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Roles Exam 3

Nurse leader the person who is expert in the area
nursing manager looking at quality outcomes for pt. Difference between status quo and what should be
hat type of hospital would give you a voice magnet, shared governence
shared governance Decisions and responsibility is shared Ex) magnet
If there is a hospital that is magnet status is JACO easier or harder Easier, because they go above and beyond the requirements
There is a large organization that has a smaller group it is called subculture
If you look at a root cause analysis you look at what kind of diagragm fish bone
What are Lewins three stages of change Unfreezing Experiencing the change Refreezing
What is unfreezing Awareness of an opportunity, need or problem (ASSESSING)
What is experiencing the change Incorporating of what is new or different into work and inter-personally process (IMPLEMENTATION)
What is refreezing When participants accept change and use the new attitude or behavior (Evaluation)
General hospital has best burn unit in country, the rural hospital is developing a rural burn unit in area and is looking at General hospital. What is that called? Benchmarking
Diffusion of innovations (Rogers) innovations spread through society, occurring in stages; knowledge, persuasion, decision, implementation, and confirmation
Translating research into practice (TRIP) Approaches that integrate the use of evidence into patient care
Your child is ill and going to be hospitalized for several months, what do you apply for FMLA
If you are on a committee to open a new hospital and have certificate of need pending, and you need to communicate with the legislature, what is the best way face to face
working in a health department and patient commits suicide, what is that called sentinel event
If you have an iv pump and you set it at 125 and it goes in at 1000 ml per hour what is that called sentinel event
When 2 hospitals merge and the PICU from 1st hospital is put into 2nd hospital and were only given 1 days notice of change. There was merging of positions, If a person makes the transition difficult it is called a internal force
You are the team leader and you have 2 RNs, 4 CNA, and the CNA comes to you and says I can't get to this patient care, and this patient care and this patient care. Team leader responds "Oh deal with it, I don't have time for that" What is it called? Barrier
A clinical RN specialist is meeting one on one with staff nurses while they are working together to discuss data about the evidenced based practice. This is known as Academic detailing
What is the basis for research utilization Analysis of research done before putting it into practice
Why do you set career goals To keep moving forward, goal to work toward
Why do you do a cover letter To introduce yourself
What do you expect to be a benefit pckg healthcare, sick days, vacation days
What will foster a successful interview process Familiar with company, position, ask questions about it, proper language, dress professionally
If someone says you didn't do something right, what should your response be Clarify communication
What does collective bargaining mean to nursing It is more successful with patient safety
What is difference between traditional and nontraditional bargaining units Traditional would be employees Nontraditional: RN do it for the safety and quality of care especially when strain occurs between management and nurses
What is whistleblowing Is when a employee voices concern about the quality of care would put them in a vulnerable position if the were (AT will employees), but due to legislation will be protected from repercussions
What is evidenced based practice The integration of individual clinical expertise, built from practice with the best available clinical evidence from systematic research applied to practice Evidenced based practice is using data and has same outcome every time
Research utilization is the process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices
What is policy A specifically designated statement to guide decisions and actions
What is politics A process of human interaction within organizations
what is power ability to influence others in an effort to achieve goals
What is political power An authority held by a group within a society that allows for the administration of public resources and implement policies for society. Power may be acquired as a means of governmental direction or in opposition to a government group.
