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Leadership Exam 3

Leadership Exam Chapters 6-7, 14

QuestionAnswer
#1 mistake new nurses make? Failure to respond/react
Keys to communication? patient-centered care, teamwork & collaboration, & safety
The person who begins the transfer of information Sender
the process the sender uses to transmit the message (verbal, nonverbal, voice inflection, & body language) Encoding
The information or content Message
The manner in which the message is sent (facial expression, body language) Sensory Channel
The person or persons whom the sender intended to receive the message Receiver
the process of interpreting the message Decoding
Determines whether the message was received as intended Feedback
Fatal flaw is overlooking the feedback. What should be done to avoid this mistake? clarify the message
Conscious method of communication. Includes many different types: all must maintain professional & understandable language, grammar, & clarity Verbal communication
Encompasses behaviors, actions, & facial expressions Nonverbal communication
Good position to hear information clearly Receiving (the info)
Engagement in the conversation, positive body language, facial expressions, & gestures Attending (be present/engaged)
Gaining an understanding of what is being said, & what may not be said Understanding (clarify if needed)
Nonjudgmental manner & being aware if anything may have upset him/her Responding (don't assume the worst or best)
Recalling previous conversations with patient to establish a starting point with re-engaging Remembering
Gender- different styles: Men more assertive & more verbal, women more collaborative & nonverbal cues & metaphors
Personal vs texting: Generation
to whom do you communicate & how? Sensitive to teaching Culture (& religion)
differences to avoid miscommunication Values & perceptions
parameters (be aware of how close you get) personal space
A type of verbal presentation or document intended to share info & which conforms to established professional rules, standards & processes & avoids using slang terminology Formal
Casual form of information sharing typically used in personal conversations w/ friends or family members Informal
Flows quickly & haphazardly at all levels of the organization & becomes more & more distorted as it moves along Grapevine
to convey the same message across the entire system Organizational communication
Fosters patient-centered care & results in quality outcomes. Refers to workers across healthcare professionals to cooperate, collaborate, communicate, & integrate care in teams to ensure that care is continuous & reliable Interpersonal communication
Enhancing communication among health-care professionals producing quality outcomes, increasing patient satisfaction, reducing error rates & improving patient safety Intraprofessional communication
Inter/intra = similar
Intra = smaller unit
Inter = incorporates more (respiratory, etc.)
Evidence-based teamwork system developed by the U.S. Department of Defense in collaboration w/ the Agency of Healthcare Research & Quality (AHRQ). Team Strategies & Tools to Enhance Performance & Patient Safety (Team STEPPS)
TeamSTEPPS aim: to optimize patient safety outcomes by improving communication
Nurse to voice concern at least twice to receive acknowledgement from another team member. Standard of care not followed Two-challenge rule
Simultaneously informs team members of important information & assigns tasks during a critical event or situation (rapid response: calling out meds, dose, route of medications given) Call out
Use closed-looped communications & verify the information that is being received is correct Check-back
C.U.S = Concerned, Uncomfortable, Safety issue
SBAR = Situation, Background, Assessment, Recommendation
These transactions in care occur when a patient is transferred from one unit to another Handover
The institute for Patient-And-Family-Centered Care identified 4 concepts that apply during nurse-to-nurse (intra) handovers Respect & dignity, information sharing, participation (being present)
an injury to a patient caused by medical management rather than the patient's underlying condition is called adverse event or a patient safety event
a blame-free environment in which staff members feel comfortable reporting errors & near misses A culture of safety
when an action is not taken or omitted, such as when a nurse does not assess a patient after surgery or does not administer a medication Error of omission
a culture that is fair to those who make an error just culture
the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim Medical error
a potential error that was discovered before it was carried out near miss
indicators that reflect elements of patient care that are directly impacted by the quality & quantity of nursing care Nursing-sensitive quality indicators
relate to the results of nursing care & include changes in a patient's health status related to nursing care, such as pressure ulcers & patient falls. Improve when there is greater quality/quantity of nursing care Outcome indicators
resembles a bar chart- Designed to look at various causes of a specific problem. A tool to help determine the small portion of causes that account for a large amount of the variance in a process Pareto Chart
