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Leadership > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

When was the Institute of medicine IOM established and by who?

A

1970 by the National Academies

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2
Q

What is the new name of the I OM

A

NAM national Academy of medicine

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3
Q

What is the mission of the NAM?

A

To improve health for all

By advancing science, accelerating health, equity in providing independent, authoritative, interested, advice, nationally and globally

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4
Q

What was in the I0M’s first report

A

It began the patient safety movement presented a strategy to improve healthcare quality over the following 10 years, and identified three domains of quality

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5
Q

What was the patient safety movement identifying

A

Medical errors as the leading cause of injury in the United States

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6
Q

What are the three domains of quality identified by IOM’s first report

A

Patient safety
Practice, consistent with current medical knowledge
Meeting customer, specific values and expectations 

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7
Q

 What are the key I OM outline six aims for healthcare improvement

A

Healthcare should be safe effective. Patient centered, timely, efficient, and equitable.

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8
Q

What are the four tiered approach to quality improvement that that IOM outlined?

A

Establish a national focus
Identifying and learning from errors
Racing performance, standards, and expectations for improvements and safety
Implementing safety systems in healthcare organizations

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9
Q

What are the six aims for healthcare in the 21st-century?

A

Safe
Effective
Patient centered
Timely
Efficient
Equitable

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10
Q

What does safe mean in the six aims for healthcare in the 21st-century

A

Avoiding injuries to patients from the care that is intended to help them

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11
Q

What does effective mean in the six aims for healthcare in the 21st-century

A

Providing services based on scientific knowledge to all who could benefit in refraining from providing services to those not likely to benefit, avoiding over, use underuse and miss use of care

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12
Q

Why did the IOM call for an overhaul by outlining six aims for healthcare improvement in the 21st-century

A

They needed major reconstructing in, addressing these performance characteristics, would leave to narrowing the quality gap

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13
Q

What is patient centered mean in the six aims for healthcare in the 21st-century

A

Providing care that is respectful of unresponsive to individual patients preferences needs and values in ensuring that patience values guide all decisions

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14
Q

What is timely mean in the six aims for healthcare in the 21st-century

A

Reducing weight and sometimes harmful delays for both those who receive in those who give care

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15
Q

What does efficient mean in the six aims for healthcare in the 21st-century

A

Avoiding waste in particular of equipment supplies ideas and energy

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16
Q

What does equitable mean in the six aims for healthcare in the 21st century

A

Providing care of that does not very good quality because of the personal characteristics, such as gender, ethnic city, geographic location, and socioeconomic status

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17
Q

Why did the IOM identify 10 rules to redesign and improve health care in the 21st-century

A

These rules are necessary to achieve significant improvement in quality. They are implemented to have an impact on healthcare, workforce and in turn require change in accountability standards of care and relationships between patients and healthcare professionals.

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18
Q

What is the goal of the QSEN core competencies?

A

To prepare future nurses with the knowledge, skills and attitudes, necessary to continuously, improve the quality and safety of healthcare

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19
Q

What are the five competencies of the QSEN core competencies

A

Provide patient centered care
Work in interdisciplinary teams
Employee evidence base practice
Apply quality improvement
Utilize informatics
Safety

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20
Q

What is important and patient centered care

A

Advocacy
Empowerment
Self-management
Health literacy
Cultural competence
Optimal healing environment

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21
Q

What is the strongest level of evidence in nursing research?

A

Evidence from a systematic review, or meta-analysis of randomized controlled trials

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22
Q

What is quality improvement in structure of care environment

A

Focusing on where nursing care is provided

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23
Q

What is quality improvement in the Kara process?

A

Focusing on how nursing care is provided

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24
Q

What is quality improvement in outcomes of care?

A

Focusing on the results of nursing care

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25
Q

What are the five principles of creating and maintaining a safety culture?

A

Providing leader ship
Respecting human limits in the design process
Promoting effective team functioning
Anticipating the unexpected
Creating a learning environment 

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26
Q

What is private healthcare?

A

Momentarily compensated health care provided to individual seeking care
Includes companies for profit and nonprofit, not associated directly with the government
Predominate form of healthcare for persons in United States

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27
Q

What is public health care?

A

Funded by tax dollars
Include state and county public health department in US government health agencies
Reduced payment options, or free care offered

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28
Q

What is government health care?