What is career progressive achievement throughout a persons professional life
What is certification Designation of special knowledge beyond basic licensure
Continuing education learning that builds on prior knowledge and experience with the goal of being a more competent professional
curriculum vitae A listing of professional life activities
licensure A right granted that gives the licensee permission to do something that he or she could not legally do absent such permisiion
portfoliio A professional assemblage of materials that represent the work of the professional including evaluations, letters of recommendation, certificates of accomplishments, etc
professional association (organization) An alliance of practitioners within a profession that provides opportunities for its member to meet leaders in the fields, hone leadership skills, policy formation specialized education and shape future
resume A summary of professional abilities and facts designed for specific opportunities
Friss career stylesWhat is a steady stateWhat is a steady state Steady state Linear entrepreneurial and transient spiral
What is a steady state Constancy in position with increasing professional skill (example: staff nurse)
What is linear career style Represent vertical movement in the organizational hierarchy (example: Nursing service administrator)
Entrepreneurial and transient appealing to nurses who wish to see the world or have a creative bent (Private practice nurse, temp assignments)
Spiral Rational, independent responsibility for shaping career (in and out, up and down) (Nurse who returns after raising a family)
mentor inspire new thinking and new opportunities and steer you to various roles and clinical areas
Intrinsic reward examples a level of competence enhancing professional autonomy and enhancing personal confidence
Extrinsic rewards recognition from peers and employers, increased consumer confidence, increased salary
American Nurses Association advances the nursing profession y fostering high standards of nursing practice
Advanced practice nursing Based on knowledge and skills acquired through basic RN education and graduate educaion and experience that includes advanced nursing theory, physical assessment, psychosocial assessment and treatment of illnesNurse practitioners, certified nurse midwives
Examples of Advanced practice nursing Nurse practitioners, certified nurse midwives, ncertified registered nurse anesthetist, and clinical nurse specialist
Clinical nurse leader masters degree prepared generalist who oversees the care coordination of a distinct group of pts in any setting. The CNL actively provides direct pt care in complex situations, evaluates pt. outcomes, & has decision making authority to change expert in ad
Doctor of nursing practice expert in advanced nursing practice who has an earned clinically focused doctorate degree in nursing
Interprofessional team Health care team composed of professionals from different disciplines including chaplains, nurses, dietitians, pharmacist, physical therapist, physicians, respiratory therapist, etc who cooperate, collaborate, communicate, and integrate care to ensure tha
Nursing roles Traditional duties and responsibilites of the professional nurse, regardless of practcie area or setting, such as the roles of care provider, eduator, counselor, client advocate, change agent, leader, manager, and are guided by specifie professional stand
manager looks at quality outcomes for pt and look at difference between what is and what should be
Leader considered experts in that area
change agent Analyzes status quo and finds problems, explores alternatives, possible outcomes and cost effective resources
Case managers identify the best resources at the lowest cost to achieve the optimal health outcome for the client
Clinical nurse leader Masters that oversees the care coordination of a distinct group of pts in any setting. Actively provides direct pt care in complex situations, may change care plans when necessary
Orientation Activities that enhance adaptation to a new environment
portfolio A collection of evidence demonstrating acquisition of skills, knowledge, and achievements related to a professional career
Professional objective Occupational position for which one aims
resume Summary of a job applicant's previous work experience and education
Coalitions Groups of individuals or organizations that join together temporarily around a common goal
empowerment The process by which we facilitate the participation of others in decision making and taking action so they are free to exercise power
influence process of using power
negotiating Conferring with others to bring about a settlement of differences
apathy little or now interest in legislative politics as they relate to nursing and health care
buy in recognition of the importance of activism within professional organization without active participation
self interest involvement in professional organization to furthers ones own career
political sophistication high level of professional organization activision
Leading the way serving in elected or appointee positions in professional organization at the state and national levels
personal power based on ones' reputation and credibility
Expert power results from the knowledge and skills one possesses that are needed by others
position power virtue of ones position within an organization or status within a group
