ATI RN LEADERSHIP PROCTORED:
FOCUS REVIEW
, ATI RN LEADERSHIP PROCTORED: FOCUS REVIEW
Chapter 1, Managing client care:
• Prioritizing client care
o Systemic before local
o Acute before chronic
o Actual problems before potential ones
o Listen carefully to clients and do not assume
o Recognize and response to trends vs transit findings
o Recognize indications of medical emergencies and complications vs
expected findings
o Apply clinical knowledge to procedural standars to determine the
priority action
• Client care assignments
o Assigning is performed in a downward or lateral manner with regard to
members of the healthcare team
o Client factors are:
▪ Condition of client and level of care needed
▪ Specific care needs such as cardiac monitoring or
ventilation mechanical
▪ Special precaution needs such as isolation or fall precautions
or seizures, procedures requiring time commitments
o Health care team factors:
▪ Knowledge and skill levels of the team members
▪ Supervision that is necessary
▪ Nurse to client ratio
▪ Experience with similar clients
▪ Familiarity of staff member with unit
o Additional factors;
▪ If receiving an unsafe assignment the nurse should bring the unsafe
assignment to the attention of the scheduling charge nurse and
negotiate new assignment, if the issue is not resolve, take the
concern
up the chain of command
▪ Nurse should file a written protest to the assignment such as an
assignment despite objection (ADO) or document of practice
situation (DOPS) with the appropriate administratior
▪ If not follow proper failure to accept the assignment following
proper channels could be considered client abandonment.
o Delegations to an assistive personnel
▪ ADLS
▪ Bathing, dressing, toileting, ambulating, feeding if pt has no
problems with swallowing
FOCUS REVIEW
, ATI RN LEADERSHIP PROCTORED: FOCUS REVIEW
Chapter 1, Managing client care:
• Prioritizing client care
o Systemic before local
o Acute before chronic
o Actual problems before potential ones
o Listen carefully to clients and do not assume
o Recognize and response to trends vs transit findings
o Recognize indications of medical emergencies and complications vs
expected findings
o Apply clinical knowledge to procedural standars to determine the
priority action
• Client care assignments
o Assigning is performed in a downward or lateral manner with regard to
members of the healthcare team
o Client factors are:
▪ Condition of client and level of care needed
▪ Specific care needs such as cardiac monitoring or
ventilation mechanical
▪ Special precaution needs such as isolation or fall precautions
or seizures, procedures requiring time commitments
o Health care team factors:
▪ Knowledge and skill levels of the team members
▪ Supervision that is necessary
▪ Nurse to client ratio
▪ Experience with similar clients
▪ Familiarity of staff member with unit
o Additional factors;
▪ If receiving an unsafe assignment the nurse should bring the unsafe
assignment to the attention of the scheduling charge nurse and
negotiate new assignment, if the issue is not resolve, take the
concern
up the chain of command
▪ Nurse should file a written protest to the assignment such as an
assignment despite objection (ADO) or document of practice
situation (DOPS) with the appropriate administratior
▪ If not follow proper failure to accept the assignment following
proper channels could be considered client abandonment.
o Delegations to an assistive personnel
▪ ADLS
▪ Bathing, dressing, toileting, ambulating, feeding if pt has no
problems with swallowing
