Exam 3 (comp) Flashcards

Question

case management- 4 principles

Answer 1

coord and integration of a continiuum of holistic care promotion/preservation of health thru periods of transition and risk conservation and allocation of scare resources provision of FU care that tracks service long term (reduce fragm care)

Answer 2

pts and families at great risk for neg outcomes high cost high risk high recidivism (returning)

Answer 3

standards of care or clinical practice guidelines map time and activity sequence based on DRG classification

Answer 4

assessments consults test treatments meds activities nutrition dc planning

Answer 5

anything that alters system, pt or provider positive (achieved b4 expected) or negative

Answer 6

decisions made by person in staffing center pros- fairer, cost effective, frees up manager cons- dec flexibility don't know employee needs

Answer 7

unit manager schedules *can be delegated to clinical coord or charge nurse pros- staff has inc autonomy more flexibility cons- unfair rewards time away frm manager

Answer 8

self-scheduling float pools per diem agent/travel flextime

Answer 9

btw 2+ grps of ppl, departments or organizations

Answer 10

internal struggle

Answer 11

btw ppl w differing values/wants/beliefs

Answer 12

pwr divisions communication misunderstandings personal goals diff than organizations resource allocation poorly define role expectations varying background/beliefs btw members

Answer 13

= strengthened relationship results in mutual benefits

Answer 14

temporary agreement little enhancement to the realtionship

Answer 15

= mutual damage one person submits to demands of the other

Answer 16

latent conflict- (no present conflict but conditions are conducive) perceived conflict (ppl recog logically before internalizing) felt conflict manifest conflict action taken (debate or withdraw) conflict aftermath either + or -

Answer 17

prov. intellectual stim and creativity facilitates change improves dm improves grp performance

Answer 18

dec comm dec performance dec cohesiveness inc absenteeism and turnover

Answer 19

compromising competing cooperating/accomodating avoiding collaborating

Answer 20

depends on nurse managers values regarding work production and human relationships

Answer 21

low results low ppl

Answer 22

use when ppl need to cool down if more info needs to be gathered cost of dealing w/ conflict exceeds benefit one party is more powerful than the other DO NOT use if you made a mistake

Answer 23

HIGH ppl low results

Answer 24

when you made a mistake issue is more important to one party than the other more concerned about preserving harmony

Answer 25

High results low ppl

Answer 26

quick, decisive action is needed (emergency situation or need to discipline ) if an unpop. action is needed focused on pt safety and care can be authoritarian

Answer 27

medium results medium ppl

Answer 28

if collab and competing fail status quo balance pwr and priorities *b/ parties lose

Answer 29

HIGH results HIGH ppl

Answer 30

*optimal approach satisfys all members need to merge vastly diff viewpoints discuss issues interfering w/ morale and productivity if seeking creative and integrative solutions

Answer 31

WE v "you and I" deal w/ conflict in context of OVERALL relationships resol should improve relationships should result in mutual benefits relationship building and conflict resol are CONNECTED

Answer 32

1. create effective atmosphere (non-threat. environ) 2. clarify perceptions (what is the conflict abt, what have you done to add to it?) 3. focus on indiv and shared needs (personal needs v grp needs) 4. build shared positive pwr (power WITH, have clear self image) 5. look at future, learn from past 6. generate options (be prepared for hidden agendas) 7. develop "do-ables" (neutral, obtainable, measurable steps) 8. make mutual benefit agreement

Answer 33

responsibility of charge nurse- facil. resolution address on own, then meet w/ antagonists together determine own responsibility (is it unit problem) have particip discuss and commit to a resolution

Answer 34

believing that only ppl affected are the ones involved do not meet sides separately

Answer 35

recog/respond to things that matter to the o/ person clam, nondefensive readiness to forgive ability to compromise

Answer 36

explosive, angry, hurtful beh inabil to compromise fear and avoidance of conflict

Answer 37

financial plan aim at controlling allocation of resources

Answer 38

attrib to specific source ex. nursing time cost of resources

Answer 39

overhead what organization is spending money on no matter what *cannot be directly attribut to one specific unit or pt

Answer 40

salaries nurse managers do this

Answer 41

expenses that change in response to vol. of service daily operating costs

Answer 42

expenses r/t capital assets or long term investments

Answer 43

based on budget from previous yr + 3%

Answer 44

justify all expenses for each yr should have 0 at the end of e/ yr takes lots of time and resources

Answer 45

emphasize outcomes and results instead of activities

Answer 46

meeting fiscal goals of company advocate for high quality and approp staffing comm, unit needs comm. budget to staff bargain for scare resources *CANNOT DELEGATE BUDGET NEGOTIATING

Answer 47

assess dx plan implement eval

Answer 48

diff btw amnt that was budgeted and actual revenue cost

Answer 49

more revenue than expected inc pt census inc pt stay inc pt acuity

Answer 50

more sick days inc travel RNs

Answer 51

time is money (dc pts faster) efficiency/ standardization motiv clients to recover using supplies sparingly

