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N202 > Exam 8 > Flashcards

Exam 8 Flashcards

0
Q

Formula for nursing care hours per pt-day

NCH/PPD

A

Patient census (#of pts)

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1
Q

Nursing care hours per pt day

A

Acuity of pt doesn’t matter
Nursing & ancillary staff
Staffing can be incomplete
Doesn’t present reality of what’s occurring on a nursing unit

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2
Q

Pt classification systems (PCS)

A 
Result of inadequate NCH/PPD
AKA workload management 
Or pt acuity tool
Group pts due to acuity
Pts are classified once /day
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3
Q

As a pt becomes sicker the acuity level?

A

Rises

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4
Q

acuity level 1

A

2.2 hours of care

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5
Q

acuity level 2

A

2.6 hours of care

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6
Q

acuity level 3

A

3.2 hours of care

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7
Q

acuity level 4

A

3.6 hours of care

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8
Q

one FTE (full time equivalent)

A

40 hours a week for 52 weeks,

one FTE can be filled by one person or a combination of staff

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9
Q

FTE productive hours

A

hours worked and available for pt care, most orginazations allow 2-15 min breaks which are considered time worked

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10
Q

FTE non productive hours

A

benefits, orientation, sick & holiday, education time, meal breaks

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11
Q

direct care vs indirect care

A

direct care is actual hours spent provided hands on care to pt
indirect is spent on activities that are r/t the pt, such as documentation, follow up, consulting with other health care providers

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12
Q

FTE formula

A

avg. nursing care hours x days in staffing period x pt census
_________________________________
80 (hours worked per FTE)

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13
Q

the process of making the personnel work assignment for a specific period of time

A

scheduling

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14
Q

centralized scheduling

A

work days and time off are repeated in regular cycles, such as Q 4 weeks
scheduling made by staffing office

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15
Q

decentralized scheduling

A

the unit managers are given the authority & assumes responsibility of staffing their own unit, staff feels more in control

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16
Q

self scheduling

A

coordinated by staff nurse, policies and rules, 4 week process, staff negotiate before and after work, unit manager reviews to make sure of coverage & refinements are met

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17
Q

alternating of rotating shifts

A

alt. between days and nights, rotating through all shifts, creates stress (sleep wake cycle)

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18
Q

traditional 8 hour shift

A

work 5 days, 40 hour week

done to decrese risk of errors

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19
Q

10 hour 4 day workweek

A

14 hours off between shifts, 4 day weekend Q 6 weeks

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20
Q

12 hour shift

A

3 days on 4 days off

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21
Q

goal of staffing and scheduling

A

to provide an adequate mix of nursing staff to match care needs

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22
Q

what does joint commision require that organizations determine criteria for what

A

Rn staffing and provide adequate # of competent staff to meet that criteria

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23
Q

pt classification systems use what

A

pt needs to determine workload requirements and staffing needs

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24
Q

oldest method of organizing care, take care of one patient and all of their needs “private duty” nursing, nurse is responsible for planning, organizging, and performing ALL care of a pt or group of pts, care provided in home

A

Total pt care or case model

ICU, PACU, CCU

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25
Q

what are the advantages of the Total pt care or case model

A

autonomy & responsibility
holistic and unfragmented care
requires skilled nursing
close relationship between RN & pt

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26
Q

disadvantages of total pt care or case model

A

inexperienced RN, cost (RNs are expensive)

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27
Q

nurses are assigned to TASKS not to pts

A

functional model or task nursing

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28
Q

characteristics of functional model or task nursing

A

ancillary staff were needed, bridge gap of nurses, Rn became manager of care rather than direct provider evolved during Depression

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29
Q

advantages of functional model or task nursing

A

very efficient, accomplish a lot in small amt of time, care was provided by minimal # of RN, staff only did what capable to do

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30
Q

disadvantages of functional model or task nursing

A

RN time to supervise UAP
care of PT became fragemented
narrow scope of practice for RN
focus was on task not overall result

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31
Q

most common model used, evolved in 50’s, goal was to decrease fragmented care, ancillary personnel provided care under direction of an RN, RN is team leader, requires good communication and coordination

A

Team model

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32
Q

advantages of team model

A

each members capabilities are maximized so satisfaction should be high, requires excellent communication, pts have one nurse (team leader), and access to other providers

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33
Q

disadvantages of team model

A

inadequate time for team care planning and communication, requires team spirit, RN may be tam leader one day and then a team member the next, care is still fragmented, assignments may not be equal if based on acuity

34
Q

care gien according to geographic area, modification of team nursing, pt unit is divided into modules, concept evolved to increases RN involvement in care

A

modular model

35
Q

advantages to modular model

A

continuity of care, allows RN more time for planning and coordinating care, geographic closeness & efficient communicatoin

36
Q

disadvantages of modular model

A

increase cost, long corridors not conducive to modular nursing

37
Q

one nurse cares for a group of patients with 24 hour accountability, Rn is primary nurse, common in hospice, home health, long term, every expensive

A

primary model

38
Q

advantages of primary model

A

high quiality, holistic care, est. rapport with pt, increase job satisfaction, decentralized of nursing care decisions, authority, and responsibility to the staff nurse

39
Q

disadvantages of primary model

A

not cost effective, primary RN must be available. high degree of responsibility and accountability

