CNL Exam Flashcards
(230 cards)
1
Q
vertical leadership
A
-hierarchical
-management at the top, clearly outlined chain of command
-authority and decision making is at the top
2
Q
horiztonal leadership
A
-chain of command is limited
-dept managers can make decisions
-collaboration, and contribution is encouraged
3
Q
7 leadership styles
A
charismatic
bureaucratic
autocratic
consultative
participatory
democratic
laissez-faire
4
Q
what type of leadership style is this?
“depends upon personal charisma to influence people, engage followers and relates to one group rather than organization at large”
A
charismatic
5
Q
what type of leadership style is this?
“follows org rules exactly and expects everyone else to do so. May engender respect, but may not be conducive to change”
A
bureaucratic
6
Q
what type of leadership style is this?
“makes decisions independently and strictly enforces rules. Most effective in crisis situations, can have difficulty gaining commitment from staff”
A
autocratic
7
Q
wha type of leadership style is this?
“presents a decision and welcomes input and questions although decisions rarely change. Most effective when gaining support of staff is critical to success of proposed changes”
A
consultative
8
Q
what type of leadership style is this?
“presents a potential decision and then makes a final decision based on input from staff or teams. Time-consuming, may result in compromises, but can make staff feel motivated”
A
participatory
9
Q
what type of leadership style is this?
“presents a problem and asks staff or teams to arrive at a solution, although the leader usually makes final decision. Can delay decision making but staff and teams can be more committed to solution because of their input”
A
democratic
10
Q
what type of leadership style is this
“exerts little direct control but allows employees/teams to make decisions with little interference. may be effective leadership if teams are highly skilled and motivated, but can also be the product of poor mgmt skills and little being accomplished”
A
laissez faire
11
Q
who came up with the theory of interpersonal relations
A
peplau
12
Q
what are the 4 phases of peplau’s interpersonal relations theory?
A
orientation
identification
exploitation
resolution
13
Q
describe the 4 phases of peplau’s theory on interpersonal relations
A
orientation: patient seeks help, nurse determines patient’s need for assistance
identification: nurse helps patient to identify who can help, sets goals for care
exploitation: patient receives care from nurse
resolution: care is complete, relationship ends
14
Q
what is the transformational leadership theory?
A
leader leads change through showing respect and consideration for individuals, challenging them intellectually, and inspiring and influencing them
lead through example
identify what needs change and work with other members of team to inspire them and motivate them to find solutions
15
Q
Lewin’s change theory: what are the 3 phases
A
unfreezing (letting go of old habits)
changing: making change to healthier habit
refreezing: implements change as new habit permanently
16
Q
change theory: what are driving forces
A
those that support change or push patients toward understanding necessary changes
(i.e. breathing easier for smokers)
17
Q
change theory: restraining forces
A
work against driving forces and inhibit change
(i.e. living with people who smoke)
18
Q
change theory: equilibrium
A
driving and restraining forces are of equal strength
19
Q
why do nurses use maslow’s hierarchy of needs
A
helps determine priorities for patients based on whether needs are fulfilled
20
Q
maslow’s hierarchy of needs
A
base: physiological needs
safety
psychological of emotional needs
self-esteem
self-actualization
*goals should match where patient is
21
Q
systems thinking
A
concerned with how each part of the environment comes together to affect other parts and the overall system
22
Q
how do nurses use systems thinking
A
think about the organization more broadly, what are the interconnected groups and frameworks that make the unit or org run smoothly
circular process - systems support and interact with one another
23
Q
what is required for systems thinking
A
collaboration w/ interdisciplinary team
24
Q
complexity theory
A
-behavior of the complex group/system and ability to self-organize as a whole may be different from individual behavior and results from interactions adaptation
-outcomes are dependent on the interactions that occur and cannot be predicted
system will evolve in its own way - no one can have complete control
25
rational organizational theory
provides a framework and structure for making decisions and focuses on the on logical/rational decisions necessary to reach goals
26
steps in rational organizational theory
determine goals/desired outcomes
collect data
brainstorm to determine possible actions
determine positive and negatives for each action
reach a decision
implement changes
analyze outcomes
27
contingency theory
theory of organizational behavior that states that there is no one best method of organizing a company, corporation, or business but that organization is contingent on a number of factors, so what works in one may not work in another
28
crisis theory
how patients respond to crisis situations that interrupt their current practices of self care
29
chaos theory
even with the most disorganized situations, there is still a sense of order
appropriate mgmt of change can prevent chaos from erupting
30
social cognitive theory
learning develops from observation, and organizing and rehearsing behavior that has occurred
31
what conditions are required for modeling (social cognitive theory)?
