Week 1 Study Deck for Nursing Theory- Ch. 9,10 & 15

Question 1

What is organizational theory?

Answer 1

systematic analysis of how organizations and their component parts act and interact. It identifies organizational culture, organizational technology and organizational structure

Question 2

What is Systems theory

Answer 2

a theory used in health care to analyze how various independent parts interact to form a unified whole or to disrupt a unified whole

Question 3

What 3 things does an organization need to form the foundation of their structure?

Answer 3

Mission, vision and philosophy

Question 4

What is an organizations “mission”

Answer 4

a reason for an organizations existence, it influences the design of the structure e.g) to meet the health care needs of a designated population to provide supportive and stabilizing care to an acute care population

Question 5

What is a vision of an organization

Answer 5

articulated goals to which the organization aspires

Question 6

What is a philosophy of an organization

Answer 6

expresses the values and beliefs that members of the organization hold about the nature of their work, about the people to whom they provide service, and about themselves

Question 7

What is a mission statement? And what 4 things does it identify?

Answer 7

a formal written document that identifies the organization’s unique purpose; its core values; the patients served; and the types of programs or services offered

Question 8

What are vision statements made up of

Answer 8

one or two phrases or sentences that identify the desired future of an organization to convey the core message of a mission statement

Question 9

What is organizational culture?

Answer 9

implicit knowledge or values and beliefs within the organization that reflect the norms and traditions of the organization. It is a combination of the “formal manner” (mission, vision and philosophy) as well as day to day lived experiences

Question 10

What is the Chaos Theory?

Answer 10

chaos theory suggests that lives—and organizations—are really web-like. Pulling on one small segment rearranges the web, a new pattern emerges, and yet the whole remains

Question 11

What factors have been influencing organizational structure designs in health care

Answer 11

rising health care costs, demands for quicker access to care, changes in government policy, and technological and research innovations

Question 12

What are the differences between redesign, restructuring and re-engineering health care structures?

Answer 12

Redesign- a process of analyzing tasks to improve efficiency (e.g., identifying the most efficient flow of supplies to a nursing unit)
Restructuring- entails fundamental changes to an organization to achieve greater efficiency or profit (e.g., identifying the most appropriate type and number of staff members for a particular nursing unit)
Re-engineering- involves a total overhaul of
an organizational structure. It is a radical reorganization of the totality of an organization’s structure and work processes

Question 13

What comes from re-engineering of an organization?

Answer 13

n re-engineering, fundamentally new organizational expectations and relationships are created

Question 14

What are the 5 characteristics of organizational structures?

Answer 14

Complexity
Division of labor and specialization
Hierarchy
Chain of command
Centralization

Question 15

describe the characteristics of complexity in an organizational structure:

Answer 15

concerns the division of labour in an organization, the specialization of that labour, the number of hierarchical levels, and the geographical dispersion of organizational units

Question 16

describe the characteristics of Division of labour and specialization in an organizational structure:

Answer 16

refer to the separation of processes into tasks that are performed by designated people

Question 17

describe the characteristics of Hierarchy in an organizational structure:

Answer 17

connotes lines of authority and responsibility

Question 18

describe the characteristics of Chain of Command in an organizational structure:

Answer 18

is a term used to refer to the hierarchy depicted in vertical dimensions of organizational charts

Question 19

describe the characteristics of centralization in an organizational structure:

Answer 19

refers to the location where a decision is made. Decisions are made at the top of a centralized organization. In a decentralized organization, decisions are made at or close to the patient-care level

Question 20

What is bureaucracy?

Answer 20

an administrative concept imbedded in how organizations are structured

Question 21

What is involved in a bureaucratic structure?

Answer 21

are formal and have a centralized and hierarchical command structure (chain of command)

Question 22

What are the characteristics of a bureucratic structure?

Answer 22

-division of labour or specialization
-clear lines of authority, -appropriate levels of discipline
-unity of direction
-equitable treatment of staff
-the fostering of individual initiative
-the promotion of a sense of teamwork and group pride

Question 23

What 3 things can you use to assess the level of bureaucratic tendencies in an organization?

Answer 23

Labour specialization (the degree to which patient care is divided
into highly specialized tasks)
* Centralization (the level of the organization on which decisions
regarding carrying out work and remuneration for work are made)
* Formalization (the percentage of actions required to deliver patient
care that is governed by written policy and procedures)

Question 24

What are the different organizational structures?

Answer 24

Functional, service-line, flat, and matrix

Question 25

What is a functional structure?

Answer 25

arranged departments and services according to specialty. For example, a health care organization with a functional structure would have vice- presidents for each major function: nursing, finance, human resources, and information technology

Question 26

What is the service line structure?

Answer 26

the functions necessary to produce a specific service or product are brought together into an integrated organizational unit under the control of a single manager or executive

Question 27

What are the 5 criteria that the provinces/ territories have to meet to qualify for federal health care funding?

Answer 27

• Public administration
• Comprehensiveness
• Universal coverage
• Portability
• Accessible

Question 28

Canada has a framework based on the sequence of access to health care. What are the three categories of health care?

Answer 28

Primary health care, secondary health care, and additional health care services

Question 29

What are primary health care servies

Answer 29

first-contact services for routine
problems and emergencies. They are also the point of referral and coordination of patient care through the continuum of care

Question 30

What is primary care?

