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ATI LEADERSHIP > NURS 461 ATI CH. 1 > Flashcards

NURS 461 ATI CH. 1 Flashcards

1
Q

Authoritative Leadership

A

motivates by coercion

comm. happens down the chain of command

work output by staff is usually high: good for crisis situations and bureaucratic settings

effective for employees with little or no formal education

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2
Q

Democratic leadership

A
  • includes the group when decisions are made
  • Motivates by supporting staff achievements
  • comm. occurs up and down the chain of command and between group members
  • work output by staff is usually good quality when cooperation and collaboration are necessary
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3
Q

Laissez-faire leadership

A

makes very few decisions, and does little planning

motivation is largely the responsibility of individual staff members

comm. occurs up and down the chain of command and between group members

work output is low unless an informal leader evolves from the group

effective with professional employees

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4
Q

Transformational leaders

A

empower and inspire followers to achieve a common, long-term vision

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5
Q

transactional leaders

A

focus on immediate problems, maintaining the status quo and using rewards to motivate followers

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6
Q

authentic leaders

A

inspire others to follow them by modeling a strong internal moral code

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7
Q

The emotionally intelligent leader:

A

has insight into the emotions of members of the team

understands the perspective of others

encourages constructive criticism and is open to new ideas

manages emotions and channels them in a positive direction, which in turn helps the team accomplish its goals

is committed to the delivery of high-quality client care

refrains from judgment in controversial or emotionally charged situations until facts are gathered

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8
Q

Five major management functions

A
  1. planning
  2. organizing
  3. staffing
  4. directing
  5. controlling
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9
Q
  1. Planning
A

the decisions regarding what needs to be done, how it will be done, and who is going to do it

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10
Q
  1. Organizing
A

the organizational structure that determines the lines of authority, channels of communication, and where decisions are made

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11
Q
  1. staffing
A

the acquisition and management of adequate staff and staffing mix

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12
Q
  1. derecting
A

the leadership role assumed by a manager that influence and motivates staff to perform assigned roles

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13
Q
  1. controlling
A

the evaluation of staff performance and evaluation of unit goals to ensure identified outcomes are being met

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14
Q

characteristics of managers

A
  • hold formal positions
  • possess clinical expertise
  • network with members of the team
  • coach subordinates
  • make decisions about the function of the organization, including resources, budget, hiring, and firing
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15
Q

characteristics of a leader

A

initiative
inspiration
energy
positive attitude
communication skills
respect
problem-solving & critical thinking
personality traits & leadership skills
influence followers to move towards goal
may have goals that differ from organization

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16
Q

Maslow’s hierarchy of needs

A

1 physiological
2 safety and security
3 love and belonging
4 self-esteem
5 self-actualization

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17
Q

Prioritization and Time management

A
  • systemic before local (life before limb)
  • acute before chronic
  • actual problems before potential problems
  • don’t assume
  • respond to trends vs. transient findings
  • emergencies vs. expected findings
  • determine priority actions
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18
Q

Priority-Setting Frameworks

A

Maslow’s hierarchy

ABC (DE)

Safety/risk reduction

Assessment/ data collection: gather information prior to making decisions.

Survival potential: like in mass casualties

Least restrictive/ least invasive

acute vs chronic, urgent vs nonurgent, stable vs unstable

evidence-based practice

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19
Q

least restrictive/ least invasive example

A

move client near nurses station before applying restraints

bladder train before indwelling catheter

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20
Q

Task Factors when deligating care

A

Predictability of outcome

Potential for harm

Complexity of care

Need for problem-solving and innovation

level of interaction with the client: is there a need to provide psychosocial support or education

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21
Q

Five rights of delegation

A

1- right task
2- right circumstance
3- right person
4- right direction and communication
5- right supervision and evaluation

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22
Q

examples to be delegated to a LPN

A
  • monitoring findings (input to an RNs ongoing assessment)
  • reinforcing client teaching from a standard care plan
  • performing tracheostomy care
  • suctioning
  • checking NG tube patency
  • administering enteral feedings
  • inserting a urinary catheter
  • administering medication (excluding IV)
23
Q

examples to delegate to an AP

A

ADL activities
bathing
grooming
dressing
toileting
ambulating
feeding (w/o swallowing precautions)
positioning routine tasks
bed making
specimen collection
I&O
vital signs (stable clients)

24
Q

steps in providing educational programs

A

identify and respond- determine need for knowledge

analyze- look for deficiencies, develop learning objectives

research- resources available

plan- program to address objectives

implement- conducive to staff availability. consider online programs

evaluate- measure behavior changes secondary to objectives

25
Q

mentor vs preceptor vs coach

A

mentor: can serve as preceptor but relationship lasts longer and focuses on assumption of the role as well as socialization to practice.

preceptor: assist in orienting, supervise performance, assigned for a limited amount of time.

coach: collab. relationship to help nurse establish goals. Relationship is task-related and typically time limited.