Promotes continuous QI (quality improvement); cycle is used to identify issues & improve care Plan-do-study-act (PDSA) cycle
a formalized investigation & problem-solving approach focused on identifying & understanding the underlying causes of an event as well as potential events that were intercepted root cause analysis (RCA)
a patient safety event that results in any of the following: death, permanent harm, & severe temporary harm & intervention required to sustain life; signals the need for immediate investigation & response Sentinel event
a rigorous method that encompasses 5 steps: define, measure, analyze, improve, & control. Used in QI to define the # of acceptable errors produced by a process. Involves improving, designing, & monitoring processes to minimize or reduce waste Six Sigma Model "don't mess around in clinical"
focuses on unsafe acts of health-care professionals & errors as the result of human behaviors, such as inattention, forgetfulness, negligence, & incompetence (you made the mistake) Human errors: personal approach
acknowledges that errors happen because humans are not perfect (what went wrong?) human errors: systems approach
what accounts for most preventable adverse events? Unintentional Human Errors & System Errors
What should a nurse do if their patient has never taken a certain medication before? Stop & clarify before giving it
Stage one of creating a culture of safety: safety management is based on rules & regulations
Stage 2 of creating a culture of safety: Good safety performance becomes an organizational goal
stage 3 of creating a culture of safety: safety performance is seen as dynamic & continuously improving
the process of developing, agreeing on & implementing uniform criteria, methods, processes, designs, or practices that can improve patient safety & quality care Standardization
Mission to make health care safer, higher quality, more accessible, equitable, & affordable Agency for Healthcare Research & Quality
1994: launched an initiative to investigate the impact of health-care restructuring on the safety & quality of patient care & the nursing profession American Nurses Association
A nonprofit organization established in 1999N in response to the recommendations from the Advisory Commission on Consumer Protection & Quality in the Health Care Industry National Quality Forum (NQF)
member states agreed on a resolution on patient safety in 2002 & recognized patient safety as a global health-care issue in 2004 World Health Organization (WHO)
accredits & certifies approximately 20,000 health-care organizations in the U.S. based on established standards The Joint Commission (TJC)
collaborates with the health-care improvement community to remove improvement roadblocks & launch innovations that improve patient care Institute of Healthcare Improvement (IHI)
relate to the care environment & include staffing levels, hours of nursing care per patient day, nursing skill levels, & education of staff Structure indicators
relate to how nursing care is provided & include elements falling under the nursing process (assessment, diagnosis, planning, intervention, & evaluation of nursing care) & job satisfaction Process indicators
NQF identifies the following 3 goals as critical in making health care safer for Americans: reduce preventable hospital admissions & readmissions; reduce the incidence of adverse health-care-associated conditions; reduce harm from inappropriate or unnecessary care
Goal is to reduce morbidity & mortality significantly in the American health-care system 1,000 Lives Campaign
defines patient safety as "the absence of preventable harm to a patient during the process of health care" World Health Organizations
developed between 2007 & 2014 to address the following issues: medication accuracy at transitions of care; correct procedure at the correct body site 5 standard operating protocols
any quality management program that addresses all areas of an organization, emphasizes customer satisfaction, & uses continuous improvement methods & tools Total Quality Management (TQM)
All QI programs incorporate 4 key principles: QI works as systems & processes; there is a focus on patients; there is a focus on being part of the team; there is a focus on the use of data
First part of the IHI Model of Improvement: fundamental questions
2nd part of the IHI Model of Improvement: Plan-Do-Study-Act (PDSA)
the Pareto chart is a tool to help determine the "small portion of causes that amount for a large amount of the variance" in a process, according to what? 80/20 principle
A dynamic process that results in altering or making something different Change
purposeful, calculated, & collaborative, & it includes the deliberate application of change theories Planned change
occurs when the need for change is sudden & necessary to manage a crisis (ex: car breaks down --> buy a new one) Unplanned change
successful leaders & managers manage unplanned change through: effective communication, adaptability, coordination, & the ability to remain grounded
the process of creating something new after thoughtful analysis of a phenomenon (ex: studying) Innovation
