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leadership > midterm > Flashcards

midterm Flashcards

1
Q

what are the four element that determine the quality of health care and the nature of nursing

A

o Standards of education
o Quality of care provided
o Number of nurses available
o Milieu in which care is offered

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2
Q

Deductive thinking

A

the application of general rules and laws to a specific concrete situation in nursing practice

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3
Q

Inductive approach/thinking

A

when you take into consideration the particulars of the context from local to global and specific details of the situation

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4
Q

what are the 5 steps that you look at when you have a new issue

A

1) identify the issue
2) Articulate the issue
3) analyze the issue using a framework
4) identify barriers to resolution
5) explore strategies for resolution

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5
Q

complexity theory

A

a theorectical perspective
o Reality is complex and is full of paradoxes, pressures, opportunities, obsticals ect. Aka the complexities of life, which make you have to think and organize all of it. BOTTOM LINE: there are never any simple answers

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6
Q

Policy

A

a statement of direction resulting from a decision-making process that applies reason, evidence and values in public or private settings (CNA’s definition)

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7
Q

Public policy

A

the principles in which social laws are built

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8
Q

Health policy

A

is an aspect of public policy. The principles, plans, and strategies for action guiding the behaviours of organizations and people involved in the health care industry

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9
Q

Politics vs. policy

A

o Politics= deals with conditions and

o Policy= deals with should and oughts

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10
Q

what are the steps in policy making

A

1) determine values and cultural beliefs
2) identify problem or issue
3) knowledge development and research
4) obtaining public awareness
5) political engagement
6) interest group activation
7) public policy deliberation and adoption
8) regulation, experience and revision

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11
Q

there are 3 requirements for success when creatign policies

A

1) being strategic
2) engaging people
3) managing change

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12
Q

Ethics

A

the process of carefully thinking through what is right and wrong in behaviour, decision making and values, academic, philisophical study of right and wrong

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13
Q

Morality

A

used interchangeably with ethics. It is the beliefs about what we might consider to be right or wrong in our actions and behaviours towards those around us, about social norms, values and beliefs

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14
Q

bioethics

A

focuses pn the study of ethical issues surrounding human lives, health and illness
ie/ Euthanasia, assisted suicide, allocation of new technology, stem cell research ect.

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15
Q

what are the three levels of moral responses to an ethical question

A

expressive, prereflective, reflective

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16
Q

Expressive level of moral responce

A

stating how we feel about something without providing justifaction or rational for our beliefs.

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17
Q

Prereflective level of moral responce

A

we justify our response with legal religious or professional norms without critically reflecting on them

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18
Q

Reflective level of moral responce

A

justifaction of our position is based on on our principles or values that we have reflected on and made a decision on that

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19
Q

Deontology

A

Concerns of the duties we have towards others

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20
Q

what are the 3 issues with deontology

A
  • it is often difficult to determain what our duties are
  • we often find ourselves with multiple and competing difficulties
  • to only be focused on our duties and to fail to consider possible outcomes or consequences of adhering to our duties can be problematic and irresponsible
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21
Q

consequentialism

A

• The rightness or wrongness of an action is determained by the outcomes or consequences of a particular action

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22
Q

what is a common consequentialist theory

A

Utilitariansim- the right action is when it minimizes the negative outcome

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23
Q

Issues with Consequentialism

A
  • Ability to predict outcomes is imperfect
  • Measuring abstract and subjective notions such as happiness or sadness is difficult
  • What one person may think is a good outcome another may not
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24
Q

fundamental 4 principles to ethical desicion making

A

autonomy
beneficence
nonmalifecence
justice

25
Q

code of ethics

A

public documentation of the expectations of ethical practice

26
Q

law and ethics

A

What may be legal might not be ethical

27
Q

Tort

A

an act of wrongdoing that results in hard or injury

28
Q

moral distress

A

when you know the right thing to do but cant do it

29
Q

fidelity to promise

A

making a promise and then keeping it

30
Q

steadfastness

A

standing up for your values adn beliefs

31
Q

patient and family shadowing

A

is the direct, real-time observation of patients and families as they move through each step of a care experience.

32
Q

care experience

A

when you are shadowing can be any aspect of the patient’s and family’s health care journey, in any inpatient or outpatient setting.

