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Final Flashcards

1
Q

What are the 3 steps in quality control?

A
  1. CRITERION / STANDARD IS DETERMINED
  2. INFO IS COLLECTED to determine whether the standard has been met
  3. EDUCATIONAL OR CORRECTIVE ACTION IS TAKEN if the criterion has not been met
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2
Q

What are the 8 steps in auditing QC?

A
  1. ESTABLISH control criteria
  2. IDENTIFY THE INFO relevant to the criteria
  3. DETERMINE ways to collect the info
  4. COLLECT AND ANALYZE the info
  5. COMPARE COLLECTED INFO with the established criteria
  6. Make a JUDGEMENT about quality
  7. PROVIDE INFORMATION and take CORRECTIVE ACTION
  8. REEVALUATE
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3
Q

Components of a quality control program to be effective.

A
  1. Support from top-level administration
  2. Commitment by the org in terms of fiscal and human resources
  3. Quality goals reflect search for excellence rather than minimums
  4. Process is ongoing
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4
Q

How can a mgr stimulate staff nurses’ involvement in QC?

A
  1. Engagement of FRONT LINE STAFF is critical when when implementing/sustaining QI efforts
  2. Impractical to expect full staff involvement, but AS MANY STAFF AS POSSIBLE should be determining criteria/standards…
  3. Designate a PATIENT SAFETY OFFICER
  4. Leaders are ROLE MODEL for high standards, encourage subordinates to SEEK MAXIMUM STANDARDS
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5
Q

What is the qualitative measurement of quality control for marketing?

A

Benchmarking

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6
Q

Benchmarking is: process of ____ products, practices, and services against ____ organization as a tool for ____ desired standards of organizational performances. The exemplar organization is then used as ____ ____ for standard ____ and ____ improvement.

A 
measuring
best-performing
identifying
role models
development
performance
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7
Q

Name 6 conflict resolution techniques used by nurse leaders:

A
  1. Compromising
  2. Competing
  3. Cooperating / Accommodating
  4. Smoothing
  5. Avoiding
  6. Collaborating
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8
Q

Explain compromising

A

Each party gives up something it wants

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9
Q

Explain competing

A

One party pursues what it wants, regardless of the cost to others

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10
Q

Explain cooperating / accommodating

A

One party SACRIFICES his/her beliefs and wants to allow the other party to win

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11
Q

Explain smoothing

A

An individual attempts to REDUCE the emotional component of the conflict

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12
Q

Explain avoiding

A

Parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it

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13
Q

Explain collaborating

A

An ASSERTIVE and COOPERATIVE means of conflict resolution whereby all parties set aside their original goals and work together to establish a SUPRAORDINATE or common priority goal

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14
Q

What are the 4 principles of negotiation?

A
  1. Comprise
  2. Accommodating differences
  3. Consider trade-offs and the bottom line
  4. Negotiation is psychological and verbal (always look calm and self-assured)
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15
Q

What are the 11 strategies of negotiation?

A
  1. Use FACTUAL STATEMENTS; listen and keep and open mind
  2. Discuss ISSUES and not PERSONALITIES
  3. Be HONEST; start tough
  4. DELAY when confronted with something totally unexpected
  5. NEVER TELL THE OTHER PARTY you are willing to negotiate totally
  6. KNOW THE BOTTOM LINE but try not to use it; TAKE BREAKS if either party becomes angry/tired
  7. End on a FRIENDLY note
  8. RESTATE the final decision
  9. HIDE ASTONISHMENT at your success
  10. Make the other party feel that he/she ALSO WON
  11. Follow up with a MEMO
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16
Q

4 goals of negotiation

A
  1. Bottom line
  2. Trade-offs
  3. Hidden agendas
  4. Consensus
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17
Q

The very least for which a person will settle is often referred to as the:

A

Bottom line

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18
Q

What are secondary gains, often future-oriented, that may be realized as a result of conflict?

A

Trade-offs

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19
Q

What are the covert intentions of the negotiation?

