Chapter 17 Flashcards

Question 1

Q

Why Is Scheduling So Difficult in Nursing? #1

Answer

A

It does not fit traditional business cycle.

There is an erratic and unpredictable health-care demand.

High-level expertise is required 24/7.

Stress of job requires balanced work–recreation schedule.

Staffing mix varies with acuity

Question 2

Q

Why Is Scheduling So Difficult in Nursing?

Who is the overall responsibility for scheduling belong to?

Answer

A

Although many organizations now use staffing clerks and computers to assist with staffing, the overall responsibility for scheduling continues to be an important function of first- and middle-level managers.

Question 3

Q

Why Is Scheduling So Difficult in Nursing? #3

What are the two different approaches to scheduling in nursing?

Answer

A

Centralized and decentralized staffing are two different approaches to scheduling in nursing, each with its own advantages and challenges.

Question 4

Q

Why Is Scheduling So Difficult in Nursing? #3

In centralized staffing, where are staffing decisions made?

Answer

A

In centralized staffing, staffing decisions are made by personnel in a central office or staffing center.

In centralized staffing, a single department or centralized unit (often the Human Resources or a similar administrative department) handles staffing for the entire organization or facility.

Question 5

Q

Why Is Scheduling So Difficult in Nursing? #3

In decentralized staffing, where are staffing decisions made?

Answer

A

In decentralized staffing, each department is responsible for its own staffing.

Definition: With decentralized staffing, each unit or department manages its own staffing independently.

Question 6

Q

Decentralized and Centralized Staffing #1:

What can decentralized scheduling and staffing lead to?

Answer

A

*Decentralized scheduling and staffing lead to increased autonomy and flexibility,

Question 7

Q

Decentralized and Centralized Staffing #1:

Which type of scheduling is more fair to employees?

Answer

A

Centralized staffing is fairer to all employees because policies tend to be employed more consistently and impartially.

Question 8

Q

Decentralized and Centralized Staffing #1:

What are the pros of centralized staffing?

Answer

A

Consistency:

Economies of Scale:

Less Duplication:

Question 9

Q

Decentralized and Centralized Staffing #1:

Pros of centralized staffing: Consistency

Answer

A

A uniform approach to staffing across units or departments.

Question 10

Q

Decentralized and Centralized Staffing #1:

Pros of centralized staffing: Economies of Scale

Answer

A

Economies of Scale: Can be more efficient for large organizations with multiple units.

Question 11

Q

Decentralized and Centralized Staffing #1:

Pros of centralized staffing: Less duplication

Answer

A

Less Duplication: Reduces the redundancy of multiple units doing their own scheduling.

Question 12

Q

Decentralized and Centralized Staffing #1:

What are the cons of centralized staffing?

Answer

A

Lack of Unit-Specific Insight:

Delayed Communication:

Potential for Lower Morale:

Question 13

Q

Decentralized and Centralized Staffing #1:

Cons of centralized staffing: Lack of Unit-Specific Insight:

Answer

A

Centralized units may not have the intimate knowledge of the specific needs and dynamics of each individual unit.

Question 14

Q

Decentralized and Centralized Staffing #1:

Cons of centralized staffing: Delayed Communication:

Answer

A

Changes or urgent needs might take longer to process due to the added layers of communication.

Question 15

Q

Decentralized and Centralized Staffing #1:

Cons of centralized staffing: Potential for Lower Morale:

Answer

A

Staff may feel that decisions are imposed from “above” without considering their specific needs or preferences.

Question 16

Q

Decentralized and Centralized Staffing #1:

What are the pros of decentralized staffing

Answer

A

Flexibility:

Immediate Communication:

Increased Autonomy:

Question 17

Q

Decentralized and Centralized Staffing #1:

Pros of decentralized staffing: Flexibility

Answer

A

Units can quickly adjust staffing based on their unique needs.

Question 18

Q

Decentralized and Centralized Staffing #1:

Pros of decentralized staffing: Immediate Communication:

Answer

A

Faster decision-making and adjustments can occur without waiting for approval from a central authority.

