final exam leadership Flashcards
what is the first step of the crucial conversation model?
introduction:
-express your intention to have a productive conversation
-use a calm and friendly tone
-(ex): “I’d like to talk with you about something that has been bothering me. I hope we can have an open and constructive conversation to resolve this issue”
what is the second step of the crucial conversation model?
express your concern:
-state the problem: “the issue I would like to address is…”
-share your feelings: “when this happened, I felt…
-describe the impact: “this has impacted me…”
what is the third step of the crucial conversation model?
seek understanding:
-ask for their perspective: “I’d like to understand your perspective better. Can you tell me how you see this situation?”
-listen actively : “I hear you, and I appreciate your viewpoint”
-ask clarifying questions: “could you elaborate on…”
what is the fourth step of the crucial conversation model?
finding common ground:
-identify shared goals: “it seems like we both want…”
-brainstorm solutions: “what do you think we could do to address this problem together?”
-evaluate solutions: “let’s consider the advantages and disadvantages of each option”
WHAT IS THE FIFTH STEP IN THE CRUCIAL CONVERSATION MODEL
agree on next steps:
-propose a resolution: “I propose that we…”
-seek agreement: “do you agree with this plan, or is there something else you’d like to suggest?”
-set a follow up: “let’s check in [specify when] to see how things are going and make any necessary adjustments”
what is laissez-faire leadership?
-takes a hands-off approach
-permissive with little or no control
-provides little direction
-does not criticize
what is situational/contingency leadership?
-suggests that no one leadership style is ideal for every situation; leader assesses the situation and group members, and selects the style or blending of styles best for the situation
-interrelationships between the group’s leader and its members are influenced by the manager’s ability to be a good leader
-determinants of leadership style include nature of the situation, skills of the manager, and abilities of the group members
-power associated with leadership and the task to be accomplished also influences it
what is servant leadership?
-puts serving others (including employees, customers, and the community) as the number one priority
-focuses on increased service to others rather than to oneself and the betterment of subordinates
what is authentic leadership?
-suggests that to lead, leaders must be true to themselves and their values and act accordingly
-people come to have faith and trust in these leaders
what is transactional leadership?
-clarifies roles and responsibilities
-uses rewards and punishments to achieve goals
-results orientated
what is transformational leadership?
-focuses on vision and empowering individuals to do and be the best they can be
-known to be caretakers and have long term vision
what is the difference between a manager and a leader?
-manager: the person who brings things about; the one who accomplishes, has the responsibility, and conducts
-leader: the person who influences and guides direction, opinion, and course of action; leadership is more dynamic than management
what is followership?
-the process whereby an individual accepts the influence of others to accomplish a common goal; a choice, not a must
-the capacity and willingness to follow a leader
-important skills include motivation, courage, service, dedication, work ethic, good judgement, and honesty
what are the types of hospital budgets?
-personnel budget
-operating budget
-capital budget
personnel budget
-developed for the number of people needed to produce the product, any costs of training them, their pay and benefits, and other factors involved
-largest of the budget expenditures in most hospitals; healthcare is labor intensive
operating budget
-budget for day-to-day expenses: reflects expenses that flex up or down in a predetermined manner to reflect variation in volume of service provided
-examples: rent or property purchase costs, advertising and marketing fees, licensing fees, utility costs, vehicle maintenance, direct materials (supply) cost
capital budget
-aid in decisions related to the purchase of long-term (> 5 years) assets that usually involve high-dollar expenditures (buildings, major equipment)
-equipment that is not used daily, more expensive than operating supplies
what is revenue?
source of income or the reward for providing a service to the patient
what are sources of revenue for hospitals?
-operating revenue = the money earned directly by providing health care services to patients; largest and most important source of hospital revenue
-grants, donations, sale of assets
define the following terms:
-deductible
-copay
-coinsurance
-out-of-pocket maximum
-deductible: the amount you pay out-of-pocket before your insurance kicks in
-copay: a set fee you pay upfront before a covered medical service or procedure
-coinsurance: the percentage you pay for a service or procedure once you’ve met the deductible (ex: once you reach your $2000 deductible, you pay 20% for services and insurance pays 80%).
-out-of-pocket maximum: the most you will pay for covered services in a rolling year; once met, your insurance company will pay 100% of covered expenses for the rest of the year
who is covered under medicare?