A

Hidden agendas

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20
Q

What is it when all parties can support an agreement?

A

Consensus

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21
Q

What is the greatest challenge in consensus building?

A

Time

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22
Q

Principles used in annual performance appraisal

A
  1. Sensitive and important part of mgmt process, requires much skill
  2. Use to determine job performance
  3. When accurate and appropriate, outcomes can be positive
  4. Can be highly charged and emotional events for most employees
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23
Q

Factors influencing effective performance appraisal

A
  1. Should be based on a standard
  2. Appraisal tool must adequately and accurately assesses job performance
  3. Employee should have input into development of standard
  4. Employee must know the standard in advance
  5. Employee must know the sources of data gathered for the appraisal
  6. Appraiser should have observed employee’s work
  7. Employee should trust and respect appraiser
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24
Q

What will increase positive outcomes in a performance appraisal?

A
  1. Develop SELF-AWARENESS regarding own biases and prejudices
  2. Use appropriate CONSULTATION
  3. Gather DATA adequately over time
  4. Keep ACCURATE ANECDOTAL RECORDS for the length of the appraisal period
  5. Collect POSITIVE data and identify areas where IMPROVEMENT is needed
  6. Include employee’s OWN APPRAISAL of his/her performance
  7. Guard against the various effects
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25
Q

The appraiser lets 1 or 2 positive aspects of the assessment or behavior of the employee unduly influence all other aspects of the employee’s performance:

A

Halo effect

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26
Q

The appraiser allows some negative aspects of the employee’s performance to influence the assessment to such an extent that other levels of job performance are not accurately recorded.

A

Horns effect

ex: an employee often late for work and has this unduly affect his performance appraisal

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27
Q

When recent issues are weighed more heavily than past performance.

A

Recency effect

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28
Q

Employees receive the same appraisal results, year after year. Those who performed well early in the employment will do well, those who struggled will struggle. Often compared to adage “the rich get richer and the poor get poorer.”

A

Matthew effect

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29
Q

Manager is hesitant to risk true assessment and therefore rates all employees as average, leading employees to discount the entire assessment of their work.

A

Central tendency trap

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30
Q

What does the Joint Commission advocate regarding employee performance appraisals?

A
  • The USE OF EMPLOYEE’S JOB DESCRIPTION as the standard for performance appraisals
  • Employers must be able to demonstrate that employees know how to plan, implement, and evaluate care SPECIFIC TO THE AGES of the patients they care for
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31
Q

How to plan a performance appraisal of deficient employee: (6)

A
  1. Don’t overwhelm
  2. Only select major problems
  3. Make sure previously mentioned conditions have been met; give copy of appraisal form
  4. Select appropriate time for conference
  5. Give employee 2-3 day notice for mental and emotional prep
  6. Mentally and emotionally prepare yourself. Cancel or reschedule if needed.
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32
Q

What is “constructive discipline”?

A

Assists employee GROWTH

  • carried out in supportive, corrective manner
  • employee reassured that punishment is given b/c of actions and not b/c of who he or she is as a person
  • primary focus is to assist employees to be self-directed in meeting org goals
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33
Q

What is “destructive discipline”?

A

PUNITIVE

  • Use of threats/fear
  • Employee alert to impending penalty/termination
  • Arbitrarily administered and either unfair in application of rules or in the resulting punishment
  • May succeed on short-term basis, but usually demotivating and reduces long term productivity
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34
Q

People will only achieve goals up to the level that they believe is necessary to ____ ____.

A

avoid punishment

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35
Q

What are the 4 elements of McGregor’s Hot Stove Rule?

A
  1. Forewarning
  2. Immediate consequences
  3. Consistency
  4. Impartiality
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36
Q

Which element of Hot Stove Rule?

  • Employees should know if they break a rule they will be disciplined
  • They must know the rule and consequence beforehand
A

Forewarning

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37
Q

Which element of Hot Stove Rule?

- All discipline should be administered immediately after rules are broken

A

Immediate consequences

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38
Q

Which element of Hot Stove Rule?