Question 19

Q

Decentralized and Centralized Staffing #1:

Pros of decentralized staffing: Increased Autonomy:

Answer

A

Can boost morale as staff feel they have more control over their schedules.

Question 20

Q

Decentralized and Centralized Staffing #1:

Pros of decentralized staffing:

In an institution that has no human resources and no nursing recruiters, who does the hiring and what does this lead to?

Answer

A

no nurse recruiters, the unit manager does the hiring, this results in Greater autonomy and flexibility for the individual staff members

Question 21

Q

Decentralized and Centralized Staffing #1:

Cons of decentralized staffing include:

Answer

A

Inconsistency:

Duplication of Effort:

Potential for Inequities:

Question 22

Q

Decentralized and Centralized Staffing #1:

Cons of decentralized staffing include:

Inconsistency

Answer

A

Different units may have different staffing standards or approaches.

Question 23

Q

Decentralized and Centralized Staffing #1:

Cons of decentralized staffing include:

Duplication of Effort:

Answer

A

Each unit reinvents the wheel when it comes to scheduling, leading to inefficiencies.

Question 24

Q

Decentralized and Centralized Staffing #1:

Cons of decentralized staffing include: Potential for Inequities:

Answer

A

Some units may have better schedules or more favorable staffing ratios, leading to perceptions of unfairness.

Question 25

Q

Decentralized and Centralized Staffing #2

Centralized and decentralized staffing is not synonymous with what?

Answer

A

Centralized and decentralized staffing is not synonymous with centralized and decentralized decision making.

Question 26

Q

Decentralized and Centralized Staffing #2

Centralized Decision Making: What is it?

Answer

A

Key decisions are made by a small group of top-level leaders or a single central authority.

Question 27

Q

Decentralized and Centralized Staffing #2

Centralized Decision Making: How does information flow?

Answer

A

Information flows from the top down.

Question 28

Q

Decentralized and Centralized Staffing #2

Decentralized Decision Making: What is it?

Answer

A

Decision-making authority is distributed across various levels or units in the organization.

Question 29

Q

Decentralized and Centralized Staffing #2

Decentralized Decision Making: How does information flow?

Answer

A

Information and decision-making flow in multiple directions.

Question 30

Q

Common Scheduling Options in Health-Care Organizations #1

Answer

A

10- or 12-hour shifts

Premium pay for weekend work

Part-time staffing pool for weekend shifts and holidays

Job sharing

Question 31

Q

Common Scheduling Options in Health-Care Organizations #1

What does a written policy provide? What does it ensure?

Answer

A

A written policy provides a standardized approach to scheduling, ensuring that decisions are consistent across different units or departments, leading to fairness.

Question 32

Q

Common Scheduling Options in Health-Care Organizations #1

When policies are written, what does it aim to ensure?

Answer

A

When policies are written (not only verbal) the aim to ensure clarity, fairness, accountability,

Question 33

Q

Common Scheduling Options in Health-Care Organizations #1

Job sharing: What is it?

Answer

A

two people share the same position and divide the shift with each other.

Question 34

Q

Common Scheduling Options in Health-Care Organizations #2

What is a dilemma with 12 hour shifts?

Answer

A

Twelve-hour shifts have become commonplace in acute care hospitals even though there continues to be debate about whether extending the length of shifts results in

increased judgment errors related to fatigue and increased sick time and more care left undone.

Question 35

Q

Common Scheduling Options in Health-Care Organizations #2

Pros of a 12 hour shift?

Answer

A

Over time pay $$$ – increase nurse satisfaction,

fewer shift changes mean more time spent with patients and better communication because of fewer handoffs

Question 36

Q

Common Scheduling Options in Health-Care Organizations #2

Cons of a 12 hour shift?

Answer

A

Not cost effective to the facility, most nurses who work 12 hour shifts do not get enough sleep lack of sleep and fatigue are known to cause poor judgment and significantly higher rate of errors.

Question 37

Q

Common Scheduling Options in Health-Care Organizations #2

Lack of sleep is known to cause what?

