Leadership & Time Management in Nursing: Delegation, Prioritization, Quality Improvement, Study Guides, Projects, Research of Law

Download Leadership & Time Management in Nursing: Delegation, Prioritization, Quality Improvement and more Study Guides, Projects, Research Law in PDF only on Docsity! Leadership Exam 1 2024 students test with correct questios and answers(100% marking scheme)  Delegation - Correct answer the process of transferring the authority and responsibility to another team member to complete a task, while retaining the accountability  Delegation Decisions are Based on: - Correct answer -individual client needs  -facility policies  -job descriptions  -state nurse practice act  -professional standards  Can LPN's delegate to other LPN's or AP? - Correct answer Yes  Five Rights of Delegation - Correct answer -Right Task  -Right Circumstance  -Right Person  -Right Direction/Communication  -Right Supervision/Evaluation  Right Task - Correct answer -repetitive  -requires little supervision  -relatively noninvasive for the client  Right Circumstance - Correct answer -consider the team members workload  -match the complexity of care demands to the skill level of the heath care team member  Right Person - Correct answer -assess and verify the competency of the health care member  -must be within the team members scope of practice and must have the necessary competence/training  -continually review the performance and determine care competency  -assess performance based on standards and IF NECESSARY take steps to remediate a failure to meet standards  Right Direction/Communication - Correct answer Communicate either in writing or orally:  -data that needs to be collected  -method and time line for reporting (including when to report concerns/assessment findings)  -specific tasks to be performed  -client specific instructions  -expected results, time lines and expectations for follow up communication  Right Supervision/Evaluation - Correct answer -provide supervision either directly or indirectly (can assign supervision to another licensed nurse)  -provide clear directions and expectations  -monitor performance  -provide feedback  -intervene if necessary  -evaluate the client and if outcomes were met  -evaluate client care tasks and identify needs for improvement/additional resources  When does supervision occur? - Correct answer AFTER delegation  A supervisor oversees a staff's performance of delegated activities and determines if: - Correct answer -completion of tasks is on schedule  -performance was at satisfactory level  -abnormal/unexpected finding were documented/reported  -assistance is needed to complete assigned tasks in a timely manner  -assignment should be re-evaluated and possible changed  What things can be delegated LPNs? - Correct answer -Monitoring client findings (ongoing assessment)  -Reinforcement of client teaching from a standard care plan  -Trach care  -Suctioning  -Checking NG tube patency  -Administering enteral feedings  -Inserting urinary catheter  -Med administration (excluding IV in some states)  What things can be delegated to AP? - Correct answer ADLs  -bathing  -grooming  -dressing  -toileting  -ambulating  -feeding (w/out swallow precautions)  -positioning  Controlling - Correct answer evaluation of staff performance and evaluation of unit goals to ensure identified outcomes are being met  Leadership is.. - Correct answer the ability to inspire others to achieve a desired outcome  Leaders - Correct answer -may have only the informal power afforded them by their peers  -you can't be a leader w/out followers  -influence willing followers to move toward a goal that may or may not reflect those of the organization  Transformational Leaders - Correct answer empower followers to assume responsibility for a communal visions, and personal development is a secondary outcome  Transactional Leaders - Correct answer focus on immediate problems, maintain the status quo and using rewards to motivate followers  Characteristics of Leaders - Correct answer -initiative  -inspiration  -energy  -positive attitude  -communication skills  -respect  -problem solving and critical thinking skills  Principles of Care Prioritization - Correct answer -systemic before local (life before limb)  -acute before chronic  -actual problems before potential future problems  -listen carefully and don't assume  -recognize and respond to trends vs transient findings  -recognize signs of medical emergencies and complications vs expected client findings  -apply clinical knowledge to procedural standards to determine priority action  Good Time Management - Correct answer -facilitates greater productivity  -decreases work related stress  -helps ensure the provision of quality and appropriately prioritized client care  -enhances satisfaction with care provided  Poor Time Management - Correct answer -impairs productivity  -leads to feelings of being overwhelmed and stressed  -increase omission of important tasks  -creates dissatisfaction with care provided  Principles of Time Management - Correct answer  Collaboration with the Interprofessional Healthcare Team to Prioritize needs of Multiple Patients to Maintain Safety - Correct answer  Nursing Process - Correct answer  Maslow's Hierarchy of Needs - Correct answer (from most important to least important!)  -Physiological  -Safety and Security  -Love and Belonging  -Self-Esteem  -Self Actualization  Urgency Factor - Correct answer  Prioritization - Correct answer -acute over chronic  -urgent over non-urgent  -unstable over stable  Identifying Priority Actions, Assessments, and Interventions to Maintain Safety for Diverse Clients - Correct answer  Staff Development/Staff Education - Correct answer -the nurse's involvement in the orientation, socialization, education, and training of fellow health care workers to ensure the competence of all staff and to help them meet standards set forth by the facility and accrediting bodies  -this is the process by which a staff member gains knowledge and skills  -GOAL: to ensure the staff members have and maintain the most current knowledge and skills necessary to meet the needs of the client  Staff Education Characteristics - Correct answer -involves methods appropriate to learning domain and learning styles of the staff  -initiated in new situations (new policies/procedures implemented, new equipment, educational need identified)  -may focus on one-on-one approach  -can use "just in time" training to meet immediate needs for client care  -higher education degree or certification  Steps in Providing Education Programs - Correct answer 1. Identify and Respond  2. Analyze  3. Research  4. Plan  5. Implement  6. Evaluate  Orientation - Correct answer Helps the newly licensed nurses translate the knowledge, skills, and attitudes learned in nursing school in to practice.  Orientation to Institution - Correct answer -introduced to philosophy, mission, goals of the institution and department  -policies and procedures based on institutional standards are reviewed  -use of and access to the institutions computer system (this is a significant focus)  -safety and security protocols in relation to the nurses role  -this is more like a "classroom" style orientation  Preceptors - Correct answer -assist in orienting newly licensed nurses to a unit and supervising their performance and acquisition of skills  -usually assigned for a limited amount of time  Mentors - Correct answer -may also serve as a preceptor  -BUT, their relationship usually lasts longer and focuses more on assumption of the professional role and relationships, as well as socialization to practice  Coaches - Correct answer establish a collaborative relationship to help a nurse establish individual goals  -the relationship is typically time limited  Orientation to Unit - Correct answer -usually moves on to the unit and is continued with an assigned preceptor  -includes: preceptors, mentors, or coaches  Competence - Correct answer -directly related to length of time in practice and exposure to clinical situations  -when nurses move to a new clinical setting that requires acquisition of new skills of knowledge....their level of competence returns to a lower stage  Benner's Stages of Nursing Expertise - Correct answer -Novice Nurse  -Advanced Beginner  -Competent Nurse  Process Indicators reflect - Correct answer how client care is provided and are established by policies and procedures (clinical practice guidelines)  -provide important info about how a procedure is being carried out  Benchmarks - Correct answer goals that are set to determine at what level the outcome indicators should be met  Just Culture - Correct answer an environment which attempts to focus on corrective action rather than punishment  FMEA (Failure Mode Effects Analysis) - Correct answer proactive approach to decrease incidences of errors in high risk or new procedures  Progressive Discipline - Correct answer process of corrective action which increases with action  Sentinel Event - Correct answer unexpected occurrence involving death or serious injury  Quantitative Methods - Correct answer -primarily used in the data collection process, although client interview is also an option  -audits  Structure Audits - Correct answer evaluate the influence of elements that exist separate from or outside client-staff interaction  Process Audits - Correct answer review how care was provided and assume relationship that exists between nurses and the quality of care provided  Outcome Audits - Correct answer determine what results, if any, occurred as a result of the nursing care provided  Nursing Sensitive Outcomes - Correct answer those that are directly affected by the quality of nursing care  ex) client fall rates and the incidence of nosocomial infections  Timing of Audits - Correct answer -Retrospective: after the client receives care  -Concurrent: while the client is receiving care  -Prospective: predict how future client care will be affected by current level of services  Root Cause Analysis - Correct answer -focus on variables that surround the consequence of an action/occurrence  -commonly done for sentinel events (client death, client care resulting in serious physical injury) but may also be done as part of the quality improvement process  What it does:  -investigates the consequence and possible causes  -analyzes the possible causes and relationships that may exist  -determines additional influences at each level of relationship  -determines the root cause/causes  Nurses Role in Quality Improvement - Correct answer -Serve as unit representative on committees developing policies and procedures  -Enhance knowledge and understanding of the facilities policies and procedures  -Provide client care consistent with these policies and procedures  -Document client care thoroughly and according to facility guidelines  -Participate in the collection of info/data related to staffs adherence to selected policy/procedure  -Assist with analysis of info/data  -Compare results with the established benchmark  -Make a judgement about performance or staff  -Act as a role model by practicing in accordance with the established standard  -Assist with re-evaluation of staff performance by collection of info/data at a specific time  Performance Appraisal - Correct answer -the process by which a supervisor evaluates an employees performance in relation to the job description for that employees position as well as other expectations of the facility  -done at regular intervals and may be more frequent for new employees  -allow nurses the opportunity to discuss personal goals with the unit manager as well as to receive feedback regarding level of performance  -may be used as a motivational tool  -formal system for conducting this should be in