A

Refers to government provided health insurance such as Medicare or Medicaid
Not provided directly by the government
The VA

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29
Q

What is national or universal healthcare?

A

Healthcare or health insurance provider to citizens through their government without involvement of private health insurers

Not available in US

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30
Q

What does access to healthcare?

A

The ability to obtain health care services, when needed
US is low in comparison to other countries in regard to prevention and care of chronic condition

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31
Q

What is uninsured mean?

A

Those without healthcare insurance coverage

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32
Q

What is underinsured mean?

A

Those who have insurance coverage, but lack an adequate income to facilitate access to care

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33
Q

What is EMTALA?

A

Emergency medical treatment in labor act

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34
Q

What does the emergency medical treatment in labor act require?

A

All Medicare participating hospitals, with emergency departments providing stabilizing emergency care for a patient seeking help regardless, their insurance status, or ability to pay

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35
Q

What are the two avenues of healthcare?

A

Through a physician or care provider practice who not required to accept patient who cannot pay

Through Hospital emergency Department

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36
Q

What are barriers to access of care?

A

Living in an area with an adequate service
Lack of health insurance
Kos prohibitions

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37
Q

Why would a patient repeatedly comes to the ER for issues that could be treated at PMD

A

Lack of insurance

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38
Q

What is better quality of care and hospitals of the US acute or chronic

A

Acute

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39
Q

Strategies for cost containment

A

Restriction on expenditures
Press control
Utilization controls
Cost sharing

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40
Q

 What is Medicare?

A

Provides health insurance for disabled people over the age of 65 and disability

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41
Q

What is Medicaid?

A

Provide coverage to low income people primarily for children through chip non-disable adults and pregnant women

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42
Q

Who can a healthcare policy be developed by?

A

Citizen, action, local policies, proceedings, legislation, at the state or federal level, WHO

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43
Q

Our leadership and management interchangeable

A

No

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44
Q

What is leadership?

A

Process of influencing others through effective relationship skills

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45
Q

What does management?

A

A formal position with a specific function

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46
Q

What are the three behavioral theories characteristics of leaders

A

Autocratic democratic laissez-faire

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47
Q

What is an autocratic leader?

A

Makes decisions without input from team
Does not consider valuable suggestions from team members input
Potentially demoralizes team members

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48
Q

What is a democratic leader?

A

Expects team members to contribute to decision making process
Encourage team input
Enables individual growth and development
Analyzes and makes final decisions
Increase his participation in projects and creative solutions
Brings about higher production and satisfaction

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49
Q

What is a laissez-faire leader?

A

Provides advice support and timelines with low level involvement
Lex focus or time management resulting in high job satisfaction with risk of low productivity
Risks the potential of team members not having the knowledge to execute the tasks
May find intro theme, disagreements common, which may produce disharmony

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50
Q

What is the trait theory of leader ship?

A

Focused on traits of leaders and noted certain men were born leaders
Looked to be able to identify potential leaders more quickly

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51
Q

What is situational leadership theory?

A

Situational factors contribute to the leadership style, and the leader may be effective in certain situations and less effective in others

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52
Q

What is the contingency leadership theory?

A

A complex process of evaluating a leader style, the relationship with followers and the task to be completed

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53
Q

What is the contemporary theories of leadership?

A

4 leaders to be effective, the values and beliefs of the environment need to be considered

Relationship within the organization, need to be cultivated in order to promote a productive and healthy environment

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54
Q

What are the five relational leadership theories?

A

Quantum leader ship
Transactional leadership
Transformational leadership
Connective leader ship
Complexity, leadership

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55
Q

What is the attribution leadership theories?

A

Authentic leadership

Servant leadership 

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56
Q

What is a relational leader ship theory

A

Focus primarily on the relationship that occurs between the leader in team member

Put more emphasis on the leaders, relationship with others and less emphasis on the leader traits, situation, context or end result

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57
Q

What is quantum leadership?

A

Focuses on holistic and relational perspectives

Looks at system processes and relationship between workers and tasks to determine efficiency and job performance

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58
Q

What is transactional leadership?

A

Focuses on the goals of the orcas the nation with a directive style, establishing expectations for team members, and motivating with rewards

Has no shared vision between the leader and team member, but both gained some thing from interaction

Limits innovation focus on task completion in concrete rewards

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59
Q

What does the leader in team member focus on in a transactional leadership?