Answer

A

lack of sleep and fatigue are known to cause poor judgment and significantly higher rate of errors.

In addition, drowsy driving following 12 hour night shift is persistent among nurses resulting in elevated rates of vehicle crash and crash related injuries and death.

Question 38

Q

Common Scheduling Options in Health-Care Organizations #2

What did a notable study in the International Journal of Nursing Studies find?

Answer

A

*One notable study published in the International Journal of Nursing Studies found that extended shifts (12 hours or longer) are linked to higher rates of errors and negative patient outcomes.

Question 39

Q

Common Scheduling Options in Health-Care Organizations #3

What is cyclical staffing?

Answer

A

Cyclical staffing, which allows long-term knowledge of future work schedules because a set staffing pattern is repeated every few weeks

Cyclical staffing is a scheduling method in which a predetermined staffing pattern is repeated over a specific period, typically a few weeks.

Question 40

Q

Common Scheduling Options in Health-Care Organizations #2

What did a notable study in the Journal of Nursing Administration find?

Answer

A

Another relevant piece of research is from the Journal of Nursing Administration, which indicates that nurses working longer hours report higher levels of fatigue, leading to decreased vigilance and an increased risk of patient safety incidents.

Question 41

Q

Common Scheduling Options in Health-Care Organizations #3

Cyclical staffing: What does it allow for?

Answer

A

Allowing nurses to exchange hours of work among themselves

Question 42

Q

Common Scheduling Options in Health-Care Organizations #3

Allowing Nurses to Exchange Hours of Work Among Themselves: What does this scheduling option permit?

Answer

A

This scheduling option permits nurses to swap or exchange their shifts or hours of work with their colleagues, provided it aligns with hospital policy and patient care needs.

Question 43

Q

Common Scheduling Options in Health-Care Organizations #4

Use of supplemental staffing- Where are they from?

Answer

A

Use of supplemental staffing from outside registries and float pools

Question 44

Q

Common Scheduling Options in Health-Care Organizations #4

What is shift bidding?

Answer

A

Shift bidding, which allows nurses to bid for shifts rather than requiring mandatory overtime

Question 45

Q

Common Scheduling Options in Health-Care Organizations #4

Shift bidding: How does it work?

Answer

A

Open shifts or overtime opportunities are posted by the management.
Nurses can then bid for these shifts, sometimes based on preferences or seniority, or even how much additional compensation they’re willing to accept.
The management reviews the bids and awards the shifts based on the set criteria

Question 46

Q

Common Scheduling Options in Health-Care Organizations #4

Float nurses: What are they?

Answer

A

full time employees internal hospital employees; they receive full salary and benefits. They are those who agree to cross train on multiple units.

They can be a resource that can be used in more than one place.

Question 47

Q

Other Scheduling Alternatives

Answer

A

Agency nurses

Travel nurses

Flextime

Self-scheduling

Float pools

Question 48

Q

Other Scheduling Alternatives

Float pools: What must float staff be able to perform?

Answer

A

Float staff must be able to perform the core competencies of the unit they are floating to meet their legal and moral obligations as caregivers.

Question 49

Q

Other Scheduling Alternatives

Self-scheduling system for nurses:

Answer

A

**Self-scheduling systems for nurses, wherein nurses have the autonomy to choose their shifts or help design their schedules, have gained popularity as a means to improve job satisfaction and reduce burnout as it gives nurses greater control over their work environment and increases employees’ autonomy over their work lives.

Question 50

Q

Here are some issues associated with self-scheduling systems for nurses:

Answer

A

Inequities in Shift Distribution:

Lack of Experience Mix:

Complexity:

Potential for Short Staffing:

Lack of Consistency:

Interpersonal Conflicts:

Over-reliance on Technology:

Lack of Oversight:

Overburdening Some Nurses:

Difficulty in Long-term Planning:

Potential for Miscommunication:

Question 51

Q

Here are some issues associated with self-scheduling systems for nurses:

Inequities in Shift Distribution:

Answer

A

Without oversight, popular shifts (like day shifts on weekdays) might always be chosen by the same group of nurses, leaving less desired shifts (like night shifts or weekends) for others.

