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Roles Exam 3
| Question | Answer |
|---|---|
| Nurse leader | the person who is expert in the area |
| nursing manager | looking at quality outcomes for pt. Difference between status quo and what should be |
| hat type of hospital would give you a voice | magnet, shared governence |
| shared governance | Decisions and responsibility is shared Ex) magnet |
| If there is a hospital that is magnet status is JACO easier or harder | Easier, because they go above and beyond the requirements |
| There is a large organization that has a smaller group it is called | subculture |
| If you look at a root cause analysis you look at what kind of diagragm | fish bone |
| What are Lewins three stages of change | Unfreezing Experiencing the change Refreezing |
| What is unfreezing | Awareness of an opportunity, need or problem (ASSESSING) |
| What is experiencing the change | Incorporating of what is new or different into work and inter-personally process (IMPLEMENTATION) |
| What is refreezing | When participants accept change and use the new attitude or behavior (Evaluation) |
| General hospital has best burn unit in country, the rural hospital is developing a rural burn unit in area and is looking at General hospital. What is that called? | Benchmarking |
| Diffusion of innovations (Rogers) | innovations spread through society, occurring in stages; knowledge, persuasion, decision, implementation, and confirmation |
| Translating research into practice (TRIP) | Approaches that integrate the use of evidence into patient care |
| Your child is ill and going to be hospitalized for several months, what do you apply for | FMLA |
| If you are on a committee to open a new hospital and have certificate of need pending, and you need to communicate with the legislature, what is the best way | face to face |
| working in a health department and patient commits suicide, what is that called | sentinel event |
| If you have an iv pump and you set it at 125 and it goes in at 1000 ml per hour what is that called | sentinel event |
| When 2 hospitals merge and the PICU from 1st hospital is put into 2nd hospital and were only given 1 days notice of change. There was merging of positions, If a person makes the transition difficult it is called a | internal force |
| You are the team leader and you have 2 RNs, 4 CNA, and the CNA comes to you and says I can't get to this patient care, and this patient care and this patient care. Team leader responds "Oh deal with it, I don't have time for that" What is it called? | Barrier |
| A clinical RN specialist is meeting one on one with staff nurses while they are working together to discuss data about the evidenced based practice. This is known as | Academic detailing |
| What is the basis for research utilization | Analysis of research done before putting it into practice |
| Why do you set career goals | To keep moving forward, goal to work toward |
| Why do you do a cover letter | To introduce yourself |
| What do you expect to be a benefit pckg | healthcare, sick days, vacation days |
| What will foster a successful interview process | Familiar with company, position, ask questions about it, proper language, dress professionally |
| If someone says you didn't do something right, what should your response be | Clarify communication |
| What does collective bargaining mean to nursing | It is more successful with patient safety |
| What is difference between traditional and nontraditional bargaining units | Traditional would be employees Nontraditional: RN do it for the safety and quality of care especially when strain occurs between management and nurses |
| What is whistleblowing | Is when a employee voices concern about the quality of care would put them in a vulnerable position if the were (AT will employees), but due to legislation will be protected from repercussions |
| What is evidenced based practice | The integration of individual clinical expertise, built from practice with the best available clinical evidence from systematic research applied to practice Evidenced based practice is using data and has same outcome every time |
| Research utilization is the process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices | |
| What is policy | A specifically designated statement to guide decisions and actions |
| What is politics | A process of human interaction within organizations |
| what is power | ability to influence others in an effort to achieve goals |
| What is political power | An authority held by a group within a society that allows for the administration of public resources and implement policies for society. Power may be acquired as a means of governmental direction or in opposition to a government group. |
| What is career | progressive achievement throughout a persons professional life |
| What is certification | Designation of special knowledge beyond basic licensure |
| Continuing education | learning that builds on prior knowledge and experience with the goal of being a more competent professional |
| curriculum vitae | A listing of professional life activities |
| licensure | A right granted that gives the licensee permission to do something that he or she could not legally do absent such permisiion |
| portfoliio | A professional assemblage of materials that represent the work of the professional including evaluations, letters of recommendation, certificates of accomplishments, etc |
