Chapter 17 Flashcards
A nurse manager is engaged in a process designed to achieve goals in dynamic, competitive environments through allocation of resources. This process is called:
a. process improvement. c. strategic planning.
b. total quality improvement. d. market analysis.
C: Strategic planning is the process by which specific goals are met through an allocation of resources. It also involves clarifying the organization’s philosophy, mission, and vision and analyzing the current environmental state. UNIT STRATEGIC PLANNING
A student asks a nurse manager why they should use a SWOT analysis. The nurse manager explains that a SWOT analysis is:
a. useful in strategic planning.
b. an acronym for a type of quality improvement technique.
c. a financial management term.
d. a human resource process.
A: A SWOT analysis is an environmental analysis used in strategic planning to measure an organization’s strengths (S), weaknesses (W), opportunities (O), and threats (T). ASSESSMENT OF EXTERNAL AND INTERNAL ENVIRONMENT
A nurse manager is composing a vision statement for the organization. The nurse should include which of the following of the four elements of a sound vision statement?
a. It is written down.
b. It is written in the present tense using action words.
c. It covers a variety of activities and spans specific short-term time frames.
d. It balances the needs of providers, patients, and the environment.
C: An effective vision statement will include a range of activities that can be accomplished within a specified time frame. VISION STATEMENT
A nurse has just started to work for an organization that employs a shared governance organizational framework. The nurse understands that this type of framework is grounded in a philosophy of decentralized leadership; however, the nurse understands that which of the following may not necessarily be correct regarding shared governance?
a. It implies the allocation of power and control.
b. It fosters autonomous decision making.
c. It consists of mutually interested or vested parties.
d. It encourages professional liaisons among all hospital levels.
D: Shared governance is an organizational framework positioned in a framework of decentralized leadership, and it implies the allocation of control, power, or authority (shared) and fosters autonomous decision making and professional nursing practice among mutually (shared) interested parties such as management and clinicians (not all hospital levels). BENNER’S NOVICE TO EXPERT
The nurse is informed that the clinic employs all four principles of the whole-systems shared governance. The nurse knows that which of the following is NOT one of these four principles?
a. Partnership c. Accountability
b. Collaboration d. Ownership
B: The principles of whole-systems shared governance are partnership (implies horizontal linkages between nursing and other staff roles), equity (staff roles are based upon relationships, not titles), accountability (individuals are accountable for their actions), and ownership (individuals own the work they perform). SHARED GOVERNANCE
A nurse works for an organization using a shared governance model, and she understands that, under such a model, structures are generally divided into multiple councils. Which council would the nurse join in order to participate in establishing practice standards for a workgroup?
a. Education council c. Clinical practice council
b. Quality council d. Management council
C: The purpose of a clinical practice council is to provide the practice standards for that workgroup. An education council assesses the learning needs of the unit staff and designs and develops programs to meet those needs. A quality council credentials staff and oversees quality management initiatives. A management council ensures that the standards of practice and governance are agreed upon and upheld and that there are adequate resources to deliver safe patient care. CLINICAL PRACTICE COUNCIL
A nurse manager is a strong proponent of the concept of learning organizations as a means to promote professional practice through the encouragement of personal mastery and awareness of one’s mental models. This concept was developed by:
a. W. Edwards Deming. c. Florence Nightingale.
b. Peter Senge. d. Philip B. Crosby.
B: Peter Senge’s (1990) seminal work, The Fifth Discipline, discussed the concept that learning organizations promote professional practice through the encouragement of personal mastery (beyond our competence and skills to an ongoing expansion of our current knowledge), awareness of our mental models (mental models influence how we take action and consist of deeply ingrained assumptions, generalizations, and biases), and team learning (a workgroup’s ability to align and develop their talents to attain a shared goal or vision). W. Edwards Deming and Philip B. Crosby are best known for their contributions to the continuous quality movement. Florence Nightingale was one of the pioneers of nursing practice, and she promoted the link between unsanitary conditions and adverse patient outcomes. EDUCATION COUNCIL
The nurse manager is aware that situational leadership maintains there is no one best leadership style, but rather effective leadership lies in matching the appropriate leadership style to the individual’s or group’s level of task-relevant readiness. The nurse manager wishes to help promote and develop the manager’s staff and followers. Under the situational leadership model, which of the following is not necessarily correct to achieve this outcome?
