482 Exam 2 Questions with Complete Solutions Graded A+

482 Exam 2 Questions and Complete Solutions Graded A+ Emergent Change - Answer: assumes that change is a continuous open-ended and unpredictable process of aligning and realigning an organization to its changing environment Planned Change - Answer: any kind of alteration or modification which is done in advance and differently for the improvement of present position into a brighter one Transformation change - Answer: a complete change in the appearance or character of something/someone, especially so that thing or person is improved Transforming care at bedside - Answer: goal to improve quality and safety on med-surg units by engaging in changes to improve practice Innovation - Answer: the introduction of a new process or new way of doing something 5 stages of innovation process (rogers theory) - Answer: 1. knowledge of innovations existence 2. persuasion to form an attitude toward it 3. decision to adopt/reject 4. implementation 5. confirmation to reinforce/reverse it Three stages of Lewins Change Theory (planned change) - Answer: Unfreezing Moving/changing Refreezing unfreezing - Answer: assessing, problem identification and definition moving/changing - Answer: planning and implementing. problem analysis and seeking alternatives refreezing - Answer: evaluation, implementation, what are the reactions of people to change - Answer: fear sadness outrage stress disorientation eroded loyalty lack of commitment low risk taking what are the stages of planned change - Answer: 1. readiness 2. justification of need 3. assessment 4. planning 5. implementation 6. measurement 7. evaluation 6. sustaining goals what is the first appropriate response to concerns regarding change - Answer: assess the situation actions for change agents - Answer: - articulate a clear need for change - get group participation - get reliable info to the implementers - motivate through rewards - do NOT make promises you can't deliver other actions to support response to change - Answer: - active listening - promote action/solutions - staff informed decisions - solicit input and encourage participation - reframe difficult messages combat change fatigue - Answer: - use effective communication - support staff in where they are in accepting change - forfeit control and involve staff in process - identify where and how staff can fit in process - model positive outlook/energy who can help the effectiveness of change process? - Answer: involvement of those directly effected by change. view recipients of change as assets rather than barriers culture - Answer: set of values, beliefs, and assumptions that are shared by members of an organization safety culture - Answer: the outgrowth of the larger organization culture and emphasizes the deeper assumptions and values of the organization toward safety climate - Answer: individual perception of what it feels like to work in an environment safety climate - Answer: the shared perception of employees about the importance of safety within the organization is culture or climate easier to change - Answer: climate what is root cause analysis - Answer: a collective term that describes a wide range of approaches, tools, and techniques used to uncover causes of problems. how do you measure culture - Answer: has been measured both qualitatively and quantitatively * one believed it is only qualitatively 5 dimensions of culture - Answer: leadership group behavior/relationship communication quality of work/life healthcare worker outcomes magnet organizations must meet what components - Answer: Transformational leadership Structural empowerment Exemplary professional practice New knowledge innovations improvement Empirical outcomes clinical judgement - Answer: o Involves forming, refining, and evaluating hypothesis based upon recognizing and analyzing cues clinical reasoning - Answer: Decision making process that is grounded in professional thought process clinical decision making - Answer: involves clinical judgements that result in interventions at the point of patient care ABC prioritization - Answer: airway breathing circulation Hierarchy of needs prioritization - Answer: meet physiological needs first CURE prioritization - Answer: critical urgent routine extra first step of decision making process - Answer: define problem second step of decision making process - Answer: gather info third step of decision making process - Answer: determine overall goal/desired outcomes fourth step of decision making process - Answer: develop solutions fifth step of decision making process - Answer: consider consequences sixth step of decision making process - Answer: make decision seventh step of decision making process - Answer: implement and evaluate outcome piolet project - Answer: Carefully defined trials used to try out a solution alternative on a small or restricted basis to reduce risk and see whether major problems will occur D - Answer: define the problem/urgency need E - Answer: Establish desirable criteria for what you need to accomplish C - Answer: consider all possible alternatives and steps to be taken I - Answer: Identify best alternatives D - Answer: Develop and