Chapter 27: Intra and Interprofessional Practice Flashcards
John is part of an interdisciplinary care team on a surgical unit. Interdisciplinary care teams:
a. Increase fragmentation of care.
b. Improve quality of patient care.
c. Increase duplication of services.
d. Need to include licenced and unregulated care providers.
ANS: B
The benefits of interdisciplinary care can be recognized through reduced duplication of services, decreased fragmentation of care, and improved quality of care for patients. Implementation and integration of interdisciplinary teams within Canada’s health care system has the potential to allow health care providers to practise to their full scope of practice and create innovative, sustainable ways to provide high quality health care for all Canadians.
The nurse manager is setting up the room assignments for the unit. One patient on the unit is
in critical condition and is going to require more care than the others. Before delegating a
task, a nurse manager should:
a. Delegate the admission assessment to the licenced practical nurse.
b. Review the employee’s performance assessment for the most recent period.
c. Assess the amount of guidance and support needed in a particular situation.
d. Create a task analysis of critical behaviours for the patient.
ANS: C
To delegate effectively, the nurse manager must assess the abilities required in the situation and the abilities that staff have. The nurse manager can thereby anticipate the amount of direction, monitoring, explanation, and independence that are needed.
A key advantage that a nurse manager has in terms of delegating is that:
a. Patients receive less attention because too many staff members make it difficult to
coordinate care.
b. Nurses report less pressure to perform necessary tasks themselves. c. Administration can predict overtime more accurately.
d. Team skills can be used more effectively.
D
The nurse on the shift from 2300 to 700 hours is assigning a component of care to an unregulated care provider. The night nurse should remain:
a. Accountable and responsible.
b. Accountable and liable.
c. Authoritative and liable.
d. Responsible and task oriented.
A
During a fire drill, the nurse manager becomes very assertive and directive in her communications with staff. This type of situational leadership depends on:
a. Supportive behaviour by the leader and immature followers.
b. The relationship with the followers and the type of behaviour of the leader.
c. Well-trained followers, combined with a strong leader who acts quickly.
d. The leader’s ability to evaluate personnel and communicate that evaluation.
ANS: B
The effectiveness of leaders depends on their relationships with followers, which should develop through motivating and inspiring others, as opposed to managing and controlling them.
The night nurse understands that certain factors need to be considered before tasks are delegated to others. These factors include which of the following?
a. Complexity of the task and the age of the delegate.
b. Potential for benefit and the complexity of the task.
c. Potential for benefit and the number of staff.
d. Complexity of the task and the risk for harm
ANS: D
In delegating tasks to others, the nurse considers factors such as stability of the patient, safety of the situation and of the patient, time and intensity of the task involved, and level of critical thinking required to achieve desired outcomes.
The unit manager is working in a large metropolitan facility and is told that two unregulated care providers are to be assigned to work with her. Delegation begins with:
a. Acknowledging the arrival of the second unregulated care provider on the unit.
b. Providing clear directions to both unregulated care providers.
c. Matching tasks with qualified persons.
d. Receiving reports from the prior shift.
ANS: C
In delegating tasks to unregulated care providers, the nurse must consider what cannot be delegated, in addition to the factors of safety, time, critical thinking, and stability of patients’ conditions.
Although interdisciplinary health care teams are the ideal in Canada, which of the following is an identified barrier to interdisciplinary collaboration?
a. Power equalities.
b. Overlapping scopes of practice.
c. Lack of legislative authority.
d. Lack of professional association support.
ANS: B
Identified barriers to interdisciplinary collaboration include policies (including policy overload), funding, power inequalities, and overlapping scopes of practice.
Who is accountable when a registered nurse performs a “transfer of function” from a physician activity?
a. The physician.
b. The director of nursing.
c. The nurse.
d. The institution.
ANS: C
The registered nurse is accountable and responsible for nursing care provided. Activities considered outside the legislative scope of nursing practice were “covered” by extensive use of delegation, or “transfer of function,” from physicians. In some cases, the physician apparently presumes that it would be the employer’s responsibility to ensure that the nurse was competent to provide the care, whereas the employer placed a large portion of the responsibility on the nurse and thus the nursing regulatory body.
In some provinces, a restricted activities or controlled acts model is currently in place. A main distinction between this model and the model of licensure that is still used in most other provinces is that:
a. Each health care provider is registered to conduct specific tasks.
b. Specific acts are licenced.
c. Acts cannot be shared among health care providers unless they are registered.
d. Nurses are bound by exclusive scopes of practice.
ANS: B
In Ontario, Alberta, and British Columbia, a common framework known as a restricted activities or controlled acts model created consistent approaches among the health professions with regard to discipline, registration, continuing competency, and restricted activities. A main distinction between this model and the model of licensure still used in all other provinces and territories is that nurses are not bound by exclusive scopes of practice. Rather than care providers being licenced, specific acts are licenced. This allows more than one profession to perform the same act, or parts of the act, for example, prescribing medication.
Which of the following exemplifies accountability for a nurse manager?
a. Consistently submitting budgets on time.
b. Consistently performing the responsibilities outlined for nurse managers at the
institution.
c. Explaining why registered nurse coverage was reduced on nights to the Nursing Practice Committee after serious patient injury
d. Actively soliciting ideas regarding scheduling from staff.
ANS: C
Reliability, dependability, and obligation to fulfill the roles and responsibilities of the nurse manager are consistent with responsibility. Accountability refers to being answerable for actions and results.
Which of the following is a benefit of the controlled acts model over the licensure model?
a. Decreased flexibility in allowing patients choice in their care provider.
b. Limited range of professional responsibility.
c. No firm boundaries.
d. Recognition that scope of practice is static.
ANS: C
Several benefits of the controlled acts model over the licensure model have been identified: It is viewed as allowing health care providers to perform to the range of their competency and abilities; the scope of practice is recognized as not static or to have firm boundaries; it places greater emphasis on standards and competence; and it increases flexibility in allowing patients more choice in providers and employers more innovation in optimal skill mix, while protecting the public from harm.
Although benefits of the controlled acts model are advantageous and arguably necessary, the legislative reform to recognize overlapping competencies has caused:
a. Role clarity.
b. A decrease in “turf” competition among health care providers.
c. A difficulty in optimizing skill mix.
d. Static boundaries for health care providers.
ANS: C
The legislative reform of the controlled acts model to recognize overlapping competencies has caused increased role confusion, further competition over “turf” for various providers, and difficulty in optimizing skill mix.
In delegating to an unregulated care provider in a home health setting, which of the following represents the most appropriate delegation communication?
a. “You will be taking care of Mrs. Srivastava. Mrs. Srivastava needs assistance with
her bath.”
b. “You will need to help Mrs. Srivastava get into and out of her shower. Ensure that
you check the condition of her feet, and let me know if you have any concerns
when you check in.”
c. “I am not sure that you know how to do this but I am giving you Mrs. Srivastava.
She is quite obese and needs skin care.”
d. “Mrs. Srivastava needs help to get into and out of her bathtub. Her bath will need
to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness.”
D
Delegation communication is very important and needs to be specific. Communication also includes conveying recognition of the authority to do what is expected.
Which of the following is a domain of the National Interprofessional Competency Framework?
a. Quality improvement.
b. Interprofessional conflict resolution.
c. Contextual issues.
d. Interdisciplinary communication.
B