attention
retention
reproduction
motivation
32
health belief model
considers a person's understanding of potential illness and its severity, the patient's risk of contracting the illness, and the benefits that would occur if steps were taken to prevent the illness, and potential barriers to prevention measures
33
ecological model
focuses on interactions b/w people and their environments
behavior effects multiple levels of influence (intrapersonal, interpersonal, socioeconomic, psychological, psychological organizational, community, public policy)
important to align individual and their environmental factors
34
theory of reasoned action
based on idea that actions people take voluntarily can be predicted according to their personal attitude toward the action and their perception of how others will view their doing the action
35
3 concepts of theory of reasoned action
attitudes
subjective norms
behavioral intention (based on weighing attitudes and subjective norms) --> leads to taking or avoiding action
36
what are 3 types of patient care models
team nursing
primary nursing
total patient care
37
team nursing approach
one nurse is team leader
each team member is responsible for certain types of care (meds, ADLs)
38
primary nursing
continuing of care - same nurse is assigned to care for same patient over time
39
total patient care
nurse is responsible for all aspects of patient care
aka case method nursing
40
decentralized unit
integrates mgmt into work of staff
work is spread out among staff, CNLs, and managers
*more nurses involved in leadership
*nursing staff feels more empowered
41
shared governance
gives nursing staff power and ability to work together and make decisions for the unit
can include council work
42
moral courage
acting in the best interests of a given situation, even if there are potentially negative consequences as a result
43
participative mgmt
style of organization that promotes mgmt of issues at all staff levels
ideas are shared, all nurses have access to communication, knowledge and guidance
44
synergistic model
occurs b/w patients and nurses when both parties work together for patient care
nurses provide care, patients must participate in health decisions regarding care (follow treatment, adhere to education)
45
what is the Omaha System used for?
used to measure patient outcomes, describe nursing interventions, and document patient needs
46
what are the 3 parts of the omaha system
problem classification: uses info gained from assessments - how are they impacted by environment, behaviors, etc.
intervention scheme: guides nurses in developing interventions for patients conditions
scale scheme: rate patient's problems, knowledge, behavior, health status, which can evaluate overall progress
47
levine's conservation model
each nurse patient relationship = an individual connection by adapting holistic approaches
conservation = keeping patient in state of wholeness or integrity when normal coping abilities are disturbed
48
medical model
focuses on diseases or illnesses that are present and seeks to find methods of treatment
patients may or may not agree, don't really give input
49
patient centered model
allows patients to have a say in the care they receive
care is focused on quality of life, more than just disease process
50
clinical microsystem
particular setting of clinical care that uses a specific group of people to provide care for patients
51
chain of command
order of authority for health care decision makers among providers
designed to protect nurses, patients and organization as a whole
52
what intellectual traits make critical thinking successful?
intellectual humility
intellectual integrity
intellectual empathy
53
6 health care disparities
SES
environment
education
diet/food
system (i.e. insurance coverage, quality of health care)
ethnicity
54
what are the 3 main components of appropriate decision making on part of patients
clinical info: give patients enough info to make informed decisions about care
clarifying values
guidance towards patients
55
3 examples of vulnerable patient populations
elderly
low health literacy
lowSES
56
who are key stakeholders that need to be involved when advocating for healthcare change?