| professional association (organization) | An alliance of practitioners within a profession that provides opportunities for its member to meet leaders in the fields, hone leadership skills, policy formation specialized education and shape future |
| resume | A summary of professional abilities and facts designed for specific opportunities |
| Friss career stylesWhat is a steady stateWhat is a steady state | Steady state Linear entrepreneurial and transient spiral |
| What is a steady state | Constancy in position with increasing professional skill (example: staff nurse) |
| What is linear career style | Represent vertical movement in the organizational hierarchy (example: Nursing service administrator) |
| Entrepreneurial and transient | appealing to nurses who wish to see the world or have a creative bent (Private practice nurse, temp assignments) |
| Spiral | Rational, independent responsibility for shaping career (in and out, up and down) (Nurse who returns after raising a family) |
| mentor | inspire new thinking and new opportunities and steer you to various roles and clinical areas |
| Intrinsic reward examples | a level of competence enhancing professional autonomy and enhancing personal confidence |
| Extrinsic rewards | recognition from peers and employers, increased consumer confidence, increased salary |
| American Nurses Association | advances the nursing profession y fostering high standards of nursing practice |
| Advanced practice nursing | Based on knowledge and skills acquired through basic RN education and graduate educaion and experience that includes advanced nursing theory, physical assessment, psychosocial assessment and treatment of illnesNurse practitioners, certified nurse midwives |
| Examples of Advanced practice nursing | Nurse practitioners, certified nurse midwives, ncertified registered nurse anesthetist, and clinical nurse specialist |
| Clinical nurse leader | masters degree prepared generalist who oversees the care coordination of a distinct group of pts in any setting. The CNL actively provides direct pt care in complex situations, evaluates pt. outcomes, & has decision making authority to change expert in ad |
| Doctor of nursing practice | expert in advanced nursing practice who has an earned clinically focused doctorate degree in nursing |
| Interprofessional team | Health care team composed of professionals from different disciplines including chaplains, nurses, dietitians, pharmacist, physical therapist, physicians, respiratory therapist, etc who cooperate, collaborate, communicate, and integrate care to ensure tha |
| Nursing roles | Traditional duties and responsibilites of the professional nurse, regardless of practcie area or setting, such as the roles of care provider, eduator, counselor, client advocate, change agent, leader, manager, and are guided by specifie professional stand |
| manager | looks at quality outcomes for pt and look at difference between what is and what should be |
| Leader | considered experts in that area |
| change agent | Analyzes status quo and finds problems, explores alternatives, possible outcomes and cost effective resources |
| Case managers | identify the best resources at the lowest cost to achieve the optimal health outcome for the client |
| Clinical nurse leader | Masters that oversees the care coordination of a distinct group of pts in any setting. Actively provides direct pt care in complex situations, may change care plans when necessary |
| Orientation | Activities that enhance adaptation to a new environment |
| portfolio | A collection of evidence demonstrating acquisition of skills, knowledge, and achievements related to a professional career |
| Professional objective | Occupational position for which one aims |
| resume | Summary of a job applicant's previous work experience and education |
| Coalitions | Groups of individuals or organizations that join together temporarily around a common goal |
| empowerment | The process by which we facilitate the participation of others in decision making and taking action so they are free to exercise power |
| influence | process of using power |
| negotiating | Conferring with others to bring about a settlement of differences |
| apathy | little or now interest in legislative politics as they relate to nursing and health care |
| buy in | recognition of the importance of activism within professional organization without active participation |
| self interest | involvement in professional organization to furthers ones own career |
| political sophistication | high level of professional organization activision |
| Leading the way | serving in elected or appointee positions in professional organization at the state and national levels |
| personal power | based on ones' reputation and credibility |
| Expert power | results from the knowledge and skills one possesses that are needed by others |
| position power | virtue of ones position within an organization or status within a group |
| perceived power | ones' reputation as a powerful person |
| information power | ones possession of selected information that is needed by others |
| connection power | gained by association with people who have links o powerful people |
| Mentors | competent, experienced professionals who develop a relationship with a less experienced nurse for the purpose of providing advice, support, information, and feedback to encourage the development of that person |
| Goal setting | helps one to know if what was planned was actually accomplished |
| Barriers | actors, internal or external to the change situation, that interfere with movement toward a desirable outcome |