Question 52

Q

Here are some issues associated with self-scheduling systems for nurses:

Lack of Experience Mix:

Answer

A

Self-scheduling might unintentionally lead to shifts with either too many novice nurses or too many experienced ones.

It’s crucial for patient safety and mentoring to have a mix of experience levels on every shift.

Question 53

Q

Here are some issues associated with self-scheduling systems for nurses:

Potential for Short Staffing:

Answer

A

If too many nurses prefer and select the same shifts, there could be other shifts where not enough nurses are scheduled, leading to staffing shortages.

Question 54

Q

Here are some issues associated with self-scheduling systems for nurses:

Complexity:

Answer

A

While it empowers nurses, self-scheduling can also be a complex process.

Collating and coordinating everyone’s preferences can be challenging and time-consuming.

Question 55

Q

Here are some issues associated with self-scheduling systems for nurses:

Lack of Consistency:

Answer

A

Lack of Consistency: Patient care can benefit from consistency in nursing staff, especially in specialized units. If nurses continuously change their schedules, it might disrupt continuity of care.

Question 56

Q

Here are some issues associated with self-scheduling systems for nurses:

Interpersonal Conflicts:

Answer

A

Without clear guidelines and oversight, self-scheduling might lead to conflicts among nurses over popular shifts or accusations of favoritism.

Question 57

Q

Here are some issues associated with self-scheduling systems for nurses:

Over-reliance on Technology:

Answer

A

If the self-scheduling system is digital, any technical glitches can disrupt the scheduling process.

Additionally, some nurses might not be as tech-savvy and could find digital systems challenging to navigate.

Question 58

Q

Here are some issues associated with self-scheduling systems for nurses:

Lack of Oversight:

Answer

A

While the idea is to empower nurses, complete lack of oversight could lead to chaos, with shifts not aligning with patient needs or not complying with union or legal stipulations (like maximum work hours).

Question 59

Q

Here are some issues associated with self-scheduling systems for nurses:

Overburdening Some Nurses:

Answer

A

There’s a risk that some highly dedicated nurses might take on too many shifts in an attempt to cover gaps, leading to burnout.

Question 60

Q

Here are some issues associated with self-scheduling systems for nurses:

Difficulty in Long-term Planning:

Answer

A

With schedules being more fluid, it might be harder for hospital administration to plan for long-term needs, training sessions, or other logistical concerns.

Question 61

Q

Here are some issues associated with self-scheduling systems for nurses:

Potential for Miscommunication:

Answer

A

If the self-scheduling system isn’t clear or if changes are made without proper communication, it could lead to nurses missing shifts or being unaware of schedule changes.

Question 62

Q

PER-DIEM staffing :

What do these staff have a flexibility for? What is this in exchange for?

Answer

A

Staff generally have the flexibility to choose when they want to work.

In exchange for this flexibility, they receive a higher rate of pay but usually no benefits.

Question 63

Q

Other Scheduling Alternatives

Travel nurses:

Answer

A

like agency nurses; external employee; they work for premium pay.

They have expertise in oncology, icu or areas in need.

Its associated with increased cost to the organization.

You get paid more and get to travel all over US.

You have to guarantee you are working for a certain amount of time. They travel places and when the need arises, they work and pay is from the agency.

Question 64

Q

Other Scheduling Alternatives

Travel nurses/agency: What are cons of this?

Answer

A

Poor continuity of patient care;

nurses are not familiar with the unit and are reluctant to ask for help.

Use of agency does not directly increase the need for overtime because they use their regular time. They’re base pay is higher.

Hospital only uses when they have to.

Answer 65

A

allows employees to select among variations among start time and end time.

It depends on what the unit needs.

They build the schedule among the unit needs. This idea is different from self scheduling.

Answer 66

A

Nurses with seniority fill their preferences first.

Answer 67

A

Closed-unit staffing occurs when the staff members on a unit make a commitment to cover all absences and needed extra help themselves in return for not being pulled from the unit in times of low census.

