LEADERSHIP NURSING MANAGEMENT EXAM i Flashcards
Centralized and Decentralized decision-making
CENTRALIZED DECISION-MAKING:
DECENTRALIZED DECISION-MAKING:
Strategic planning
-examining the purpose, mission, philosophy, and goals as they relate to the external environment. Effective tools include SWOT analysis and balanced scorecard.
-Planning has many dimensions, including timespan and complexity or comprehensiveness.
-complex plans are long-range or strategic plans.
-STRATEGIC PLANNING TYPICALLY EXAMINES AN ORGANIZATION’S PURPOSE, MISSION, PPHILOSOPHY, AND GOALS IN THE CONTEXT OF ITS EXTERNAL ENVIRONMENT.
Cycle: formulate strategy > propose mission > propose goals > examine internal issues > examine external issues > summarize findings in a SWOT analysis > formulate strategy.
Primary care nursing
Primary nursing is also called “Relationship-Based Nursing.”
-it uses some of the concepts of total patient care.
-it brings the nurse back to the bedside to provide clinical care.
-job satisfaction is high.
-there is a high degree of responsibility and autonomy required of the nurse.
-an example = home health, clinic nursing, bedside nursing, perioperative nursing, and community health.
Some extra components include: communication, accountability, patient-centered advocacy, individualized care, autonomy, commitment, continuity, responsibility, coordinates and collaborates, decentralized, authority, and assertiveness.
Budgeting ——
-capital
-personnel
-operating
CAPITOL:
-responsibilities include planning for the purchase of buildings or major equipment which has a long life of >5-7 years, is not used in daily operations, and is more expensive than operating supplies.
The value of the equipment exceeds a certain dollar amount. $1,000-$5,000 is common.
Managers are generally required to complete specific capital equipment requests annually or semiannually and to have the data to justify their requests.
PERSONNEL
OPERATING
Hospital value-based purchasing
Forecasting
Root cause analysis
Nursing unions ——-
-why nurses join
-influential roles
-logistics in bringing in a union
-management vs leadership
-agency shop (open shop)
-collective bargaining
Organizational structures
FORMAL
-(authority) the emphasis is on organizational positions and formal power.
INFORMAL
-(social) the focus is on the employees, their relationships, and the informal power that is inherent within those relationships (Facebook, text messages, breakroom chat).
Organizational committee
Components of an organizational chart
Nursing leadership roles
-charge nurse
-nursing supervisor
-director
-case manager
CHARGE NURSE
DIRECTOR
NURSING SUPERVISOR
CASE MANAGER:
-Case managers facilitate patient care by assessing individual patient needs, evaluating treatment options, creating treatment plans, coordinating care, and gauging progress. They address the length of stay and profit margins.
-They collaborate with physicians, social workers, families, and other providers.
-The overall goal for case managers is to improve clinical outcomes, increase patient satisfaction, and promote cost-effectiveness.
-The key difference between case management and disease management is that the primary goal of disease management is to target high-cost disease populations. Case management referrals originate from inpatient settings, whereas disease management originates from outpatient/community settings.
Inter-professional collaboration
Decentralized and centralized staffing
DECENTRALIZED STAFFING
CENTRALIZED STAFFING
Organizing patient care
-organization and attitudes influence the patient care delivery system
-all members have a role.
-team effort increases productivity and work activity.
-leadership and management ensure quality care and staff satisfaction.
-leadership’s focus is for patient care delivery to promote professional models of practice, reduce cost, improve outcomes.
PATIENT AND FAMILY-CENTERED CARE:
-organized around the needs of patients.
-patient and family perspectives are sought out and choices are honored.
-open and honest communication that empowers patients and families.
-patients, families, and health-care providers collaborate regarding facility design and the implementation of care.
-the voice of the family and patient are represented at both the organizational and policy levels as well as in the health system’s strategic planning.
-Examples: outpatient rehab., medical labs, hospitals, elder services, skilled nursing facilities, home care, pharmacies, and behavioral health centers.
Patient classification systems
-Patient’s are classified using a patient classification system (PCS) to keep nurses from having all high-acuity patients to one nurse. This allows for a more balanced work environment clinically.
Nursing care hours
-typically 10-12 hour shifts
Planned change - lewins change theory
Kurt Lewin’s Change Theory involves 3 main phases:
- Unfreeze=create right environment.
-gather data.
-accurately diagnose the problem.
-decide if change is needed.
-make others aware of change-often involves deliberate tactics. Change must be perceived prior to change. - Change=support change to desired state.
-develop a plan.
-set goals and objectives.
-identify areas of support and resistance.
-include everyone who will be affected.
-set target dates.
-develop appropriate strategies.
-implement the change. - Refreeze=reinforce to another change.
-support others so that the change continues.
Nurse delegation to CNA
-measure input & output
-may help a patient with ADL’s, including feeding, up with assist to restroom or bedside commode, changing, clothing, ambulating.
Nurse delegation to the LPN
-CAN’T LET LPN GIVE IV MEDS.
-LPN can give oral medications.
-establish IV access and install a catheter.
Clinical practice guidelines
Patient satisfaction
Magnet status
Benefit of team effort..
increases productivity and work activity
SWOT Analysis
Focuses on
STRENGTHS
WEAKNESSES
OPPORTUNITIES
THREATS
