hesi 101 Nursing_Leadership_Finals

Hesi 101 Nursing Leadership Finals   HESI 101 Nursing Leadership = Everything (Final) Complete! 1. #1 thing to remember about negative feedback Unsatisfactory work must be acknowledged and discussed 2. 2 biggest/worst actions that lead to malpractice lawsuits Altering/falsifying a medical record, violation of an internal or external standard of practice 3. 2 out of 3 people leave a job because of this Ineffective/incompetent management 4. 2 types of change Planned/Managed, Unplanned/Reactive 5. 2 types of resistance to change Active resistance and passive resistance 6. 2 ways to be an emotionally stable leader 1. Recognize and understand your own emotions, learn to manage them, stay calm and clear headed. 2. Listen to others, perceive unspoken concerns, acknowledge others perspectives, helpful 7. 3 qualifications for RN licensure in the USA Graduate from an approved RN program, english language proficiency, disclosure of criminal convictions 8. 3 quality behaviors of effective nurse managers? Interpersonal, decisional and informational behaviors along with leadership, business sense and clinical expertise 9. 3 stages of lewins theory of change Unfreeze(take out of comfort zone), Change(discomfort), Refreeze(new comfort zone) 10. 3 types of liability Personal, vicarious, employer/corporate 11. 4 stages of burnout 1. high expectations and idealism, 2. pessimism and early job dissatisfaction, 3. withdrawal and isolation 4. irreversible detachment and loss of interest 12. According to JCAHO what is the reason for a large number of sentinel events that occur? Communication deficits among health care providers 13. According to Rogers what are typical responses to change? innovators, early adapters, early majority, late majority, laggards and rejectors. 14. Advice for giving feedback Give both negative and positive, give immediately, give frequently, give negative feedback in private, base it on observed behavior, include suggestions for change. 15. AKA - Bottling emotions (inappropriate way of dealing reality shock) Rutter 16. These are activities that an RN may NOT delegate Initial and follow up assessments, decisions and judgements about client plan of care, interventions that require professional RN knowledge or skills, decisions/judgements needed to evaluate care 17. These are clinical protocols involving all disciplines Critical pathways 18. These are established guidelines for the nursing profession to ensure quality of care Nursing Standards 19. _______________ are influenced by values Choices 20. These are non life essential values (things, people, ideas, kindness, and understanding) Extrinsic values 21. These are offenses committed against state laws Criminal acts 22. These are organized thoughts about why people exist in the universe Beliefs 23. Behaviors at risk for violence History of violent behavior, delusions paranoia suspicion, aggression, threats, rapid speech, anger, stiff posture, clenched fists, ETOH/drug use, male or youth, unrealistic policies/procedures 24. Causes of reality shock Culture shock (expectations distorted with reality), incongruent school values and work values, lack of support, lack of a mentor 25. Choices to resolve conflict Avoid it, accommodate, compete, compromise, collaborate 26. Common actions leading to malpractice lawsuits Fail to assess properly, fail to report changes in pt status, fail to document, fail to obtain informed consent, fail to report co-worker negligence, fail to provide adequate education * TWO BIGGEST* Altering/falsifying a medical record and Violation of an internal or external standard of practice 27. Common causes of negligence Client falls, equipment injuries, failure to monitor, failure to communicate, medication errors, medical errors 28. Common mistakes made during change implementation Failure to make need for change clear, unclear goals, too little time, poor leadership, insufficient coordination of the change process, insufficient education, dismissing complaints 29. The CQI program evaluates what 3 things? 1.Structure within which care is given, 2. the process of giving the care 3. the outcome of that care 30. Describe the traditional organizational structure Tall and narrow chain of command - Employees ranked top to bottom with the number on bottom greater than the top, authority is at the top only, power is distributed, communication is a challenge because of all of the layers of power 31. Dont's of feedback Focus on negatives, let personalities intrude, be vague, play favorites, correct people publicly 32. Do's and Don'ts for managing diversity Do - recognize it, value it and develop support for it, Ensure fairness, make all of the above part of your philosophy. Don't- pretend all are alike, expect everyone to conform, seek quick solutions, develop different performance standards, expect one workshop/meeting to solve it. 33. Do's of feedback Include positive comments, be objective, be specific, treat everyone the same, correct people privately 34. These ethical concepts are learned and change with maturity and experience Values (The amount of values a person holds, isn't as important as "which" values they consider important) 35. Explain the differences between management and leadership Management-Assigned formal position, budgets, hires/fires. Leadership -Achieved informal position, part of every RN's responsibility 36. Formal statements of behavior rules for a