- If the employee breaks the rule again, he/she will be disciplined

A

Consistency

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39
Q

Which element of Hot Stove Rule?

  • If any other person breaks the rule, he/she will also get burned
  • Discipline must be impartial, and everyone treated in the same manner when they break the rule
A

Impartiality

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40
Q

Actions a nurse leader would take in a scenario with a subordinate who should be disciplined:

A

Look in the book, Display 25.1

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41
Q

Respond ____, poor attitudes among employees can ____.

A

promptly

spread

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42
Q

Thoroughly ____ the situation that prompted the ____.

A

investigate

discipline

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43
Q

Consult with a ____ or the HR dept before ____ an employee.

A

superior

dismissing

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44
Q

Problem behaviors can assume many forms, including ____ ____ such as refusing to perform a task, not reporting to work on time, or showing disrespect. Can also be more ____ such as undermining fellow team members and creating a ____ workplace.

A

blatant insubordination
subtle
hostile

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45
Q

When employees are ____ in meeting organizational goals, mgrs must:

  • ____ the reasons for this failure
  • ____ employees accordingly
A

unsuccessful
identify
counsel

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46
Q

If employees fail because they are ____ to follow the rules or ____ to perform duties adequately, despite assistance and encouragement, the mgr must take ____ ____.

A

unwilling
unable
disciplinary action

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47
Q

Responses demonstrated by an employee who is confronted by the mgr regarding suspected CHEMICAL impairment:

A

Denial

Anger

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48
Q

Why would healthcare workers be less likely to admit they are using?

A
  • Do not get peer acceptance
  • Frequently deny, even to themselves
  • Usually caught rather than self-report
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49
Q

To avoid/minimize anger when confronting the employee who is using:

A
  • Mgr must focus on employee’s performance DEFICITS, not the underlying PROBLEM/ADDICTION
  • Mgr must not preach, demoralize, scold, or blame
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50
Q

When confronting the chemically impaired employee:

A
  1. Gather EVIDENCE
  2. IMMEDIATE confrontation
  3. Expect DENIAL
  4. OUTLINE the plan
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51
Q

The mgr (should/should not) nurture or counsel the impaired employee. Why/why not?

A

Should not

Could lead to enabling

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52
Q

The chemical impairment rate of health professionals is usually (lesser or greater) than the general public.

A

Greater

Most licensing board disciplinary actions are r/t drug use and sale

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53
Q

What 3 BEHAVIOR CHANGES are often noted in employees who are using?

A
  1. Personality/behavior
  2. Job performance
  3. Time and attendance
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54
Q

Nursing admin may face no mgmt problem more costly or emotionally draining than that of nurses whose practice is impaired by what 2 things?

A

Substance abuse

Psychological dysfunction

55
Q

Reentry of chemically impaired employee into the workplace:

1. No ___ ___ use is tolerated

A

psychoactive drug

56
Q

Reentry of chemically impaired employee into the workplace:

2. Assigned to ___ ___ for the 1st year

A

day shift

57
Q

Reentry of chemically impaired employee into the workplace:

3. Paired with a successfully ___ ___ when possible

A

recovering nurse

58
Q

Reentry of chemically impaired employee into the workplace:

4. Consent to ___ ___ ___

A

random urine screen

59
Q

Reentry of chemically impaired employee into the workplace:

5. Involved with ___ ___

A

support group

AA or NA

60
Q

Reentry of chemically impaired employee into the workplace:

6. Participate in ___ program

A

aftercare

61
Q

Reentry of chemically impaired employee into the workplace:

7. Seek individual ___ as needed

A

counseling

62
Q

8 causes of under-delegation:

A
  1. FEAR of being seen as lack of ability
  2. Desire to complete WHOLE JOB by themself
  3. Thinks subordinates will RESENT the work
  4. Lack of EXPERIENCE in job or with delegation…need to CONTROL or be PERFECT
  5. ENJOYS the work
  6. Not enough TIME
  7. Fail to ANTICIPATE
  8. Difficult to assume MANAGER ROLE
63
Q

Delegation empowers whom? (delegator or delegatee)

A

BOTH!

