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Leadership & Management > EXAM 2 > Flashcards

EXAM 2 Flashcards

1
Q

Productive Hours

A

Hours doing pt care

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2
Q

Nonproductive hours

A

hours in staff meetings, CEUs, etc

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3
Q

Employee Classifications - Direct care

A

Time spent providing hands-on care to pts

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4
Q

Employee Classifications - Indirect care

A

Time spent on activities related to patient care

EX: documentation, interacting with multidisciplinary team members

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5
Q

Nurse Intensity

A

Measure of amount and complexity of nursing care needed by a patient

  • Patient classification system (PCS) is used to determine workload
  • patient acuity (workload each pt generates)
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6
Q

Utilization of Classification system data

A

acuity data used to plan nursing staffing during next 24-hour period

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7
Q

Considerations in developing a Staffing Plan

A
  • Skill mix (ex ratios of RN to LPN to PCTs)
  • Staff support (pt transport)
  • Historical Information
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8
Q

Average daily census (inpatient unit)

A

Total numbers of pts at census time, usually midnight, over period of time and dividing by number of days in time period.

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9
Q

Units of Service

A

Nursing workload dependent on nursing care needs of patients

Nursing hours per pt day (NHPPD) (required nursing hours for 24hr period, hrs of operation)

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10
Q

Considerations for Staffing

A
  • Staff experience

- Patient need

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11
Q

Shift Variations

A
  • Traditional (8s)
  • 12-hr shifts
  • weekends
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12
Q

Scheduling concerns

A

Financial implications

Impact on pt care

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13
Q

Models of Care Delivery

A
  • Care delivery models organize work of caring for pts

- choose care delivery model based on needs of pts and availability of competent staff

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14
Q

Delegation

A
  • pg 369
  • primarily about entrusting your authority to others
  • at its most basic, it is empowering one person to act for another
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15
Q

Accountability

A 
Being responsible and answerable for actions and inactions of self or others in context of delegation
S - specific
M - measurable
A - achievable
R - realistic
T - time bound
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16
Q

KSBN - 65-1165 - Supervision of delegated nursing procedures

A

All nursing procedures, including but not limited to administration of medication, delegated by a licensed nurse to a designated unlicensed person shall be SUPERVISED.

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17
Q

KSBN - 65-1136 - IV fluid therapy

A

“Supervision” means provision of guidance by a qualified nurse for the accomplishment of a nursing task or activity with initial direction of the task or activity and periodic inspection of the actual act of accomplishing the task or activity.

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18
Q

Responsibility

A
  • Involves reliability, dependability, and obligation
  • Involves people providing pt care to perform at an acceptable level for which they have been educated
  • Nurse transfers responsibility and authority for delegated tasks, but retains ACCOUNTABILITY for delegation process
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19
Q

Authority

A

Right to delegate duties and give directions to unlicensed assistive personnel places RN in position of authority

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20
Q

Assignment

A

Distribution of work each staff member is responsible for performing as condition of employment
-within legal scope

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21
Q

Competence

A

Required to practice safely and ethically in designated role and setting
-Built on knowledge gained in nursing education program, orientation to specific settings, and experiences of implementing nursing

-License = minimal competence

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22
Q

Competence requires application of:

A

Knowledge, interpersonal decision making, and psychomotor skills

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23
Q

Supervision

A

Provision of guidance or direction, oversight, evaluation and follow up by licensed nurse for accomplishment of nursing tasks delegated.

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24
Q

Levels of supervision

A
  • Unsupervised
  • Initial direction and periodic inspection
  • Continuous
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25
Q

Assistive Personnel Scope

A

bathing, feeding, toileting, ambulating

-Cannot assess or evaluate response to treatment

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26
Q

LPN responsibilities

A
  • Provides care for STABLE patients, with predictable outcomes
  • Cannot complete initial patient assessment
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27
Q

Rights of delegation

A 
Right task
Right circumstance
Right person
Right direction/communication
Right supervision
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28
Q

Tasks that can NEVER be delegated

A
  • Patient assessment
  • Triage
  • Nursing diagnosis
  • Nursing plans of care
  • extensive teaching or counseling
  • Telephone advice
  • Outcome evaluations
  • patient discharges
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29
Q

Successful organization of patient care requires:

A
  • Governance structures
  • Patient care delivery process
  • Measures of outcome of care delivery
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30
Q

External and Internal

A

.