group Ethical Codes 37. Goals of managed healthcare organizations Decrease cost, promote health, provide seamless healthcare 38. Good _______________ empowers others Leadership 39. How are error events in health care categorized? Near miss, adverse event, accident, never event 40. How do managed health care organizations control costs? By providing incentives to consider lower cost treatment alternatives 41. How do managed healthcare organizations promote health? Education, early diagnosis, self-care, prevention, reduce duplication 42. How do nurses practice autonomy for pts? Respecting the pts right to make their own choices about healthcare 43. How do nurses practice beneficence for pt care? They need to assist pts in meeting all of their needs (Biological, psychological, social) 44. How do nurses practice nonmaleficence for their pts? Requires nurse to protect pts who can not protect themselves 45. How do nurses treat pts with justice? They must be nonjudgmental to every patient 46. How is the nursing process used while delegating care? Use Assessment to assess needs of pts, set specific goals, match the right personnel with the appropriate skills care for the pt, Use Planning to mentally identify who is best suited for the task, and prevent later problems, Use implementation to assign appropriate personnel who have the right level of expertise for the pt to deliver the care, and use Evaluation to oversee the care and determine if the pt care needs have been met and allow for feedback. 47. How much actual time does an RN spend on pt care? 35% 48. How to prepare for a trial deposition Don't volunteer information, be familiar with the case, clarify questions, don't assume, don't exaggerate, allow 5 seconds before answering (Practice this), tell the truth always, speak slow and clear, eye contact, bring resume, request a break/rest, think before answering, avoid anger/absolutes, read deposition ahead of time, if asked the same question twice- ask them to play back or repeat your previous answer. 49. Inappropriate reactions when dealing with reality shock Native (i'll just keep doing this because it's easier), runaway, rutter, burnout, loner, remain new, be the change agent 50. In this nursing care delivery model the nurse is responsible for planning, organizing, and delivering all care. It is the oldest method of organizing care. Total Patient Care Nursing 51. In this nursing care delivery model the RN acts as a leader and coordinates all care for a group of patients. Was formed in the 50's to improve pt satisfaction and reduce fragmented care Team Nursing (RN team A LPN team A PCA team A delivers care for the group of pts assigned to team A; RN teamb, LPN team B PCA team B delivers care for the group of pts assigned to team B) 52. In this nursing care delivery model, the RN is the main caregiver and responsible for planning, directing and evaluating all care. Created in the 70's for promoting RN autonomy. Primary Nursing 53. In this nursing care delivery model the staff members are assigned to complete tasks for a specific group of patients and unskilled workers are trained to perform routine simple tasks, evolved during WWII as a result of the nursing shortage. Functional Nursing 54. In this type of managed health care organization, the primary care provider controls access to services HMO 55. In this type of organization, authority figures have all of the power/control Centralized/Traditional 56. Is burnout an emotional disturbance or a reaction to organizational stressors? It is a reaction to organizational stressors 57. Keys to surviving reality shock Think before you answer, take vacations, support co-workers (be a good listener), be comfortable, treat yourself, get rid of energy drains, learn to say NO 58. Laws relevant to Nursing Good samaritan, confidentiality, slander/libel, false imprisonment, assault and battery, malpractice, liability, and negligence 59. List 3 levels of criminal law offenses Felony, Misdemeanor, Juvenile 60. List 3 qualities a leader must develop 1. Ability to diagnose or understand the situation you want to influence or change 2. Adaptation in order to allow your behaviors to close the gap between the current situation and what needs to be changed 3. Communication 61. List 3 sources that laws come from Constitution, statutes, Administrative 62. List 3 types of healthcare organizations -Private/nonprofit, publicly supported, private/for profit 63. List 4 points about grapevine communication It always exists, it travels rapidly, spontaneous, may lack accuracy 64. List four types of nursing care delivery methods Team nursing, Functional nursing, Primary nursing, total care nursing 65. List some barriers to effective delegation lack of experience, lack of licensure, quality of care, assigning work to others, poor communication or follow through/follow up, lack of trust 66. List some behaviors characteristic of a leaders Critical thinking, problem solving, respect people, communicates skillfully, sets goals, shares a vision, develops self and others 67. List some examples of professional negligence Duty owed, duty breached, forseeability(Knowingly fails to meet standards), causation, injury, damages 68. List some sources of power Formal vs informal, authority, reward, coercion, expertise/information, connections/referent 69. List some ways RNs organize their work Set long and short term goals, use lists, ticker files, time blocks, filing systems 70. list the 4 phases of unplanned change? Design the change, plan implementation, implement the change, integrate the change 71. List the 5 dimensions of followership Courage to assume leadership/responsibility as needed, courage to serve, courage to challenge, courage to participate in change/transformation, courage to leave 72. List the conflict resolution process Identify the problem, generate possible solutions, evaluate suggested solutions, choose the best solutions, implement the solution chosen, is the problem solved?, if yes end process if not repeat. 