patients/families/caregivers
health care providers
health care orgs and associations
employers and insurers
health care industry/manfuacturers
policy makers
57
legitimate power
comes from position/certain status
58
referent power
comes from having the respect of others
59
how can nurses influence policy reform at institutional level
nurses may serve on committees or lobby the organization's administration to make changes in policies and procedures in the hospital or clinic where they work
60
how can nurses influence policy reform at community level
can speak with comm leaders, promote outcomes through EBP by working with nursing organizations, or establish health policies in public health and preventative care
61
how can nurses influence policy reform at national level
work with legislators and politicians to educate them on importance of certain health standards
speak to groups about policy reform
serve on national committees for nursing orgs
62
when was CNL speciality implemented into practice
2007
63
who can the CNL collaborate with to disseminate information
team meetings
board of directors/administration
community health care providers
professional organizations
research opportunites
community groups
64
lateral integration
integrating different disciplines involved in clinicial quality
65
how do CNLs act as lateral integrators?
-coordinate patient activities and care
- meet with various professionals involved in care
-share info among health care team
-overseeing clinical care of patient
-effective hands off procedures
-intervening when necessary
-reviewing labs and imaging
-ensuring patient/family receive necessary info and education
-assist with development of plan of care and discharge plan
66
care coordination
process of organizing patient care, can involve various providers
67
problem based focus assessment
focuses on finding a solution to chief complaints and current health problems
ensures critical problems are addressed first
68
holistic nursing care
focuses on patients and their relationship to health, environment, and self care
consider physical, psychological, cognitive, spiritual, and social systems
69
holistic assessment
includes various aspects of patient's backgrounds beyond physical symptoms
can include developmental assessment (i.e. developmental stages), cultural and spiritual assessment
70
clinical microsystem
small team of health care providers who work together to provide health care to a specific group of patients
71
purpose of the clinical microsystem assessment
is the microsystem working to max efficiency and achieving desired outcomes
72
altruism
caring for others in a selfless manner by considering the needs of others without expecting a reward in return
73
autonomy
patient's rights to make their own decisions regarding their health
right to self determination
74
beneficience
process of doing good things for the sole benefit of others
75
non-maleficence
not doing things that would be harmful to patients
76
veracity
telling the truth
nurses have an ethical obligation to tell patients the truth about their conditions
77
bioethics
studying how ethical issues may arise within science and medicine
78
ethical codes
guides that are given to direct appropriate behavior and response when ethical dilemmas are encountered
79
does the code of ethics apply to all nurses
yes
80
end of life decision making
process of making decisions that may or may not prolong patient's lives
decision made by patients caregivers, physicians and families
81
negligence
performing any act of omission or commission that a reasonable person would otherwise not do
(i.e. wrong dose of meds)
82
agents
items that cause or contribute to disease conditoins
83
biological agents
may or may not be infectious
bacteria, viruses, fungi
84
psychological agents
affect mental health, can cause disease such as stresss
85
physical agents
means that might occur environmentally, such as accidents or natural disasters
86
nutritional agents
impact the body based on patient's nutrient intake, vitamin deficiency or toxicity
87
chemical agent
substance that contributes to disease, industrial chemicals or pesticides
88
active immunity
resistance to certain types of diseases
(can be from exposure to specific disease or immunizations)
89
health trajectory
course of an illness OR condition of patients
90
patient focused outcomes
associated with patient's physical processes,
ex: how the body responds to certain types of treatments, the physiological progression of the disease within the body, changes in body processes as responses to interventions, or changes in emotional status as a result of CBT
91
provider focused outcomes
activities that nurses perform to help patients reach their goals
ex: effective patient care, nursing competence in skills
92
medical diagnoses vs. nursing diagnoses
medical: provided by physicians, based on symptoms, history and diagnostics
nursing: provided by nurses, based on nursing assessments as well as potential outcomes surrounding the conditions of patients
93
nursing sensitive indicators
patient care measures that affect the nursing process
3 types: structure, process, outcome
94
structure indicators
describe components of the nursing staff: education, expertise, staffing ratios, current certifications
95
process indicators
measures certain type of care that nurses may give, such as performing assessments, developing nursing diagnoses, and providing interventions
96
outcome indicators
help to determine the quality of patient care provided based on patient outcomes
indicators may include outcomes like infection rates, wound development, patient falls