-most adults age 65 and older
-some people with disabilities younger than age 65
-people who have end stage renal disease
what are the different parts of medicare and what is covered under each?
-part A: hospital insurance; inpatient hospital, inpatient skilled nursing facility, hospice, and some home health services
-part B: medical insurance; physician services, outpatient care, durable Medical Equipment (DME), lab and X-ray services, home health services, and many preventive services
-part C: medicare advantage; medicare-approved private insurance companies who provide all Part A and Part B services and may provide prescription drug coverage and other supplemental benefits (dental, vision, hearing)
-part D: prescription drug benefit: medicare-approved private insurance companies provide outpatient prescription drug coverage
who is covered under medicaid?
-people with disabilities
-low income adults
-elderly people
-children
-pregnant women
-eligibility, scope of services, and payment set by each state
what is managed care? what is the most common type?
-variety of healthcare plans designed to contain the cost of health care services delivered to members while maintaining the quality of care
-managed care = price for specific procedure or service
-HMO = one of most common types; network of providers
who have agreed to accept payment at a certain level for any services they provide; keeps monthly premiums, coinsurance, and coinsurance more affordable, but does not cover out-of-network care
what are the 5 rights of delegation?
- right task (can the task be delegated?)
- right person
- right circumstances (appropriate patient setting, available resources, consider relevant factors)
- right directions/communication (clear/concise description)
- right evaluation/supervision (appropriate monitoring, evaluation, intervention, and feedback)
what does SBAR stand for and what information should be included in each area?
-begins with the exact reason you are calling; usually for a change in patient status
S: situation (situation you want to discuss, what is happening right now, introduce self)
B: background (admitting diagnosis, list of current meds/allergies, most recent vitals, labs, synopsis of tx to date, code status)
A: assessment (any changes from prior assessments, patient condition unstable or worsening)
R: recommendation/request (specific treatments, tests needed, patient needs to be seen now)
what is the CURE method for clinical decision making?
-critical: patient situations that need immediate attention
-urgent: patient situations that must be addressed within a couple of hours
-routine: basic cares and tasks that must be performed on patients but only need to be completed by the end of the shift
-extra: extra cares or tasks that would be nice to do for the patient or family but are not necessary
-what is critical to do first? what is urgent for you to do next? what is basic or routine for you to do? what are some extra things about your unit or population that you should do?
how and when do nurses delegate?
-RN scope of practice & delegation guidelines determined by nurse practice act
-RN must determine the needs of the patient and whether those needs are matched by the knowledge, skills and abilities of the delegatee & can be performed safely; RN cannot delegate any activity that requires clinical reasoning, nursing judgment or critical decision making.
-RN must ultimately make the final decision whether an activity is appropriate to delegate to the delegatee based on the 5 rights
-RN is giving the responsibility, but maintains accountability
what tasks may the RN delegate to a UAP (CNA, HHA, client care technician, surgical tech)?
tasks that are considered routine, that do not require substantial scientific knowledge/technical skill, that are considered safe for the client, and that have a predictable outcome
-taking vital signs
-measuring I & O
-client transfers
-ambulation
-postmortem care
-bathing, feeding, gastrostomy feedings
-attending to safety
-weighing
-simple dressing changes
-suctioning of chronic tracheostomies
-basic life support (CPR)
what cannot be delegated to UAPs?
-assessment
-interpreting data
-making a nursing diagnosis
-creating a nursing care plan
-evaluating care effectiveness
-care of invasive lines
-administering parenteral medications
-inserting NG tubes
-client education
-performing triage
-giving telephone advice
what tasks may the RN delegate to an LPN?
-administering PO medications
-inserting a urinary catheter
-administering enteral tube feedings
-dressing changes, trach care, suctioning
-reinforcing RN’s teaching
what tasks cannot be delegated to an LPN?
-independent assessment or client education
-administering high-risk medications
-administering IV push medications, titrating medications
-client admission or discharge
what is a nursing care delivery model?
-the method used to provide care to patients
-determines who does what, who knows what, who has the authority to make decisions (like delegation), who is the team leader
what are the 4 main types of nursing care delivery models?
-total patient care
-functional nursing
-team nursing
-primary nursing
what is total patient care nursing? (what are the pros/cons, where is this model commonly seen?)
-oldest method of nursing; model in which the nurse plans, organizes and performs all care
-common areas = ICU, PACU
-provides highest degree of autonomy for nurses, but is arguably not cost effective