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31
Q

Environmental assessment

A

SWOT analysis

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32
Q

Stakeholder

A

any person, group or organization that has vested interest in program or project under review
-could be its, nurses, docs, community reps, insurances companies, hospital administrators, or accreditation agencies.

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33
Q

Philosophy

A

Statement of beliefs based on core values

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34
Q

Values

A

-Stated in mission statement

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35
Q

Mission statement

A

Formal statement of purpose or reason for organizations existence

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36
Q

Three elements of a mission statement

A
  • No longer than a couple sentences
  • States organizations PURPOSE using ACTION words
  • Simple and from the heart
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37
Q

Four elements of a Vision Statement

A
  • Written down
  • Present tense as though it were already accomplished
  • Covers variety of activities

Balances needs of providers pts and environment

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38
Q

Goal

A

Specific aim or target that unit wishes to attain with in time span of ONE year

39
Q

Objective

A

Measurable step taken to reach goal

40
Q

Shared Governance

A

Organizational framework grounded in philosophy of decentralized leadership that fosters atonomous decision making and professional nursing practice
-Implies allocation of control, power or authority among mutually vested parties

41
Q

Five main arenas of Shared governance model

A
  • Clinical practice
  • Quality
  • Education
  • Research
  • Management of resources
42
Q

Responsibility of Clinical practice council

A

Establishes nursing practice standards for workgroup

43
Q

Responsibility of Quality council

A

Makes recommendations about hiring, promoting, and credentialing nursing staff
-Oversees unit’s quality management initiatives

44
Q

Responsibility of Nursing Education council

A

Assesses learning needs of unit staff, develops and implements programs to meet needs

45
Q

Responsibility of Research council

A

Advances research utilization with intent of incorporating EBP findings into clinical practice

46
Q

Responsibility of Management council

A

Ensures upholding of standards of nursing practice and governance agreed upon by unit staff and adequate resources to deliver patient care

47
Q

Responsibility of Coordinating council

A

Facilitates and integrates activities of other councils, usually composed of first-line pt care manager and chairpersons of other councils

  • facilitates annual review of unit mission and vision
  • develops annual operational plan
48
Q

Benner’s Novice to Expert - Five levels

A
  • Novice nurses
  • Advanced beginner
  • Competent
  • Proficient
  • Expert
49
Q

Novice

A

Task-oriented and focused on rules

50
Q

Advanced beginner

A

Demonstrate marginally acceptable independent performance

51
Q

Competent

A

Have developed ability to see own actions as pare of long-range goals for patients

52
Q

Proficient

A

Can perceive whole situation

53
Q

Expert

A

Intuitively knows what is going on with patients

54
Q

Situational Leadership

A

There is no one best leadership style

-effective leadership lies in matching leadership style to individual’s or group’s level of task-relevant readiness

55
Q

Accountability-based care delivery

A

Focuses on roles, their relationship to work to be done, and outcomes they are intended to achieve

56
Q

Accountability

A

Is about OUTCOMES rather than processes
Is individually defined
Inherent in roles, but delegated
Foundation for evaluation

57
Q

Time management

A

Set of related commonsense skills that help people use time in the most effective and productive way possible

58
Q

Pareto Principle (time management concept)

A

Time management requires shift from wasting time on process of being busy to organizing time to achieve desired outcomes
80/20 rule

59
Q

Time analysis

A

Consider what tasks can be delegated to personnel who receive less compensation than nurses

60
Q

Prioritizing use of time

A
  1. Life threatening or potentially life-threatening conditions
  2. Activities essential to safety
  3. Activities essential to plan of care
61
Q