| change management | The overall processes and strategies used to moderate and manage the preparation for, effect of, responses to, and outcomes of any condition or circumstance that is new or different from what existed previously (planning, organizing, implementing, evalua |
| change outcome | The end product of a change process |
| change process | The series of ongoing efforts applied to managing a change |
| change situations | The field comprising various factors and dynamics with which change is occuring |
| chaos theory | Theoretical construct defining the random appearing yet deterministic characteristics of complex organiztions |
| cybernetic theory | Regulation of systems by managing communication and feedback mechanisms |
| facilitators | Factors, internal or external to the change situation, that promote movement toward a desired outcome |
| high compexity change | A complicated change situation characterized by the interactions of multiple variables of people, technology, and systems |
| informal change agent | Person without designated authority who advances the change among a group of people |
| learning organization | The designation of a type of organization in which continual learning as an expectation permeates all levels to promote adequate responses required by dynamic, accelerated change |
| low complexity change | An uncomplicated change situation characterized by the interactions of the limited influences of people, technology, and systems |
| negative feedback | nformation indicating a correction is needed |
| nonlinear change | change occurring from self organizing patterns not human induced ones, in complex open system organizations |
| planned change (linear) | change expected and deliberately prepared beforehand by using systematic directional processes to develop and carry out activities to accomplish a desired outcome (reorganizing storage of unit supplies) |
| strategies | Approaches designed to achieve specific purposes |
| What are the two approaches on change | linear and nonlinear |
| change agent in linear planned changes focus on | specific goals and incremental steps needed to attain those goals |
| change agents in nonlinear, complex changes | Serve as monitors of the environment, negotiators of influences on a change, and precise forecasters of possible scenarios and their anticipated outcomes |
| What is force field anoalysis | an analysis of change situation including early and ongoing assessment of barriers and facilitators |
| Havelock six phases of planned change idea | change can be planned, implemented and evaluated in 6 sequential steps Useful for low-level, low-complexity change |
| Lippit, watson, and westley 7 phases of planned change | Useful for low-level, low-complexity change |
| Rogers innovation-decision proces | Useful for individual change |
| Senges 5 disciplines of learning organizations | 1. systems thinking 2. personal mastery 3. Mental models 4. Shared vision 5. Team learning |
| Example of chaos and learning organization theory | community hospital that has been sensitive to and has adapted to external and internal environmental influences, such as the need to make changes in reimbursement and accreditation policies |
| Hirschhorn three aspects to change | Political (working with pharmacy to effect a change in delivery of meds to pts) ,marketing (Determining what motivates others to change) military (Paying attention to the change outcomes |
| 6 behavioral responses to change | Innovators Early adopters Early majority Late majority Laggards Rejectors |
| Innovators | Thrive on change , may be disruptive to stability |
| Early adopters | respected by their peers and sought out for advice and information about changes |
| Early majority | prefer doing what has been done in the past but eventually will accept new ideas |
| Laggards | prefer keeping traditions and openly express their resistance to new ideas |
| rejectors | oppose change actively, even use sabotage |
| leadership rounding tool (Studor group) | -Establish and maintain a human rapport with staff -Ask what is working well for staff as they perform their daily functions -Ask what is not working well -Ask if there is someone whom they would like to especially recognize as a contributor to outsta |
| cooptation | manipulated involvement through an appointed or assigned role |
| manipulation | appeals to the motivational needs of others and influences them to participat |
| coercian | use of power to force others to make a change |
| Diffusion theory (Rogers) | Describes how the innovation is communicated and spreads over time throughout members of a specific culture or group |
| The starfish and the spider (Brafman and Beckstrom) | 2 leadership styles Starfish: neural network of cells (decentralized due to no head or central command)(ie. AA) Spider: 1 head and 8 legs (centralized organizatio) We need both |
| Acknowledgement | Recognition that an employee is valued and respected for what the have to offer to the workplace, team, or group |
| Active listening | Focusing completely o the speaker and listening without judgment to the essence of the conversation |
| Commitment | Feeling passionate about and dedicated to project or event |
| Dualism | An "either/or" way of conceptualizing reality in terms of 2 opposing sides or parts |
| Effective communication | A process that leads to positive outcomes for senders and receivers in terms of clarity, usefulness, and efficiency |
| Group | A number of individuals assembled together or having a unifying relationship |
