Exam #1: Organization Structure

Question 1

Organization Structure

Answer 1

1. Communication
2. Authority
3. Formal Relationships

Question 2

Chain of command

Answer 2

Formal paths of communication and authority

Question 3

Unity of command

Answer 3

Reporting to one person

Question 4

Span of control

Answer 4

The number of direct reports

Question 5

Organizational Chart Position/Levels

Answer 5

1. Board of Directors
2. Advisory committee
3. CEO/President
4. Executive Leadership (CFO, COO, CNO)
5. Directors (Senior Managers) -> Assistant Director of Nursing
6. First-level Managers (Managers, Charge Nurses)
7. Nurses, LPN’s, CAN’s, unit secretaries

Question 6

Board of Directors

Answer 6

Responsible for direction of where the organization is going.

Question 7

Advisory committee

Answer 7

• Group of people who have something to contribute to help move organization in a direction.
• They have no power/authority but will make suggestions.

Question 8

CEO/President

Answer 8

• Top of the organization.

- They answer to board of directors.

Question 9

Executive Leadership: CNO

Answer 9

• Responsible for nursing department.
• Their job is to have a vision for the nursing department.
• Their thinking is big, asks “how do we move forward”.
• The person who is ultimately responsible for implementing guidelines.

Question 10

Executive Leadership: COO are responsible for

Answer 10

• Housekeeping staff
• Axillary staff
• Maintenance
• Etc.

Question 11

Directors (Senior Managers)

Answer 11

• Have more than 1 unit under their belt.
• Help get a little more specific with what their department needs to do and then share that with managers to implement on each separate floor.

Question 12

First-Level Managers: Managers

Answer 12

• Get direction from directors of what is to happen on their unit.
• All gives information to the directors about what they need to do their job.

Question 13

Charge Nurse

Answer 13

Day-to-day working of the unit, more working on the floor

Question 14

Shared Governance

Answer 14

• Gives nurses control over their own practice, allows for shared decision making at a faculty level
• Ex: if the Director of ICU wants to get new IV pumps, the nurses on the floor are best for input on what kind of IV pumps to get
• Ex: All policies and procedures of nursing school are a result of faculty not just the dean.

Question 15

Advantages of Shared Governance

Answer 15

• More accountability
• More control over work environment
• Improves job satisfaction
• Decreases turnover rate
• Improves recruitment abilities
• Nurses become more fiscally responsible

Question 16

Disadvantages of Shared Governance

Answer 16

decisions not congruent across all units

Question 17

Organizational Culture

Answer 17

How the unit carries out care; shared beliefs

Question 18

Organizational Climate

Answer 18

How the employees perceive an organization; individual and vary among employees.

Question 19

Magnet Status

Answer 19

• Developed by American Credentialing Center (ANCC)
• Recognition for hospitals w/ well qualified nurse executives and an organizational structure that emphasizes open, participatory management
• Improved patient outcomes and higher staff nurse satisfaction -> more access to professional development
• Lengthy process, Awarded for 4 years
• Not available in Nevada

Question 20

How to qualify for Magnet Status

Answer 20

• Hospital must submit an application and undergo a multiday onsite evaluation
• Presence of ALL 14 Forces of Magnetism (basically a perfect hospital)
• Lengthy process, takes years to form, and requires a lot of money

Question 21

Managerial levels/roles

Answer 21

1. Upper Level (Executive Leadership): CEO, COO, VP of Nursing, DON
2. Middle Level (Senior Managers): directors, supervisors, assistant DON
3. First Level: charge nurses, head nurse, nurse manager

Question 22

Upper Level Management

Answer 22

• Look at the organization as a whole including external forces
• Most communication is top down although some upward
• Focus on strategic planning
• Ex: budgeting for each department, achieving magnet status, long term goals

Question 23

Middle Level Management

Answer 23

• Roles in several things, such as overseeing departments, budgeting within departments
• Looking at everything in more broad of a view.
• Ex: replacing new vents and getting new hospital beds for the department

Question 24

First Level Management

Answer 24

• Focus on day to day activities
• Long and short term planning
• Lots of communication up and down
• Looks at more specifics
• Ex: inventory, performance improvement activity

Question 25

Patient Care Delivery Model: Total Patient Care

Answer 25

-Complete care for a group of patients
-1 nurse assigned to a group of patients
Ex: ICU

Question 26

Patient Care Delivery Model: Functional

Answer 26

-Tasks are assigned
-1 nurse assigned to give meds, another nurse assigned to do vitals, etc.
Ex: Psychiatric setting (mental health charge), med surg nurse

Question 27

Patient Care Delivery Model: Team Nursing

Answer 27

• Lead nurse uses a group of workers to provide care
• RN, LPN, CNA all work together
• CAN be responsible for ambulating, documenting I&O, bed bath, under stable and normal conditions.

Question 28

Patient Care Delivery Model: Primary Nursing

Answer 28

• Nurse has 24 hr responsibility for each patient

- Nurse sleeps at hospital

Question 29

Committees

Answer 29

• Have a defined purpose

- Functions: advisory, communication, problem solving, improve services

Question 30

Standing orders

Answer 30

• Always going to exist

- Ex. Pharmacy, therapeutics

Question 31

Ad how

Answer 31

-We want to do something and gather a group together to get this task done. -Once task is accomplished, there is no more group.

Question 32

Stakeholders

Answer 32

• Individuals or groups who have interests in what the organization does. -They may or may not have power or influence
• Internal v external
• Ex: As a student of the SON, I am an internal stakeholder for the SON.