Leadership Exam 2 Flashcards
What stage of team formation involves the members getting to know each other and the leader defining tasks/offering direction?
forming
At what stage of team formation does conflict arise?
storming
At what stage of team formation are rules established and roles are taken on?
storming
What happens in the norming stage of team formation?
- rule establishment
- members show respect for one another
- tasks begin to be accomplished
What is the focus during the performing stage of team formation?
the accomplishment of tasks
What is used to support change with the rational-empirical change strategy?
factual information
When is the rational-empirical change strategy used?
when resistance to change is minimal
What is used to support change with the normative-reduction change strategy?
interprofessional relationships
What is used to support change with the power-coercive change strategy?
rewards
When is the power-coercive change strategy used?
when individuals are highly resistant to change
How long is case management used for?
from the time the client starts receiving care until they no longer receive services
What is the goal of case management?
to avoid fragmentation of care and control cost
What is the nurse’s roles (6) om case management?
- coordinating care
- facilitating continuity of care
- improving the efficiency of care and utilization of resources
- enhancing quality of care
- limiting unnecessary costs and lengthy stays
- advocating
What are critical pathways used for?
to support the implementation of clinical guidelines and protocols
What are critical pathways usually based on?
cost and length of stay parameters
When is a variance documented?
when a client requires treatment other than what is typical or requires a longer length of stay
Who is a professional who provides expert advice in a particular area?
a consultant
What is a referral?
a formal request for service by another care provider
What are examples (6) of why a discharge referral can be made?
- canes
- walkers
- wheelchairs
- home health nurses
- hospice nurses
- home health aide
When should discharge planning start?
upon admission
When is it the nurse’s role to provide written and verbal reports of the client’s status and care needs?
transfers
What information is pertinent for a nurse to give during transfer?
- diagnosis and providers
- demographic information
- health status, plan of care, recent progress
- alterations that can precipitate immediate concern
- most recent vitals and meds
- assessment or care needed within the next few hours
- diet and activity prescriptions
- presence/need for specific equipment or adaptive devices
- family involvement and health care proxy
What does a discharge plan include a review of?
- the need for additional service
- current health and prognosis
- religious beliefs
- ability to perform ADL’s
- mobility status and goals
- sensory, motor, physical, or cognitive impairments
- support systems
What instructions should be given at discharge?
- home procedure step-by-step instructions
- medication regimen
- medication adverse effects
- names/numbers of provider and community resources
- plans for follow-up care and therapies
What does a written summary include prior to discharge?
- type
- date and time
- who accompanied a client
- how the client was transported
- condition
- destination
- disposition of valuables, meds brought from home, and prescriptions
- copy of discharge instructions
What does the PSDA say the client must be informed of upon admission?
their right to accept and refuse care
What identifies clients’ rights in the health care settings in the Patient Care Partnership?
the AHA
What should be done if the patient refuses treatment or wants to leave the hospital without approval from the provider?
- notify the provider
- discussion of potential risks/complications
- documentation
- sign an AMA form
What are some situations where advocacy would be necessary?
- end-of-life decisions
- access to healthcare
- protection of client privacy
- informed consent
- substandard practice
What skills are important for advocacy?
- risk-taking
- vision
- self-confidence
- articulate communication
- assertiveness
What values are important for advocacy?
- caring
- autonomy
- respect
- empowerment
When is written consent required?
invasive procedures or surgeries
Who can grant consent for another person?
- parent of a minor
- legal guardian
- court-specified representative
- health care surrogate
- spouse or closest to kin
What does the provider do for informed consent?
- explain procedure
- who will be performing the procedure
- possible harm, pain, or discomfort
- other treatments and possible consequences
- right to refuse
- risk of no treatment
What does the nurse do for informed consent?
- witness signature
- ensure the provider gave adequate info and the client understood it
- ensure client competency
- notify the provider if pt has more thoughts/questions/concerns
What does the nurse document for informed consent?
- reinforcement of information
- forward client questions to the provider
- use of interpreter
What is a legal document that expresses the client’s wishes regarding medical treatment if the client cannot express it themselves?
a living will
What is a legal document that designates a healthcare surrogate to make healthcare decisions for a client who is unable?
a durable power of attorney
What is the nurse’s role with advanced directives?
- provide written info
- document AD status
- ensure the AD is current
- recognize that the client’s choice takes priority over the family or provider
- inform members of the healthcare team of the client’s AD
Who can access a client’s healthcare records?
only healthcare team members that are directly responsible for the client’s care
When can part of the client record be copied?
ONLY for authorized exchange of documents between healthcare institutions
What can a nurse use an electronic format for?
- laptop: documentation
- medication dispensing system: dispense meds
What can a nurse use databases for?
review meds, diseases, procedures, treatments
When are computers beneficial for clients?
- visual impairments
- access EHR online
What type of law relates to an individual’s relationship with the government?
criminal law
Is a misdemeanor or felony more serious?
felony
What does civil law protect?
the individual rights of people (torts)
What are unintentional torts?
negligence and malpractice
What is practice or misconduct that does not meet expected standards of care and places the client at risk for injury?
negligene
What is practice or misconduct that does not meet expected standards of care and places the client at risk for injury?
negligence
What is defamation?
- false communication
- communication with careless disregard for the truth
- intent to injure an individual’s reputation
What type of defamation is through written word or photographs?
libel
What type of defamation is through spoken word?
slander
What makes another person fearful and apprehensive (threat)?
assault
What is intentional or wrongful contact that involves injury or offensive contact?
battery
What is false imprisonment?
a competent person not at risk for injury to self or others is confined or restrained against their will
What are examples of federal regulations (7)?
- HIPAA
- ADA
- Mental Health Parity Act
- Patient Self-Determination
- Uniform Anatomical Gift Act
- National Organ Transplant Act
- Emergency Medical Treatment and Active Labor Act
What do Boards of Nursing do (4)?
- adopt rules/regulations
- issue/revoke a nursing license
- set standards for nursing programs
- tell the scope of practice
What laws protect nurses who provide emergency assistance outside of the employment location?
good samaritan laws
What elements are necessary to prove malpractice (5)?
- duty to provide care as defined by a standard
- breach of duty by failure to meet standard
- foreseeability of harm
- breach of duty has potential to cause harm
- harm occurs
Where are standards of care found?
the nurse practice act of each state
Who develops published standards of nursing practice?
professional organizations
- ANA
and specialty organizations
What is an example of an accrediting body?
the joint commission
What does failure mode and effects analysis examine?
potential failures in designs, including event sequencing risks, vulnerabilities, and improvement areas
What are national patient safety goals used for?
augmenting core measures and promoting client safety
How is client safety promoted (6)?
- client identification
- effective staff communication
- safe medication use
- infection prevention
- safety risk identification
- preventing wrong-site surgery
Where are healthcare policies and procedures maintained?
in the facility’s policy and procedure manual
What happens if a nurse practices according to institutional policy and the care still results in injury?
the nurse is legally protected
What is mandatory to report (3)?
- suspected child abuse
- suspected violence or neglect against vulnerable persons (older/dependent adults)
- communicable disease
What can reporting communicable diseases help with (6)?
- ensure proper medical tx
- monitor for common-source outbreaks
- plan and evaluate control/prevention plans
- identify outbreaks/epidemics
- determine public health priorities based on trends
- educate the community on prevention and tx
What regulates organ and tissue donation?
federal and state laws
How can you tell if someone wants to donate their organs?
- stipulated in a will
- designated on an official card
What are nurses responsible for regarding organ donation?
Answering questions and providing emotional support
