Exam 2 Flashcards
What is the importance of critical thinking and nursing?
Involves skillful directed thinking
Identifie an essential skill
Making sound clinical judgment and safe patient care decisions
What are the eight elements of thought
the problem question concern or issue being thought about
The purpose or goal of thinking
The point of view, the thinker holds
The assumption the thinker holds true about issue
The central concepts, ideas, principles and theories, the thinker uses in reason
The evidence that information provided
The interpretation inferences reasonings of formulated thought that leads to the thinkers conclusion
The implications and consequences
What is interpretation?
Clarifying data and circumstances to determine meaning and significance
What is analysis?
Determining a problem or issue issue based on assessment data
What is an inference?
Drawing a conclusion
What is the evaluation?
Determining if expected, outcomes have or have not been met, and if the outcomes have not been met, why
What is explanation?
Justifying actions with evidence
What is self regulation?
Examining one’s practice for strengths and weaknesses, in a critical thinking and promoting continuous improvement
What is reactive thinking?
Serves as an automatic reaction to situations
Often result in errors
Restricts innovation and maintain status quo
Leaks to vague or inaccurate reasoning
What is reflective thinking?
Involves deliberate, thinking and understanding, using one’s own personal experience and knowledge
Uses what is known and needs to be known and how to bridge the gap between
Promote shared decision-making
What is intuitive thinking
An instant understanding of knowledge, without supporting evidence, or based upon a background
Result and nurse, taking quick action in the delivery of safe effective. Patient care.
How can a nurse, leader and manager use reflective thinking
Create a sense of trust and safety on the unit
What type of critical thinking do you want to avoid?
Reactive, thinking
What are the two types of decisions?
Patient care decisions, or those that affect direct patient care
Condition of work decisions, or those that affect the work environment
What are the steps to decision-making making?
Gathering information
Analyzing information and creating alternatives
Selecting a preferred alternative
Implementing
Following up on implementation
What is the decide model
Defined the problem
Establish criteria
Consider the alternatives
Identify the best alternative
Develop an implemented plan of of action
Evaluate and monitor for solution
Seek feedback if necessary
What is the decision-making grid analysis
List, options and factors on a table or grid in a sign a numeric score to each option to indicate poor to very good or not likely to very likely
What Is the SWOT analysis?
Read factors by strength, weakness, opportunities, and threats
What is shared decision-making
Includes staff
Requires nurse leaders and managers to involve staff
And powers nurses to provide effective, efficient, safe and compassionate quality care
Positively impact nurse satisfaction, recruitment retention, patient satisfaction and reduction of adverse effects
What is appreciative inquiry?
A problem-solving strategy that capitalizes on the positive characteristics of an outcome by valuing in building on them
Results in culture change, or development of a plan
Engages staff, and healthy exchange of knowledge
What are the four stages of appreciative inquiry?
Discovery
Dreaming
Design
Destiny
What is problem Solving
Identify a problem and implement an active systematic process to solve it
What is clinical reasoning
The process by which nurses make judgments
What is a clinical judgment
Involves an interpretation about the patient’s needs, and the decisions to take action or not modified standard approaches or improvise new ones
 what are the four aspects of clinical judgment model?
Noticing- a perceptual grasp of the situation
Interpreting -developing sufficient understanding of the situation
Responding -deciding on an appropriate course of action
Reflecting -attending to the patient’s response to action, while reviewing outcomes
The nurse leaders of a large, acute care facility have decided to implement the shared decision-making on each nursing unit and expect to see what results
Improve retention of nurses
More nurses applying for leadership positions
Decrease nurse to patient ratio
Elimination of medication errors
 improve retention of nurses
The staff nurses from an orthopedic surgery unit are dissatisfied with the admission process of a patient following surgery. The nurse states that there may be 4 to 5 admissions within one hour period as they are discharged from the post anesthesia recovery unit with many patients arriving at the same time the staff does not feel able to give the patients the closest assessment. They deserve and complete the admission process. The Director of the nurse suggest that these nurses observe the system that the woman’s health unit uses for multiple Admissions That happens at the same time due to deliveries and female surgeries. What problem-solving technique is the director using
Critical thinking
Shared decision making
Decide model
appreciative inquiry
Critical thinking
 appreciative inquiry
The nurse manager knows that which of the following is the first step in critical thinking process
Reflection
Judgment
Evaluation
Criticism
Reflection
The nurse manager has been evaluating the nursing unit, strengths, and weaknesses, and effort to ensure that the unit continues to improve safety practices and using cognitive skills of critical thinking process in this exercise
Interpretation
Self regulation
Analysis
Evaluation
Self regulation
The nurse manager knows that which of the nurses on MedSurg unit will be the best best at using intuitive thinking
The nurse who graduated from nursing school six months ago and has worked on the unit for three months
The nurse just started working on the unit, but has worked on a pediatric unit for two years
The nurse who worked in the intensive care unit for one year and has worked on this unit for four months
The nurse who worked in a long-term care facility for six years and has worked on this unit for six months
The nurse who worked on the intensive care unit for one year and has worked on this unit for six months
The nurse leader manage a nursing unit that has a pre-endurance of nurses who have graduated from nursing school with the last 12 months, and knows that what type of thinking will provide the best guidance to the nursing staff
Reactive
Intuitive
Reflective
Automatic
Reflective
The nurse manager has determined that nursing unit should see a reduction in medical errors by 50% and knows that this decision equates to what part of the nursing process
Assessment
Diagnosis
Outcomes identification
Planning
Outcomes identification
The nurse manager has determined that patient care on the unit would be more efficient if a different nursing model was used in plants to use use that tool for decision-making that gives the manager the opportunity to look at more than one feasible alternative
Decision making grid
Decide model
SWOT analysis
Shared decision making
Decision-making grid
The nurse manager has decided to begin to share decision-making model on nursing unit and knows that individual staff nurses will receive what benefit from this decisions
Sense of entitle
Sense of empowerment
Sense of inquiry
Sense of intellect 
Sense of empowerment
The nurse manager is holding a unit meeting and ask each staff member to share one thing that the individual believes works best on the unit. What technique is the nurse manager using in this meeting?
