NUR 456 STUDY GUIDE EXAM 2025

What is a bias? - -a predisposition or preference in favor or against people, or groups Implicit bias - -subconscious preference/prejudices Explicit bias - -conscious and intentional choices or action in favor of or again people, groups or things Destructive conflict - -Tendency to expand and escalate. Conflict continues until becomes irrelevant and or have been forgotten Productive conflict - -conflict centered in a perspective of a problem solving which is mutually rewarding to the conflicting individuals/groups Conflict practical management strategies: step 1 - -Acknowledge/agree that there is a problem (Who and what), identify the players and the causes Conflict practical management strategies: step 2 - -choose an option for dealing with the problem (how and why); what is the goal? What are we trying to accomplish? Conflict practical management strategies: step 3 - -methods of management; how to cope? Avoidance, compromising, collaboration, accommodation Key ingredients to productive conflict resolutions - -- good communication -establishing trust - creating a good working relationship - clearly identifying your interest /goals - recognizing and understanding emotions and how they may be affecting the dynamics of the situation - creating opportunities for mutual gain -agreeing and disagreeing Team work in nursing - -involves functioning effectively within nursing and interdisciplinary teams. Requires effective open communication, mutual respect, and shared decision making to achieve quality patient care Authoritarian - -leader is making decisions without input from the team (not ideal type of leadership, more dictatorship), useful in emergency situations Laissez-faire leadership style - -a leader that lets people lead themselves and make decisions for themselves, leads to low productivity and frustration because there is no actual leadership NUR 456 NUR 456 Demographic leadership style - -leader and team work together towards the same goals and outcomes. Promotes group satisfaction, but slows decision making when getting everyones input Tranformational leadership - -promotes teamwork and shared decision making; leader is seen as trustworthy and respected. Leader is strong and making decisions but is considering input from the team (ideal leadership style) Transactional leadership - -a reward in exchange for tasks being done Quality improvement process - -process by which we find ways that we can improve the quality of care that we deliver to our patients, foes along with evidence based practice Inequality - -uneven or unequal distribution of health resources between groups/populations Disparity - -measurable negative health outcomes or status affecting a vulnerable population Proactive planning - -strategy that involves planning ahead and looking for potential problems to avoid Reactive planning - -a strategy that is used to deal with unforeseen situation after it has taken place; used in response to an unplanned event or problem Profession - -a calling requiring specialized knowledge and often long and intensive academic preparation Professional - -an individual who does a job requiring special education, training and skill Professionalism - -the demonstration of accountable and responsible behaviors that reflect core values integral to the profession while incorporating legal and ethical principals and regulatory guidelines that comply w standards of the professions Evidence based practice - -the best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Leader - -the ability to motivate and change actions in other Leadership - -an interactive process in which an individual influences and guides others to act in a desired manner Management - -the process of planning, organizing, directing and coordinating the work within a group or organization NUR 456 NUR 456 Teamwork - -collaborative actions toward a collective end goal Teamwork in nursing - -functioning effectively within nursing and interdisciplinary teams. Successful teamwork requires open effective communication, mutual respect and shared decision making to achieve quality patient care Communication - -the active exchange of information between individuals in the form of verbal language and nonverbal cues that are processed and interpreted with the goal of creating a shared meaning Clinical decision making - -process used by clinicians to identify client problems using assessment, then planning and implementing the most appropriate interventions to achieve specified outcomes, these outcomes are then identified for effectiveness. Nurses must possess clinical decsion making skills to provide safe and effective nursing care. Critical thinking - -the use of cognitive skills of interpretation, analysis, evaluation, inference, explanation, and reflection during decision making in response to an actual or potential clinical problem or situation Clinical reasoning - -the use of discipline-specific knowledge, to gather and analyze patient information, evaluate its relevance and weigh evidence-based alternative actions as a clinical situation changes Clinical judgement - -an interpretation or conclusion about patient needs, concerns or health problems, guiding decisions making and actions related to patient care and practices Health care systems - -social, political and economic structures in place for the delivery of health care services. Each health care system has established policies, processes and procedures that guide and govern the delivery of services. Hospital/health care provider organization and legal policies dictate the standards of the practice for the nurses and other care team members within the various types of practice settings. Safety - -the condition of being protected from ongoing harm; protection from reduction of preventable harm, injury or loss Culture of safety - -values, beliefs and norms that support and promote patient and employee safety. Characterized by; blame free environment for reporting errors or risks without fear of repercussions; open communication, respect and event reporting Quality improvement - -a systemic approach aimed at enhancing the efficiency, effectiveness and adaptability of organizational processes or systems. Characterized as a continuous effort to make incremental improvements over various organizations NUR 456 NUR 456 systems and processes with the goal of improved quality and outcomes for patients and staff Legal issues - -polices, legislation and laws govern behaviors and practice. Sources include constitutions, statutes, administrative agencies, court decisions, as well as organizational policies Ex: nurse practice act of each state governs the boundaries of practice nurses- creating the foundation for legal concepts malpractice or professional negligence. Ethics - -moral principles, or principles of conduct that govern individual or group decisions or behaviors. Health policy - -decisions, plans and actions that are undertaken or achieve specific care goals within a society Accountability - -being responsible for consequences of group or individual actions. Level of accountability are linked to knowledge and power of the individual (nurse) or group. Advocacy - -actions by individuals (nurse) or groups aimed at influencing political ,economic, and or social institutions. This is a primary role for nurses. The nurse advocates for themselves, the professions and others unable or disempowered to make decisions for themselves Delegation - -the transfer of responsibility for the performance of a selected nursing activity or task from a licensed nurse authorized to preform the activity or task to someone who does not have the authority Legal delegation - -is derived from the authority of the nurse licensure or other professional licensure (nurse practice act) Delgate - -the individual staff person receiving the delegated tasks Delegator - -the individual making the decisions (the RN) 5 rights or delegation - - Right task Right circumstance Right person Right direction/ communication Right supervision Under delegation - -not enough work is delegated Over delegation - -work is appropriate, but workload is beyond what the delegate can reasonably do in the assigned time NUR 456 NUR 456 Improper delegation - -one for the following occurs; wrong task, wrong patient, wrong circumstance, wrong directions, wrong supervision Refusal by delegate - -delegate refuses to agree to accept an assignment Steps for delegation - -1. Assess the patient 2. Assess the competency, job description, experience, education of delegate 3. Did delegate confirm or reject What CANNOT be delegated - -- requiring nursing assessment, analysis, planning and evaluation of patient data leading to a clinical conclusion -may lead to an unpredictable outcome - involves anticipated modification - formulation of the nursing plan of care or evaluation of the patients response to the care provided - administration of medications except as permitted in M.G.L 94C and I05 CMR - patient/client health teaching and counseling Clear communication and delegation - - - define task clearly - delineate end results, time frame and standards - delegate the objective, not the procedure - blood glucose monitoring Causes of Improperly Delegating - - - wrong time, to the wrong person or for the wrong reason - beyond the capability of the person or something the manager should do - decision making w/out providing adequate information Resistance to delegation - -- resistance is a common response by subordinates to delegation - one of the most common causes of resistance/refusal of delegated tasks is the failure of the delegator to see the subordinates perspectives - resistance to delegation may also occur when task are over delegated What is quality control? - -activities that are used to evaluate, monitor or regulate services rendered to consumers What is the standard? - -predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced Hallmarks of effective quality controls problems - -- requires: support from top-level administration, commitment by the organization in terms of fiscal and human resources, quality goals reflect search for excellence