73. Major issues handled by the state boards of nursing include what? Falsifying documents, felonies, drugs/alcohol problems, functioning outside the scope of practice, abuse 74. The manager that believes this theory of McGregor believes in guidance rather than control and development rather than supervision with added rewards is the best way to manage employees Theory Y 75. The manager that believes this theory of McGregor believes that employees need strict rules, constant supervision and threat of punishment Theory X 76. McGregor has two theories of workers name them Theory X and Theory Y 77. Name 3 types of managed healthcare HMO, PPO, POS 78. Name four types of costs incurred by businesses Direct, indirect, fixed and variable 79. Name some ethical principles Autonomy, nonmaleficence, beneficence, justice, fidelity, confidentiality, veracity, accountablity 80. Name some types of Standards nurses must follow Internal, organizational, accepted state and national standards, nurse practice acts, patient care partnerships 81. Name some ways that healthcare is financed Insurance companies, Government insurance, managed care organizations 82. Name the ethical principle meaning truthfulness. It also builds trust Veracity 83. Name the three types of leadership styles Authoritarian/autocratic, Democratic, laissez fare 84. Name two things required to motivate people Power and authority 85. Pain tolerance is what type of research? Qualitative 86. Phases of decision making Define objectives, generate options, identify advantages and disadvantages, rank options and select one, implement option selected, evaluate the results 87. Phases of reality shock Honeymoon, shock, recovery and resolution 88. QI vs CQI QI - Nightengale began, structured/organized, evidence based CQI-Purpose, Identify and collect data, analyze, evaluate and change, responsibility, evaluate structure process and outcome 89. Re-admission rates are what type of research? Quantitative 90. Requirements for informed consent Mentally competent adult - voluntary, client understands exactly what they are consenting to, Consent includes risks alternative treatments available and outcomes, consent is written 91. Rights of a person participating in research/experimentation? Voluntary consent, if the subject of the research is human - they can stop at any time they choose, patients are adequately informed 92. The role of this group is to provide unbiased, expert advice to improve health. (they drive healthcare) Institute of medicine (qsen, quality and safety - we teach to the IOM) 93. Situations that increase a workers susceptibility to violence Routine contact with the public, work alone or in small numbers, work late, poor security, patients and families with weapons, lack of experienced staff, units and patients that require seclusion/restraint activities 94. Six aims for quality improvement in healthcare - (Institute of Medicine) Healthcare should be 1. safe 2. effective 3. pt centered 4. timely 5. efficient 6. equitable 95. These standards are maintained in policy and procedure manuals/online access. Developed by institutions Internal standards 96. Steps of a lawsuit Complaint, discovery, deposition, and trial 97. Steps to follow if possible lawsuit is pending Immediately seek legal counsel, never sign documents without legal counsel, notify your malpractice carrier if covered and employer, keep all correspondence (written and verbal) 98. Steps to solving a problem Gather data, analyze data, establish outcome, implement, evaluate 99. Strategies for group decision making Increase acceptance, increase time, more ideas generated the better, increase team building, all members need knowledge, some members may dominate, competition can develop 100. Strategies for groups to decide on changes Brainstorm, nominal group techniques, focus groups, delphi technique(Panel of professionals to educate) 101. Ten rules to govern healthcare reform for the 21st century as published/recommended by the institute of medicine 1. care is based on a continuous healing relationship 2. care is provided based on pt needs/values 3. pt is a source of control of care 4. knowledge is shared and free. 5. Evidence based decisions 6. safety as a system is a priority 7. secrecy is harmful, transparency is necessary 8. anticipate pt needs 9. decrease waste continually 10. cooperation needed between the healthcare providers 102. Things an RN should do when evaluating the delegation process Oversees the care, determine if pt care needs have been met, allow for feedback 103. This approach to error resolution addresses a problem and goes deeper, and deeper and deeper to find out "why" Root cause analysis 104. This budget is a plan for monthly bills and receipts Cash Budget (Petty cash) 105. This budget used by businesses is to purchase equipment Capital Expenditure budget 106. This budget