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Leadership Exam 4
Leadership Exam Chapters 8-10
| Question | Answer |
|---|---|
| a concept involving a system that guides & tracks patients over time through a comprehensive array of health services spanning all levels & intensity of care (doc office, hospital, home care); goal is to decrease fragmentation of care | continuum of care |
| basic elements of continuum of care include: | integrate health promotion, injury prevention, disease prevention, & disease management |
| fragmentation: | breaking the plan/cycle |
| acute care setting (continuum of care): | fall prevention |
| owned by stockholders, shareholders, or corporate owners; money is reinvested into the organization, & reserve funds to pay corporate owners/stockholders; funds are NOT always readily available for purposes that can affect nurses & patient care. | For-Profit |
| DON'T have stockholders/shareholders; must have funds available to run organization; sources of funding: public & govt. funding, grants, private donations, or a combo; typically serves a large # of nonpaying pts; may have to cut services or make changes | not-for-profit |
| largest type of health-care organization (most nurses work in these) | hospitals |
| substance abuse treatment facilities long term or short term? | short term (usually 3-6 months) |
| first line of defense: health promotion & illness prevention; focus is on health education & health screening; ex: health-care provider's offices, immunization centers, wellness centers | primary |
| emergency care & acute care; focus on diagnosis, treatment, & limiting disability; ex: hospitals, urgent care centers, ambulatory care facilities, birthing centers | secondary (in & out, fix you & move you out) |
| restoration & rehabilitation; focus on maintaining & improving current state of health; ex: rehab centers, assisted living centers, long-term care facilities, & hospices | tertiary (disease management, get you better & back to normal) |
| flu shots, mammograms, screenings? | primary |
| finger gets cut off --> get it fixed? | secondary |
| support groups? | tertiary |
| outlines who is accountable & responsible for the work in an organization, helps to define working relationships: | organizational structure |
| formal line of authority: top to bottom | chain of command |
| each individual employee is accountable only to one manager, with expectations clearly defined & well understood | unity of command |
| manager's scope of responsibility & reflects the number of employees who report to a given manager | span of command |
| authority that can change day to day and makes sure patients are taken care of on a day to day basis? | charge nurse |
| maintains budget, scheduling, resource & education you need, licenses, immunizations, credentials | manager |
| structure: hierarchical; authority for decision-making is held by a few individuals at the top; minimal innovation or creativity & problems are dealt w/ by few leaders/managers (delay decision making); communication from top to bottom, tightly controlled | centralized structure |
| structure: authority/power for decision making are shared by a # of individuals across organization (flat); problems can often be solved at level where they occur; staff members are responsible for making decisions related to their areas of expertise... | decentralized structure |
| type of organizational structure for magnet status? | decentralized structure |
| an organization description of overall purpose; future oriented; regional hospital: "our promise is to provide the highest quality, compassionate care- every patient, every time." | mission statement (usually very short) |
| reflects the image for the future the organization plans to create; regional hospital: "To be the healthcare provider of choice for the Wabash Valley & the customers we serve." | vision statement |
| statement of beliefs, values, concepts, & principles that reflect the ideas, convictions, & attitudes of the organization; regional hospital: " values- integrity, courage, accountability, respect, exceed expectations" | philosophy |
| who have a major responsibility to model the core values of the organization & ensure that the activities for their unit or department reflect the vision, mission, & philosophy of the organization? | nurse leaders & managers |
| defined as a continuous, systematic process of making risk-taking decisions today w/ the greatest possible knowledge of their effects on the future; how an organization defines future; can be considered a roadmap for the future | strategic planning |
| primary goal of strategic planning? | to maximize organizational performance |
| analysis that can assist nurse leaders & managers in improving care delivery; positive or helpful; negative or harmful | SWOT analysis |
| what does SWOT analysis stand for? | strengths, weaknesses, opportunities, threats |
| move away from the traditional business model to a more futuristic approach; rationale- cost containment, operational efficiencies, & safety & quality mandates | future |
| focuses on health-care organizations to improve patient experiences, safety, & quality of care, employee culture, & financial status | Patient Protection & Affordable Care Act of 2010 |