40
Q

traditional models of care

A 
total pt care or case model
functional model or task nursing
team model
modular model
primary model
41
Q

integrated models of care

A

case mangagement
practice partnership model (co-primary)
critical pathways

42
Q

a stragegy to improve pt care and reduce hospital costs through coordination of care, organize pt care by DRG’s and focuses meeting outcomes with specific time frames, follow pt progress from admission to d/c, do not provide direct pt care, have 10-15 pts

A

case mangagement

43
Q

RN is partnered with an LPN or CNA, work together with the same schedule and same group of pts, modification of primary nursing

A

practice partnership model

44
Q

advantages of practice partnership model

A

more cost effective, RN can enourage training & growth in partner

45
Q

disadvantages of practive partnership model

A

Rn may have difficulty delegating to parter, consistent partnership difficult to maintain due to varied schedule

46
Q

outline a predetermined written plan of care for a particular health problem, address a common medical dx, specify desired outcomes and trasdiciplnary intervention, dictate & type & amt. of care given & thus have financial implications

A

critical pathways

47
Q

barriers to female communication skills

A

more passive, intuitive, emotional and expected to follow orders

48
Q

barriers to male communication skills

A

confident, independent, emotionally controlled

49
Q

female to female relationship problems

A

more competitive with other women, gossip about others

50
Q

identifies with male colleagues instead of women, feels superior to other women, can develop an attitude of its my way or else

A

queen bee syndrome

51
Q

divides women against each other, verbal attack toward another in an attempt to destroy

A

trashing syndrome

52
Q

personality consists of 3 ego states, each state has its though system, feelings, and behaviors

A

parent: controls and is source of values, opinions and rules (SUPER EGO)
adult: logical thinking, and rational, collects info, sets goals, makes decision, tests reality (EGO)
child: dominated by emotions and the feeling state (ID)

53
Q

a health individual maintains what with all three ego states

A

a balance

54
Q

may not participate in problem solving bc they think they already have the answer and know what is right and wrong

A

parent dominated ego state

55
Q

may e borning bc they work really hard and have little time for fun

A

adult dominated ego state

56
Q

doesnt engage in rational problem solving, screaming and being emotional has helped them get what they want

A

child dominated ego state

57
Q

transactions are when people share opinons with each other

A

parent to parent

58
Q

transitions are usually business like or when reasoning together

A

adult to adult

59
Q

transactions involves an emotional exchange

A

child to child

60
Q

one person takes a psychologically superior position over the other

A

parent to child

61
Q

the response to the stimulus is predictable and expected, communication will continue if the transactions are complementary

A

complementary transactions

62
Q

results in closing communications, the response may be inappropriate or unexpected, may confuse or threaten the sender

A

crossed transactions

63
Q

assigning the blame/instilling guilt, avoids responsibiltiy by being vindictive

A

see what you made me do

denile of responsibility

64
Q

to keep everyone looking in the other direction, constantly pointing the finger at the short comings, real or imagined of others

A

the blemish, fault finding

*kevin

65
Q

getting away with irresponsibility, uses a handicap real or imagined, to avoid responsibility

A

wooden leg, Andy

66
Q

a blaming game, people who feel inadequate will blame others for their inability to achieve

A

if it werent for you, Amber

67
Q

demonstrates a lack of respect for ones own needs, at a loss for words, often aplogiizes, feels others can guess their needs, goals are not achieved, want others to guess our needs

A

passive style

poor eye contact, have strained relationships, avoid making a stand or a decision, over apologize

68
Q

violates rights of others, loud, makes accusations, blames others, rude, acts superior, uses people, manipulative

A

aggresive style

stare or glare, hit people or things, slames doors, “dirty look”

69
Q

true feelings are shared through actions, not words, disconnect between what is said and done, violate rights of others (aggressive), while attempting to llok as though they were placing the rights of others first (passive)

A

passive aggressive style

stare or roll eyes but deny anything is wrong, verbals and non verbals dont match

70
Q

communication style that confirms your right to be heard, but in a caring and respectful manner towards others,

A

assertiveness style

honest expression, try to resolve an issue without conflict, verbals and non verbals match

71
Q

what is the most important word in beding assertive

A

“I”

72
Q

key points of being an assertive leader

A

speaks clearly and calmly, knows how to defend her actions without arguing, not afraid to say what you mean, peaks up but doesnt hurt others, speaks honestly

73
Q

a # of indivduals assembled together or haing some unifying relationship

A

group

74
Q

is a # of people who work cooperativley with each other to achieve same goal

A

team

75
Q

what are the 4 things a team needs

A

defined objectives
ongoing post. relationships
supportive enviornment
focus to accomplish a specific task

76
Q

teams are essential in providing

A

cost effective high quality healthcare

77
Q

stages of development

A 
forming stage
storming stage
norming stage
performing stage
adjourning stage
78
Q

interpersonal relationships are being formed, anxiousness, leader gives clear directions, try to put ppl at ease

A

forming stage

79
Q

arguments can occur, conflict is evident, power struggles, if properly managed, ppl learn to be more trustful of each other

A

storming stage

80
Q

group feels more relaxed with each other, est. of rules for group, actions are more productive, more relaxed, have feelings of belonging to a group

A

norming stage

81
Q

longes stage, when work is getting done, each person is getting individual tasks done, leader becomes facilitator or resource of groups

A

performing stage

82
Q

group comes to an end, has accomplished a goal, celebration at the end, leader gives apprechiation to group

A

adjourning stage

N202 (8 decks)

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