used by businesses is used for day to day expenses Operating Budget 107. This drives healthcare, (QSEN standards also) IOM- Institute of Medicine 108. This ethical principle is loyalty and a promise to fulfill all commitments. (accountability) Fidelity 109. This ethical principle means being responsible for your own action to self and other collegues accountability 110. This ethical principle means "doing good" for others Beneficence 111. This finding in research means there is low probability the result was due to just chance "significant findings" (Not chance - proven probability) 112. This health practice model advocates for continued growth of nursing, provides vision, practices self and shared governance and empowerment of nursing practice Professional practice model 113. This is a health care delivery system that uses financial incentives and management controls to direct efficient and appropriate health outcomes (capitated system) Managed Care 114. This is a health care initiative by the institute of medicine that states the gaps in actual care and high quality care can be attributed to key inter-related areas within healthcare "Crossing the quality chasm" 115. This is a measure of the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current and professional knowledge Quality 116. This is a persons own code for what is acceptable behavior (conscience) this is learned Morals 117. This is a problem in which conflicts of belief exist making decisions difficult Ethical dilemma 118. This is a type of leadership in which the nurse is acting in an approved/appointed management role Formal leadership 119. This is created as an attempt to demand lower health care prices by consumers and employers. (the strongest movement in healthcare) Managed Health Care organizations 120. This is "do no harm" ethical principle nonmaleficence 121. This is leadership exercised by a person with no official power but influences others (can be positive or negative influence) Informal leadership 122. This is something in the environment that changes (research/experimentation methods) Variable 123. This is the ability to influence the beliefs, opinions or behaviors of a person or group toward overall goal acheivement Leadership 124. This is the act of getting work done through others by planning, organizing and commanding employees Management 125. This is the ethical belief that each person must be treated equally Justice 126. This is the freedom to make ones own decisions Autonomy 127. This is the law that involves the violation of one persons rights against anothers Civil law 128. This is the model in which each person in an organization share a mission, vision, values and partnerships. They believe that each person has a right to healthcare and each person is accountable to communicate and contribute to their healthcare. It is a planned partnership. Empowerment for each persons healthcare begins with themselves. Clinical Practice Model for healthcare 129. This is the negative phenomenon that occurs in highly cohesive groups similar prejudices suppress open discussion. It often interferes with critical thinking and increases pressure to conform. Group Think 130. This is the "right" or "wrong" of human behavior, and the motivation behind it Ethics 131. This is the term used for professional negligence Malpractice 132. This is the unintentional tort of acting or failing to act, resulting in harm to the person owed care Negligence 133. This liability is your individual responsibility for action or inaction Personal liability 134. This managed healthcare organization is when the physician and health services are contracted with the insurance company to provide services at discounted fees PPO 135. This managed healthcare organization type allows choice of providers but cost may be higher POS 136. This occurs when the novice RN adjusts to the new evironment Resolution 137. This occurs when the novice RN begins to understand the culture of the unit after reality shock Recovery 138. This personality test studies Extro/introversion, sensing/intuition, thinking/feeling and judging/perceiving MBTI (Myers-Briggs Type Indicator) personality testing (some employers use this to seek out possible new employees) 139. This Practice for research holds the "TRIP" value system (translating research into practice) Evidence based practice 140. This prevents some medical practices from being considered battery Informed consent 141. This process includes data information collection and knowledge. It is the infrastructure for Evidence based practice, and collects data for standardized nursing practice, Hospital information data and administrative database maintenance (collection of private, secure data) Informatics 142. This research is objective, numbers are used as analysis Quantitative 143. This research method asks "Does the tool really measure what it is supposed to?" Validity 144. This research technique combines information from multiple sources, and is quick and powerful Triangulation technique 145. This research term describes the likelihood that something will happen Probability 146. This research type is subjective, words are used as element of analysis Qualitative 147. This skill is a prerequisite for good delegation skills? Good organizational skills 148. This states that the supervisor that gives an order can be sued if the person below them fails to follow it. Malpractice -(respondeat superior) 