perceived power ones' reputation as a powerful person
information power ones possession of selected information that is needed by others
connection power gained by association with people who have links o powerful people
Mentors competent, experienced professionals who develop a relationship with a less experienced nurse for the purpose of providing advice, support, information, and feedback to encourage the development of that person
Goal setting helps one to know if what was planned was actually accomplished
Barriers actors, internal or external to the change situation, that interfere with movement toward a desirable outcome
change management The overall processes and strategies used to moderate and manage the preparation for, effect of, responses to, and outcomes of any condition or circumstance that is new or different from what existed previously (planning, organizing, implementing, evalua
change outcome The end product of a change process
change process The series of ongoing efforts applied to managing a change
change situations The field comprising various factors and dynamics with which change is occuring
chaos theory Theoretical construct defining the random appearing yet deterministic characteristics of complex organiztions
cybernetic theory Regulation of systems by managing communication and feedback mechanisms
facilitators Factors, internal or external to the change situation, that promote movement toward a desired outcome
high compexity change A complicated change situation characterized by the interactions of multiple variables of people, technology, and systems
informal change agent Person without designated authority who advances the change among a group of people
learning organization The designation of a type of organization in which continual learning as an expectation permeates all levels to promote adequate responses required by dynamic, accelerated change
low complexity change An uncomplicated change situation characterized by the interactions of the limited influences of people, technology, and systems
negative feedback nformation indicating a correction is needed
nonlinear change change occurring from self organizing patterns not human induced ones, in complex open system organizations
planned change (linear) change expected and deliberately prepared beforehand by using systematic directional processes to develop and carry out activities to accomplish a desired outcome (reorganizing storage of unit supplies)
strategies Approaches designed to achieve specific purposes
What are the two approaches on change linear and nonlinear
change agent in linear planned changes focus on specific goals and incremental steps needed to attain those goals
change agents in nonlinear, complex changes Serve as monitors of the environment, negotiators of influences on a change, and precise forecasters of possible scenarios and their anticipated outcomes
What is force field anoalysis an analysis of change situation including early and ongoing assessment of barriers and facilitators
Havelock six phases of planned change idea change can be planned, implemented and evaluated in 6 sequential steps Useful for low-level, low-complexity change
Lippit, watson, and westley 7 phases of planned change Useful for low-level, low-complexity change
Rogers innovation-decision proces Useful for individual change
Senges 5 disciplines of learning organizations 1. systems thinking 2. personal mastery 3. Mental models 4. Shared vision 5. Team learning
Example of chaos and learning organization theory community hospital that has been sensitive to and has adapted to external and internal environmental influences, such as the need to make changes in reimbursement and accreditation policies
Hirschhorn three aspects to change Political (working with pharmacy to effect a change in delivery of meds to pts) ,marketing (Determining what motivates others to change) military (Paying attention to the change outcomes
6 behavioral responses to change Innovators Early adopters Early majority Late majority Laggards Rejectors
Innovators Thrive on change , may be disruptive to stability
Early adopters respected by their peers and sought out for advice and information about changes
Early majority prefer doing what has been done in the past but eventually will accept new ideas
Laggards prefer keeping traditions and openly express their resistance to new ideas
rejectors oppose change actively, even use sabotage
leadership rounding tool (Studor group) -Establish and maintain a human rapport with staff -Ask what is working well for staff as they perform their daily functions -Ask what is not working well -Ask if there is someone whom they would like to especially recognize as a contributor to outsta
cooptation manipulated involvement through an appointed or assigned role
manipulation appeals to the motivational needs of others and influences them to participat
coercian use of power to force others to make a change
Diffusion theory (Rogers) Describes how the innovation is communicated and spreads over time throughout members of a specific culture or group
The starfish and the spider (Brafman and Beckstrom) 2 leadership styles Starfish: neural network of cells (decentralized due to no head or central command)(ie. AA) Spider: 1 head and 8 legs (centralized organizatio) We need both
