc)
Can help improve culture, trust, work together
51
What is the discovery & action dialogues
Fosters finding solution to challenging issues
Group 5-10 members are asked a series of questions
When do they know the issue exists?
What do they believe contributes and prevents effectively resolving the problem?
Who deals well with resolving the problem?
What actions do they do?
What other problem solving ideas can we do to address the issue?
Who needs to be involved in moving forward?
52
What is TRIZ (innovative problem solving)
Address activities that limit success in non-threatening ways.
Make a list of all the activities that can be done to make sure the worst result is achieved. Then work backwards, what does unit have - takes away form blaming current staff or unit
53
Describe the What, So What, Now What
Promotes a shared understanding of different perspectives, ideas and reasons for actions and decisions
What Happened/What is the Issue?
So What? to enable the group to identify the important points and patterns
Now What?- enables the group to identify next steps
54
Describe the 15% solution
Assist in identifying the influence and ability they have to create change- what can you do to create change without any resources or anything
Enables group to realize the power they already have individually- then work together to implement change
55
Describe what the design team impromptu structure is
Stewards the culture change- made up of members form the unit
Provides leadership through identifying, facilitating, supporting, making recommendation, tracking and reporting back the activist and program
56
What are the 4 core components of resilience
```
Connections (prioritize relationships) connect with empathetic and understanding peoples, accept Help from people who care about you, join a group)
Foster wellness (self-care, mindfulness, avoid negative outlets)
Find purpose (help others, self-discovery, realistic goals to move in a positive direction)
Embrace healthy thoughts (keep things in perspective, accept change, maintain a hopeful outlook, learn from your past)
```
57
What are the 6 principles of integrating care across the continuum
```
Person Centred Care;
Quality Services;
Health promotion and illness prevention;
Equitable access to quality care;
Sustainability; and
Accountability
```
58
What is nurses role in advancing technology
Nurses we still need to access, analyse and synthesise the vast amounts of information obtained through big data to make decisions, need human aspect,
Empathy, creativity, judgement
59
What is entrepreneurship. What are advantages and disadvantages
Act upon opportunities and ideas and transform into value for other - that value that is created can be financial, cultural or social
Process of uncovering and developing an opportunity to create value through innovation and seizing the opportunity without regard to either resources or human capital
Self employed, work independents (florence nightingale)
Advantage
Own boss, income increase, creative, innovative, many possible, salary
Disadvantage
Money pressure, no benefits, long hours, decision made alone
60
What is social entrepreneurship
Approach that involves the design and implementation of innovate ideas and practical models for achieving a social good - focuses on creating social returns - notice a need and developed a way of remedying the issue
Leader a change agent who recognizes what isn't working and purses practical innovative and sustainable ways to generate solutions
61
What are factors to include to make new ideas stick
Social current (how does it make people look to talk about idea)
Trigger (reminder for ppl to talk about idea)
Emotions (utilise emotions)
Public (keep idea visible)
Practical value (present information so easy to pass on)
Stories (embed idea in story from people to share)
62
What are barriers to self employment
Lack of recognition, lack of safety net, adversity
63
What is intrapreneurship. Advantages and Disadvantages
Salaried employee, who develops, promotes and delivers an innovate health or nursing services within a healthcare setting such a hospital or nurse-led clinic
Develop innovation with organisational framework in which they work and share risks and benefits associated with
Advantage
Stay well known environment, lower risk, using organisational resources/knowledge/name, access to customer and infrastructure
Disadvantage
Reward may not be expectation, may not be appropriate for innovation, not your own boss limits structure and policies
64
What is similar between intrapreneurship and entrepreneurship
Involve opportunity recognition, unique serve/product
Balance vision with managerial skill/passion, proactiveness and patience, time
Need to watch for window of opportunity and requires risk
Need self confidence
65
Difference between intrapreneurship and entrepreneurship
Startup entrepreneur - takes risk, intrapreneur organization takes the risk
Entrepreneur - own concept, intrapreneur concept property of orgnaization
Entrepreneur - own strategy, bad decisions instant failure - intrapreneur has support
Entrepreneur susceptible to outside environment , intrapreneur has buffer
66
What is intraprofessional collaboration
Multiple Members of the same profession working collaboratively to deliver quality care within and across setting
67
What is interpfrofessional collaboration
```
Partnership between team of health provider and a client in participatory collaborative and coordinated approach to shared decision making around health and social issues
Need
--Role clarification
--Interprofessional conflict resolution
--Collaborative leadership
-- Team functioning
```
68
What is important about workplace empowerment and what it creates within the workplace
It is shown to be an important precursor of employees positive relationships with their work, thereby improving job satisfaction and enhancing organizational commitment
69
What are the 4 parts of process for empowerment in which people, organizations or groups ....