Answer 68

A

A closed- unit staffing is a model where the nursing staff assigned to a particular unit or department remain within that designated area and are not mandated to float to other units, regardless of staffing needs elsewhere in the facility.

Answer 69

A

The philosophy behind closed staffing units is rooted in the idea that nurses become specialists in their specific areas, gaining in-depth expertise and familiarity with their particular patient population, equipment, protocols, and team dynamics.

Answer 70

A

NCH/PPD = Nursing Hours Worked in 24 hours/ Patient Census

Answer 71

A

Groupings of patients according to specific characteristics

Answer 72

A

Hours of nursing care assigned for each patient classification

Answer 73

A

Unique to a specific institution

Answer 74

A

Ongoing review critical

Answer 75

A

The critical indicator (or Categorical) PCS
The summative task (or Enumerative) PCS

Answer 76

A

The critical indicator (or Categorical) PCS uses broad indicators such as bathing, diet, intravenous fluids, medications, and positioning to categorize patient care activities.

Answer 77

A

Method: Patients are assessed based on these broad categories, and the assessment is relatively quick. A patient might be categorized as “stable,” “unstable,” “critical,” etc., based on a set of predefined criteria.

Answer 78

A

Advantages:

It’s a faster method because it doesn’t require enumerating each specific task a patient needs.

It can be more intuitive for nurses and staff.

Answer 79

A

Challenges: It might be less precise than the summative approach because it doesn’t capture the full range of tasks and interventions a patient requires.

Answer 80

A

The summative task (or Enumerative) PCS requires the nurse to note the frequency of occurrence of specific activities, treatments, and procedures for each patient.

This approach is based on a detailed list of tasks or interventions a patient might require. Each task has a certain weight, or score associated with it, which reflects the time or skill needed to complete it.

Answer 81

A

The care a patient needs is assessed by enumerating all the tasks required for that patient.

The scores of these tasks are then summed to give a total that represents the patient’s acuity or care requirement.

Answer 82

A

Advantages: It provides a more detailed and potentially more accurate representation of a patient’s needs.

This can lead to more precise staffing decisions.

Answer 83

A

It’s more time-consuming than the critical indicator approach because each task must be listed and scored.

It also requires a comprehensive and regularly updated list of tasks with associated weights, which can be challenging to maintain.

Answer 84

A

At the national level, the use of a PCS is a condition for participation in Medicare and is required by The Joint Commission for certification.

Answer 85

A

**The most fiscally responsible method for determining staffing needs for a hospital unit is to use a staffing formula, provided it is based on an accurate patient classification system (PCS).

Answer 86

A

A Patient Classification System (PCS) is a tool used in healthcare settings to determine the level of care a patient requires.

Answer 87

A

A review of the literature consistently demonstrates that as RN hours decrease in NCH/PPD, adverse patient outcomes increase. This includes:

Answer 88

A

Increased medication errors

Patient falls

Decreased patient satisfaction with pain management

Answer 89

A

Decisions made must meet state and federal labor laws and organizational policies.

Answer 90

A

Staff must not be demoralized or excessively fatigued by frequent or extended overtime requests.

Answer 91

A

Patient care must not be jeopardized.

Answer 92

A

Minimum staffing criteria refer to the baseline or the least number of healthcare staff (often specifically nursing staff) that must be present in a healthcare setting to provide safe and effective care.

Answer 93

A

These criteria are often determined by healthcare organizations, regulatory bodies, and sometimes through legislation.

Answer 94

A

Ensure Patient Safety: The primary goal of minimum staffing criteria is to ensure that patients receive safe, high-quality care.

Protect Healthcare Workers:

Answer 95

A

Insufficient staffing can lead to adverse outcomes, including medication errors, falls, and decreased patient satisfaction.

Answer 96

A

Protect Healthcare Workers: Adequate staffing levels reduce the risk of burnout, fatigue, and job dissatisfaction among healthcare workers

Answer 97

A

In mandatory overtime, employees are mandated to work additional shifts, often under threat of patient abandonment.

Mandatory overtime for nurses refers to the practice where nurses are required to work beyond their scheduled shift, typically without prior notification.

