Chapter 18 Flashcards
A nurse is deciding on an appropriate time management strategy. Which of the following time management strategies does not belong?
a. Outcome delivery c. Focus on priorities
b. Analysis of time cost and use d. Visualization of the big picture
A: Some basic time management strategies include outcome orientation (not delivery), an analysis of the cost of use of time, a focus upon priorities, and the ability to visualize the big picture. KEY CONCEPTS
The nurse manager is trying to plan the shifts in the most effective manner. The manager knows that one characteristic of effective shift planning includes which of the following?
a. Getting the job done in the least amount of time
b. Nobody died
c. Everybody showed up for work
d. Evaluation of optimal and reasonable outcomes
D: Effective shift planning involves deciding what goals or outcomes they want to achieve. Identifying optimal outcomes (best possible objectives), as well as reasonable outcomes (realistic objectives given the resources at hand), and evaluating progress made toward these outcomes during and at the end of the shift are qualities that lead to effective planning during one’s shift. Often enough, nurses do not allow themselves permission to do less-than-optimal work, but sometimes, due to circumstances beyond their control (short staffed), achieving reasonable goals is the best that can be expected KEY CONCEPTS
A nurse manager is providing instruction on related commonsense skills that can help nurses to use their time in the most effective and productive manner possible. These skills are best known as which of the following?
a. Pareto principle c. Shift planning
b. Time management d. Effective leadership
B: A definition of time management is “a set of related common-sense tools that helps you use your time in the most effective and productive way possible” (Mind Tools, 2006). The Pareto principle concerns the concept that 20 percent of focused efforts results in 80 percent of outcome results. Shift planning deals with the organization and prioritization of patient care and tasks per shift. While the use of time management skills is a quality of effective leadership, it encompasses a variety of other attributes and qualities such as management skills, knowledge of leadership techniques, theory, and practice.GENERAL TIME MANAGEMENT CONCEPTS
A nursing instructor wants to determine whether a nursing student understands the importance of the Pareto principle. Which of the following responses would indicate that the student understands?
a. It is the principle that 80 percent of unfocused effort results in 20 percent of outcome results.
b. It is a way to record your activities over a period of time to see how your time is spent.
c. It is the principle that 20 percent of focused efforts equals 20 percent of outcome results.
d. It is the principle that 80 percent of focused efforts results in 80 percent of focused time.
A: The Pareto principle is based upon the prioritization of work effort through such measures as managing one’s time effectively. The basic premise is that 80 percent of unfocused efforts results in 20 percent of outcome results or that 20 percent of focused efforts results in 80 percent of outcome results. THE PARETO PRINCIPLE
A nurse manager observes that a few of the new employees continue to mismanage their time, which results in a flurry of activities that do not achieve the expected outcome goals for the time spent. The most likely cause of this behavior is that the nurses:
a. want to appear busy.
b. love crises.
c. know about time management but do not think it applies to them.
d. think they are far too superior to need to plan their time.
B: Unfortunately, many people still function in the crisis mode to get things done. An example of this would be a student who does not study for an exam until the night before, thereby creating a “crisis” that stimulates them to do the work. People continue to mismanage their time for other reasons: they do not know about time management, or they think they do not have time to plan or do not want to stop to plan. THE PARETO PRINCIPLE
When developing long-term goals, the nurse manager is always aware that these goals should remain:
a. long. c. flexible.
b. short. d. inflexible.
C: It is important, when making long-term goals and outcomes, that they remain flexible. The concept of flexibility should be built into any outcome orientation such as goal setting because, at times, the long-term goals may no longer be realistic or may need to be changed as circumstances change. OUTCOME ORIENTATION
The nurse manager suggests that a subordinate nurse use a time management tool that may benefit the nurse when determining how much time is spent. Which time management tool would the manager most likely suggest?
a. Shift assignments c. Shift action plan
b. Nursing chart d. Activity log
D: The activity log is a time management tool in which behaviors are logged consistently over a period of days to determine how time is spent. Nursing charts, shift action plans, and shift assignments are all good methods for organizing time and tasks. TIME ANALYSIS
You are planning your schedule for the day. Your plan includes a list of objectives that should be achieved given less-than-optimal circumstances and limited resources. These objectives are called:
a. optimal outcomes. c. reasonable outcomes.
b. general outcomes. d. unreasonable outcomes.