Acknowledgement Recognition that an employee is valued and respected for what the have to offer to the workplace, team, or group
Active listening Focusing completely o the speaker and listening without judgment to the essence of the conversation
Commitment Feeling passionate about and dedicated to project or event
Dualism An "either/or" way of conceptualizing reality in terms of 2 opposing sides or parts
Effective communication A process that leads to positive outcomes for senders and receivers in terms of clarity, usefulness, and efficiency
Group A number of individuals assembled together or having a unifying relationship
Synergy A phenomenon in which teamwork produces extraordinary results that could not have been achieved by any one individual
Team A number of people associated together in specific work or acctivities
Veterans live by rules and don't question authority
Boomers lived through cold war and influenced by assassinations of Kennedy, MLK, civil rights, womens rights
Gen X latch key kids (both parents worked, divorce common, poor job stability
Gen Y Future, massive tech, terrorism and natural disasters, education is key to success
When the sender is feeling stressed they could act how Atttibution of blame Placation Constrained, cool-headedness irrelevant congruence
Attribution of blame Mostly "you" messages; like "you really blew it"
Placation " I was wrong. I'm sorry. Its all my fault"
Constrained, cool-headedness "Studdies ahve show that in 75% of cases, the pt is correct. I decided to use research data in comeing to a solution" No feelings
irrelevant (changes the subject)
Congruence "For now, I feel concerned about the anger and hostility exhibed by Dr. X. I'm wondering what approach would de-esculate him" (words, actions, feelings match)
Barriers to communication Distractions Inadequate knowledge poor planning differences in perception emotions and personality
Communication pitfalls Giving advice making others wrong being defensive judging the other person patronizing giving false reassurance asking why questions blaming others
Keys to concept of team conflict resolution singleness of mission willingness to cooperate commitment
Tools and issues that support teams In groups and out groups power and control Use, develop, and be appreciated for my skills and resources
Qualities of a team player adaptable collaborative committed communicative competent dependable disciplined enlarging enthusiastic intentional mission conscious prepared relational self improving selfless solution oriented Tenacious
To create synergy consistently Establish a clear purpose use active listening be compassionate tell the truth be flexible commit to resolution
Druskat and wolff believe that 3 major componenet of smoothly functioning teams must be created mutual trust among all members Strong sense of team identity Sense of team efficacy
Work group effectiveness improves when team is functioning smoothly and emotions and feelings are being addressed on a routing basis
fear False Evidence Appearing Real
Agency for Healthcare Research and quality The primary federal agency devoted to improving quality, safety, efficiency, and effectiveness of health care
DNV A new deeming organization as of 2008 to accredit healthcare organizations Direct competitor for JCAHO internationally
Institue for Healthcare Improvement An independent organization devoted to improving pt. safety and health care globally Transforming care at the bedside Focuses on safety, reliability, care team vitality, patient-centeredness, increased value
Institute of Medicine An organization that works outside of the federal government to provide independent, scientific advice "to err is human" and "preventing medication errors"
Magnet Recognition Program Only national designation built on evolving through research. Designed to acknowledge nursing excellence
National Quality Forum A membership based organization that sets priorities and goals for performance improvement and endorses standards for measurement "Never events"
The Joint Commision An organization that accredits healthcare organizations and is deemed by the center for medicare and medicaid services as holding healthcare facilities to CMS standards Not for profit but facility must pay lots of $ for approval
STAR approach to pt safety Stop to concentrate on task Think about task Act to accomplish the task Review how well the task was accomplished
at will employee An individual who works without a contract
CDC The main federal agengy protecting the health and safety agency protecting the health and safety of people in the US
Collective action A mechanism for achieving professional practice through group decision making
collective bargaining Mechanism for settling labor disputes y negotiation between the employer and representatives of the employees
culture It consists of values, beliefs, attitudes, practices, rituals, and traditions
empowerment A sharing of power and control with the expectation that people are responsible for them selves
followership Those with whom a leader iteracts
governance System by which an organization controls and directs formulation and administration of policy
mentor An experienced person who helps a less experienced person navigate into expertis
role model A person who enacts a role, typically in a positive way, so that others can follow the example
shared governance A flat type of organizational structure with decision making decentralized
