Test4

Question 1

student-to-instructor

Answer 1

harassing and threatening, false complain, cutting class, cheating, refusal to participate, unpreparedness, distracting teachers/other students, complaining behind teachers back.

Question 2

instructor-to-student

Answer 2

sarcasm, ignoring, unpreparedness, unavailability

Question 3

student-to-student

Answer 3

previous year’s notes, bullying, two-faced behavior, cutting each other off, test banks

Question 4

Contributing factors to incivility

Answer 4

stress, clinical setting, developmental issues, hierarchical social structure

Question 5

Administrators and faculty escalating problem

stems from

Answer 5

personality conflicts, extreme self-interest, a high need for control or power, jealousy, spite, or even revenge

Question 6

Administrators and faculty- an escalating problem from faculty incivility increases

Answer 6

heavy work-loads, unclear role expectations, pressure to publish, evolving technological demands, lack of skills to manage conflicts with other faculty, envy of achievements.

Question 7

Overt lateral violence

Answer 7

name calling, threatening body language, physical hazing, bickering, fault finding, negative criticism, intimidation, gossip, shouting, blaming, put-downs, raised eyebrows, rolling of the eyes, sarcasm

Question 8

Covert lateral violence

Answer 8

unfair assignments, marginalizing a person, refusing to help someone, ignoring someone, making faces, refusing to work with certain people, thing, sabotage, exclusion, fabrication.

Question 9

delegation

Answer 9

the process whereby a nurse directs another health care team member to perform specific nursing tasks, procedures, and activities that are beyond the person’s traditional role and are not routinely performed by them.

Question 10

Delegation is the transfer of _________

Answer 10

responsibility

Question 11

Assignment

Answer 11

allocation of tasks that each staff member is already authorized to perform during a given shift.

Question 12

ANA definition of delegation

Answer 12

transfer of responsibility for the performance of an activity from one individual to another while retaining accountability.

Question 13

Responsibility

Answer 13

the duty of a person to complete tasks and assignments that are within their power, control and authority. Member of a group to complete tasks and assignments that are within the power and authority. Concept of a person being able to or authorized to take actions by themselves when they are in charge of other individuals - assessments or decision making that goes along with the tasks.

Question 14

Are UAPs allowed to assess?

Answer 14

NO, has to be within their role and authority

Question 15

Can UAPs take vitals?

Answer 15

yes

Question 16

Accountability

Answer 16

an obligation or willingness to be answerable for one’s own actions and or actions of another.

Question 17

Guidelines for delegation

Answer 17

To ensure client safety and high client care. Careful consideration to the patient they are delegating. Pt is stable -> delegate. Assess the client, know staff availability, know the job description, educate the staff member.

Question 18

Outcomes

Answer 18

expectations must be clear and predictable.

Question 19

Tasks should not require

Answer 19

excessive supervision, complex-decision making, detailed assessment during its performance

Question 20

Direct Delegation

Answer 20

Specific decision made by the RN and physically watching

Question 21

Indirect Delegation

Answer 21

Checking in on making sure they are done. List of tasks produced by the facility.

Question 22

LPN/LVN

Answer 22

cannot do admission assessments
cannot give IV push medications
cannot write nursing diagnosis/care plans
cannot do most teaching
cannot do complex skills
cannot take care of acute conditions
cannot take care of unstable clients
NO DISCHARGE PATIENTS
NO END OF SHIFT PATIENTS

Question 23

UAP/CNAs

Answer 23

look for the lowest level of skill required for the task. Look for the least complicated task. Look for the most stable patient. Look for the client with the chronic illness. NO MEDICATIONS!
Bathing, restroom, vital signs.

Question 24

Internal Barriers

Answer 24

Lies with the delegator: lack of experience, lack of confidence in others, lack of experience with delegation, personal insecurities, demanding perfectionism, indecision, poor organizational skills, fear of not being liked by everyone, micromanaging, poor communication.

Question 25

External barriers

Answer 25

Unclear policies about delegation, policies that do not tolerate mistakes, management-by-crisis model for facility. Unclear delineation of authority and responsibilities, poor staffing, lack of competence in the person being delegated to, over dependence on the person delegating, unwillingness to accept responsibility for ones own practice, immersion in trivia and gossip, work overload.

Question 26

ANA Direct Delegations

Answer 26

specific decision made by the RN who can perform which task

Question 27

ANA Indirect delegation

Answer 27

List of tasks produced by the facility.