97
goal oriented patient care outcomes
focuses on patient's well-being across several measures
patients take part in deciding their own goals
goals should be measurable and achievable
98
five rights of med admin
right patient
right med
right dose
right time
right route
99
schedule 1 drugs
controlled substances
highest likelihood of contributing to addiction of abuse
i.e. LSD, heroin
100
schedule 2 drgus
drugs that carry a risk of abuse as well as physical or psychological dependence
ie opioids
101
schedule 3 drugs
may carry a risk of abuse but are less of a risk than schedule 2
ie stimulants
102
schedule 4 drugs
substances have less risk abuse but may cause psychological dependence
i.e. benzos
103
schedule 5 drugs
medications are least likely to cause abuse or dependence
i.e. opioids mixed with another med, cough meds
104
3 measures that can be used to anticipate complications
vital signs
knowledge of disease progression
knowledge of medication adverse reaction
105
transition
can involve moving from a hospital to a home or another facility
106
what are some key resources to think of when patients are transitioning from hospital to home or another facility
food
meal prep
support system
financial need
housing
transportation
107
predictive health
considers the potential effects of physical and emotional factors and how they will ultimately impact future health
looks at: healthy behaviors, genetics, biomarkers and social factors to determine how they will affect a persons' health throughout a lifespan --> influences interventions a patient will recevie
108
3 factors that influence response to illness and care
ethnicity
SES
support system
109
what tool can you use to test adult literacy skills
rapid estimate of adult literacy in medicine (REALM)
ascertains individuals knowledge of medical terms
110
pharmacogenomics
takes into account patient's genetic background in determining appropriate medications
111
biomarkers
biological markers that cause changes in the body, which guide clinicians in making decisions about care and treatment
can indicate changes at tissue, cellular or bloodstream level
112
deterministic beleifs
patients believe that outside forces predetermine illness or injury, no use trying to fight it
113
biomedical beliefs
illness is due to a system breakdown in the body
114
magico-religious beliefs
centered on spiritual, religious or magic forces that impact health and wellness
115
how are healthy behaviors addressed at individual level
self exam of healthy practices, setting goals for wellness
i.e. eating right, exercising, attending classes that promote health
116
how are healthy behaviors addressed at interpersonal group level
small groups of people gather together to discuss their ideas for healthy behaviors and incorporate them for a change
i.e. walking groups, book clubs, weight loss support groups
117
how are healthy behaviors addressed at organizational level
larger groups (health care centers, schools) support healthy living through campaigns or educational offerings
118
what are interventions to modify risk factors?
-assess patients
-establish a baseline for patient by which they can measure progress
-educate what constitutes risk factors and how these risk factors affect health
-evaluate motivation for change
-educate about methods to mitigate
-help develop plan for change
-advise about community resources
-provide access to programs
-track program and provide feedback
-develop reward system
-engage family and friends to help
-develop maintenance plan
119
what is this? "campaign that sets objectivesfor health of people in America based on scientific methods and is updated every 10 years"
healthy people
120
health policy
decisions, plans, or actions to achieve specific health care goals within a society
121
regulatory controls
limits and requirements health care organizations must follow that ensure they are in line with the standards set by the regulatory agency
122
what did the American Recovery and Reinvestment Act do
passed in 2009
goals of supporting jobs, encouraging economic activity and requiring accountability for government spending
designated money for public health programs, spend money on health care tech
123
what does CHIP provide
health insurance for families with children who do not have insurance or who meet low income guidelines
covers hospital care, outpatient programs, and emergency care, well visits, and immunizations
124
who governs CHIP
states w/ some federal funding
125
what are 4 things impacted by health care policy
health promotion/disease prevention
standards of care
scope of practice
access to care
126
health policy directives
instructions given about how to implement health practices that have been passed by legislation
127
what is aesthetic knowing
concentrates on how nurses perceives patients and their needs, as well as aspects of the relationship that are distinctive or unique
128
ethical knowing
understanding of what is moral or ethical, such as nurses' knowledge of measures that are correct in behavior, policies, and actions
129
what is the responsibility of nurses in disease surveillance
monitoring outbreak of disease in a community, tracking how it spreads, and determining how it affects the population
can also monitor rates of chronic diseases
130
data set
comprised of information applied to statistical analysis that is investigated as part of disease surveillance
131
what is the beveridge model
-developed for NHS in the UK
-citizens have a health card that gives them access to health care that the gov pays for through taxes