149. This takes the value of right/wrong and applies it to life/death issues Bioethics 150. This type of civil law involves damage to a persons reputation with words, defamation of character, invasion of privacy, or breech of confidentiality Quasi-Intentional Tort 151. This type of civil law is a legal duty of care (Duty to not harm) Tort 152. This type of error event is when no harm or minimal harm is done Near miss 153. This type of error event is when serious injury occurs, very concerning, major mistake Sentinel event 154. This type of error event shouldn't have happened. Ever. Never Event 155. This type of leader is directive an controlling and can damped the creativity and inhibit motivation of the group (Very efficient) Autocratic/ authoritarian 156. This type of leader is usually characterized by guidance from the leaders, rather than control by Democratic 157. This type of leader leads people to feeling confused, without goals or guidance and is often ineffective with little control or responsibility for the leader (not efficient) Laissez-Fare 158. This type of leader makes no attempt to motivate or move the group in any direction Laissez-Fare 159. This type of leader tries to move the group toward the groups goals - Shared responsibility (Somewhat efficient overall) Democratic 160. This type of leader tries to move the group toward their own (the leaders) goals Autocratic/authoritarian 161. This type of liability is dependent on hiring of quality staff, in a safe environment Employer/Corporate liability 162. This type of liability is employers being held accountable for negligence of employees Vicarious liability 163. This type of organizational structure is less bureaucratic, more flexible, decisions are made by those who implement the changes, autonomy is emphasized, communication is up and down Innovative/Decentralized/Non-traditional 164. This type of organization gives power to those who are affected by decisions Decentralized/Non-traditional/Innovative 165. This type of resistance to change attacks the idea, refuses to change, argues, organizes resistance of other people Active resistance 166. This type of resistance to change avoids discussion, ignores the change, refuses to commit, and agress but doesn't act on the change Passive resistance 167. This was a group of recommendations by the institute of medicine to enhance safety, encourage learning from errors, sets standards for safety and safety systems "To Err is Human" recommendation 168. Tips for a successful Team conference Present the info in a clear concise manner 169. Tips for prevention of malpractice Keep informed about new information r/t your practice (CEU's), Insist on employer keeping personnel informed of all changes in policy/procedure and new technology, follow standards of care, ID at risk clients for problems, maintain safe environment, document precisely, write detailed incident reports, file incident reports, recognize client behaviors that might be a problem 170. To keep a current license RN's complete CEU's. At least one of these CEU's must be about _________________. Pain or pain management 171. Top 3 types of quality errors that can happen in an institution 1. Service occurrences 2. serious incident 3. sentinel event 172. True or false, conflict is always a negative experience False, not necessarily 173. True or false, conflict is inevitable in large groups True 174. True or false, effective leadership ensures good management skills False 175. True or False, good management skills ensure good leadership skills? False 176. True or False, it is more difficult to provide positive feedback than to provide negative feedback? false, it is more difficult to provide "good negative feedback" Than positive feedback. 177. True or False, the courts uphold the authority of boards of nursing to regulate standards True 178. Two things (Forces) that can happen during change (according to Lewin) 1. Driving forces and 2. Resisting forces 179. Types of Civil Law Tort, Quasi-Intentional Tort, Negligence, Malpractice 180. Types of ethical values Intrinsic, extrinsic, personal and professional 181. Types of law Criminal, Civil 182. These types of tests determine probability (likelihood something will happen) statistical tests 183. These types of values sustain life - (food/water) Intrinsic values 184. What are 4 things that the Institute of Medicine states about quality of care 1. quality can be defined and measured 2. quality problems are serious and extensive 3. current approaches are inadequate to improve quality 4. there is an urgent need for rapid change 185. What are driving forces for change? They call for the change, enable it. It must increase in order for the change to occur 186. What are restraining forces of change? Resistance to change. They must decrease for the change to occur 187. What are some advantages of functional nursing care Care is provided economically and efficiently, minimum number of RNs required, tasks are completed quickly 188. What are some advantages of primary nursing care? High quality holistic patient care, Establish good rapport with RN, the RN feels challenged and rewarded 189. What are some advantages of team nursing care? High quality, comprehensive care with a high proportion of subordinate staff, each team member participates in care decision making and contributes their own expertise 190. What are some advantages to total patient care nursing? High degree of