26
Q

Patricia Benner 5 stages of nursing ability

A
  1. novice nurse
  2. advanced beginner
  3. competent nurse
  4. proficient nurse
  5. expert nurse
27
Q

Novice nurse

A

students or newly licensed nurses
- minimal clinical experience

  • approach situations from theoretical perspective relying on context-free facts and established guidelines.
  • rules govern practice
28
Q

Advanced beginner

A

most new nurses function at this level

  • practice independently in the performance of many tasks and can make some clinical judgments
  • begin to rely on prior experience to make decisions.
29
Q

competent nurse

A

usually have been in practice 2-3 years

  • demonstrate increasing levels of skill and proficiency and clinical judgment.
  • exhibit the ability to organize and plan care using abstract and analytical thinking
  • can anticipate the long-term outcomes of personal actions
30
Q

Proficient nurse

A

significant amount of experience

  • enhanced observational abilities allow nurses to be able to conceptualize situations more holistically.
  • well-developed critical thinking and decision-making skills allow nurses to recognize and respond to unexpected changes.
31
Q

Expert Nurse

A

wealth of experience
- view situations holistically and process information efficiently

  • make decisions using an advanced level of intuition and analytical ability.
  • do not need to rely on rules to comprehend a situation and take action.
32
Q

Core measures

A

national standardized measures to improve client outcomes

developed by the Joint Commission

used to measure client outcomes and provides information to support accreditation of hospitals

33
Q

Core measures include;

A

stroke
venous thromboembolism
heart failure
acute MI
substance use

34
Q

structure audits

A

evaluate the influence of elements that exist separate from or outside of the client-staff interaction

35
Q

process audits

A

review how care was provided and assume a relationship exists between nurses and the quality of care provided

36
Q

outcome audits

A

determines what results occurred as result of the nursing processs

37
Q

5 stages of conflict

A
  1. latent conflict
  2. perceived conflict
  3. felt conflict
  4. manifest conflict
  5. conflict aftermath
38
Q

Steps in Progressive discipline:
First infraction

A

informal reprimand

manager and employee meet

discuss the issue

suggestions for improvement/ correction

39
Q

Steps in Progressive discipline:
Second infraction

A

written warning

manager meets with employee to distribute written warning

review of specific rules/ policy violations

discussion of potential consequences if infractions continue

40
Q

Steps in Progressive discipline:
Third infraction

A

employee placed on suspension with or w/o pay. Time away from work gives the employee opportunity to:
examine the issues
consider alternatives

41
Q

Steps in Progressive discipline:
Fourth infraciton

A

employee termination

follows after multiple warnings have been given and employee continues to violate rules and policies

42
Q

Client Factors when Assigning care

A
  • condition of client and level of care needed
  • specific care needs (cardiac monitoring, mechanical vent)
  • need for special precaution
  • procedures requiring a significant time commitment (ex. dressing change)
43
Q

Health Care team factors when Assigning care

A
  • knowledge and skill level of team members
  • amount of supervision necessary
  • staffing mix
  • nurse-to-client ratio
  • experience with similar clients
  • familiarity of staff members with unit
44
Q

These 3 should apply for clients to share a room with an infectious diseae

A
  • have the same active infection
  • clients remain at least 3 feet away
  • no other infection
45
Q

Staff Education
Unit managers, staff development educators

A
  • new policies and procedures implemented
  • new equipment becomes available
  • educational need identified
46
Q

Staff education
unit manager, charge nurse, preceptor

A
  • can focus on one-on-one approach
47
Q

Staff education
staff members, supervisors

A

can use “just in time” training to meet immediate needs for client care

48
Q

Staff education
higher education degree or certification

A

staff

49
Q

Root cause analysis

A

focuses on variables that surround the consequence

commonly done for sentinel events but also in quality improvement process

investigates the consequence and possible causes

analyzes possible causes and relationships that can exist

determines additional influences at each level of relationship

determines the root cause or causes

50
Q

Steps in quality improvement process

A

standards are made available by policies and procedures

quality issues are identified

interprofessional team is developed to review the issue

current state of structure and process r/t issue is analyzed

data collection methods are determined (quantitative)

data is collected, analyzed, and compared to benchmark

if benchmark isn’t met, a root cause analysis is performed

potential solutions are analyzed and one is selected

education is implemented

issue is reevaluated at a preestablished time

51
Q

Steps in the Problem-Solving Process

A

IDENTIFY PROBLEM- in objective terms

DISCUSS SOLUTIONS

ANALYZE IDENTIFIED SOLUTIONS

SELECT A SOLUTION

IMPLEMENT SELECTED SOLUTION- procedure and timeline

EVALUATE SOLUTION’S ABILITY TO RESOLVE ORIGINAL PROBLEM

52
Q

Cost-effective Care

A

cost-containment

cost-effective

53
Q

Cost-containment

A

strategies that promote efficient and competent client care while also producing needed revenues for the continued productivity of the organization

ex. managed care- provides clients with a plan designed to meet their needs eliminating the unnecessary use of resources or extended hospital stays

54
Q

Cost-Effective

A

strategies that achieve optimal results in relation to the money spent to achieve those results. “Getting your money’s worth”

spending on staff training for transmission-based precautions, resulting in effective use of PPE. Leads to decrease infection transmission

ATI LEADERSHIP (3 decks)

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