64
Q

When delegating, look for employee who:

A
  • is CAPABLE
  • has the TIME
  • is INNOVATIVE, willing to take RISKS
  • considers the task IMPORTANT
  • has the SKILLS to complete the task
65
Q

Whose responsibility is it to stretch new/capable employees who want to grow?

A

Leader

66
Q

When delegating to assistive personnel, be aware of their:

A

job description
knowledge base
demonstrated skills

67
Q

5 Rights of DELEGATION

A
  1. Right TASK
  2. Right CIRCUMSTANCES
  3. Right PERSON
  4. Right DIRECTION/COMMUNICATION
  5. Right SUPERVISION
68
Q

If subordinate is having difficulty carrying out delegated task, the manager could:

A
  1. See from employee’s perspective
  2. See if capable but lacks confidence
  3. Question if delegated task is appropriate
  4. See if resistant to authority
  5. Question if tasks are over-delegated in terms of specificity
69
Q

7 criteria that MUST be met when delegating to UAP:

A
  1. Frequently recur in the daily care of a client
  2. Are performed according to a standardized sequence of steps
  3. Involve little or no modification from one client to another
  4. May be performed with a predictable outcome
  5. Do not inherently involve ongoing assessment, interpretation, or decision making
  6. Do not endanger the client
  7. Are allowed by agency policy
70
Q

What involves helping others to grow and self-actualize?

A

advocacy

71
Q

For whom/what do nurses advocate?

A

themselves
clients
subordinates
profession

72
Q

Advocates must ___ others of their ___ and make sure they have enough ___ to make informed decisions.

A

inform
rights
information

73
Q

Advocacy is defined as ___ and ___ what one believes in for both self and others

A

protecting

defending

74
Q

What 4 ways can nurses act as advocates?

A
  1. Help others make informed DECISIONS
  2. Act as INTERMEDIARIES in the environment
  3. Directly INTERVENE on behalf of others
  4. Advocate for social JUSTICE
75
Q

5 elements of the MORAL model:

A
  1. MASSAGE the dilemma
  2. OUTLINE options
  3. REVIEW criteria and resolve
  4. AFFIRM position and act
  5. LOOK back
76
Q

Which step of the MORAL model?

- Collect data about the ethical problem and who should be involved in the decision-making process

A

MASSAGE the dilemma

77
Q

Which step of the MORAL model?

- Identify alternatives and analyze the causes and consequences of each

A

OUTLINE options

78
Q

Which step of the MORAL model?

- Weigh the options against the values of those involved in the decision; may be done through a weighting or grid

A

REVIEW criteria and resolve

79
Q

Which step of the MORAL model?

- Develop the implementation strategy

A

AFFIRM position and act

80
Q

Which step of the MORAL model?

- Evaluate the decision making

A

LOOK back

81
Q

Review the ANA code of ethics

A

pg 79

82
Q

Define autonomy

A

Promotes self-determination and freedom of choice (or accepting the responsibility for one’s choice)

83
Q

What is the most basic and universal ethical principle?

A

Respect for people

84
Q

The major ethical principles stem from what other principle?

A

Respect for people

85
Q

What is confidentiality?

A

keeping privileged info private

86
Q

Who defines the legal boundaries of nursing in a state?

A

Nurse Practice Acts

87
Q

The 51 Nurse Practice Acts are examples of ___

A

statutes

88
Q

How is it determined that a nurse acted with reasonable care in a legal situation? (6)

A
  1. Followed STANDARDS of care
  2. Gave COMPETENT care
  3. COMMUNICATED with other team members, and the client
  4. Developed a caring RAPPORT with the client
  5. Fully DOCUMENTED care
  6. Used EQUIPMENT responsibly
89
Q

Is “just following MD’s orders” a sufficient defense for malpractice?

A

NO!

