Ati Flashcards
Contact precautions
Shigella MRSA RSV Herpes simplex: gown and gloves Anthrax
Droplet precautions
Meningococcal pneumonia
Pharyngitis, strep, scarlet fever, rubella, pertussis, mumps, pneumonic plague
Airborne precautions
TB
LPN tasks
Wound irrigation Catheter Sterile specimens Enteral feeding Sterile dressing changes Monitoring client findings, reinforcement of client teaching from a standard care plan, tracheostomy care, suctioning, checking NG tube patency, urinary catheter insertion, medication administration minus intravenous in some states
AP tasks
Ambulating
Thickening foods
Activities of daily living such as bathing, grooming, dressing, toileting, ambulating, feeding without swallow precautions, positioning, and bedmaking. Specimen collection, intake and output, vital signs on stable clients, basic dressing changes
Critical pathways
Prevent unnecessary expense.
Include time bound activities, interventions, and outcomes. This should include treatment milestones.
Disaster tags
Class I/ red tag
Class II/yellow tag. Trt in 30 min-2 hours
Class III/green tag. Non urgent, minor. LPN treats.
Class IV/black tag. Expected to die. Have AP transport.
Advocacy
Promoting and protecting safety for staff and clients by providing info that allows staff to act autonomously.
Ex. In service for readmission due to complications.
Change
Role model positive behavior
Encourage staff members who support change to discuss issue with resistive staff.
Do not: redirect conversation, reprimand, or tell them to move.
Plan for hand hygiene
Set a goal for improvement in adherence. Is first step.
Effective time management.
Make a list of non-essential tasks for later
Delegate, chart as you go.
Conflict resolution
Latent conflict: awareness of situations that cause it
Perceived conflict: Discussing in an impersonal manner
Felt conflict: Those affected become personally involved
Manifest conflict: begin to take action
Conflict aftermath: positive and negatives are recognized.
Living will
Family members have the right to question the mental capacity of the client at the time the living will was completed. Evidence that the client was incompetent could result in the living will being revoked.
Advanced directives
Do not require a prescription for it to be valid
Spanish speaking
Use a Spanish English medical dictionary. Use bilingual assistive personnel to help. Request the use of an interpreter. Do not ask a family member and do not speak loudly.
Health education order
Determine knowledge needed by group/assessment
Develop learning objectives/planning
Encourage family participation/implementation
Client outcomes/evaluation
Restraint order
Place restraint Written order Staff member remains with pt Check q 15-30 min Document
Implement change strategy
Educate staff about changes
ID resistance
Set target dates
Require compliance
Discipline process
- Verbally reprimand in managers office. Suggestions for improvement and correction.
- Written warning. Manager review specific rules and policy violations and discusses potential consequences if it continues
- Employee is placed on suspension. The time gives the employee opportunity to examine the issues and consider alternatives
- The employee is terminated after multiple warnings have been given and the employee continues to violate them.
Transformational leader
Empowering followers to assume responsibility for a communal vision and personal development is a secondary outcome.
Transactional leader
Focus is on immediate problems, maintaining the status quo, and using rewards to motivate followers
Maslows
Physiological Safety and security Love and belonging Self-esteem Self actualization
Assigning
The process of transferring the authority, accountability, and responsibility of client care to another member
Delegating
Transferring the authority and responsibility to another team member to complete a task while retaining the accountability
Supervising
Directing, monitoring, and evaluating the performance of tasks by another member of the healthcare team. RNs are responsible for the supervision of client care tasks delegated to assistive personnel and LPNs.
An inappropriate assignment
First bring it to the attention of the scheduling/charge nurse and negotiate a new assignment. If no resolution, take the concern up the chain of command. If still unresolved, and unsafe staffing complaint form or an assignment despite objection or document unsafe practice situation should be filed with the appropriate administrator. Failure to accept the assignment without following proper channels may be considered abandonment.
Tasks to consider when delegating
Predictability of the outcome, the potential for harm, Complexity of care, the need for problem-solving and innovation, the level of interaction with the client. They should also consider the delegatee factors such as education and training, knowledge and skill, the level of critical thinking required, the ability to communicate, demonstrated competence, the culture, and agency policies and procedures.
Five rights of delegation
Right task, right circumstance, to the right person, with the right direction and communication, and the right supervision and evaluation.
Steps in providing educational programs
- Identify and respond: identify the need for knowledge or skill proficiency
- Analyze the deficiencies and develop objectives
- Research
- Plan
- Implement
- Evaluate
Root cause analysis
They are done for sentinel event such as death, serious injury, but can be done as part of the improvement process. It investigates the consequence and possible causes. It analyzes the possible causes and relationships that may exist. It determines additional influences at each level of relationship. It determines the root cause or causes. Potential solutions and corrective actions are then analyzed and one is selected. Educational or corrective action is implemented. It is re-evaluated at a determined time.
Problem-solving
Identify the problem
Discuss possible solutions
Analyze identified solutions/list the pros and cons
Select a solution
Implement the solution along with a procedure and a timeline
Evaluate the solution