-gov sets prices to keep costs low
132
bismarck model
all citizens are covered by insurance with costs of insurance paid for by both employers and employees
health insurance companies don't make a profit so costs are contained
133
national health insurance model
-founded in Canada
-single payer system with the government funding the insurance program
-costs are contained
134
out of pocket model
people required to pay out of pocket because they don't have insurance or gov provided medical assistance
135
universal health care model
system of health care financing is in place in which all citizens receive a health card that provides access to care at no additional cost or limited additional cost
136
what forces impact delivery of care
political forces (change in leadership can expand or limit Medicaid)
legal/regulatory (i.e. CMS)
economic
137
SBAR
situation
background
assessment
recommendation
138
hospitalists
physicians who specifically care for patients in hospital
139
bargaining strategies: distributive
a competitive process in which one side wins and the other loses (zero sum, win lose)
140
bargaining strategies: integrative
a collaborative process (win-win). parties involve bargain jointly trying to solve problems
most successful if there is trust
141
bargaining strategies: mixed
combines some aspects of distributive and integrative
142
phases of collaboration
problem setting: identifies people to serve on team, individual roles of team members, and ideas for what the problem is
direction setting: team works together to establish identified problem and discuss resources
structuring phase: team members get assignments according to expertise, roles are assigned and clarified
143
groupthink
when all members of a group hold the same view or position on a matter
can be positive when all members agree but can limit possibilities for discussion, exchange of ideas or alternatives to current practice
144
3 types of group processing
task groups
teaching group
therapeutic group
145
task groups
designed to develop, plan, & implement a certain task
i.e. conference planning committee
146
teaching group
meets to provide education
ie. educational forum for patients os they can learn about exericse and weight control
147
therapeutic group
designed to manage situations that may cause stress or emotional disturbances
i.e. support group
148
error making process
when either one person on the team or a group of team members contribute to an error in decision making
process includes bringing error to attention of team and team works together to take action to fix it
149
error recovery process
necessary once an error has been discovered, whether it was the result of an individual or group
150
task conflict
occurs when team members disagree about certain practices
d/t educational differences, diversity in skill levels, difference of opinion
151
AVID approach to prevent conflict from escalatiing
assume - nurses assume positive things
validate - nurses listen to another's POV and confirm their feelings about the situation even if they dont agree
ignore - if nurses are unable to change a situation or validate, they should ignore and move on
do - do something to prevent stress of conflict form negatively affecting them
152
what does a culture of retention promote
employee satisfaction and preservation
staff is recognized for efforts and staff feels valued
153
incident based peer review
occurs when an incident happens as a result of a nurse's work and the situation is reviewed to determine outcomes and discipline
154
safe harbor peer review
occurs when a nurse has concerns regarding her assigned practices
may happen if a nurse feels her work is beyond her scope of practice
protects nurses from working beyond licensing requirements
155
what are 3 components of peer review process
observation - gather pertinent info about nurses's activity
feedback - nurse is given info about performance
strategizing - addresses needs and concerns that are raised during peer review
156
steps in designing a peer review process
1. get support for process from staff that will be participating
2. process of review is designed
3. nurses are educated about the process so they are aware of their roles --> implement for use and then evaluate
4. fix any issues identified and revise as needed
157
what does critical listening ential
hear what patients say
recognize body language
don't interrupt or interject
analyze what patients say, clarify and determine if there is anything else to be explored
158
voice mgmt
how nurses speak when they communicate with others
should adapt to patient (i..e low health literacy skills or language barriers)
159
therapeutic alliance
involves patients and nurses working together for patient focused care
160
shared decision aking
allows patients to have a voice and participate in plan of action for their care
patients receive evidence based info about their treatments, mgmt, screenings and preferences
individualizes care
161
positive regard
having respect for patients and seeing them as people of value and worth
162
emotional intelligence
ability to understand and manage one's emotions as well as the ability to recognize and understand the emotions of others
163
4 abilities involved in emotional intelligence
ability to perceive, use, understand and manage emotions
164
three responses to conflict
avoidance
accommodation
collaboration (best way)
165
what should nursing documentation include
care given (tx, education, responses to tx, measures that demonstrate they followed orders)
meds - type, dose, time, patients response
166
informed consent: what is the nurse's role?
