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,Effective Leadership & Management in ki ki ki ki
Nursing, 9e (Sullivan)Chapter 1 Introducing
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Nursing Management
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1) A nurse manager is participating in the healthcare organization's strategic planning
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committee. Which factor is the primary driving force and controlling factor in new
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initiativesthis committee might recommend?
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1. Cost of care ki ki
2. Access to care ki ki
3. Availability of care ki ki
4. Quality of ki
careAnswer: 1
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Explanation: 1. While all of the options given are driving forces in today's healthcare
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environment, the cost of providing care is still the primary issue. Cost of care controls
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access,availability, and quality.
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2. Access to care is controlled by the ability to pay.
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3. Care will not be available if it cannot be funded.
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4. Healthcare providers do not like to correlate quality with cost, but the economic reality
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isthat quality care must also be funded care.
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Cognitive Level: Applying ki k i
Client Need: Safe Effective Care
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EnvironmentClient Need Sub: Management
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of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Leadership
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Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including
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thoseresulting from implementation of the Affordable Care Act; demands to reduce errors
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and improve patient safety; and evolving medical and communication technology.
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,2) A nurse has been invited to discuss healthcare costs at a senior citizens' club.
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Whatinformation should the nurse plan to include in this discussion?
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1. While healthcare costs continue to rise, the percentage of the United States (U.S.)
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economyspent on healthcare has slowly declined to less than 12%.
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2. Regulations brought about by the Patient Protection and Affordable Care Act ki ki ki ki ki ki ki ki ki ki
(PPACA)should bring financial relief to healthcare consumers.
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3. The United States spends more money on healthcare than any other country.
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4. Healthcare spending in the United States is slowly declining due to passage of bills such ki ki ki ki ki ki ki ki ki ki ki ki ki ki
asthe Patient Protection and Affordable Care Act (PPACA).
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Answer: 2 k i
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's ki ki ki ki ki ki ki ki ki ki ki ki
grossdomestic product.
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2. Implementation of PPACA and its regulations have not been formulated. ki ki ki ki ki ki ki ki ki
3. The United States spends more than $2.5 trillion on healthcare annually, more than
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anyother country.
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4. While this act has been passed, it is not operationalized. Healthcare spending continues
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torise.
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Cognitive Level: Analyzing ki k i
Client Need: Safe Effective Care ki k i ki ki
EnvironmentClient Need Sub: Management
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of Care
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Nursing/Int Conc: Nursing Process: Planning/Education ki k i ki ki
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including
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thoseresulting from implementation of the Affordable Care Act; demands to reduce errors
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and improve patient safety; and evolving medical and communication technology.
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3) A 70-year-old client develops a catheter-induced urinary tract infection. Which statement
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by the nurse would indicate to the nurse manager a need for additional understanding of
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thissituation?
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1. "I wonder if there was a break of sterility when this catheter was inserted."
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2. "Thankfully we can treat this with an antibiotic." ki ki ki ki ki ki ki
3. "This could potentially cost the hospital a lot of money."
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4. "I will talk to my unlicensed assistants about proper urinary catheter
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care."Answer: 2
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Explanation: 1. Wondering about a break in sterility indicates that the nurse is k i ki ki ki ki ki ki ki ki ki ki ki
concernedabout the process that might have contributed to this infection.
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2. The nurse who focuses on taking care of the results of a potential medical mistake is
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notaccepting the seriousness of the situation.
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3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by
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medical mistakes. This urinary tract infection could cost the hospital the cost of
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treatment,including increased length of stay.
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4. The nurse has identified that improper care may result in poor outcomes for the
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client.Cognitive Level: Applying
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Client Need: Safe Effective Care ki k i ki ki
EnvironmentClient Need Sub: Management
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of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Education ki k i ki ki
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including
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thoseresulting from implementation of the Affordable Care Act; demands to reduce errors
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and improve patient safety; and evolving medical and communication technology.
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4) Which healthcare situations reflect the philosophy of quality management as designed
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byDeming?
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Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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, Select all that apply. ki ki ki
1. A nurse asks visitors to leave because it is after visiting hours.
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2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed
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fromnothing by mouth (NPO) status.
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3. A nurse tells the manager that a housekeeper's work is not up to standards.
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4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
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5. A nurse who has not made a medication error in two years asks for a salary
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increase.Answer: 2, 3, 4
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Explanation: 1. The philosophy of quality management is focus on the needs of the client.
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Ifthere is no reason for the visitors to leave other than it is after visiting hours, this is not
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focused on client need.
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2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs.
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Thisis an example of quality management.
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3. Quality management empowers the employee to evaluate quality. ki ki ki ki ki ki ki
4. This nurse has seen a need and is working to improve the quality of service. This is
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qualitymanagement.
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5. Salary increases can be tied to quality improvement initiatives, but just asking for
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anincrease is not quality management.
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Cognitive Level: Applying ki k i
Client Need: Safe Effective Care ki k i ki ki
EnvironmentClient Need Sub: Management
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of Care
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Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice ki k i ki ki ki ki
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including
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thoseresulting from implementation of the Affordable Care Act; demands to reduce errors
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and improve patient safety; and evolving medical and communication technology.
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