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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
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
Total pt care or case model | ICU, PACU, CCU
25
what are the advantages of the Total pt care or case model
autonomy & responsibility holistic and unfragmented care requires skilled nursing close relationship between RN & pt
26
disadvantages of total pt care or case model
inexperienced RN, cost (RNs are expensive)
27
nurses are assigned to TASKS not to pts
functional model or task nursing
28
characteristics of functional model or task nursing
ancillary staff were needed, bridge gap of nurses, Rn became manager of care rather than direct provider evolved during Depression
29
advantages of functional model or task nursing
very efficient, accomplish a lot in small amt of time, care was provided by minimal # of RN, staff only did what capable to do
30
disadvantages of functional model or task nursing
RN time to supervise UAP care of PT became fragemented narrow scope of practice for RN focus was on task not overall result
31
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
Team model
32
advantages of team model
each members capabilities are maximized so satisfaction should be high, requires excellent communication, pts have one nurse (team leader), and access to other providers
33
disadvantages of team model
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
care gien according to geographic area, modification of team nursing, pt unit is divided into modules, concept evolved to increases RN involvement in care
modular model
35
advantages to modular model
continuity of care, allows RN more time for planning and coordinating care, geographic closeness & efficient communicatoin
36
disadvantages of modular model
increase cost, long corridors not conducive to modular nursing
37
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
primary model
38
advantages of primary model
high quiality, holistic care, est. rapport with pt, increase job satisfaction, decentralized of nursing care decisions, authority, and responsibility to the staff nurse
39
disadvantages of primary model
not cost effective, primary RN must be available. high degree of responsibility and accountability
40
traditional models of care
``` total pt care or case model functional model or task nursing team model modular model primary model ```
41
integrated models of care
case mangagement practice partnership model (co-primary) critical pathways
42
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
case mangagement
43
RN is partnered with an LPN or CNA, work together with the same schedule and same group of pts, modification of primary nursing
practice partnership model
44
advantages of practice partnership model
more cost effective, RN can enourage training & growth in partner
45
disadvantages of practive partnership model
Rn may have difficulty delegating to parter, consistent partnership difficult to maintain due to varied schedule
46
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
critical pathways
47
barriers to female communication skills
more passive, intuitive, emotional and expected to follow orders
48
barriers to male communication skills
confident, independent, emotionally controlled
49
female to female relationship problems
more competitive with other women, gossip about others
50
identifies with male colleagues instead of women, feels superior to other women, can develop an attitude of its my way or else
queen bee syndrome
51
divides women against each other, verbal attack toward another in an attempt to destroy
trashing syndrome
52
personality consists of 3 ego states, each state has its though system, feelings, and behaviors
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
a health individual maintains what with all three ego states
a balance
54
may not participate in problem solving bc they think they already have the answer and know what is right and wrong
parent dominated ego state
55
may e borning bc they work really hard and have little time for fun
adult dominated ego state
56
doesnt engage in rational problem solving, screaming and being emotional has helped them get what they want
child dominated ego state
57
transactions are when people share opinons with each other
parent to parent
58
transitions are usually business like or when reasoning together
adult to adult
59
transactions involves an emotional exchange
child to child
60
one person takes a psychologically superior position over the other
parent to child
61
the response to the stimulus is predictable and expected, communication will continue if the transactions are complementary
complementary transactions
62
results in closing communications, the response may be inappropriate or unexpected, may confuse or threaten the sender
crossed transactions
63
assigning the blame/instilling guilt, avoids responsibiltiy by being vindictive
see what you made me do | denile of responsibility
64
to keep everyone looking in the other direction, constantly pointing the finger at the short comings, real or imagined of others
the blemish, fault finding | *kevin
65
getting away with irresponsibility, uses a handicap real or imagined, to avoid responsibility
wooden leg, Andy
66
a blaming game, people who feel inadequate will blame others for their inability to achieve
if it werent for you, Amber
67
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
passive style | poor eye contact, have strained relationships, avoid making a stand or a decision, over apologize
68
violates rights of others, loud, makes accusations, blames others, rude, acts superior, uses people, manipulative
aggresive style | stare or glare, hit people or things, slames doors, "dirty look"
69
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)
passive aggressive style | stare or roll eyes but deny anything is wrong, verbals and non verbals dont match
70
communication style that confirms your right to be heard, but in a caring and respectful manner towards others,
assertiveness style | honest expression, try to resolve an issue without conflict, verbals and non verbals match
71
what is the most important word in beding assertive
"I"
72
key points of being an assertive leader
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
a # of indivduals assembled together or haing some unifying relationship
group
74
is a # of people who work cooperativley with each other to achieve same goal
team
75
what are the 4 things a team needs
defined objectives ongoing post. relationships supportive enviornment focus to accomplish a specific task
76
teams are essential in providing
cost effective high quality healthcare
77
stages of development
``` forming stage storming stage norming stage performing stage adjourning stage ```
78
interpersonal relationships are being formed, anxiousness, leader gives clear directions, try to put ppl at ease
forming stage
79
arguments can occur, conflict is evident, power struggles, if properly managed, ppl learn to be more trustful of each other
storming stage
80
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
norming stage
81
longes stage, when work is getting done, each person is getting individual tasks done, leader becomes facilitator or resource of groups
performing stage
82
group comes to an end, has accomplished a goal, celebration at the end, leader gives apprechiation to group
adjourning stage

N202 (8 decks)

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