| seeing the relevant opportunities that could emerge from the future & strategizing how to make the most of them | strategic foresight |
| bringing vision to the planning process, seeing the relevant opportunities that are emerging & creating a desired future | future thinking |
| 4 practices that create a culture where the future can be assessed & leveraged: | collaborating, reflecting, envisioning, & strategizing |
| policies directly/ indirectly influence nursing practice & the nature & functioning of the health-care system | regulation |
| developed & implemented by federal, state, & local govts. as well as private organizations (Joint Commission) | regulation |
| mission: to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations & inspiring them to excel in providing safe & effective care of highest quality & value | The Joint Commission |
| created in 2013: merged Det Norske Veritas (norway) & germanischer Lloyd (germany) ; National Integrated Accreditation for Healthcare Organizations (NIAHO) | DNV GL |
| is Union Hospital a Joint Commission hospital? | no |
| a credential that organizations earn in recognition for quality patient care, nurse excellence, & innovations in professional nursing practice | magnet recognition |
| transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovations & improvements, empirical quality results | 5 model components (14 forces of magnetism) |
| need to reflect patterns, purpose, & processes & require a continuum-based, person- & outcome- driven system design. Cyclical rather than linear. | contemporary organizational theories |
| the whole is greater than the sum of its parts; open systems & closed systems | general systems theory |
| derived from the general systems theory, physics, & suggests that relationships are the key to everything | complexity theory |
| described by Peter Senge (1990), to excel, future organizations will need to discover how to tap people's commitment & capacity to learn at all levels in an organization | learning organization theory |
| key concepts of complexity theory: | attractors, patterns, nonlinearity, self-organization, & emergence |
| combines computer technology with data & telecommunications technologies to provide solutions to the health-care industry | Information technology (IT) |
| integrates nursing science, computer science, information science, & information technology to manage & communicate data, information, knowledge, & wisdom | nursing informatics |
| two major types of information systems: | administrative & clinical |
| phases of the life cycle: | planning & analysis, design, implementation, & support & evaluation |
| electronic record of a patient that is used by a single organization | electronic medical record |
| used by more than one organization, provides information throughout | electronic health record |
| an electronic form of a patient's medical record that the patient can take w/ him or her to send to a health care provider | personal health record |
| fundamental framework of an information system that allows electronic devices to transfer information between each other (most common ex: internet; within a health care organization's own: intranet) | network |
| collection of info, facts, or numbers; gathered, managed, analyzed, & interpreted to ensure effective operation of the unit as well as safe & effective delivery of nursing care | data |
| central place that stores data | database |
| database in which data from all information systems within an organization are kept & controlled | clinical data repository |
| process of extracting specific data info or knowledge that was previously unknown; can be used to understand patient symptoms, predict diseases, & identify possible interventions | data mining |
| used to match data points from one system to the other so data can be communicated between systems or sent to a main info system for collective use & analysis | interfaces |
| used to provide warnings to other decision support methods in order to help health care professionals become more aware of certain clinical info or utilize evidence-based practices | decision support systems |
| requires an action within the system to trigger or "fire" it (ex: we don't give 30 mg of morphine) | rule |
| a straightforward warning to implement precautions per institutional policy, which usually requires acknowledgement of the warning or a reason for overriding it (ex: giving too much heparin --> pump beeps) | alert |
| designed to safeguard an individual's health information | privacy rule |
| establishes a set of national standards to protect electronic health information | security rule |
| requires all health care organizations to report any data breaches | breach notification rule |
| health-care component known as the Health Information Technology for Economic and Clinical Health Act or HITECH Act | American Recovery & Reinvestment Act of 2009 (ARRA) |
| data collected from electronic health records to improve health care & patient outcomes; the joint commission, the center for medicare & medicaid services, & the U.S. department of health & human services | regulatory requirements |
| CMS programs (ex: medicare) that require use of the electronic record to improve patient care & consists of 3 stages | meaningful use program |