90
Q

What makes nurses more liable for their own practice? (3)

A

Authority
Autonomy
Accountability

91
Q

Nurses have an ___ responsibility to take appropriate steps to ___ patients

A

independent

safeguard

92
Q

6 ways to reduce the risk of malpractice claims:

A
  1. Practice within the SCOPE of the nurse practice act
  2. Observe agency POLICY AND PROCEDURES
  3. Model practice after established STANDARDS using EBP
  4. Always put pt’s RIGHTS AND WELFARE first
  5. Be aware of relevant LAW and legal doctrines
  6. Practice within the area of individual COMPETENCE and upgrade technical skills consistently
93
Q

Nurse’s responsibility if an error from previous shift is found?

A
  • See if pt is okay

- File incident report

94
Q

8 steps of personal responsibility for career mgmt:

A
  1. SELF-ASSESS interests, skills, strengths, with weaknesses and values
  2. DETERMINE goals
  3. ASSESS the ORGANIZATION for opportunities
  4. ASSESS FOR OUTSIDE opportunities
  5. DEVELOP strategies
  6. IMPLEMENT plans
  7. EVALUATE plans
  8. REASSESS and make new plans as necessary (at least biannually)
95
Q

2 types of transfers in reference to career mgmt

A

Lateral transfer

Downward transfer

96
Q

One staff person moving to another unit, to a position with a similar scope of responsibilities, within the same organization:

A

Lateral transfer

97
Q

When someone takes a position within the organization that is below his or her previous level

A

Downward transfer

98
Q

Why would a nurse take a downward transfer?

A
  • Can increase chance of long-term career success
  • When expecting periods of stress or role overload
  • Later in career to reduce career roles
99
Q

What factors could lead nurses to become disengaged in their careers (aka “burnout”)?

A
  • illness
  • absenteeism
  • turnover
  • performance deterioration
  • decreased productivity and job satisfaction
100
Q

What should leaders do to avoid/manage burnout?

A
  • Acknowledge feelings and get help

- Selfcare is the most important strategy for avoiding burnout and maintaining a high level of motivation

101
Q

What are 3 practical ways to provide selfcare?

A

(The 3 R’s of selfcare)

  1. Regular time off
  2. Recreation
  3. Relationships outside work
102
Q

What does an organizational chart depict?

A
  1. Identify roles and expectations
  2. Structure
  3. Defines formal relationships within the institution
103
Q

Solid and dotted lines depict what on an organizational chart?

A

Solid:

  • Formal relationships
  • Lines of communication
  • Authority

Dotted:
- Staff positions

104
Q

Solid horizontal lines on org chart show

A

People with similar spheres of responsibility and power, but different functions

105
Q

Solid vertical lines on org chart show

A

Official chain of command (formal paths of communication and authority)

106
Q

Mode of communication that allows people to express themselves in a direct, honest, and appropriate way that does not infringe on another person’s rights is defined as…

A

assertive communication

107
Q

A simplistic definition for assertive communication is:

A

Having an informed voice that insists on being heard without being rude or insensitive

108
Q

5 ways to display assertive communication:

A
  1. Using “I” statements
  2. Direct eye contact
  3. Calm voice
  4. Congruent verbal and nonverbal messages
  5. Never become aggressive
109
Q

Sequence of the management process (5)

A
  1. Planning
  2. Organizing
  3. Staffing
  4. Directing
  5. Controlling
110
Q

Management process:
- Encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long and short range projections; determining a fiscal course of action; and managing planned change

A

Planning

111
Q

Management process:
- Includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit understanding and using power and authority appropriately

A

Organizing

112
Q

Management process:
- Functions consist of recruiting, interviewing, hiring, and orienting staff. Scheduling staff development, employee socialization, and team building are also often included as staffing functions

A

Staffing

113
Q

Management process:
- Sometimes includes several staffing functions. However, this phase’s functions usually entail HR mgmt responsibilities such as motivating, managing conflict, delegating, communicating, and facilitating collaboration

A

Directing

114
Q

Management process:
- Functions include performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control

A

Controlling

115
Q

How do leaders build a cooperative and effective team?