nurses must document that the patient was given info and agreed to it, that they were given alternatives, and right to change to another health care provider
167
what is a culturally competent health care setting
one that recognizes that there are different sets of beliefs, values, and practices among patients and consumers
shows respect for different cultures and takes steps to bridge gaps
168
what should nurses do before working with patients from different cultures
self-reflection
169
acculturation
process of one person or group taking on the cultural identities of another
170
what 3 concepts are required for quality improvement
determination toward commitment to quality improvement
ideas
implementation
171
how is performance improvement different than research
research is to identify new info that can be applied to clinical setting
performance improvement works to improve already existing care practices - localized to affected area
172
Hospital Quality Initiative
started by CMS as a method of providing QI info to patients and consumers
*voluntary participation from healthcare orgs
173
Interdisciplinary Research Quality Initiative
created by Robert Wood Johnson Foundation in 2005 to determine how nurses impact quality of patient care and use nurses as a source of improving standards that affect patient outcomes
174
Agency for Healthcare Research and Quality (AHRQ): how is it funded and when did it start?
branch of US HHS, receives funding from Congress
started in 1989
175
what is the purpose of the AHRQ
seeks to promote quality health care measures, reduce costs and encourage use of evidence
promotes evidenced based practice
maintains database of clinical practice guidelines (National Guideline Clearinghouse)
176
magnet recognition program
recognition system for health care org that demonstrate quality, leadership, and excellence in nursing care
177
what are the 4 components of the magnet program model
transformational leadership
structural empowerment
exemplary professional practice
interdisciplinary teamwork
178
errors of omission
happen when nurses fail to provide a service for which they are responsible (i.e. not giving meds)
179
errors of commission
when nurses perform an incorrect act (i.e. wrong med dose)
180
sentinel event
event that is unintended and causes death or significant physical or psychological injury or risk of this occurring
requires an investigation
181
incident report
document that should be filled out after an adverse incident occurs that affects a patient, family or staff
182
what is a patient registry
system that collects data about patient outcomes related to specific groups
can be used to guide caregivers on interventions, cost effectiveness of certain practices, measure quality standards, maintain safety
183
product registries
used to evaluate safety and effectiveness of certain medications, therapies, or interventions to provide surveillance for potential adverse outcomes that could occur
184
three types of qual data sampling
purposive
snowball
quota
185
purposive sampling
most common
selects samples according to particular research question or the number of participants available who are appropriate for the specific data needed
186
snowball sampling
uses the contacts of those participants already involved to gain new participants
187
quota sampling
researcher determines how many participants are needed for the study and what characteristics they want involved
188
descriptive stats
provide a summery of the results of a study
use measures like central tendency and measures of variability to describe outcomes of the research data that were measured
189
inferential stats
processes that must be calculated to help the researcher understand or predict what the process might be
ex: calculating probability of certain event or finding statistical signifcance
190
what is nursing surveillance
process of acquiring patient data, interpreting results, and analyzing the information to determine what actions are appropriate and where changes must be made
191
Clinical Quality Value Analysis
helps decision makers to recognize whether certain products or services are valuable to organization, financially stable, and will improve patient outcomes
192
gap analysis
considers a company's current performance with what it could be
used to look at current performance and set a goal of where it should be within a certain time frame
193
root cause analysis
performed to determine what factors were associated with an event occurring and what activities led up to the sentinel event
should be performed within 45 days
194
secondary analysis
performed by questioning completed data and reviewing it again to obtain answers
195
quant analysis of rirsk
uses statistical results to explain risk in an environment
results are measurable, include hard facts that can be calculated
196
qual analysis of risk
more descriptive and ask questions
197
intrinsic risk factors
related to patients and their health
198
extrinsic risk factors
items in the environment that may contribute harm to patients and put them at risk for adverse outcomes