A

Leader focuses on getting job done while team member, motivated by reward

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60
Q

What is a transformational leader ship?

A

Involves active involvement of both the leader and team members they motivate each other

Affective type of leader ship to lead the change necessary to meet the demands of current health system

Everyone is involved

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61
Q

What is a connective leadership?

A

Focuses on caring

Incorporates the needs of diverse stakeholders within healthcare

Identifies and foster strength of team members by including them in the process of change within the organization

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62
Q

What is complexity, leader ship?

A

Focuses on learning creative, an adaptive capacity of complex system with the contacts of organizations

These leaders cultivate relationships, except feedback, Tolerate uncertain situation, seek diverse opinions, and listen to multiple points of views

Effective in fast pace world encourages flexibility

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63
Q

What is an attribution leadership theory?

A

Considers the characteristics or attributes of the leader, as the corner store in within the leader ship

Takes into consideration either the contacts or the intrrrelational aspects

64
Q

What is an authentic leader?

A

Evidence by a strong commitment to truth, telling decreasing ambiguity in the system, and increasing efficiency and productivity

Embraces self-awareness and self regulation to enhance more leadership

Creates environment that is predictable, efficient and steadfast

65
Q

What are five distinguishing characteristics of an authentic leadership?

A

Purpose, heart, self-discipline, relationships, and values

66
Q

What is a servant leadership?

A

Ability to lead by desire to serve others

Creates a reassuring and kind workplace

67
Q

What is emerging leadership theories?

A

Aspect of strategic agility in system leader ship

Moving away from individual leadership, ability to collective leader ship

68
Q

What are some characteristics of a leader?

A

Character
Commitment
Connectedness
Compassion
Confidence
Emotional intelligence

69
Q

What do you need in your fellowship when your leader?

A

Not passive participants need followers, who do not undermine the goal of the leader

70
Q

What is a mentorship

A

Process in which two people engage in a relationship designed to support the growth and development of a less experience party

71
Q

What must a mentor do?

A

Focus on the exchange of information to assist the mentee in advance in clinical competency’s research, skills or leadership ability

72
Q

What must a mentee do?

A

Embrace, open minded dialogues with other nurses leaders in managers

73
Q

What are the core concepts of nursing?

A

Person, culture care, health, healing environment, and nursing itself

74
Q

What are ethics?

A

Actions people should take in a specific situation based on their own morals
Influenced by personal life and value systems

75
Q

What are morals?

A

Ingrained in one’s consciousness

Provide people with establish rules of conduct

Reflect, and what’s right and wrong and good and bad

76
Q

What is moral integrity?

A

Refers to quality of character and involves acting consistently with personal and professional values

77
Q

How is moral integrity demonstrated

A

Honest and trustworthy
Consistent and doing the right thing
Stand up for what is right despite consequences

78
Q

What is moral obligation?

A

A duty to provide care in nondiscriminatory manner

A primary commitment to the recipient of care

A nurse cannot abandon a patient wants a relationship has been established

79
Q

What are values?

A

Personal beliefs, that influence behavior, and give meaning and direction to life

May change and grow

80
Q

What is values clarification?

A

Process of reflecting on, and analyzing values to better understand what is important

Leads to self-awareness self reflection

Necessary to develop nonjudgmental approach

81
Q

What is professionalism

A

Consistent demonstration of core values, evidenced by nurses working with other professionals

82
Q

What are the five core professional value is critical to nursing?

A

Altruism
Autonomy
Human dignity
Integrity
Social justice

83
Q

What is altruism?

A

Showing concern for the welfare and well-being of others

84
Q

What is human dignity?

A

Respecting the inherent worth and uniqueness of an individuals in a population

85
Q

What does integrity

A

Acting in accordance with inappropriate code of ethics and accepted standards of practice

86
Q

What is social justice?

A

Acting in accordance with fair treatment, regardless of economic status, race ethnicity age, sexual orientation, disability

87
Q

What do ethical theories offer for nurses?

A

A guide to clarify the personal values and beliefs

88
Q

What is utilitarianism?

A

Acting morally , increase human happiness, and make the world a better place
Determined by consequences of actions to determine the greatest good

Overlooks the rights of an individual

89
Q

When is utilitarianism used in nursing?