most widely used 3 step model: Lewin's force-field model (1951)
according to Lewin, change results from what 2 fields or environmental forces? driving forces (helping) that attempt to facilitate the change & move it forward; restraining forces (hindering) that attempt to impede change & maintain the status quo (ex: self doubt, stress)
Lewin's force-field model (1951) involves what 3 stages? Unfreezing stage, Moving stage, & Refreezing stage
stage that determines change is needed: Unfreezing stage
stage that begins initiation of the desired change: Moving stage
stage that involves stabilizing the change & achieving equilibrium: Refreezing stage
cyclical rather than linear & require organizations to react with speed & flexibility Emerging theories
The newer emerging change theories proved another perspective from which to view change & innovation based on what? complexity science
recognizes that the world is a continual motion & that a change in one area can result in numerous changes in other areas complexity science
nonlinear & unpredictable, & it explains why a small change in one area can have a large affect across an organization. Known as the "butterfly effect"; ex: shortage of nurses leads to increased errors & burnout Chaos theory
Senge (1990): to excel, future organization will need to "discover how to tap people's commitment & capacity to learn at all levels in an organization" Learning Organization Theory
organization where people continually expand their capacity to create results they truly desire, where new & expansive patterns of thinking r nurtured, where collective aspiration is set free, & where people are continually learning how to learn together Learning Organization
4 competencies for facilitating change: personal knowledge of & accountability; understanding the essence of change; the ability to collaborate & fully engage team members; competence in embracing vulnerability & risk taking
One who leads & manages the change process, including management of group dynamics, resistance to change, continuous communication, & the momentum toward the desired outcome. "cheerleader" change agent
how threatened a person feels by change resistance
forces on the relationship needs of staff members, uses peer pressure, & relies on staff members' desires to have satisfactory work relationships Normative-reeducative strategy
assumes that staff members are essentially self-interested & providing info & education will assist staff in changing behavior & adopting the change or innovation empirical-rational strategy
based on power & authority & assumes that staff will respond to authority & threats of job loss. This strategy is used when resistance is expected. Results in rapid change & is often perceived by staff as they must accept the change or find new work power-coercive strategy
change initiative typically fail due to: poor coordination, ineffective communication, lack of staff cooperation
a state of disharmony among people & occurs when people have differing views conflict
a little conflict can result in what? organizational growth
internal conflict, or a conflict coming from within a person Intrapersonal conflict
a disagreement between or among 2 or more people interpersonal conflict
occurs between groups of people (ER staff vs ICU staff) intergroup conflict
disagreement between staff & organizational policies & procedures, standards, or changes being made (worker bee against management) organizational conflict
withdrawing or hiding from conflict. Postpones conflict. Not resolved. Avoiding
sacrificing one's own needs or goals & trying to satisfy another's desires, needs, or goals. Does not resolve conflict. accommodating
pursue own needs, desires, or goals at the expense of others. Power driven & can result in aggression. competing
effecting conflict resolution. Everyone gives something up & everyone gets something they want in return. Must be on an even playing field. Compromising
best strategy. Shared goals, commitment to working together. Time consuming, best chance for resolution collaborating
remind respect & focus on the issue & not the other person mutual respect
differentiate between what they need & what they want needs vs wants
understanding each other & hearing the other person's position compassion & empathy
remind those involved to focus on "I" statements & avoiding using "you" statements & avoid blaming staying in the "I"
which term describes the sound, timely, smooth, unfragmented, & seamless transmission... continuity of care
which action most likely to promote continuity of care? referring client to home health visits...
which is not a breach in patient health info confidentiality? charge nurse discusses patient's condition during shift report
Celebrity is patient, what actions by other nurse violates patient's privacy? (SATA) Takes photo when walking past patient's room, using photo taken & client's name to enhance hospital image, unassigned nurse goes through patient's chart
which of the following is a primary task to have an effective control system? identify the values of the department, improving safety precautions within the workplace
Created by: yulissalira
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