33
Q

Shadowing can help you to

A
  • Understand patients’ and families’ frustrations, confusions, and anxieties.
  • Identify the aspects of care experiences that patients and families view as positive.
  • Feel a renewed sense of empathy for patients and their families, which can lead to a sense of urgency to make improvements.
  • Reveal inefficiencies that waste time — not only your time as a caregiver, but the valuable time of patients and families.
  • Understand that data is not always the best tool to motivate change.
  • Gain qualitative information, i.e., “This is how it feels,” not just “This is how it looks.”
34
Q

In a culture of safety, you’ll find the following characteristics:

A
  • Psychological safety.
  • Active leadership
  • Transparency
  • Fairness.
35
Q

Good team leaders promote safety by doing the following

A
  • Engaging all team members
  • Using first names to bring everyone on an even playing field
  • Involving team members in two-way conversations
  • Encouraging feedback
  • Responding to suggestions
  • Respecting and valuing every team member and his or her input
36
Q

why does the gendering of nursing occure

A

because of societies discourse

37
Q

gender definition

A

the ways in which feminity and masculinity are relfected in the lived life, it is seperate from sex

38
Q

how/ where is gender created

A

by society and the interaction with people

39
Q

what is wrong with nursing?

A

EVERYTHING THE SYSTEM IS FUCKED UP

40
Q

what are the 4 phases of an improvemnet project

A

innovation- coming up with the project and its direction
pilot- start testign your ideas, small scale
implementation- make it a new standard of practice
spread- spreading change through multiple locations

41
Q

hardwiring

A

the steps that are taken to prevent us from slipping back into old ways

42
Q

According to Herbert Kaufman, which of the following are reasons health care workers commonly resist change?

a) The expected autonomy of health care workers
b) A real or perceived limit on resources
c) An accumulation of policies, procedures, regulations
d) All of the above

A

D

43
Q

Imagine that your health care organization is trying to reduce worker fatigue. Your improvement team is working on a planned nap program in which you offer the opportunity for staff members working a shift of more than 12 hours to take a planned nap. You have identified a designated room for the nap, and you have communicated with the staff about the importance of rest in ensuring patient safety. Unfortunately, data reveal that workers are not taking advantage of the program. Your team is frustrated, because this program worked at another hospital in a neighboring town.

In the example, which of the following is a process change?

a) The planned nap
b) The data that show whether staff members are taking a planned nap
c) The belief that a planned nap can support patient safety
d) None of the above

A

A

44
Q

Imagine that your health care organization is trying to reduce worker fatigue. Your improvement team is working on a planned nap program in which you offer the opportunity for staff members working a shift of more than 12 hours to take a planned nap. You have identified a designated room for the nap, and you have communicated with the staff about the importance of rest in ensuring patient safety. Unfortunately, data reveal that workers are not taking advantage of the program. Your team is frustrated, because this program worked at another hospital in a neighboring town.

Which of the following represents a culture change?

a) The planned nap
b) The designated room for the nap
c) The staff education about the nap
d) The belief that a planned nap can support patient safety

A

B

45
Q

Imagine that your health care organization is trying to reduce worker fatigue. Your improvement team is working on a planned nap program in which you offer the opportunity for staff members working a shift of more than 12 hours to take a planned nap. You have identified a designated room for the nap, and you have communicated with the staff about the importance of rest in ensuring patient safety. Unfortunately, data reveal that workers are not taking advantage of the program. Your team is frustrated, because this program worked at another hospital in a neighboring town.

What’s the likeliest reason the program failed?

a) The nap wasn’t long enough.
b) The room for the nap was too noisy.
c) The culture of the organization did not support napping during a shift.
d) Workers weren’t as tired as managers thought they were.

A

C

46
Q

Imagine that your health care organization is trying to reduce worker fatigue. Your improvement team is working on a planned nap program in which you offer the opportunity for staff members working a shift of more than 12 hours to take a planned nap. You have identified a designated room for the nap, and you have communicated with the staff about the importance of rest in ensuring patient safety. Unfortunately, data reveal that workers are not taking advantage of the program. Your team is frustrated, because this program worked at another hospital in a neighboring town.

