ATI RN LEADERSHIP PROCTORED: FOCUS REVIEW
Chapter 1, Managing client care:
Prioritizing Customer Care
o systemic before local
o acute before chronic
Real problems facing potential people
o Listen carefully to customers and do not listen
o Identify and respond to trends vs. transit findings
o Identify signs of medical emergencies and complications versus expected
findings
o Apply clinical knowledge to procedural standards to determine priority
action
Client care assignments
Assignments are done in a downward or lateral manner in relation to
members of the health care team
O Customer factors are:
Customer status and level of care required
Specific care needs such as cardiac monitoring or ventilation mechanical
Special precaution requirements such as isolation or fall precautions or
seizures, procedures Time commitments required
o Health care team factors:
Knowledge and skill level of team members
, Supervision that is required
Nurse to client ratio
Experience with similar customers
Staff member acquaintance with the 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
Positioning
Routine task, bed making
Specimen colletion
Intake and output
Vital signs for stable clients
Quality improvement
o Standars of care should reflect optimal goals and based on evidence
Outcomes indicators-client outcomes related to standard under
review
Structure indicators- setting in which care is provided and the
available humand and material resources
Process indicators- how client care is provided and are established by
policies and procedures( clinical practice guidelines)
Benchmarks- are goals that are set to determine at what level the
outcome indicators should be met
Focuses on assessment of outcomes and determines ways to improve
the delivery of quality care.
Chapter 1, Managing client care:
Prioritizing Customer Care
o systemic before local
o acute before chronic
Real problems facing potential people
o Listen carefully to customers and do not listen
o Identify and respond to trends vs. transit findings
o Identify signs of medical emergencies and complications versus expected
findings
o Apply clinical knowledge to procedural standards to determine priority
action
Client care assignments
Assignments are done in a downward or lateral manner in relation to
members of the health care team
O Customer factors are:
Customer status and level of care required
Specific care needs such as cardiac monitoring or ventilation mechanical
Special precaution requirements such as isolation or fall precautions or
seizures, procedures Time commitments required
o Health care team factors:
Knowledge and skill level of team members
, Supervision that is required
Nurse to client ratio
Experience with similar customers
Staff member acquaintance with the 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
Positioning
Routine task, bed making
Specimen colletion
Intake and output
Vital signs for stable clients
Quality improvement
o Standars of care should reflect optimal goals and based on evidence
Outcomes indicators-client outcomes related to standard under
review
Structure indicators- setting in which care is provided and the
available humand and material resources
Process indicators- how client care is provided and are established by
policies and procedures( clinical practice guidelines)
Benchmarks- are goals that are set to determine at what level the
outcome indicators should be met
Focuses on assessment of outcomes and determines ways to improve
the delivery of quality care.