| Synergy | A phenomenon in which teamwork produces extraordinary results that could not have been achieved by any one individual |
| Team | A number of people associated together in specific work or acctivities |
| Veterans | live by rules and don't question authority |
| Boomers | lived through cold war and influenced by assassinations of Kennedy, MLK, civil rights, womens rights |
| Gen X | latch key kids (both parents worked, divorce common, poor job stability |
| Gen Y | Future, massive tech, terrorism and natural disasters, education is key to success |
| When the sender is feeling stressed they could act how | Atttibution of blame Placation Constrained, cool-headedness irrelevant congruence |
| Attribution of blame | Mostly "you" messages; like "you really blew it" |
| Placation | " I was wrong. I'm sorry. Its all my fault" |
| Constrained, cool-headedness | "Studdies ahve show that in 75% of cases, the pt is correct. I decided to use research data in comeing to a solution" No feelings |
| irrelevant | (changes the subject) |
| Congruence | "For now, I feel concerned about the anger and hostility exhibed by Dr. X. I'm wondering what approach would de-esculate him" (words, actions, feelings match) |
| Barriers to communication | Distractions Inadequate knowledge poor planning differences in perception emotions and personality |
| Communication pitfalls | Giving advice making others wrong being defensive judging the other person patronizing giving false reassurance asking why questions blaming others |
| Keys to concept of team | conflict resolution singleness of mission willingness to cooperate commitment |
| Tools and issues that support teams | In groups and out groups power and control Use, develop, and be appreciated for my skills and resources |
| Qualities of a team player | adaptable collaborative committed communicative competent dependable disciplined enlarging enthusiastic intentional mission conscious prepared relational self improving selfless solution oriented Tenacious |
| To create synergy consistently | Establish a clear purpose use active listening be compassionate tell the truth be flexible commit to resolution |
| Druskat and wolff believe that 3 major componenet of smoothly functioning teams must be created | mutual trust among all members Strong sense of team identity Sense of team efficacy |
| Work group effectiveness improves when | team is functioning smoothly and emotions and feelings are being addressed on a routing basis |
| fear | False Evidence Appearing Real |
| Agency for Healthcare Research and quality | The primary federal agency devoted to improving quality, safety, efficiency, and effectiveness of health care |
| DNV | A new deeming organization as of 2008 to accredit healthcare organizations Direct competitor for JCAHO internationally |
| Institue for Healthcare Improvement | An independent organization devoted to improving pt. safety and health care globally Transforming care at the bedside Focuses on safety, reliability, care team vitality, patient-centeredness, increased value |
| Institute of Medicine | An organization that works outside of the federal government to provide independent, scientific advice "to err is human" and "preventing medication errors" |
| Magnet Recognition Program | Only national designation built on evolving through research. Designed to acknowledge nursing excellence |
| National Quality Forum | A membership based organization that sets priorities and goals for performance improvement and endorses standards for measurement "Never events" |
| The Joint Commision | An organization that accredits healthcare organizations and is deemed by the center for medicare and medicaid services as holding healthcare facilities to CMS standards Not for profit but facility must pay lots of $ for approval |
| STAR approach to pt safety | Stop to concentrate on task Think about task Act to accomplish the task Review how well the task was accomplished |
| at will employee | An individual who works without a contract |
| CDC | The main federal agengy protecting the health and safety agency protecting the health and safety of people in the US |
| Collective action | A mechanism for achieving professional practice through group decision making |
| collective bargaining | Mechanism for settling labor disputes y negotiation between the employer and representatives of the employees |
| culture | It consists of values, beliefs, attitudes, practices, rituals, and traditions |
| empowerment | A sharing of power and control with the expectation that people are responsible for them selves |
| followership | Those with whom a leader iteracts |
| governance | System by which an organization controls and directs formulation and administration of policy |
| mentor | An experienced person who helps a less experienced person navigate into expertis |
| role model | A person who enacts a role, typically in a positive way, so that others can follow the example |
| shared governance | A flat type of organizational structure with decision making decentralized |
| subculture | Element of a main culture that has formed its own culture that differs in some way |
| whistleblower | A person who makes public a serious wrongdoing or danger concealed within an organization when internal actions have failed to correct or make public a situation |
| workplace advocacy | Refers to acting on or in behalf of another who is unable to act for himself or herself to effect change about workplace conditions |