Answer 30

first point of contact with a general practitioner

Question 31

What is primary health care?

Answer 31

a community-based health care service philosophy that focuses on illness prevention, health promotion, treatment, rehabilitation, and identification of people at risk

Question 32

What is secondary health care services?

Answer 32

health care services that take place after the initial patient contact with primary health care services, like a primary care practitioner referring a patient to specialized care

Question 33

What are additional health care services?

Answer 33

care that isn’t usually covered by public health insurance like prescription meds, dental care and vision care

Question 34

What services does public insurance cover?

Answer 34

-standard or public ward accommodation and meals
-nursing service
-diagnostic procedures such as blood tests and X-rays
-the administration of medications
-the use of operating rooms, case rooms, and anaesthetic facilities

Question 35

What are 7 external factors that influence health care organizations?

Answer 35

Legal–political- The federal, provincial, and territorial levels of government enact laws and set policies to regulate health care delivery (ex. Canada Health Act)

economic- related to efficiency in health care delivery and the allocation of scarce resources in the face of unlimited demands

sociocultural- customs, values, beliefs, education, level of income, and patterns of behavior—influence lifestyle and well-being (eg. social determinants of health)

accreditation-a process of assessing health services against standards, to identify what is being done well and what needs to be improved (ex. surveys to see what is going well)

technology- technological advances can influence the ability of healthcare providers to improve clinical practice and communication

Professional Associations & Unions- Professional associations are not-for-profit, voluntary organizations that act in the interests of their members and their patients. They promote the advancement of the discipline by facilitating continuing education and research; mentoring in career development; advocating on issues relevant to the discipline; promoting interaction among members through conferences and networking; and providing access to personal or career-related benefits

regulatory bodies- Healthcare organizations are regulated and monitored by external organizations

Question 36

What are some internal factors that influence health care organizations?

Answer 36

Nurse shortages
the educational requirements of nurses, type and scope of practice

Question 37

What are the three health care services classifications?

Answer 37

Public Health Services- strengthen Canada’s capacity to protect and improve the health of Canadians and to help reduce pressures on the health care system

Community Care Services- Community care services include a large range of services delivered in private homes, long-term residential care settings, retirement communities, and community clinics, excluding those services related to public health and prevention services

Hospital Care Services- “Hospital services” are outlined in the Canada Health Act and include
(1) standard or public ward accommodation and meals
(2) nursing service
(3) diagnostic procedures such as blood tests and X-rays
(4) the administration of medications
(5) the use of operating rooms, case rooms, and anaesthetic facilities

Question 38

What is the open systems theory?

Answer 38

views organizations as dynamic, interactive systems that are strongly influenced by internal and external forces. The system is open, as opposed to closed, because it constantly interacts with and adapts to both internal forces and external forces

Question 39

What are internal factors that may affect open systems theory?

Answer 39

People, materials, equipment, funds, information, policies, and infrastructure

Question 40

What is a Nursing Care Delivery Model?

Answer 40

the method nurses use to provide care to patients

Question 41

What are the 5 models of nursing care?

Answer 41

The case method
Functional nursing
Tram nursing model
Primary nursing model
Nursing case management model

Question 42

What happens in the “cast method” care delivery model?

Answer 42

it focuses on total patient care for one specific patient for a specific time period. This is common in the CCU

Question 43

What are some issues with the case method care delivery model?

Answer 43

expenses- because having one nurse per patient causes there to be a need for more staff

Question 44

What is the “functional nursing” care delivery model?

Answer 44

a model for providing patient care in which each regulated and unregulated member of the care team performs specific tasks for a large group of patients. It very much depends on a HCP scope of practice

Question 45

What are the advantages and disadvantages of functional nursing care delivery models?

Answer 45

Advantages- it can be efficient and tasks can be done well by those who specialize in those tasks

Disadvantages- The physical and technical aspects of care may be met, but the psychological and spiritual needs of care may be overlooked

Question 46

What is the “Team Nursing” care delivery model?

Answer 46

a nurse team leader is responsible for coordinating a group of regulated and unregulated personnel to provide patient care to a group of patients

Question 47

What are some advantages to the team nursing model?

Answer 47

improved patient satisfaction, decision making by staff nurses (which enhances their satisfaction), and cost- effectiveness for the employer

Question 48

What are some disadvantages to the team nursing model?

Answer 48

If the team lead or the head nurse has poor leadership skills or communication skills. it can cause problems

Question 49

What is the “Primary Nursing” care delivery model?

Answer 49

one nurse functions autonomously as the patient’s primary nurse throughout the hospital stay. The primary nurse is a registered nurse who is responsible for planning and delivering care to a consistent group of patients. the primary nurse plans, collaborates, communicates, and coordinates all aspects of patient care with other nurses as well as other disciplines.

Question 50

What is the primary nurse responsible for?

Answer 50

-The primary nurse, preferably at least baccalaureate-prepared, is accountable for meeting outcome criteria (criteria are the result of patient goals that are expected to be achieved)
-plans, collaborates, communicates, and coordinates all aspects of patient care with other nurses as well as other disciplines

Question 51

What are the advantages and disadvantages to the primary nursing care delivery system?

Answer 51

Advantage- less unregulated healthcare professionals

Disadvantage- nurses may not have the knowledge base to provide total care on their own