Answer 52

90% most expensive item

Answer 53

pt census diag related grps acuity/complexity of care full time equivalent (FTE)

Answer 54

dx related groups reimbursement for care days DO NOT account for acuity lvls and pt needs

Answer 55

avg dailiy census based on historical data regulated by JCAHO 1 pt day= 1 pt/day

Answer 56

HPPD hrs of care per pt per day no diff is made based on acuity lvl of pt HPPD= nursing hrs (24)/ pt census

Answer 57

ratio output to inputs

Answer 58

nursing care, hrs of care, # home visits

Answer 59

resources used to provide services, personal hrs, supplies

Answer 60

dec input and inc output dec productivity= inc input and dec output

Answer 61

objective method to classify pts by determining amount and complexity of care needed fed and state mandate use of PCS to determine staffing levels category I - IV I- 2hrs iII- 6hrs III- 7 hrs IV- 9 hrs

Answer 62

unit of service (vol of work needed)/ pt days (avg daily census) ex. 26 total pts 161 total/24hrs 161 (hr)/ 26 (#)= 6.19= 6.2 standard unit for budget

Answer 63

HPPD (constant) x avg daily census x 365/ 2080 (1FTE) = # FTEs ex. HPPD= 6.2 avg daily= 26 (6.2 x 26x 365)/ 2080 = 28.3 FTEs for year/unit

Answer 64

hrs worked per wk/40 ex. 1 RN 3p-3a monday and wed 12 hrs- 2d/wk= 24 24/40= 0.6 FTE

Answer 65

number nursing hrs/ pt census

Answer 66

based on indivi, not # of staff

Answer 67

ex. standard of care= 6.2 HPPD 161 hrs of care per 24hrs 26 pts when 150 hrs are provided 161/150= 1.07 >1 = productivity inc <1= productivity dec

Answer 68

motivation of employees to perform productively goal- organizational cul makes wrk interesting and leads to satisfied wrkers and clients form of management controlling

Answer 69

systematic standardized eval of quality of work work contribution potential for advancement "D"

Answer 70

nursing performance (based on standards) should result in inc retention, productivity and pt care

Answer 71

cognitive- critical thinking, dm, problem solving affective interpersonal skills, comm. psychomotor physical tasks

Answer 72

trait scales peer review self eval management by objectives

Answer 73

absolute- eval performance against internal standards (ex. 1-5 rating) BARS- form of absolute- description of what quantitative # means ex. 1 novice, 5 excellent behav. anchored rating scales- form for each job classification comparative- compares employees to one another personalized to grp- ranking depends on avg competence of class not commonly used in HC

Answer 74

goals written in form of objectives for given time period mutually set w/ employee and manager

Answer 75

1-2 positive aspects influence all other performance generalized overall high rating vice versa overall poor rating

Answer 76

everyone high rates bc they belong to a "great team"

Answer 77

everyone average does not know much about the person

Answer 78

performance varies depending on rater some ppl are more strict

Answer 79

same appraisal results yr after yr if you perform well you get good marks if you struggle, you continue to struggle

Answer 80

total # of distinct absence periods, regardless of duration ex. 9 days in a row = 9 total days absent, 1 freq period ex. 9 mondays = 9 total days absent, 9 freq periods

Answer 81

vol- under employees control invol- outside employees control

Answer 82

inc cost dec morale of peers (inc workload, dec productivity) dec quality of care inc stress/conflict inc absenteeism "D"

Answer 83

inc cost dec morale impaired team functioning (conflict, staffing issues) loss of management potential

Answer 84

relocation family considerations transportation school

Answer 85

clinical ladder programs magnet designation mentoring/coaching residency programs

Answer 86

molding mind/character to bring out desired beh (disiplina) latin= teaching, learning, growth

Answer 87

old used discipline to control beh works for short term but is demoting and dec productivity

Answer 88

new helps employee grow demonstrate the actual v expected performance puts burden on employee to change requires mutual trust

Answer 89

self discipline

Answer 90

"disruptive beh" low morale, high turnover, poor pt care usually rude and can incl non-verbal beh

Answer 91

disrupts unit functioning works to meet MINIMUM standards "D"

Answer 92

id who they are dev explicit action plan performance deficiency coaching fire to transfer to diff unit if needed

Answer 93

gather data, beh, work perform, attendance etc confront develop plan, goals (can refer to trtmnt) have to be ubered home from work. meeting w/in 24 hrs to discuss return "D"

Answer 94

forewarning know they will be discip if they break rule immed conseq consistency everytime break rule impartiality

Answer 95

eval performance provide feedback steps for sanctions start least severe to most

Answer 96

verbal (remind of policies- counsel/coach) written (employee must agree that beh needs to change) suspension from work (day off w/ no pay- need to return to work w/ written decision) termination can apply directly after incident or if employee fails to comply in the future

Answer 97

discipline- training/molding to get desired beh punishment- undesirable event s/t unacceptable beh