Answer 98

A

While mandatory overtime is neither efficient nor effective in the long term, it has an even more devastating short-term impact in terms of staff perceptions of a lack of control and its subsequent impact on mood, motivation, and productivity.

Answer 99

A

Unforeseen Staffing Shortages:

Increased Patient Acuity or Volume:

Lack of Relief:

Organizational Policies:

Answer 100

A

This can be due to unexpected call-outs, illnesses, or emergencies among the staff.

Answer 101

A

A sudden influx of patients, such as in the case of a mass casualty event or during a public health crisis, can necessitate extra hours from the present staff.

Answer 102

A

If the next shift’s staff doesn’t arrive on time or at all, the current staff might be mandated to continue working to ensure patient safety.

Answer 103

A

Organizational Policies: Some hospitals might use mandatory overtime as a staffing strategy, though this can be controversial and is often criticized.

Answer 104

A

Mandatory overtime should be a last resort, not standard operating procedure because an institution does not have enough staff.

Answer 105

A

California is the only state in the U.S. that has enacted legislation requiring mandatory staffing ratios in hospitals and long-term care facilities.

Answer 106

A

The answer as to whether mandated ratios have improved care or created new cost burdens for California is still unclear.

Answer 107

A

In the United States, labor laws regarding mandatory overtime vary significantly from state to state, and there are federal laws in place as well that broadly govern overtime work for employees, including nurses.

Answer 108

A

The intent of mandatory staffing ratios for the purpose of improving patient care - Legislation is at the state level not federal, level.

Answer 109

A

Silent generation 1925 to 1942
Baby Boomer 1943 to early 1960s
Generation X Early 1960s to 1980
Generation Y 1980 to mid-1990s
Generation Z 1996 to 2015

Answer 110

A

If not retired, they are more at risk averse and highly respect authority and discipline. They are more risk averse. Hihgh levels of loyalty to the employer. They respect authority. They don’t argue. More disciplined.

Answer 111

A

50% of the current work force.

Traiditonal work values and are more materialistic and willing to work long hours to get ahead.

Answer 112

A

Gen X: not interested in lifelong employment in one place. They are looking for opportunities of flexibility and more opportunity for time off. They are less economically driven.

Answer 113

A

Gen Y: require different org culture to meet needs; are more socially conscious.

Answer 114

A

Gen Z: have more technical skills and they’re looking for more open work culture and open communication.

Answer 115

A

Managers need to Look at the type of generation in the unit and the types of resistance they may face. And how they are dealing with nursing shortage.

Answer 116

A

Fiscal accountability to the organization for staffing is not incompatible with ethical accountability to patients and staff.

Answer 117

A

It should be possible to stay within a staffing budget and meet the needs of patients and staff.

Answer 118

A

Situation: A hospital’s Neonatal Intensive Care Unit (NICU) has a designated budget for staffing. Over the past year, patient admissions have increased, and the current nurse-to-patient ratio is sometimes stretched thin, leading to concerns about patient safety and staff burnout.

Fiscal Accountability: The nurse manager reviews the staffing budget and identifies areas of potential efficiency. She finds that several nurses are interested in shifting from full-time to part-time roles and that there are periods during the day when patient needs are predictably lower. By adjusting shift patterns and integrating part-time schedules, the nurse manager can optimize the number of nurses available during peak times without hiring additional staff.

Answer 119

A

To Patients: By optimizing the shift patterns, the nurse manager ensures that every neonate receives attentive care during crucial periods. The risk of errors or oversights due to understaffing - decreases.

Answer 120

A

To Staff: Nurses who wanted more flexible or part-time hours get their desired schedules, leading to improved job satisfaction. Those who were feeling overburdened during peak times now have additional support, reducing the risk of burnout.

Answer 121

A

Outcome: The NICU stays within its staffing budget while also maintaining a safe nurse-to-patient ratio, ensuring high-quality patient care and improving staff job satisfaction.