- - become aware of the power dynamics
- - develop the skills and capacity for gaining reasonable control over their lives
- - exercise this control without infringing on the rights of others
- - support the empowerment of others
70
What are the 3 dimensions of empowerment
Personal - take control set agenda, gain insight and skill, self confidence, self reliance, self-esteem, sense of self, change the voice within your head
Close Relationship -- Ability to negotiate, communicate, get support, defend self, develop a sense of self, dignity, must defend but not be defensive
Within the collective-- Sense of collective dignity & agency, group dignity, shared identity, self-organization, interpersonal support, positive interdependent
71
How can you become empowered
Key power broker - who has the power, how to get on their radar, how to find power within you
Circle of influence, take risks, beginning at the right place
72
What is the definition of power
Ability to exert action that either directly or indirectly cause change in the behaviour and/or attitude of another individual or group
73
What are the 5 types of power
Reward power --- person with formal power provides reward
Coercive - Apply punishment or withhold reward
Legitimate power - Formal position and the perception that the person has the right to exert influence and expect complainant
----Nurses - ppl look up to we have knowledge
Referent power---Personal attractive quality, want to be associated with that person be part of the group. Nurses have - COVD, people realize how nurses make a difference - i want to be a part of that
Expert power - Perceived extent of person knowledge or expertise
74
How do nurses have legitimate, reward, expert, coercive and referent power
Nurses have power due to their professional position and interactions with patients and families (Legitimate Power)
Knowledge is power (Expert Power)
Have power with patient on when and how care is met, patients can be fearful of challenging the nurse (Reward Power/Coercive Power)
Applications to nursing schools are highest in years (Referent Power)
75
What is peace & power
Typically there are people with more relative power in any group and tend to be able to exert their will or values on people with less power.
People seek a space in life where they are relatively free from competition and power imbalances, where cooperation and peace prevail
Conflict is inevitable in all human relationships and can be handled in constructive ways.
When people feel more connected to the process, they experience a greater level of satisfaction.
Strong leadership needed in more diverse, interdependent organizations and resolve conflicts in a productive manner.
76
In regard to peace & power, what are 5 important qualities/facotrs
Praxis-act of engaging, applying, exercising, realizing or practising ideas.
Empowerment-growth of personal ability to enact one’s will in the context of respect for others
Awareness-growing knowledge of self and others
Cooperation-commitment to group cohesiveness and integrity
Evolvement-commitment to deliberate growth and change
77
What is the definition of politics.
Involves choices and influence and is based on power dynamics (who has the greatest influence, resources, knowledge, money) and involves strategies needed to achieve the desired goal
78
What is public policy
Directives that document government decisions
Usually expressed as a regulation or law
Many public policies affect health-housing, social security, food and tobacco industries, and the environment
79
What is health policy
Principles, plans, and strategies for action guiding the behaviour of organizations, institutions and professions involved in the field of health, as well as their consequences for the healthcare system
80
What is nursing policy
Public Sources-laws determined by government (what is funded)
Organizational Sources-developed by healthcare organizations to govern work-who can do what and how
Professional Sources-Regulation bodies, standards guideline
81
What are the 5 types of political strategies
Push strategies that threaten or force others to change behaviour through assertiveness, or blocking through non-cooperation
Pull strategies use positive motivation to influence behaviour through recognition benefits or the satisfaction achieving goals
Persuasion strategies that appeal to logical reasoning or convincing other about behaviour in relations to goals
Preventative strategies designed to prevent an issue from arising through leaving off an agenda, shifting focus, avoidance of topic
Preparatory strategies aimed at preparing the ground work or creating conditions favourable to other strategies-way you dress for an interview, how you order agenda, present information.
82
Difference between power and politics
POWER IS YOUR ABILITY EITHER GIVEN OR TAKEN AND POLITICS IS WHAT YOU DO WITH YOUR POWER
83
What is quality improvement
Quality improvement is a process of structured series of steps designed to plan, implement and evaluate changes in care activities.