Internal climate

A

How you perceive yourself

62
Q

External climate

A

How others perceive you

63
Q

Levels of communication

A

Public
Intrapersonal
Interpersonal

64
Q

Group communication - Forming

A

interpersonal relationships, expectations, directions

65
Q

Group communication - Storming

A

comfortable enough to disagree; can lead to increased trust, positive competition, effective barganing

66
Q

Group communication - Norming

A

establishes rules and define the work; doesn’t come if can’t agree

67
Q

Group communication - Performing

A

the work gets done

68
Q

Barriers to communication

A

-Use of language
-Anger
DEFENSIVENESS
-false reassurance
-Stereotyping
-interrupting
-being inattentive
-being stressed
-unclear expectations
-giving incongruent responses
-illiteracy

69
Q

Workplace communication

A

Nurses’ diverse roles and relationships require different communication patterns with supervisors, co-workers, practitioners, etc

70
Q

Workplace communication- GRRRR

A 
Greeting
Respectful listening
Review
Recommend or request more info
Reward
71
Q

Communication skills

A

.

72
Q

Assertiveness

A

A ways of communicating that allows people to express themselves in direct, honest and appropriate ways that do not infringe on another person’s rights

73
Q

Passive communication

A

a person suffers in silence although they may feel strongly

74
Q

Aggressive communication

A

express themselves in a direct and hostile manner that infringes on others’ rights- demonstrating self-excellence

75
Q

Passive-aggressive communication

A

An aggressive message presented in a passive way

76
Q

Strategic planning

A

sum total or outcome of processes by which organization engages in environmental analysis, goal formulation and strategy development for purpose of organizational development

77
Q

Steps in Strategic planning

A

-Environmental assessment
Situational assessment, external assessment, internal assessment
-SWOT analysis
-Community and stakeholder assessment

78
Q

SWOT analysis

A

Strengths
Weakness
Opportunities
Threats

79
Q

Organizational climate

A

How employees perceive the organization

80
Q

Cultural traits

A
  • Adaptability
  • Involvement
  • Consistency
  • Mission
81
Q

Division of labor

A

way labor force is divided or organized has impact on how mission is accomplished

82
Q

Factors that influence organizational structure

A

-Experiencing severe problems
-Technology
-Diversity
-Size of organization
-Other reasons to rethink structure
ie EXTERNAL REVIEW PROBLEMS

83
Q

Lewin’s Force-Field Model (Change theory)

A
  • Unfreeze
  • Move to a new level
  • Refreeze
84
Q

Lippitt’s Phases of Change (Change theory)

A
  • Dx problem
  • Assess motivation and capacity for change
  • Assess change agents motivation and resources
  • Select progressive change objective
  • Choose role of change agent
  • Maintain change
  • Terminate helping relationship
85
Q

Havelock’s Six step change model

A
  • Build relationship
  • Dx problem
  • Acquire resources
  • Choose solution
  • Gain acceptance
  • Stabilize and renew
86
Q

Roger’s Diffusion of Innovations theory

A 
Five steps:
Awareness
Interest
Evaluation
Trial 
Adoption
87
Q

Stages of Change model (SCM)

A 
5 steps:
Precontemplation
Contemplation
preparation
action
maintenance
88
Q

Steps in the change process

A 
A- assessment
P-planning
I-implementation
E-evaluation
Stabilization
Adjourning
89
Q

Stabilization of change

A

Change is no longer pilot or experimental

-should occur as soon as change process complete

90
Q

Adjourning

A

Final stage of change process

Termination and consolidation occur

91
Q

Natural and expected response to change

A

Resistance

92
Q

Factors that affect staff responses to change:

A

Trust
Predictability
Ability to cope with change

93
Q

Leadership & Management roles in conflict management

A 
S- share the facts
T- tell your story
A- ask for opinions
T- talk tentatively, value for person
E- encourage testing

Leadership & Management (4 decks)

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