Answer 122

A

Sick leave

Vacations

Holidays

Call offs for low census

On-call pay

Tardiness and absenteeism

Shift work

Answer 123

A

Name of person responsible for staffing schedule

Type and length of staffing cycle used

Rotation policies if shift rotation is used

Fixed shift transfer policies

Time and location of schedule posting

When shift begins and ends; day of week schedule begins

Weekend off policy; tardiness policy

Low census procedures

Absenteeism policies

Answer 124

A

Policy for trading days off; days off request procedures

Policy regarding rotating to other units

Procedures for vacation time and holiday time requests

Procedures for resolving conflicts regarding time off

Emergency request policies

Transfer request policies

Mandatory overtime policy

Answer 125

A

Priorities in nursing practice are determined using several frameworks such as nursing process, ABC, and Maslow’s Hierarchy of Needs.

Answer 126

A

In addition to prioritizing and reprioritizing nursing care, nurses must also effectively prioritize and manage their time to avoid nonessential activities that could jeopardize their priorities in delivering nursing care to their patients.

Answer 127

A

Life-threatening problems or those that could result in harm to the patient if left untreated first.
Actual problems and needs before potential problems or risks.
Acute problems before chronic problems.
Problems identified as important to the patient

Answer 128

A

Using the Eisenhower Matrix can help nurse managers and staff prioritize their workload effectively,

Answer 129

A

Using the Eisenhower Matrix can help nurse managers and staff prioritize their workload effectively, ensuring that critical patient care tasks are handled promptly while also allowing time for important but non-urgent activities.

Answer 130

A

This approach supports better time management, enhances patient safety, and contributes to overall job satisfaction by reducing stress and burnout.

Answer 131

A

Quadrant 1: Important and Urgent

Quadrant 2: Important but not Urgent

Quadrant 3: Urgent but not Important

Quadrant 4: Not Important and Not Urgent

Answer 132

A

Tasks that are essential for patient care and long-term health outcomes but do not need to be addressed immediately.

Answer 133

A

*A patient with diabetes needs education on diet and exercise to prevent complications. While this is critical for their long-term health, it can be scheduled for a later visit and is not an immediate concern.

*Completing a comprehensive care plan for a patient being discharged tomorrow. While this is vital for their ongoing care, it doesn’t require immediate action if the discharge is still several hours away.

Answer 134

A

Tasks that require immediate attention but do not significantly impact patient care or long-term outcomes.

Answer 135

A

A patient asks for a glass of water urgently while they are waiting for their medication. While it needs to be addressed quickly, it doesn’t have a major impact on their health if it takes a few minutes longer.

*A nurse receives a call from another department asking for a routine update on patient numbers, which needs to be answered right away but does not affect patient care directly.

Answer 136

A

Appropriate staffing is critical to the delivery of quality care at every practice level and in every setting. (ANA, 2020, p. 4)

Answer 137

A

Nurse leaders and managers are responsible for making sure to have the appropriate number and mix of nursing staff at all times. Because staffing affects the ability of a nurse to deliver safe and effective care at every practice level and in all settings, staffing is a complex process (ANA, 2020).

Answer 138

A

Nurse leaders and managers must understand and follow federal, state, and local regulations related to scheduling and staffing, uphold nurse practice acts, verify and track licensure of nursing staff, respect nurses’ rights, ensure staff competencies, and substantiate staff complaints with regulatory and professional standards.

Answer 139

A

inadequate staffing leads to reduced job performance and diminished patient and nurse satisfaction

Answer 140

A

Unique patient care settings

Patient flow (admissions, discharges, and transfers)

Patient acuity

Skills, education, and experience of the available nursing staff

Answer 141

A

Research on safe staffing has revealed that it is effective in reducing adverse events, improves quality of care received, and improves nurse satisfaction, which in turn reduces costly nurse turnover.

Answer 142

A

There is not a perfect method for determining staffing.

Answer 143

A

Approaches to safe staffing include

patient classification systems,

ANA’s Principles for Safe Staffing,

Agency for Healthcare and Research Quality nurse staffing model, and

National Database of Nursing Quality Indicators staffing benchmarks

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Chapter 17 Flashcards

Exam 2

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