| stage 1 of meaningful use program: | data capture & sharing |
| stage 2 of meaningful use program: | advanced clinical processes |
| stage 3 of meaningful use program: | improving outcomes |
| strategic planning for technology & computer systems in an organization | chief information officer |
| a physician who integrates the field of medicine & IT | chief medical information officer |
| integrates nursing & IT, in charge of strategic planning for the information system | chief nursing information officer |
| responsible for planning, monitoring, & execution of an informatics project | project manager |
| analyzes education needs of clinical staff who will utilize information system (not necessarily the ones teaching) | clinical systems educator |
| process of taking the data in a patient file & applying an industry-standard medical code to the data | coding |
| supports documentation of medications by providing a list of medication orders & when they are due to be administered | electronic medication administration record |
| allows providers to enter orders directly into a patient's record | computerized provider order entry (CPOE) |
| process in which clinicians use a barcode reader to verify patient identity & drug info immediately prior to giving medication to a patient | barcode medication administration |
| web-based platforms that allow patients to access their health info | patient portals |
| specialty in which electronic devices & telecommunication technology are used to serve education & health care to clinicians & patients | TeleHealth |
| point when you switch from one system to another or turn on a new application | conversion |
| requires technical, vendor, education, & support resources | implementation support |
| support of the application through enhancements to the system throughout the rest of the system life cycle | maintenance |
| procedures in place to tell staff how they will get info when the system is down | system downtime |
| what's important for nurse leaders & mangers to consider when recruiting & hiring? | hire a balance of new nurse graduates & experienced nurses |
| new graduate nurses exhibit novice to advance beginner characteristics (marginally accepted performance) | Benner's Novice to Expert Model |
| nurses feel safe from physiological & psychological harm & can find meaning & joy in their work | healthy work environment |
| the art of guiding another individual toward fulfilling his or her future, to assist a person in achieving his or her goals, a coach helps him or her develop & prioritize viable solutions & then act on them | coaching staff members |
| a formal evaluation of the work performance of an employee that is conducted by the nurse leader & manager | appraising performance |
| includes threats & fear to control the employee behavior, by criticizing the employee & making him or her feel humiliated | destructive feedback |
| form of peer review; a type of anonymous, constructive feedback in which nurses receive feedback from everyone around them | 36 degree feedback |
| 1st violation corrective action plan: | an informal verbal reprimand is given (nurse leader/manager explores plan for improvement & agrees on plan w/ employee) |
| 2nd violation corrective action plan: | a written reprimand is given (establishes plan for improvement, discusses consequences if violation continues or no improvement is shown) |
| 3rd violation corrective action plan: violation occurs a 3rd time w/ no improvement | consults w/ human resources; suspends employee w/ or w/o pay, determines plan for improvement, documents reprimand in writing |
| 4th violation corrective action plan: violation continues to occur after multiple reprimands or employee fails to improve performance to the level of standard of performance | consult HR, meet w/ employee, terminate employee, document process in writing according to policy & procedures |
| the charge nurse is planning assignment. Which factors should the nurse remain mindful when planning? | acuity levels of the clients; clients needs & workers' needs & abilities |
| the registered nurse is planning assignments for the day. Which is most appropriate assignment for a UAP? | a client who requires urine specimen collections |
| a new nurse manager on the unit is teaching a registered nurse how to correctly chart a patient's current condition. This is an example of what function of management? | controlling |
| the nurse manager has come up w/ new change for nursing unit. A registered nurse is resistant to the change & is not implanting it into her practice. Which of the following is best acting for the nurse manager to take? | Ask RN about her feelings & resistance to change |
| a client w/ a history of suicide attempts is admitted... the priority of the nurse is to assess for: | presence of suicidal thoughts |
| an RN on a busy med surg unit has administered the wrong medication to her patient. Her first response should be to: | report to the physician |
| the lack of necessary supplies & equipment to adequately & safely care for patients is an example of a: | system variance |
Created by:
yulissalira
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