| 4 main purposes of collective participation | To promote the practice of professional nursing To establish and maintain standards of care To allocate resources effectively and efficiently To create satisfaction and support in the practice |
| 6 critical considerations in shared governance | Defined by the person in the role Defined by role, not job or task Based on outcomes Set in advance Linked to results Has observable processes |
| porter, Hawkins, and Parker basic principles of shared governance | partnerships, equity, accountability, and ownership |
| Gadow's manifestations of advocasy | Ensuring relevant information Enabling the selection of information Disclosing a personal view Providing support for making and implementing decisions Helping determine personal values |
| Benchmarking | Best practices, processes, or systems identified by a quality improvement team to be compared with the practice, process, or system under review |
| Continuous quality improvement | A comprehensive program designed to continually improve the quality of care |
| Failure mode and effects analysis | A method to analyze reliability problems proactively to avoid negative outcomes |
| Near miss | A clinical situation that resulted in no injury but that highlights the need for action |
| Never event | Error in medical care that is clearly identifiable, preventable, and serious in its consequences for the patient and that indicates a real problem in the safety and credibility of a health care facility |
| Nursing-sensitive outcome | Patient outcomes that relate to the quality of nursing care provided |
| paitent care outcome | A measureable end result of patient care |
| performance improvement | The aplication of quality improvement principles on an ongoing basis |
| quality assurance | A process that focuses on the clinical aspects of a providers care often in response to an identified problem Goal: To improve quality Focus: Discovery and corretion of errors Major tasks: Inspection of nursing activities & chart audit Quality team : Q |
| quality improvement | n ongoing process of innovation, prevention of error, and staff development used by an organization that has adopted a quality management philosophy Goal: To improve quality Focus: Prevention of errors Major tasks: Review of nursing activites, innovat |
| Quality management | A corporate culture emphasizing customer satisfaction, innovation, and employee involvement in quality improvement activities |
| Risk management | Integrated into a quality management program as a process of developing and implementing strategies that will minimize risks and mitigate the impact of adverse effects |
| Root-cause analysis | The process used to identify all possible causes of a sentinel event and all appropriate risk reduction strategies |
| Sentinel event | A serious, unexpected death or injury, such as suicide, infant abduction, or wrong site or wrong site surgery |
| Total quality management | A comprehensive program designed to achieve perfection in quality of care |
| Six Sigma 5 step methodology | Define opportunities Measure performance Analyze opportunity Improve performance Control performance |
| Pareto chart | Bar chart that identifies the major causes or components of a particular quality control problem |
| Fishbone | Effective method of summarizing a brainstorming session for a specific problem or outcome |
| Histogram | Bar chart that shows the frequency of events |
| Flowchart | describe complex tasks |
| line graphs (trend chart) | present data by showing the connection among variables |
| NANDA | North American Nursing Diagnosis Association |
| NIC | Interventions |
| NOC | Outcomes |
| NDNQI | National Database of Nursing Quality Indicators from the ANA that provides hospitals with unit level performance reports with comparisons with national averages and percentile rankings |
| Clinical guidelines | Statements of practice expectations developed by a group of healthcare practitioners to guide the clinical management of pts. |
| diffusion of innovation | Process by which ideas spread through a culture |
| evidence-based practice | The integration of individual clinical expertise, built from practice, with the best available clinical evidence from systematic research applied to practice |
| meta-analysis | Statistically combines similar studies on a particular issue to determine if the findings are significant across settings |
| outcomes | Anticipated or actual effects of program activities and outputs |
| practice based evidence | A research methodology that helps inform practice decisions by examining outcomes in the real world where patients may not be similar and the actual application of an intervention may have multiple variations |
| practice based research network | Originally formed to adress research issues in primary care. PBRN's are increasingly being used in large healthcare organizations having the capability of integrating system sacross multiple practice sites. The exist for primary care, community nursing ce |
| randomized controlled trial | Study in which patients are assigned by chance to one of the groups defined in the study |
| research | A systematic investigation to determine the truth or falsehood of a hypothesis |
| research utilization | Process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices |
| translating research into practice (TRIP) | Approaches that integrate the use of evidence into patient care |
Created by:
Laura ridenour
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