What would be a good way for the team to respond to the resistance to the change?

a) Share data that shows the process change is associated with a decrease in adverse events.
b) Abandon the idea.
c) Tell a story about a patient whom medical science was able to save.
d) A, B

A

A

47
Q

In designing a performance improvement team, it is helpful to:

a) Choose people who are unlikely to disagree with one another
b) Have a mix of different types of people on the team
c) Have everyone on the team exhibit similar personality preferences
d) All of the above

A

B

48
Q

Personality and work style profile assessments can help to:

a) Identify the personalities present and work to everyone’s strengths.
b) Identify why some people will never respond well to change.
c) Determine who has the right expertise to be on an improvement team.
d) A and C

A

A

49
Q

Which of the following are strategies to help members of a QI team establish common goals?

a) Create a team roster.
b) Share stories.
c) Write down a shared work plan.
d) All of the above

A

D

50
Q

What is the order of the four steps teams typically follow to get to a place where they are running smoothly?

a) Forming, storming, norming, performing
b) Norming, performing, forming, storming
c) Storming, forming, norming, performing
d) Performing, storming, forming, norming

A

A

51
Q

You’re on a team seeking to improve the process for treating patients with sepsis. Which of the following is an example of “advocacy”?

a) Listening to your teammate’s idea to improve screening for sepsis.
b) Stating your idea for updating the sepsis protocol.
c) Adapting your idea for the sepsis protocol based on your teammate’s input.
d) A and C

A

B

52
Q

One hospital CEO insists on including performance data in the hospital’s annual report. “We do very well on most measures, except for one or two, but we put those in anyway,” she says. “We want to hold ourselves accountable.” Does this practice demonstrate effective or ineffective leadership?

a) Ineffective leadership: Because results are an important indication of leadership, publicly sharing poor results is an unwise practice.
b) Effective leadership: Being transparent, even about poor results, is a mark of a good leader.
c) Ineffective leadership: Leaders are people who have followers, and sharing poor results might cause the leader to lose some followers.
d) Effective leadership: It is good to share results in the annual report, but the leadership would be even more effective if it shared only the strongest results

A

B

53
Q

At the large multi-specialty clinic in which you work, there have been two near misses and one medical error because various clinicians did not follow up on patient results. Different caregivers were involved each time. After the second near miss, the physician involved was asked to leave the clinic.

This outcome is an example of a failure of which aspect of a culture of safety?

a) Psychological safety
b) Orderliness
c) Fairness
d) Transparency

A

C

54
Q

At the large multi-specialty clinic in which you work, there have been two near misses and one medical error because various clinicians did not follow up on patient results. Different caregivers were involved each time. After the second near miss, the physician involved was asked to leave the clinic.
A nurse who realized that his colleagues weren’t consistently following up on patient results reported the problem to the clinic leadership right away. Which response would be most consistent with a culture of safety?
a) Transferring the nurse to another clinic
b) Writing a letter of commendation for his file
c) Thanking the nurse and asking him to keep quiet about it
d) Placing the item on the agenda for the leadership meeting next year

A

B

55
Q

Why is psychological safety a crucial component of a culture of safety?

a) Without it, people won’t be interested in improvement work.
b) It allows people to remove unsafe members of the team quickly.
c) Without it, patients will not follow their doctors’ advice.
d) It allows people to learn from mistakes and near-misses, reducing the chances of further errors

A

D

56
Q

On a particularly busy night in the emergency department, a patient comes in with chest pain. The triage nurse, who’s been on the job only two days, takes the patient’s information, fills out the form, and puts the patient’s chart on the rack so he’ll be seen in the order in which he arrived. She mentions to a passing nurse, “There’s a patient here who has pain — he’s waiting to be seen.” Thirty minutes later, still waiting to be seen, the patient collapses in the waiting room.

What likely contributed to this outcome?

a) The lack of a shared plan for patients with chest pain resulted in a failure to act quickly.
b) The high patient volume caused a long delay in caring for a patient with a critical condition.
c) A new nurse was placed in triage, which was not safe.
d) No clear standard of care exists for chest pain patients, so the nurse couldn’t have known what to do.

A

A

57
Q

During a debriefing, it becomes clear that a nursing assistant was concerned about a patient’s breathing just after a drug was administered, but he did not feel comfortable telling the physician. What conclusion can you draw about the unit where this adverse event occurred?

a) The unit’s culture doesn’t effectively promote psychological safety.
b) There are too many patients in the ICU.
c) The unit’s lack of an electronic health record endangers patients.
d) None of the above

A

A

58
Q

Which of the following is an example of transparency?

a) Firing the physician with the lowest patient satisfaction ratings each year
b) Discussing a time when you made an error similar to one that just occurred, and explaining what you learned
c) Making sure that all data regarding errors are seen only by senior leadership
d) Making sure that all data regarding errors are stripped of identifying information

A

B

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