Nursing Practice
2000 IOM report, To Err is Human - ✅✅-Suggested that health professionals
should be educated in teams using evidenced-based methods such as simulation
and checklists.
A healthcare organization is collecting data about the quality of nursing care in
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regards to effective coordination of care. What data/measurement will tell us
precisely what is going on with this process? - -Patient satisfaction survey: 60%
were satisfied with discharge education.
A nurse who is a member of an QI team notices that another member rarely speaks
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during meetings. What is the responsibility of the nurse to this team member? -
-Encourage the team member's participation in meetings.
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Act of collaboration in an inter-professional team might be best exemplified by -
-defining patient goals individually and then coming together as a team to
select the most important ones. Care is too complex today for a single discipline to
direct all caregivers represented on the team.
Act related to the PDSA. - ✅✅ -Communicate the results via graphs, charts,
meetings, etc. This means we may need to assess needs again to develop new
AIMS and start a new cycle of PDSA.
Advance Roles with large domains of Authority:
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Nurse Manger, Nurse Administrator, CNO. Lead and manage resources, money and
personnel. - -Hire and fire, manage a budget, responsible for activities of
multiple personnel. Day-to-day monitoring and on the spot correction. Manages
service lines, units, words. Often close to the front line.
Advance Roles with large domains of Influence:
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OI Manager, Infection Control Practitioner. Lead and manage programs and
committees that cross service lines and involve multiple professions. - -Use
evidence to make a compelling case that will convince people to do the right thing.
Perform organization risk assessment that helps steer the organization in a particular
direction. Often little to no budget or staff. Usually not very close to the front line.
Advanced Practice Role Key ideas: - ✅✅ -Support engagement of team members:
Participate, Facilitate, Collaborate and Negotiate. Effective communication and
leadership. Conflict resolution, shared decision making with patients. Shared
, governance with nurses and other staff. Patient centered care. Culture of safety and
to think big.
Advanced role or nurse advocate: - ✅✅ -MSN is positioned to advocate for those
who are unable to have a voice in the decision-making process.
After a year of working on a project to prevent surgical site infections, we have a
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decrease in the infection rate of 60%. What is the next step in the QI process? -
-Examine the data to see which patients were most affected.
Aim - ✅✅ -First step in the QI project is to determine the need. Example: decrease
Falls, decrease hospital Acquired infection.
An acute care hospital wants to change their HIPAA privacy policy to enable
personal health information to be shared with any person a patient give permission
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to enhance patient-centered care. How should this change be evaluated to
determine if it is successful? - -Compare patient satisfaction metrics between
pre-policy and post-policy change.
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An increased number of incident reports do not mean increased number of
incidences. - -This may be an indicator of psychological safety.
Appropriate delegate - ✅✅ -a subordinate who is the complete package in terms of
time, competency, and interpersonal skills.
Autonomy - ✅✅ -independence or freedom, as of the will or one's actions: the
autonomy of the individual.
Baseline Measurement date used: - ✅✅ -Substantiate the importance of change,
support the need to spend resources and provides a baseline for comparison after a
change takes place.
Benchmarks - ✅✅ -Benchmarks are external to organization. Competitor
performance and/or industry standard. Domains to consider when evaluating: quality,
quantity and consistency,
Beneficence - ✅✅ -the doing of active goodness, kindness, or charity, including all
actions intended to benefit others.
Change Agents - ✅✅ -People with high emotional intelligence are more effective on
teams and can help make change transitions easier.
Clinical leadership in a large hospital has assigned a team to determine the need for
a weight-loss support program at one of its clinics. What information must be