Question 28

RN does this

Answer 28

physiologic/injury

Question 29

Can wait

Answer 29

psychological

Question 30

Acute

Answer 30

always the RN

Question 31

Chronic

Answer 31

LPN - I can see them last

Question 32

Unstable

Answer 32

See them first

Question 33

Stable

Answer 33

delegate

Question 34

Unpredictable

Answer 34

Do not delegate

Question 35

Predictable

Answer 35

delegate

Question 36

delegate

Answer 36

stable, predictable, good task

Question 37

Fleet Enema/Molasses Delegation

Answer 37

medication that comes in a bottle that has to be pulled out of the pixus. LPN can give this, UAP cannot.

Question 38

Tapwater Enema

Answer 38

UAP/CNA and LPN can give this.

Question 39

MEATUS

Answer 39

meds (IV), evaluation, assessments, teaching, unstable patients, skills

Question 40

MEATUS

Answer 40

meds (IV), evaluation, assessments, teaching, unstable patients, skills-can delegate the skills to an RN - no care plan or diagnoses though.

Question 41

Blood transfusion

Answer 41

vital signs, check, start blood, vital signs 15 mins, 30 mins, every hour. The CNA cannot do the first or second set of vital signs. If it is the last 30 minutes or hour of transfusion then yes, they are stable.

Question 42

The Institute of Medicine

Answer 42

defines quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes are are consistent with current professional knowledge.

Question 43

Adverse event and Medical Errors

Answer 43

In 2000, it was estimated that 98,000 people die each year due to adverse events and medical errors in hospitals. The IOM published its first report in 2000, "To err is human: Building a Safer Health System."

Question 44

Building a Safer Health System

Answer 44

recommended changes for advocacy to reduce errors and improve the quality of health care. The report is a four tiered approach.

Question 45

Leadership, research, tools, and protocols.

Answer 45

Enhance the safety knowledge base.

Question 46

Mandatory National Reporting

Answer 46

encourage participation in voluntary standards and exceptions.

Question 47

JCO and ACN

Answer 47

oversight organizations, health-care purchasers, and professional organizations to increase performance standards and expectations for safety improvements.

Question 48

point-of-care delivery

Answer 48

EHR, scanning meds at the bedside.

Question 49

To err is human

Answer 49

the public became more aware of how frequently medical errors occur. Consumer demand for higher quality care has increased dramatically.

Question 50

2001 report

Answer 50

crossing the quality chasm focused on developing a new health-care system that improved quality of care.

Question 51

6 aims for improvement

Answer 51

safe: avoid injuries from the care that is intended to help effective: providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit. patient centered timely: reducing waits efficient: avoiding waste, including waste of equip equitable: providing care that does not vary in quality because of personal characteristics.

Question 52

Quality Assurance

Answer 52

health care attempt to guarantee that when an action is performed by a health care professional, it is performed correctly the first time and each time thereafter.

Question 53

QA

Answer 53

requires that actions and activities are continuously measured and compared to standards of care established by a professional org and that processes of monitoring be in place to provide continuous feedback to prevent errors.

Question 54

Exceed Expectations

Answer 54

continuous quality improvement is based on the belief that the organization with higher quality services will capture a greater share of the market than competitors of lower quality services.

Question 55

Goal

Answer 55

meet the expectations fo the client but also exceed. This plan is multidisciplinary- design, measure, assess and improve the performance of the organizations.

Question 56

hospital consumer assessment healthcare provider systems

Answer 56

client satisfaction: the hospital care quality information from the consumer perspective also known as HCAHPS began in 2008 and provides a standardized survey instrument and data collection method to obtain client satisfaction data on eight key topics.

Question 57

Eight key topics

Answer 57

communication with health-care providers, communication with nurses, responsiveness of hospital staff, pain management, communication about medications, discharge information, cleanliness of environment, and quietness of hospital environment.

Question 58

Health care research and quality

Answer 58

uses quality indicators or QIs as measures of health care quality from easily accessible inpatient hospital administrative data.

Question 59

QIs

Answer 59

prevention, inpatient, patient safety, and pediatric.

Question 60

Risk management

Answer 60

identifying, analyzing, and evaluating risks.

Question 61

High risk areas

Answer 61

medication erros, complications from tests and treatments, and falls, refusal of tx or refusal to sign tx consents and client/family dissatisfaction.

Question 62

JCO

Answer 62

sets national patient safety goals that address particular risks for clients.

Question 63

Sentinel Events

Answer 63

unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. Serious injury includes loss of limb or function, these are not the same as errors. Not all sentinel events are due to errors and not all errors cause sentinel events.

Question 64

QSEN five competencies developed by IOM

Answer 64

client-centered care, teamwork and collaboration, evidence based practice, quality improvement, safety, informatics.

Question 65

Agency for healthcare research and quality

Answer 65

1 of 12 Department of health and human services agencies that supports research that improves the quality of health care and helps people make informed health care decisions.