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NURS 420

Exam 3 aka Final

QA/QI? discover/correct errors QA
QA/QI? prevent errors QI
QA/QI? inspection of nurse activities & chart audits QA
QA/QI? review nurse activities, innovation, & staff development QI
QA/QI? QA or department personnel QA
QA/QI? multidisciplinary team QI
QA/QI? set by a team with input from staff QA
QA/QI? set by a team with input from staff & patients QI
QI process steps 1. ID needs 2. Assemble multidisciplinary team 3. Collect data 4. Establish outcomes & quality indicators 5. Select & implement plan 6. Evaluate
In ID Nee what is #1 importance? improved patient outcome
outcomes improve the greater quality or quantity
process nursing care, assessments, nursing interventions
structure number of nurses
Risk Management Process steps 1. Define a high-risk situation 2. Determine frequency 3. Intervene & investigate 4. Identify opportunities to improve care
near misses no injury but highlights need of action
failure mode & effects analysis (FEMA) method to analyze reliability problems proactively to avoid negative outcomes
Malpractice elements duty, dereliction, damage, direct cause
duty nurse has responsibility to patient
dereliction nurse did not carry out duty
damage patient was injured
direct cause injury secondary to the nurse's failure to carry out duties
consumer relationships encounters between the consumer and healthcare system representatives
the multiple parts of healthcare make it difficult to do what? develop trust
nurses responsibilities in consumer relationships service, advocacy, teaching, leadership
service orientation focuses on the needs of the customer. also includes nursing care quality, nurse-patient relationships, and caring atmosphere
advocate empowers and promotes self-determination, promotes autonomy, ensures respect, equality, and dignity for others, defends & promotes rights of others
3 P's for consumer education philosophy, priority, performance
keys to successful nurse advocate - developing networking systems - being involved in associations - acquiring knowledge needed to access systems - learning about community resources & support networks - developing skill in referring & engaging patients
conflict disagreement in values or beliefs within oneself or between people that causes harm or the potential to cause harm
types of conflict intrapersonal or organizational or interpersonal
intrapersonal conflict confronted with something that you wouldn't see yourself doing ie. grad school or changing schedule
organizational conflict don't agree with code of conduct or policies & procedures
stress = poor patient outcomes
compromise is used to avoid dealing with the conflict
interpersonal conflict differing opinion ie. family, nurse, doctor
conflict process 1. frustration 2. conceptualization 3. action 4. outcomes
frustration perception that your goals may be blocked resulting in emotions
conceptualization what's important to people and what should happen next
action seek clarification about about others view point, collect additional info that informs the issue, engage in dialog about issu then take actions to resolve conflict
successful resolution identifying a common goal that unites the two
outcomes assess what happened & whether anything happened with the relationship
constructive conflict results in resolution leading to growth, problems resolved, groups unified, productivity increased, and commitment increased
bullying real or perceived power differential between the instigator and recipient must be present in bullying
lateral voilence aggressive and destructive behavior or psychological harassment of nurses against each other
STAMP assessment Staring Tone & volume of voice Anxiety Mumbling Pacing
delegation achieving performance of care outcomes for which you are accountable & responsible for by sharing activities with other individuals who have the appropriate authority to accomplish the work
key in delegation communication
why delegate cost-effective
Rights in delegation task, circumstances, person, direction/communication, supervision
absenteeism is linked to role stress & strain thus need to clarify role
recognition of chemical dependency absent a lot, changed good nurse to making lots of mistakes, nurse wants to take of patient with pain meds
priority if chemical dependency is suspected intervene to ensure patient safety
emotional problems manifestations poor judgement, increased errors, increased absenteeism, decreased productivity, and negative attitude
steps to clarify role 1. oral reminder 2. written & oral reminders 3. day of decision(day off without pay) 4. termination
steps in progressive discipline 1. counsel 2. reprimand 3. suspend 4. work with stipulations 5. termination
who plays a key role in role transitions? organizations
ROLES Responsibilities Opportunities Lines of communication Expectations Support
what is the heart of leadership? communication
mentor benefits stimulate new ideas, development, self-awareness, enlarging colleague pool, new relationships
mentee benefits one-to-one relationship, advice on career development, enlarged network, self-confidence, insight into organization
phases of role transistion 1. preview 2. acceptance 3. exploration 4. discrepancy 5. development 6. internalization
preview phase dating
acceptance phase commitment to decision
exploration phase honeymoon
discrepancy phase honeymoon phase over
development phase comes from expectation s and performance
internalization phase know role and expectation & it becomes 2nd nature
resume or CV? quality resume
resume or CV? quanitity CV
resume or CV? doesn't list everything resume
resume or CV? used for a specific position or role resume
resume or CV? everything you have ever done CV
addiction signs irritable, restless, discontent
impaired professionals look at attendance, performance, behavior, physical sings, & narcotics discrepancies
reporting avenues for impaired nursing Board of Nursing or TPAP
Board of nursing process for impaired nursing formal investigation, findings reviewed, sanctions may occur
TPAP process for impaired nursing confidential reporting or referral by Board of nursing, evaluation, contract if treatment required, avoids sanctions
Key to chapter 20 on Quality Management practice more efficiently and decrease malpractice
who defines quality? customers
risk management looks to decrease losses after something happnens
losses length of stay, negative public opinion, employee dissatisfaction
some examples of a sentinel events wrong site surgery, suicide, med error, fire, abduction, transfusion error, uninteded retention of foreign body
Created by: midnight1854