a. Coaching c. Collaborating
b. Supporting d. Delegating
C: Hersey and Blanchard’s (1993) situational leadership framework is based upon four stages of behavior through which leaders can move back and forth as they determine which style they need to use to promote staff development. These stages are directing, coaching, supporting, and delegating (not collaborating). SITUATIONAL LEADERSHIP
A nurse manager is trying to develop a means to facilitate professional staff development by building upon the skills, abilities, and experience of each practitioner. This method is otherwise known as:
a. career enhancement. c. the novice to expert model.
b. clinical ladder. d. situational leadership model.
B: The use of a clinical ladder is a means of ensuring staff competence, and it acknowledges that staff members have varying skill sets and abilities based upon their education and experiences. The clinical ladder helps to evaluate these abilities and rewards each staff member differently according to his placement in the designed (ladder) clinical structure. ENSURING COMPETENCE AND PROFESSIONAL DEVELOPMENT
A nurse manager is attempting to devise a statement that reflects the purpose of a health care agency. This statement is referred to as which of the following?
a. Core values c. Vision
b. Philosophy d. Mission
D: An organization’s mission statement reveals its purpose, direction, and reason for existence. A philosophy is a statement of beliefs based upon core values (inner forces that give it purpose). A vision statement reflects the organization’s vision (foresight) of what it wants to be. MISSION STATEMENT
A nurse manager is using Benner’s (1984) novice to expert model for clinical and career promotion ladders in order to provide a framework for facilitating professional staff development. Which of the following is not necessarily one of the five stages of Benner’s novice to expert model?
a. Novice c. Competent
b. Beginner d. Expert
B: Benner’s novice to expert model consists of five stages of experience: novice, advanced beginner (not just beginner), competent, proficient, and expert. TABLE 17-1 BENNER’S MODEL OF NOVICE TO EXPERT
The nurse manager decides to use the Bassett Healthcare Professional Nursing Pathway model because it builds upon the original work by Benner regarding clinical ladder stages. The nurse manager knows that which of the following is not necessarily a stage in this model?
a. Novice c. Preceptor
b. Competent d. Expert
C: The four stages of the Bassett Healthcare Professional Nursing Pathway model are Stage I, novice; Stage II, competent; Stage III, proficient; and Stage IV, expert. While being a preceptor for either clinical or managerial tasks can be an example of a proficient or expert individual who has been selected to train others, it is not one of the stages of this particular model. FIGURE 17-5 PROFESSIONAL NURSING PATHWAY
A nursing instructor wants to determine whether the students understand accountability-based care delivery systems. During the class, the instructor explains that the system emphasizes that accountability is based upon several elements. When questioned about the elements, which response by the students would indicate that further teaching is needed?
a. Processes, not outcomes c. Individually defined
b. Inherent in the role d. Foundation for evaluation
A: Accountability-based care delivery systems focus upon roles, their relationship to the work being done, and the goals or outcomes they are to achieve. Elements of this type of system are that accountability is about outcomes, not processes, is individually defined, is inherent in the role, is not delegated, and is the foundation for evaluation. ACCOUNTABILITY-BASED CARE DELIVERY
A nurse manager is developing a comprehensive unit-based performance quality improvement program that includes outcomes tracked from four domains. Which of the following would the nurse manager least likely choose as one of the domains?
a. Process c. Cost
b. Service d. Clinical quality
A: Unit-based quality improvement programs need to track certain aspects of care that reflect the unit’s goals in order to ensure their compliance with regulatory and quality initiatives. These outcomes should come from four domains: access, service, cost, and clinical quality. Process is not included, but various processes will be used in the tracking and monitoring procedures. UNIT-BASED PERFORMANCE IMPROVEMENT
A student nurse asks a nurse educator what the Bassett Healthcare Quality Compass is used for. The nurse educator responds that it is used for:
a. staff evaluation and promotion. c. quality assurance.
b. accountability-based care delivery. d. unit-based performance improvement.
D: The Bassett Healthcare Quality Compass can be used to display the outcomes of unit-based performance improvement programs such as patient satisfaction, cost, and utilization. UNIT-BASED PERFORMANCE IMPROVEMENT