autonomy, Lines of responsibility and accountability are clear, patient receives holistic unfragmented care 191. What are some common areas for Functional nursing delivery? Operating Room 192. What are some common areas for primary care nursing delivery? Hospice, Home Health, Long Term Care, (my sub-acute detox facility I work on) 193. What are some common areas for team nursing delivery? Inpatient and outpatient care settings (Med/Surg, Pine Rest Inpatient units etc) 194. What are some common areas for Total Patient Care Nursing delivery? ICU, PACU, and Nursing students often provide total patient care. :D 195. What are some common errors of delegation? Overloading self by not delegating, old patterns of behavior, unclear communication, release of control, pressure to delegate in appropriately 196. What are some decisional behaviors of nurse managers? Employee evals, resource allocation, planning, job analysis and redesign 197. What are some disadvantages of functional nursing care? Care can be fragmented, Pt may become confused with so many different care providers, caregivers feel unchallenged 198. What are some disadvantages of primary nursing care? Primary nurse must be able to practice with a high degree of autonomy, RN must accept 24 hour responsibility, more RN's are needed so it is not cost effective 199. What are some disadvantages of team nursing care? Continuity suffers if daily team assignments vary, team leaders must have good leadership skills, There may be inefficient time for planning and communication between team members and teams 200. What are some disadvantages of total patient care nursing? Inconsistency- each RN may have different approach to care, not cost effective, Lack of RN availability 201. What are some examples of ethical dilemmas Assisted Suicide, technology issues, gene therapies, designer babies, organizational climate 202. What are some factors the RN should consider when delegating tasks? Is there potential for harm?, Complexity of the RN activity/task, what problem solving/innovation is required, how predictable is the outcome? 203. What are some fiscal responsibilities of RN's? Understand that budgeting drives healthcare, achieve patient outcomes in a safe/cost efficient manner, judicious use of equipment and supplies 204. What are some good team communication guidelines? Active listening, communicate genuine concern and interest, provide the employee with adequate information, use team members ideas in the plan of action, maximize feelings of self respect, focus on the team members ability to help themselves, don't minimize value of time allowed to learn, seek alternatives, respect values and dignity, depresonalize potential conflict situations 205. What are some informational behaviors of nurse managers? Spokesperson for staff and the organization, monitor activities of units/work groups, dissemination of information 206. What are some interpersonal behaviors of nurse managers? Networking, conflict resolution, employee development, rewards/punishment 207. What are some methods used to organize nursing care? -critical pathways, computerized information sheets, personalized worksheets, delegation trees 208. What are some possible goals of a health care organization other than "caring for the health and wellbeing of people) -Survival, Growth, Profit, Status, Dominance 209. What are some potential conflict generators in the workplace? Competition, increased workload, multiple role demands, threats to safety/security, scarce resources, cultural differences, invasion of personal space 210. What are some reasons delegation is necessary? RN shortage, health care reform, increased need for nursing services, cost containment, time management, demographic trends, use of UAP 211. What are some RN only tasks that should not be delegated? Initial teaching, nursing diagnoses, assessments, delegation to others 212. What are some roles of the nurse manager? Customer service, team building and motivation, decisions/mediation, evaluations, delegation, change agent, clinical consults, staff development, corporate supplier 213. What are some things that can make groups (in general) feel more empowered? Joining/participating in Professional organizations, collective bargaining, shared governance 214. What are some trends in informatics today? EMR/Smartcards, telehealth, email help, health websites and evaluation of web resources 215. What are some types of errors that can occur in healthcare delivery Diagnostic, treatment, preventative 216. What are some ways in which nurses feel empowered? Assist with decision making, Keeping workloads manageable, reward/recognition, fairness/equality 217. What are some ways to lower resistance to change (Restraining forces) Information dissemination (give as much info as possible for better understanding), Disconfirm currently held beliefs(risks if a change does happen), Psychological safety must be ensured, Command (usually commanding doesn't work) 218. What are the 2 times in which confidentiality may be violated? If the pt is indicating they may harm themselves or others, if the pt gives permission for the information to be shared 219. What are the 5 rights of delegation a nurse must remember? Right task, Right circumstance, Right person, Right direction/communication, Right supervision/evaluation 220. What are the differences between mission statement, vision and philosophy of an organization Mission - reason