84
What are 6 qualities/values in a high quality health care system
```
Safe
Effective
Patient centered services
Timely fashion
Efficient
Equitable (equity not equitable)
```
85
What are the 5 components of big data
Volume – Data presenting in significant size and scale that would overwhelm traditional management or analysis approaches
Velocity - commonly big data is accumulated and generated very quickly
Variety – Data can present in any combination of structured or unstructured forms
Health Informatics – Use of information technology to support the creation and use of health related data, information and technology
Analyses everything – Who created the analogues/ where did data come from
86
What is big data in relation to health care ( what does it examine)
Examine how the quality of care in a health setting compares with the type of desired care
Measured over time can identify improved practice and areas that are not improving
Ongoing need to demonstrate how nursing care affects patient care outcomes to administrators and public
87
What are nursing quality indicators in relation to big data (what is different with nurses in regard to records)
Patient - falls/injury, pressure ulcers, pain assessment, physical restraint, infection, safety
Staff - staff mix, nurse:patient, nursing care hours per patient per day, OSH, nursing education
Most medical records do not capture any work done by the nurse. Nurses need to advocate for indicators of nursing
88
What is C-HOBIC ( Canadian Health Outcomes for Better Information and Care) and the nursing sensitive indicators
Need to be able to identify the results from the interventions that are specifically due to nursing practice.
C-HOBIC provides standardized clinical data to answer research questions about the impact of practice on clinical outcomes and to support research on new approaches to clinical practice.
Nursing Sensitive Indicators
- -Functional status (activities of daily living);
- -Therapeutic self care (ability to self-administer medications and manage symptoms such as pain);
- -Symptom management for pain, nausea, fatigue and dyspnea; and
- -Patient safety outcomes related to pressure ulcers, physical restraints and falls
89
what are the 4 goals/tasks of the Canadian Nurses Informatics Association (CNIA)
To strategically seek out partnerships and networking opportunities to provide leadership and expertise for Nursing Informatics in Canada
To foster innovation by expanding and disseminating knowledge about nursing and health informatics for nurses and the healthcare community
To create awareness about the value of standardized data in health care to facilitate knowledge driven care and health system use
To engage in national and international nursing and health informatics initiatives.
90
What is a 4 step guide, to measuring quality indicators
Plan (gather committee, pull data, positive deviance)
Do, (chose what issues to develop solutions)
Check (what went well what didn't)
Act (check to see if you need a new solution
91
What are measures of patient harm
Healthcare/medication associated conditions
Healthcare associated infections
Patient accidents
Procedure associated conditions
92
what are the 5 most common types of harm
```
Electrolyte & fluid imbalance
Urinary tract infection
Delirium
Anaemia-haemorrhage
Pneumonia
```
93
What is important regarding teamwork and patients
Breakdown in team working and communication has an impact on patient safety outcomes including: - increase length of stay, mortality, medication errors
Collaborative interprofessional practice (nurses more likely than physicians to report barriers to patient safety) SBAR, huddles (very important)
Developing a safety culture through authentic leadership (self-awareness, morals, relational transparency, balanced processing)
94
What is a near misses
Event that might have resulted in harm by the problem did not reach the patient because of timely intervention by healthcare providers or the patient or family or due to good fortune
Important in identifying systems issues
** if patient says look different than normal - stop probably near miss
95
What is just culture
Leadership is essential where a balance is created between accountability of individuals and the institution.
Expectations of a work environment in which staff can speak up and express concerns and alert team members to unsafe situations
Does not mean eliminating individual accountability but rather puts greater emphasis on an analysis of the problems that contribute to adverse events in a system
Open communication about errors is an important aspect of a just culture.