C: Outcomes can be categorized in a variety of different groups. Reasonable (realistic) outcomes are those that can reasonably be expected to occur given limited resources and less-than-optimal circumstances. Unreasonable outcomes are those that are expected to occur under unreasonable circumstances. While many nurses decide they will settle only for optimal outcomes, it is wise to plan for the less-than-optimal circumstances and situations and to be more reasonable and realistic. FORMULATE THE PLAN FOR THE SHIFT
A nurse preceptor wants to determine if a novice nurse is able to organize tasks and categorize them according to patient needs and conditions. Which of the following categories, if included by the novice, would indicate to the preceptor that further teaching is needed?
a. Life-threatening or potentially life-threatening conditions
b. Activities essential to patient safety
c. Activities essential to the plan of care
d. Activities essential to hospital/governmental regulation
D: Prioritizing care is one means nurses have of organizing their patient care. Life-threatening or potentially life-threatening conditions (such as assessing the ABCs) are always the top priority, with patient safety second (availability of crash carts and equipment to help prevent patient falls or injury), followed by items relating to the plan of care (pain medication and patient positioning). FORMULATE THE PLAN FOR THE SHIFT
A nurse manager is trying to implement the Joint Commission (JC) patient safety goals for 2006 pertaining to time organization. One of those goals is to:
a. improve the effectiveness of critical alarm systems.
b. eliminate wrong-site, wrong-patient, and wrong-procedure.
c. improve the safety of infusion pumps.
d. standardize the approach to hand off communication.
D: Improving the effectiveness of communication among caregivers (hospital goal # 2) was expanded in 2006 (hospital goal # 2E) to “implement a standardized approach to ‘hand off’ communications, including an opportunity to ask and respond to questions,” which pertains directly to end-of-shift reports and the “handing off” of patients from one location (such as surgery or admission from another unit) to another. UTILIZE SHIFT HANDOFF REPORT
A nurse manager is deciding whether or not to employ audiotaped end-of-shift handoff reports. The nurse manager would recognize that which of the following is a potential disadvantage of this method?
a. Report is brief.
b. Previous shift provides care during report.
c. Information may be inaccurate.
d. Report is taped before the new shift arrives.
C: Disadvantages of audiotaped end-of-shift reports are that the information may be inaccurate due to the report’s being taped earlier in the shift and the quality of the report (equipment, diction, and clarity of the speaker) may not be easy to hear. The report’s being brief due to lack of interruptions from questions, patients being cared for by the outgoing shift, and the fact that the report is ready for the incoming shift when they arrive are all advantages of audiotaped reports. UTILIZE SHIFT HANDOFF REPORT
A nurse manager is addressing concerns in the shift action plan. Which of the following would be least likely to be addressed in the shift action plan?
a. Resources c. Task completion due dates/times
b. Optimal outcomes d. Guidelines for task completion
B: Concerns that can be addressed in shift action plans include understanding the big picture (staffing issues, number of patients, environmental concerns), task completion due dates/times (time frame for accomplishment of tasks), understanding the priorities (emergency equipment checks, identification of patients at greatest risk for life-threatening complications), reasonable outcomes (those that are realistic to accomplish, not optimal outcomes), and resources (staff available to do work). TABLE 18-5 FACTORS TO CONSIDER IN PLANNING FOR A SHIFT
The nurse manager is making nursing assignments for the day shift. When making patient assignments, which of the following should not be a consideration?
a. Complexity of patient care
b. Skill, education, and competency of staff members
c. Staff preferences
d. Attitude and dependability of staff
C: A number of factors would be considered when making the shift assignment. Some of these factors would include the complexity of patient care; skill, education, and competency of staff members; attitude and dependability of the staff; the nurse practice acts; other responsibilities of the staff; and the need for continuity of care. Staff preferences would not be a major consideration. TABLE 18-6 FACTORS CONSIDERED IN MAKING ASSIGNMENTS
A nurse manager is dealing with a series of issues related to procrastination, inability to delegate, inability to say no, management by crisis, haste, indecisiveness, interrupting telephone calls, socialization, and complaining. These issues can all be categorized as examples of which one of the following?
a. Mistakes c. Time wasters
b. Errors d. New nurses
C: Marquis and Huston (2005) identified five criteria that contributed to wasting time and hindered the outcomes being achieved: procrastination, inability to delegate, inability to say no, management by crisis and/or haste, and indecisiveness. Sullivan and Decker (2009) added interrupting telephone calls and socialization, and Reed and Pettigrew (2006) added complaining to this rather lengthy list. EVALUATE OUTCOME ACHIEVEMENT
A nurse manager is giving a briefing to the nursing staff regarding traps nurses can fall into related to prioritization, as described by Vacarro (2001). Which of the following is not one of those traps?
a. Doing what hits first c. Relying on misguided judgment
b. Taking the path of least resistance d. Completing tasks by default
C: Vacarro (2001) identified five potential “traps” of prioritizing that nurses need to be aware of and avoid. They are doing what hits first, taking the path of least resistance, responding to the squeaky wheel, relying on misguided inspiration (not judgment), and completing tasks by default. AVOID PRIORITY TRAP