implement plan of action E - Answer: Evaluate and monitor situation how do personal values impact decision making - Answer: o Values drive behavior, drive the way resources are distributed, and reflect how the organization treats staff. what can managers do to improve job satisfaction - Answer: - leaders with a vision - value contribution - managers who empower not control - values lived not just spoken - employees who can voice concerns moral distress - Answer: occurs when clinicians know the ethical action to take but are prevented from doing so by either internal or external obstacles. time management - Answer: Deliberative process of identifying and focusing on the activities needed to accomplish tasks and goals in the time available. how can managers help with time management - Answer: - time audit self-assessment - prepare for the next workday - engage in projects - complete routine tasks - meetings only when necessary - model self care why are manager rounds/accessibility important - Answer: Role modeling leader access, visibility at all levels and support of creative and innovative ideas that translate into change initiatives will inspire and gain commitment from the change team. stress - Answer: o Negative emotional experience associated with biological changes that trigger the body to make adaptions. Can be physical, mental, psychological, or spiritual. Response to a stressor experience that is evaluated by individual as taxing or exceeding resources and threatening to one's sense of well-being. job stress - Answer: harmful physical and emotional responses that occur when the requirements of the job do not match capabilities, resources, or needs of the worker. stratigies to manage stress - Answer: - journaling to track stressors - set boundaries - take time to recharge - relaxation techniques - express gratitude - reflect - self care delegation - Answer: As the planned learning of new skills and opportunities for an individual that transfers duties or tasks to that individual for a purpose that is mutually beneficial for the individual and delegator. five rights of delegation - Answer: Right task Right condition Right individual Right instruction Right supervision and assessment tort - Answer: Civil or personal wrong, Wrongful act (other than breach of contract) committed against another person or organization or their property that cause harm and can be remedied by a civil lawsuit, Civil personal wrong purpose is to adjust losses by compensating one person because of actions of another. Only remedy available in civil lawsuit based on tort is monetary damages. intentional tort - Answer: Deliberate invasions of a person's legal rights, Represents direct interreference with a person's physical integrity or right to property, Common civil lawsuits include assault, battery, false imprisonment, property conversion, trespassing, intentional infliction, emotional distress. unintentional tort - Answer: Result from negligent, Occur when the defendant's actions or inactions were unreasonably unsafe negligence - Answer: failure to exercise the care toward others that aa reasonable or prudent person would do in the circumstances, taking action that such a reasonable person would not four components of neglegence - Answer: Duty, Breach of duty, Cause, Harm- results from breach of duty. Burden of proof is on plaintiff, must prove there was a well-established duty and an obvious breach of such duty. Must prove connection to harm claimed. who is responsible for the errors that occur because of delegation - Answer: nurse is accountable for supervision, follow-up, intervention, and: a. corrective action of the event what is the most important reference for delegation - Answer: Effective leadership and role management. Nurse leaders need to role-model proper and effective delegation through role management. civil law - Answer: private law; law between individuals - includes malpractice Criminal law - Answer: Based on public statue or common law, which consists of federal or state laws that make specific behaviors illegal - misuse of narcotics, practicing without a license, stealing, intentional patient harm vicarious liability - Answer: held liable for a wrong action you did not commit. attachment of responsibility to a person for harm or damages caused by another person in either a negligence lawsuit or criminal prosecution autonomy - Answer: patients right of self-determination and freedom of decision making beneficence - Answer: doing good for patients and providing benefit balanced against risk nonmaleficence - Answer: do no harm to paitnets justice - Answer: norm of being fair to all and giving equal treatment including distributing benefits, risk, and cost equality fidelity - Answer: being loyal and faithful to commitments and accountable for responsibilities veracity - Answer: norm of telling the truth and not intentionally, deceiving, or misleading comments confidentiality - Answer: Prohibits some disclosures of some information gained in certain relationships to some third parties without consent of the original source of the information. privacy - Answer: a right of limited physical or informational inaccessibility