Blame free
96
What do persons and families want to know when it comes to disclosure
Facts about what happened
The steps that were and will be taken to minimise harm
Healthcare provider organization and/or provider are sorry for what happened
What will be done in the future to prevent similar events
97
What term should you avoid using in terms of disclosure
Avoid using term error - need to provide support, and disclose medication error to ensure will not happen again
98
What is the process of disclosure
Apology, convey sincerity, Acknowledge difficult and emotional situation for everyone
Apology is not considered an admission of legal liability
Gaining clarity to what happened is very important
99
What are key aspects in regard to safety culture
Leadership, teamwork, communication, learning, just culture, patient centered
Can't change what happens but can change what happens in future
100
What is the nursing scope of practice statement
The practice of nursing is the promotion of health and the assessment of the provision of, care for, and the treatment of , health conditions by supportive, preventive, therapeutic , palliative and rehabilitative means in order to attain or maintain optimal function
101
What are controlled acts
Controlled acts are considered to be potentially harmful if performed by unqualified persons
A regulated health professional is also authorized to perform a portion or all of the specific controlled acts that are appropriate for that profession’s scope of practice
102
What are the 5 acts that RN and RPN can do
Performing a prescribed procedure below the dermis or a mucous membrane
Administering a substance by injection or inhalation
Putting an instrument, hand or finger
- -beyond the external ear canal
- -beyond the point in the nasal passages where they normally narrow,
- -beyond the larynx
- -beyond the opening of the urethra
- -beyond the labia majora
- -beyond the anal verge or
- - into an artificial opening into the body
Dispensing a drug (give one or more prescribed medication doses to a client to take at a later time.
Treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning.
103
When can a registered nurse (RN) or register practical nurse (RPN) perform a procedure within the controlled acts authorized to nursing
if it is ordered by a physician, dentist, chiropodist, midwife or Nurse Practitioner (NP); or
if it is initiated by an RN or RPN in accordance with conditions identified in regulation.
104
Difference in controlled acts between RN and RPN
RN CAN
- irrigate, prob, debrid, , pack
- - venipuncture to establish access TKVO NaCL 0.9% only where delay would be harmful
- - instrument for health management activities (nasal, larynx, urethra)
- - instrument for assessing or assisting (labia majora)
- -Instrument into artificial opening
105
What are the three CNO factors for performing or delegating controlled acts
Nurse factors, client factors and environmental factors
106
What are nurse factors )regarding controlled acts)
```
Accountability
Foundational Knowledge
Enhanced knowledge
Expertise
Competence
Autonomous practice
Consultation
Collaboration
```
107
What are client factors regarding controlled acts
Complexity
--Degree to which client condition needs care, variables influencing health status, variability of clients condition. Usually less complex RPN more complex RN
Predictability - stable, can condition be anticipated
Risk of negative outcomes
--Likely that a client will experience negative outcomes as a result of the client's health condition or as a response to treatment
108
What are environmental factors in regards to controlled acts
Practice supports
---Clear procedures, policies, assessments. What Are number of expert nurse who are families with the environment
Consultation resources
--Are nurses available to consult, other resources to manage outcomes
Stability and predictability
---What is rate of client turnover, frequency of unpredictable events
109
When making a decision what do you need to consider
Being innovative, values, equity or equality, and respect and teamwork should be demonstrated in practice and decision making
110
When making a decision a leader must...
Outline process prior to directions, provide staff with selection criteria, be transparent,
Communicate - in a variety of mediums
111
Describe collaborative decision making
Group decision making when the group makes a decision vs. an individual
Often decided by a vote (can be good, or bad ec 51% happy 49% not happy)
112
Describe consensus decision making
Collaborative or group decision making
Group makes a decision based on everyone’s ideas where there is a general agreement with the decision, rather than a vote
113
What are the 5 principles of the decision framework for staffing
Base decisions on client health needs
Base decisions on nursing care delivery model and evidence
Sustain implementation with organizational components and leadership
Involve direct care providers and nursing management
Make decisions with the support of information systems
114
what are 3 types of staff mix decision making processes
Reliance on professional judgement (experience)
Patient classification/workload measurement
Standardized ratios
- --Norms for particular kinds of units and settings (ex. Critical care 1:1
- --Can be good to keep pt assignment down, but not flexible if staff member class in sick for ex,
115
What is nursing skill mix / staff mix
Refers to the numbers and types of personnel used to provide care to a group of patients or clients in a setting
116
What is direct care
Direct care refers to nursing activities with the client
| anything involving care directly with the patient-treatments, teaching, giving the patient medications
117
What is indirect care
indirect care refers to activities away from the client
| reviewing doctor’s orders, preparing medications, rounds
118
What does CNA say nursing leadership is about
Lead where you land (stand) - push boundaries, critical independent thinking, evidence, delegate and take charge
119
What does CNO say about nursing leadership
All nurses provide leadership through informal and formal roles
Take action and resolve conflict, coordinate care
Advocate for clients
120
What are the two types of organizational commitment
Relational — believe in what you are doing at work, ex. Skipping breaks to give proper care
Transactional — only work for what they pay you ex. If two minute overtime want that 2 minute pay