for existence, Vision-goals/ambitions for future, Philosophy-value of principles/beliefs/behaviors 221. What are the different types of nursing practice models -Professional practice model, - Clinical practice model 222. What are the key things that should be included in shift change report? Pt ID, Pt Dx, Where the pt is, Treatment plan, Responses to treatments, omit personal opinion and judgement 223. What are the main components of michigans professional health recovery program? Intake, referral, treatment, recovery monitoring and completion 224. What are the qualities of a good leader? Integrity, courage, initiative, energy, optimism, perseverance, balance, ability to handle stress, self awareness 225. What are the requirements of the patient self determination act Advanced directives - (Each person must be provided with information regarding them, documentation must be made, education necessary, respect pts rights, demonstrate cultural humility) 226. What are the skills needs of a novice RN? Interpersonal skills, Clinical skills, organizational skills, delegation skills, prioritization skills, improved social skills 227. What do followers expect from good leadership? Respect, tools to do the job, guidelines/input into the decision and how it will affect them as followers, openness to change, quality relationships with supervision, rewards/recognition, balance of life, professional development opportunities 228. What happens if a student doesn't pass NCLEX after 3 x in one year Must have to repeat an RN program. Then gets 3 more chances in 12 months to pass (this may vary state to state) 229. What impact do ineffective nurse managers have on others? Can harm employees, clients and the organization for which they work 230. What is evidence based care model standards to follow? Ask a clinical question, acquire the evidence, appraise the evidence, apply the evidence to practice, assess the outcomes 231. What is formal power? Written policies set in stone 232. What is horizontal delegation" RN to RN (transfer of responsibility and accountability) Transfer to person of same expertise level. 233. What is informal power? Powers under the radar (stems from relationships you build/rapport etc - the way you speak to certain people can gain you power) 234. What is SWOT analysis? Strengths, weaknesses, opportunities, threats 235. What is the difference between delegating and assigning? Delegate- RN remains accountable (verticle RN to UAP), Assign-Transfer of responsibility (Horizontal RN to RN) (verticle -responsibility of the task if transferred to the delegatee, accountability remains with the delegator) 236. What is the difference between Theory X and Theory Y (McGregor) Theory X - Work is avoided, people want to do as little as possible, control and punishment is needed. Theory Y - Work itself can be motivating/rewarding, people actually want to do their job well, guidance and development with rewards are needed 237. What is the purpose of a mission statement? To show purpose/reason for existence, outlines aim of organization, critical in strategic planning and guides planning 238. What is the purpose of belief systems To explain concepts such as life and health, good and evil, and health and illness 239. What is the purpose of peer review? To provide the individual with feedback from those best acquainted with the requirements and demands of the position. 240. What is the role of the staff nurse pertaining to budget? Control spending /cost on the unit without compromising patient safety 241. What is the safety goal of JCAHO? Improve communication among health care providers 242. What is the staff RN role in research? Ensure rights, Identify problems, assist with research, implement findings, read widely and critically, attend conferences, seek an environment in support of research, journal clubs, collaborate with researchers 243. What is vertical delegation? From Rn to less qualified or UAP (RN is still accountable) 244. What should the nurse consider when implementing delegation to staff (assignments) Assign appropriate personnel who have the level of expertise necessary to deliver the care or carry out the activities. 245. What three traits are necessary in a person to prevent burnout 1. a sense of personal control rather than powerlessness 2. commitment to work and lifes activities rather than alienation 3. seeing lifes demands and changes as a challenge rather than a threat (THINK POSITIVE) 246. What to do if workplace safety is compromised Report to supervisor, call police, get medical attention, contact union/collective bargaining/ nurses association, participate in policy making 247. What type of law states that nurses have a duty to deliver care in such a manner that pts will not be harmed? (civil law) Tort 248. What were some reasons for the crossing the quality chasm initiative from the institute of medicine? Growing complexity of science and technology, increase in chronic medical conditions, poorly organized delivery of care system, constraints on exploiting the revolution in information technology 249. When must the NCLEX be taken within two years of graduation 250. Where does funding for research come from? Private foundations, nursing organizations, government (organizations NIH, Dept of Health and human services) 251. Who is responsible for RN disciplinary action? State boards of Nursing 252. Why are clinical pathways used? To decrease cost (save money)