(i.e inadequate hand hygiene from nurses)
199
3 types of observational studies
panel
cohort
case control
200
panel studies
same group is observed over a period of time
201
cohort studies
obeserve a group over a period of time but group may change if observations are repeated
202
case control studies
compare groups of people who are classified into different groups
203
meta analysis
type of study in which nurses look at research results from various studies and analyze the results
204
systematic review
literature review to search for evidence to be used to support or change practice standards
205
three phases of knowledge transfer when developing and using EBP
knowledge creation and distillation - performing research and then providing recs for clinical practice based on results
diffusion and dissemination: distributes the info to users
implementation: end user adoption
206
translation science
considers the factors that affect adoption and implementation of EBP that may be used to improve clinical standards of care
concerned with factors that may be preventing the implementation of EBP - looks for ways to overcome barriers
207
CINAHL
cumulative index of nursing and allied health literature
208
information literacy
consists of the knowledge and ability to determine when info needs to be sought, how to research and locate information, and how to consider its results for practice
209
return on investment equation
net profit/total cost of investment x 100
210
bundled payments
episode of care payments
payments are received by health care providers in a lump sum in advance of care for specific conditions or courses of treatment
211
value based purchasing
CMS program
acute hospitals receive incentive payments based on quality of care in 4 domains: safety, clinical care, efficiency and cost reduction, and patient/caregiver centered experience
assigned improvment points and assigned consistency points --> get a total performance score and VBP incentive payment is determined
212
what basic marketing strategies are involved in healthcare
internal review
external review/market analysis
growth initiatives
cost benefit analysis
plannign
213
how do you determine the cost effectiveness of a nursing intervention
consider the cost of the intervention and divide it by the cost of the benefits for patients
214
resource utilization
involves considering what resources are available in the clinical setting, their cost effectiveness, and how they affect nursing care and interventions
215
product evaluation committee
comprised of members of an org who review and evaluate products used in the organization to determine how cost effective they are
216
tangible assets
physical items used for health care as well as the building where the org is
217
intangible assets
skills of nursing staff, relationships b/w orgs and consumers, health care agreements, medical records, franchise rights, computer software, IT, historical documents
218
benchmarking
ongoing process of measuring practice, outcomes, and services against a standard
219
stewardship
involves using available resources and planning for the future to continue to improve standards
220
federal anti-kickback statues
makes it illegal for health care orgs to accept money or rewards from sources as a method of getting them to use certain services
221
nursing informatics
comprehensive system that combines nursing, computer science and health information mgmt into a method of monitoring patient outcomes, communicating among providers, and evaluating the effectiveness of interventions
222
computerized provider order entry (CPOE)
process of ordering meds for patients through a computer system that automatically transmits info to the pharmacy that dispenses medication
streamlines process!
223
work flow technology
streamlines the process of getting patients from one point of care to the next
(i.e. nurse can alert those needed to take the next step of getting patients home like transport)
224
group ware
type of computer technology that uses computer network systems for collaborating b/w members of teams or groups that are working on similar strategies
225
computer mediated communication
provides communication among nurses, among nurses and providers, and other members of interdisciplinary team
can be through video or instant messaging
226
personal health records
electronic records where patients can keep track of their private health information to use when needed
can be filled out and kept online, can only be accessed by authorized users (i.e. physicians)
227
accidental disclosures
situations in which patients privacy is breached unintentionally
228
servant leadership
leadership philosophy in which the main goal of the leader is to serve and share power, while putting the needs of the employees first so they may develop and perform as highly as possible
229
CNL toolkit of skills
EBP
healthcare outcomes
lateral integration
feedback
coaching/mentoring
leading teams
promoting a safe and ethical environment
230
pareto chart
tool to chart the correlation between the cause and effect of problems