A

By identifying emotions that exist in themselves and others

116
Q

Where would the functions and priorities of an organization be communicated?

A

The goals and objectives

117
Q

Descriptors of a powerful image of a team leader:

A

pg 40

Display 2.3

118
Q

3 Steps in time mgmt

A
  1. Taking time to plan and ESTABLISH PRIORITIES
  2. Completing the HIGHEST PRIORITY TASK whenever possible; finishing one task before beginning another
  3. RE-PRIORITIZE what tasks will be accomplished based on new info received
119
Q

What are 2 mistakes common in planning ?

A
  • underestimate the importance of a daily plan

- not allowing adequate time for planning

120
Q

Steps to time efficiency:

A
  1. Gather all SUPPLIES before starting activity
  2. GROUP THE ACTIVITIES that are in the same location
  3. Use TIME estimates
  4. DOCUMENT asap
  5. Strive to end workday ON TIME
121
Q

What is the most critical skill in good time mgmt?

A

Completing highest priority task first

122
Q

Not all important things are ___, and not all urgent things are ___.

A

urgent

important

123
Q

What is necessary for organization and increased productivity on a nursing unit?

A

???

124
Q

Nurse educator should include these steps in developing a class:

A
  1. Identify desired KNOWLEDGE or skills staff should have
  2. Identify PRESENT LEVEL of knowledge of skill
  3. Determine the DEFICIT of desired knowledge and skills
  4. Identify the RESOURCES AVAILABLE to meet needs
  5. Make MAX USE of available resources
  6. EVALUATE and test outcomes after use of resources
125
Q

Realistic goals for a mgr with regard to staffing and scheduling:

A
  1. Employees feel they have some control over scheduling

2. Ensure a safe amt of staff on each shift

126
Q

How mgrs can maintain adequate staff:

A
  1. Watch for fluctuations in pt census
  2. Comprehensive scheduling and staffing policies
  3. Look for innovative methods to overcome staffing difficulties
  4. Use workload measurement tools
127
Q

What are 2 workload measurement tools to determine adequate staffing?

A
  • Nursing care hours per patient day (NCH/PPD)

- Patient acuity (classification) system

128
Q

Issues associated with NCH/PPD system:

A
  • may be too restrictive

- may not represent reality of today’s inpatient care setting (fluctuates among and within shifts)

129
Q

What does research sho is the primary factor r/t finding joy in the workplace?

A

???

130
Q

How would a mgr reduce the incidence of sexual harassment in the workplace?

A
  1. PROTECTIVE approach: Be alert to sexual harassment and intervene immediately
  2. PLAN to outline steps to deal with allegations
131
Q

Responsibilities of the unit mgr in fiscal planning:

A

See blueprint # 48

132
Q

What are 6 principles of decision making?

A
  1. Define OBJECTIVE clearly
  2. Gather DATA carefully
  3. Take the TIME necessary
  4. Generate many ALTERNATIVES
  5. THINK logically
  6. Choose and ACT decisively
133
Q

Mgmt functions in planned change:

A
  1. Planned change results from a well thought-out and deliberate effort to make something happen
  2. Successful leader-mgrs must be well grounded in change theories and be able to apply such theories appropriately
  3. Mgmt functions
134
Q

What are some mgmt functions in planned change:

A
  1. Forecasts unit needs while understanding the org’s climate
  2. Recognizes the need for planned change
  3. Assesses and responds to driving and restraining forces when planning for change
  4. Identifies and implements appropriate strategies to minimize/overcome resistance to change
  5. Seek subordinates input
  6. Supports and reinforces the individual efforts of subordinates
  7. Uses appropriate change strategies to modify subordinate behavior
  8. Periodically assesses the unit for signs of org aging and plans renewal strategies
  9. Continues to be actively involved in the refreezing process until the change becomes part of the new status quo

Leadership (1 decks)

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