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