Management of Care Flashcards
As a new nurse, if you don’t know how to manage, assign, supervise, and prioritize care, you cannot provide ____ ____ your clients.
SAFE CARE
General Info
• Judgements in management situations are based on ____ knowledge
- If you don’t understand disease processes, you cannot set ____ of care or determine which staff member would be best to take of the client
- you MUST know your ____ CONTENT, and then you can move on to management decisions
- med-surg knowledge
- priorities
- CORE CONTENT
Assignment
• sharing of what?
• assigned tasks are part of?
- The sharing of ROUTINE care, activities, procedures that each staff member (RN, LPN/LVN, UAP) is responsible for during a given shift or work period
- Assigned tasks are part of course work taught in the basic educational program of staff member
Delegation
• allowing a specific task to be performed that is not ____?
• to do this, the staff member who is delegated a task should have received what?
- not routinely performed and is beyond the traditional role of staff member
- received ADDITIONAL TRAINING/EDUCATION
As an RN:
You can delegate _____ of task, but not the ultimate ____
- Can delegate RESPONSIBILITY
- CANNOT delegate ACCOUNTABILITY – RN is accountable for all aspects of nursing care provided including choices made about who is competent to perform each task
5 Rights of Delegation
- Right task
- Right circumstances
- Right person
- Right direction or communication
- Right supervision and evaluation or feedback
Right task
• role of UAP? type of clients can they provide care for? what tasks can they perform?
UAP
• supportive nursing role;
• stable clients in uncomplicated situations
• routine, simple, repetitive, common activities (hygiene, feeding, I&O, routine VS, ambulation–EVERYDAY THINGS!
Examples of tasks:
- total bed bath and dress the client
- serve meals, assist w/ eating
- turn client q2h, provide skin care
- assist to the bathroom w/ walker
- answer client’s call light
- clean and sanitize the client room
- change linen on a totally bedridden client
- provide mouth care and denture cleansing
Can a UAP take VS on a client receiving IV Dopamine?
no
Right task
• role of LPN/LVN? type of clients can they provide care for? what tasks can they perform?
LPN/LVN
• assist RN with data collect/monitor/observe
• STABLE clients; stable and complex at the same time
• Update client data and Do basic standardized teaching or reinforce teaching from RN’s care plan; Treatment; Med Administration
Examples of tasks:
- Finger sticks (bg monitor)
- Administer IVPB meds
- Monitor transfusion of blood products
- Administer meds and nutrition via NG tube, G-tube or button, J-tube
- Insert, maintain and remove urinary catheters
- Maintain and remove peripheral IV catheters
- Calculate and monitor IV flow rate
What tasks are not within scope of practice of UAP?
- Cannot perform sterile/invasive procedures (ex: obtain a urine specimen from a catheter)
- Cannot do medicated enemas (ex: perform a fleet enema)
What tasks are not within scope of practice of LPN/LVN?
- CANNOT ASSESS, EVALUATION, TEACHING
- Cannot evaluate the client to determine if a goal has been met
- Cannot devise a teaching plan for a NEWLY diagnosed diabetic
- Cannot Administer IVP pain meds, Cannot initiate transfusion of blood products
If an LPN collects the admission data for you, NEVER sign off on the form until you have ____ the data
VALIDATED
Always consider a new admit ____
UNSTABLE
The RN should assess the newly admitted client first. The new admission is your responsibility or ____
PRIORITY
Stable/Unstable
- Diabetic w/ low blood sugar
- Client returning from an invasive procedure
- Client w/ neurological problems, stable VS, no change in LOC/neuro checks
- Client w/ Acid-Base imbalance and respiratory distress w/ unstable VS
- Client w/ chronic HTN, hx of angina controlled w/ meds and lives alone
- Clients w/ HIV+, med compliance and works full time
STABLE
3, 5, 6
UNSTABLE
1, 2, 4
Right Circumstance
could be influenced by what factors?
work setting and change in clients status (stable to unstable)
If there’s changes in the client status (stable to unstable), LPN or UAP must what?
report this to RN
If you’re unsure the UAP can perform a procedure–what to do?
go w/ them yourself, make sure no harm is done
When staff members are pulled to a new floor, you should pretend they are what?
a brand new nurse all over again–do not give clients requiring any specialized care
Routine task assignments of LPN or UAP can change based on the circumstance–so if there’s ever a degree of potential HARM, what to do?
the RN must retain the task no matter how routine it is
Right Person
• know ____ and _____ of staff that work w/ you
• Don’t assume someone is ____ just because of their job description
• RN’s responsibility to figure out the staff’s what?
• hospice or grieving client–send what kind of nurse?
• child who needs an IV started?–send who?
- scope of practice and job descriptions
- competent to do something
- strength and weaknesses, knowledge level and skills
- most compassionate nurse
- most experienced IV nurse along w/ new RN to be mentored
Right Direction and Communication
• The RN is responsible for providing what kind of communication to nursing staff? (4 Cs)
• Must communicate ____ and ____ of the task
• Provide ____ directions and expectations
- Clear, Concise, Correct, Complete COMMUNICATION
- time frame and priority –tell what you want done first
- SPECIFIC
Right Supervision and Evaluation or Feedback
• You must ____, ____, ____ the carrying out of any delegated task
• You must ____ to see that the nursing tasks that you delegated are done properly
• What 3 questions after a delegated task is completed?
• when a task is performed and you identify a weakness, you supposed to what?
- guide, supervise, evaluate
- follow up
- 1) was the task done properly and in a safe manner? 2) was the task done in the proper time frame? 3) were the client’s needs met?
- TEACH!!!!
Transferring Care between RNs
• Called what?
• it transfers what?
- Called a “handoff”
* transfers both RESPONSIBILITY and ACCOUNTABILITY
Priorities of Care
• You will go see all of the clients, but you have to set ____ and go see client who has the _____ first?
• priorities; most life-threatening condition
Are you responsible for keep all client information confidential
yes
Can you post pictures of your clients on social media sites
no
Social media posts violate clients’ right to ____
privacy
Violations infringe on federal privacy laws and could lead to what?
job loss, action by board of nursing, loss of license
You are the client ____. You are responsible for making sure that client _____ and ____ are maintained
advocate, privacy and confidentiality
Confidentiality and privacy should be maintained with what?
conversations, electronic records, or any sources of client information
Can you access a client’s record that you are not responsible for providing care to?
no
Organ donation decision made by a ____ can be refused by a family even if there’s a document of organ donation wishes of client
minor
Living will
client’s desire regarding their medical treatment
Health care proxies
having someone to make health care decisions for the client
Do Advanced Directives guide care when the client is still competent?
no
If client is still competent, who has the authority to make healthcare decisions–client or family?
Competent client holds the authority to make healthcare decisions and is the final word–not family
If competency is in debate whether a client can make healthcare decisions, what happens next?
report differences of opinion to supervisor → consult legal system