A

Staffing schedules
Time off request

90
Q

What is deontology

A

The right Ness, or wrongness of an action often depends on the nature of the act rather than the consequences of the act

91
Q

When can a nurse use deontology

A

Meaning to be objective when making hiring decisions
Steff assignments
Promotion

92
Q

What is virtue ethics?

A

A person’s actions are based on the persons character in action is right if it is what the richest person would do

93
Q

What is principalism?

A

Uses rule base criteria for conduct that stems from the identification of obligations and duties

Says one or more ethical principle should be used to dress ethical issues or dilemmas

94
Q

What are ethical principles?

A

Basic moral truths that guide a persons actions

95
Q

What is autonomy?

A

Refers to self governance in that an individual is free to make choices about what they can be done to his or her body

96
Q

What is beneficence

A

Refers to an action intended to benefit another. In other words one’s action should always promote good.

97
Q

What is non-malfeasance

A

Refers to the moral obligation to do no harm or injured to another person

98
Q

What is justice?

A

Obligation to provide fair, equitable, inappropriate treatment, all patients based on their needs without prejudice

99
Q

What is fidelity?

A

Refers to being faithful or loyal by keeping promises to others

100
Q

What is veracity

A

Refers to the notion that patients have a right to truthful information

101
Q

What is privacy?

A

Refers to a persons right to have control over an access to his or her personal information

102
Q

What is confidentialities?

A

Refers to preventing disclosure of private information shared between a patient in healthcare’s team

103
Q

What is the codes of ethics?

A

Reflect the values and beliefs, shared by members. Inform the public of standards of ethical conduct provides rules and principles surf self-regulation

104
Q

What does advocacy

A

Nursing advocacy, encompasses, caring respect for the individuals autonomy an empowerment

105
Q

What are ethical dilemmas

A

Occur when principles and rights values and beliefs are in conflict

Not always clear-cut, right or wrong solution

106
Q

What is moral uncertainty

A

Results when a nurse senses there is moral problem, but he or she is not sure of the moral, correct action or what is moral principles apply

107
Q

What is moral distress?

A

Results of a nurse knows the right action to take to solve a moral problem, but cannot follow his or her mobile believes because of an organizational constraints

108
Q

What is moral courage?

A

Requires a study, fast commitment to fundamental moral principles, despite facing potential risk

109
Q

What is moral resilience?

A

The capacity to sustain, restore or deep in one’s integrity, in response to Moral complexity, distress, or setbacks

110
Q

How much do nurse identify an ethical decision making

A

Identify ethical problems and gather relevant facts

Consider all involved

Identify possible options

Implement decision

111
Q

What are the three interrelated functions of an ethical committee?

A

Policy review and development
Ethics, education
Case consultation

112
Q

What is conscientious objection?

A

An individual is motivated to do what is right because it is right

Occurs when the nurse refuses to participate, because they believe action would violate their moral values

113
Q

What is lateral violence?

A

Negative acts that occur between nurses

114
Q

What does incivility

A

Rude and discourteous action, including gossiping in spreading rumors

115
Q

The nurse is commitment is always to the

A

Patient

116
Q

When unsafe or a questionable practice occurs, nurse leaders are managers must

A

Confront a nurse in an effort to change the practice and take action of change is not made

 Support staff, who report unsafe practice

Report the nurse to state board of nursing if required

117
Q

What are the three major functions of organizational finances.

A

Planning control decision

118
Q

Chief nurse executive is responsible for what finances

A

Financial management at organizational level
Negotiate and establish amount of resources available held accountable for spending above or below plan budget

119
Q

Mid-level managers, responsible financially

A

Area of the division of nursing that includes one or two units hope guideline managers through budget process

120
Q

First line managers in finances responsible

A

Unit based financial management, and must answer to mid-level
Must understand budget process

121
Q

The budgeting process has a direct effect on what

A

Quantity and quality of nursing care provided

122
Q

What is the role of a nurse leader in manager and budgeting

A

Focus on the goal, taking high-quality value for every dollar spent

Monitor financial status of unit

Provide quality cost effective nursing care 

123
Q

Nurse leaders in managers and cost containment and effectiveness must

A

Recognize they have control over unit activities that contribute to budget

Engage Steff in budget process and emphasize financial impact on unit

124
Q

What is the budget process

A

A systemic plan that provides the best estimate of nursing expenses and revenues

It’s best stated in terms of attainable objectives

125
Q

What is the average daily census?