Critical thinking
Share decision making
Appreciative inquiry
Reflective thinking
Appreciative inquiry
A nurse leader is explaining the process of appreciative inquiry to a group of nurses who hope to use this process and bringing changed to their nursing unit. The leader shares that what are the stages of appreciative inquiry
Discovery
Dreaming
Dramatics
Design
Destiny discovery, dreaming design destiny
The nurse manager is planning to use the side model to assist in improving nursing staff self scheduling and is explaining the use of this tool by comparing it to the nursing process and knows that the ECI of the model corresponds to which parts of the process
Assessment
Diagnosis
Identification of outcomes
Planning
Evaluation
Diagnosis, identification of outcomes
What is the bureaucratic management theory
Focused on the structure of organization and authority of management, rules regulations to improve success of the organization
Was believed it would protect employees from our arbitrary decisions
What is the principles of management theory?
Best known for identifying management, functions of planning, organization, command, coordination, and control
What is the scientific management theory
Use scientific knowledge in mathematical formulas to manage the amount of work that could be a accomplished
Introduce the concept of using financial rewards
What is the human relations theory
Explored the underlying differences in human behavior, characteristics and roles of a group
What are the classical organizational theories?
Bureaucratic management
Principles of management
Scientific management
Human relations theory
What are the contemporary organizational theories
General systems theory
Complexity, theory
Learning organization theory
Hi reliability theory
Why was contemporary organizational theories created?
To approach as a cyclical, rather than linear to be able to require organizations to react with speed and flexibility
Bill on top of classical theories
What is the general systems theory?
The hole is greater than the sum of its parts
Based on an open and close system
What is a close system?
Has little to no interaction with system outside
It is overly focused on internal functions
What is an open system?
Interteracte with the systems inside and out
 is composed of interrelated elements, including inputs through puts and outputs
Is a constant cycle
What is input in open system?
Resources such as staff, patient equipment and supplies
The nurses knowledge
What is the throughput in an open system?
The work of the organization
What is the output in an open system?
The outcome of the work
What is an example of an open system?
A hospital
What is the difference between an open and a closed sub system?
Open subsystems have a permeable boundaries in her constant interaction with other sub systems in contrast, close sub systems. Do not interact with other sub systems.
What is the complexity theory?
Derived from the general systems theory
Suggest relationships are key to everything
What are attractors in a complexity theory
Points of attraction that describe behavior in a complex system, in which patterns of energy attract more energy
What is the hierarchical structure in a complexity theory?
Structure with a top-down management approaches

no longer effective in healthcare today
What must nurse leaders and managers do in a complexity theory?
Embrace the complexity of healthcare to promote a relationship oriented structure
Constantly monitor balance between stability and chaos
Focus on outcomes be able to act with speed and adaptability through chaos
What is the learning organizational theory?
People continuously, expand their capacity to create in result, continue to learn and improve process
What are the five disciplines of the learning organization theory
Systems thinking
Personal mastery
Mental models
Building shared vision
Team learning
What does systems thinking mean in the learning organization theory
Everything is connected and interdependent
What is personal mastery in the learning organization theory?
Developing high-level proficiency
What is the mental models in the learning organization theory?
Through reflection, one can achieve awareness of attitudes and perception to help avoid bias
What is building shared vision in the learning organization theory?
Establish mutual purpose that fosters genuine commitment to vision and organizational goals
What is team learning in the learning organizational theory?
Dismissal of assumptions, free-flowing exchange between workers focused towards common goal
What must the nurse leaders and managers do in the learning organization theory
Involve staff and problem-solving and decision making
Promote interprofessional and interrupt, professional, teamwork
Improve communication
What is the high reliability theory?
Principles of organizational design and leadership, that prevent patient harm and promote quality and safety
Leaders, assume risk, exist, and device strategies to cope with it
What is collective mindfulness in high reliability
A mental orientation that is continuously evaluating the environment
What is a high reliability organization?
An organization that operates in complex high risk domains and constantly delivers services without serious accidents or failures
What are the five key characteristics of a hi reliability organization
Sensitivity to operation
Reluctance to simplify
Preoccupation with failure
Deference to expertise
Resilience
What is the continuum of care?
Covers the delivery of healthcare over a period of time as expensive as from birth to end of life
Ensure safe and quality care
What is a for-profit organization?
Owned by stockholder, shareholders are corporate owners
Money brought in, must be reinvested into the organization
Funds may not always be readily available
What do you use money brought in for in a for-profit organization
Maintenance expansion purchasing of equipment and supplies