place and used consistently  -tools should reflect the staff members job description and may be based on various types of scales/survey  Performance Expectations - Correct answer should be based on the standards set forth in a job description and written in objective terms  Data Collection in Performance Appraisal - Correct answer -various sources should be collected to ensure an unbiased and thorough evaluation of an employees performance  -should be collected over time and not just represent isolated incidents  -actual observed behavior should be documented/used as evidence of satisfactory/unsatisfactory performance (may be called anecdotal notes)(kept in unit managers files)  -peers can be a valuable source  -the employee should be given the opportunity to provide input into the eval  Peer Review - Correct answer -Should begin with an orientation of staff to the peer review process, their professional responsibility in regard to promoting growth of colleagues, and the disposition of data collected  -Focus on the peers performance in relation to the job description or an appraisal tool that is based on institutional standards  -Be shared with the peer and usually the manager  -Be only part of the data used when completing a staff members performance apprasial  Performance Appraisal Review - Correct answer -should be hosted by the unit manager in a private setting -held at a time conductive to the staff members attendance  -UM should review the data with the staff member and provide the opportunity for feedback  -personal goals of the staff member should be discussed and documented and avenues for attainment discussed  -staff members who do not agree with the unit managers evaluation of their performance should have the opportunity to make written comments on the evaluation form and appeal the rating  Disciplinary Action - Correct answer -Deficiencies identified should be presented in writing, and corrective action should be based on institutional policy  -Evidence regarding a deficiency must support such a claim  -Lesser infractions should follow a stepwise manner which gives the staff member the opportunity to correct unacceptable behavior  First Infraction - Correct answer -informal reprimand  -manager and employee meet  -discuss the issue and suggestions for improvement/correction  Second Infraction - Correct answer -written warning  -manager meets with employee to distribute written warning  -review specific rules/policy violations  -discuss of potential consequences if infractions continue  -lose lose situation  Competing/Coercing - Correct answer -one party pursues a desired solution at the expense of others  -managers may use this when a quick or unpopular decision must be made  -the party who loses something may experience anger, aggravation, and a desire for retribution  -win lose situation  Cooperating/Accommodating - Correct answer -one party sacrifices something, allowing the other party to get what it wants  -opposite of competing  -the original problem may not actually be resolved  -solution may contribute to future conflict  -lose win situation  Compromising/Negotiations - Correct answer -each party gives up something  -to consider this a win/lose-win/lose solution, most parties must give up something equally important  -if one party gives up more than the other, it can become a win-lose solution  Assertive Communication - Correct answer -may be necessary during conflict negotiation  -allows expression in direct, honest, and nonthreatening ways that do not infringe upon the rights of others  -acknowledges and deals with conflict, recognizes others as equals, and provides a direct statement of feelings  Elements of Assertive Communication - Correct answer -Selection of an appropriate location for the verbal exchange  -Maintenance of eye contact  -Establishing trust  -Being sensitive to cultural needs  -Speaking using "I" statements and including affective elements of the situation  -Avoid using "you" statements that can indicate blame  -Stating concerns using open, honest, and direct statements  -Conveying empathy  -Focusing on the behavior or issue of conflict and avoiding personal attacks  -Concluding with a stamens that describes a fair solution  Grievances - Correct answer -a wrong perceived by an employee based on a feeling of unfair treatment that is considered grounds for a formal complaint  -ones that can not be satisfactorily resolved between the parties involved may need to be managed by a 3rd party  -all health care facilities have a formal grievance policy that should be followed when a conflict can't be resolved  Typical Steps of the Grievance Process - Correct answer 1) Formal presentation of the complaint(s) using the proper chain of commands  2) Formal hearing if the issue is not resolved at a lower level  3) Professional mediate if a solution is not reached during a formal hearing  Resource Management - Correct answer -includes budgeting and resource allocation  -human, financial, and material resources must be considered  -providing cost-effective client care should not compromise quality of care  Budgeting - Correct answer usually the responsibility of the unit manager, but staff nurses may be asked to provide input  Resource Allocation - Correct answer is a responsibility of the unit manager as well as every practicing nurse  Cost Effective Resource Management - Correct answer -using all levels of personnel to their fullest when making assignments  -providing necessary equipment and properly charging clients  -returning uncontaminated, unused equipment to the appropriate department for credit  -use equipment properly to prevent wastage  -provide training to staff unfamiliar with equipment  -return equipment (IV, kangaroo pump) to the proper department (central service, central distribution) as soon as it is no longer needed (this action will prevent further cost to clients!)