A

Average number of patients on a unit of any given day over a period of time

126
Q

What is the break even quantity?

A

The number of patients needed to break even

127
Q

What is the cost per unit service?

A

Total cost divided by units of service

128
Q

What is the full-time equivalent?

A

Equivalent of one full-time employee working for one year can become a nation of employees working part time

129
Q

What is nursing hours per patient day?

A

Amount of productive, nursing care hours per patient on a 24 hour.

130
Q

What does productivity

A

Measure of input required for the output

131
Q

What does variance

A

Deviation from the projected budget

132
Q

What are the steps of budgeting?

A

Assessment
Diagnosis
Planning
Implementation
Evaluation

133
Q

What is the assessment aspect of budgeting?

A

Gather data and assess the needs for the upcoming fiscal year

Examine the present nursing activities, as well as those plan for the future

134
Q

What is the diagnosis part of budgeting?

A

Determine the nursing productivity goal for the upcoming fiscal yea

Evaluate unit goals from the previous year to ensure they are in alignment with the organizations current mission

Revise or develop new goals for future year

135
Q

What is the planning stage of budgeting?

A

Determine effective use of human in material resources

Consider the needs of the unit as well as the organization

Use budget worksheet and perform break even analysis

136
Q

What is the implementation step for budgeting?

A

Keep the unit functioning with the budget plan

Engage all staff in the process and motivate them to work within constrains of budget

Meet with Steff to explain budget

Encourage input regarding any deviations

137
Q

What is the evaluation step of budgeting?

A

Address any deviation

Perform variance analysis

Analyze the cause of variances, and determine strategies to avoid them in the future

Monitor trends in variances to assist in addressing work load issues

138
Q

What is productivity and budgeting?

A

Ratio of output and input monitoring procedures, admission, and patient outcomes versus skill level and experience of staff, finding a balance between safe quality, patient care and cost containment

139
Q

What is effectiveness and efficiency and budgeting?

A

Providing care based on evidence in avoiding under use in overuse of resources

140
Q

What are necessary care activities?

A

Activities essential to delivery of patient care, but not directly benefit the patient

141
Q

What is an example of a necessary care activity?

A

Transcribing orders and documenting medication administration

142
Q

What is the value added care activity?

A

Direct care activities are typically performed by registered nurses

143
Q

What is an example of a value added care activity?

A

Assessment taking vital signs, wound care, communication with patient, family and your team

144
Q

What is a non-value added care activity

A

Activities performed by RNs that do not benefit the patient and are not necessary to delivering patient care

Can lead to increased cost

145
Q

What is an example of a non-value AdaCare activity

A

Looking for equipment or people waiting for phone calls and waiting for patient transportation

146
Q

What is the operating budget and what does it include?

A

Overall plan accounts for expenses in revenue is related to the day-to-day operation

All unit expenses

147
Q

What is a fixed expense

A

Do not change over the budget. Regardless to volume or activity level.

148
Q

What does variable expenses?

A

Fluctuate, depending on patient volume and acuity or an activity level

149
Q

What is direct expenses?

A

Cost of providing patient care

150
Q

What is indirect expenses?

A

Are necessary for daily operations of the organization, but do not affect patient care

151
Q

What is the personnel budget?

A

Largest budget
Allocates expenses related to nursing personnel
Requires vigilant, monitoring to avoid over staffing or understaffing

152
Q

What do you need to consider when setting the personal budget?

A

The staffing needs and staffing plan for the unit

153
Q

What is the capital budget?

A

Includes equipment, furniture, technology, hardware, software, and building, renovations

154
Q

What does the capital budget require?

A

Input from staff to identify items that me the cost limit they have

Requires an understanding of financial implications of leasing versus purchasing equipment, expected life of equipment in estimated cost of maintenance

155
Q

What does incremental budgeting?

A

Involves multiplying the current year’s budget by a predetermined figure based on the cost of living consumer price index or inflation rate

156
Q

What does performance budgeting?

A

Emphasizes outcomes in results, rather than activities and outputs

Helps determine amount of money needed to provide value, added nursing care, non-value added nursing care in quality nursing care

157
Q

What is zero based budgeting

A

Starts from zero each year with goal to have zero friends left at the end of the fiscal year

Requires meticulous prioritize and justify or rear justify request funds

Forces priorities, avoid Waze using resources, efficiently

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