subculture Element of a main culture that has formed its own culture that differs in some way
whistleblower A person who makes public a serious wrongdoing or danger concealed within an organization when internal actions have failed to correct or make public a situation
workplace advocacy Refers to acting on or in behalf of another who is unable to act for himself or herself to effect change about workplace conditions
4 main purposes of collective participation To promote the practice of professional nursing To establish and maintain standards of care To allocate resources effectively and efficiently To create satisfaction and support in the practice
6 critical considerations in shared governance Defined by the person in the role Defined by role, not job or task Based on outcomes Set in advance Linked to results Has observable processes
porter, Hawkins, and Parker basic principles of shared governance partnerships, equity, accountability, and ownership
Gadow's manifestations of advocasy Ensuring relevant information Enabling the selection of information Disclosing a personal view Providing support for making and implementing decisions Helping determine personal values
Benchmarking Best practices, processes, or systems identified by a quality improvement team to be compared with the practice, process, or system under review
Continuous quality improvement A comprehensive program designed to continually improve the quality of care
Failure mode and effects analysis A method to analyze reliability problems proactively to avoid negative outcomes
Near miss A clinical situation that resulted in no injury but that highlights the need for action
Never event Error in medical care that is clearly identifiable, preventable, and serious in its consequences for the patient and that indicates a real problem in the safety and credibility of a health care facility
Nursing-sensitive outcome Patient outcomes that relate to the quality of nursing care provided
paitent care outcome A measureable end result of patient care
performance improvement The aplication of quality improvement principles on an ongoing basis
quality assurance A process that focuses on the clinical aspects of a providers care often in response to an identified problem Goal: To improve quality Focus: Discovery and corretion of errors Major tasks: Inspection of nursing activities & chart audit Quality team : Q
quality improvement n ongoing process of innovation, prevention of error, and staff development used by an organization that has adopted a quality management philosophy Goal: To improve quality Focus: Prevention of errors Major tasks: Review of nursing activites, innovat
Quality management A corporate culture emphasizing customer satisfaction, innovation, and employee involvement in quality improvement activities
Risk management Integrated into a quality management program as a process of developing and implementing strategies that will minimize risks and mitigate the impact of adverse effects
Root-cause analysis The process used to identify all possible causes of a sentinel event and all appropriate risk reduction strategies
Sentinel event A serious, unexpected death or injury, such as suicide, infant abduction, or wrong site or wrong site surgery
Total quality management A comprehensive program designed to achieve perfection in quality of care
Six Sigma 5 step methodology Define opportunities Measure performance Analyze opportunity Improve performance Control performance
Pareto chart Bar chart that identifies the major causes or components of a particular quality control problem
Fishbone Effective method of summarizing a brainstorming session for a specific problem or outcome
Histogram Bar chart that shows the frequency of events
Flowchart describe complex tasks
line graphs (trend chart) present data by showing the connection among variables
NANDA North American Nursing Diagnosis Association
NIC Interventions
NOC Outcomes
NDNQI National Database of Nursing Quality Indicators from the ANA that provides hospitals with unit level performance reports with comparisons with national averages and percentile rankings
Clinical guidelines Statements of practice expectations developed by a group of healthcare practitioners to guide the clinical management of pts.
diffusion of innovation Process by which ideas spread through a culture
evidence-based practice The integration of individual clinical expertise, built from practice, with the best available clinical evidence from systematic research applied to practice
meta-analysis Statistically combines similar studies on a particular issue to determine if the findings are significant across settings
outcomes Anticipated or actual effects of program activities and outputs
practice based evidence A research methodology that helps inform practice decisions by examining outcomes in the real world where patients may not be similar and the actual application of an intervention may have multiple variations
practice based research network Originally formed to adress research issues in primary care. PBRN's are increasingly being used in large healthcare organizations having the capability of integrating system sacross multiple practice sites. The exist for primary care, community nursing ce
randomized controlled trial Study in which patients are assigned by chance to one of the groups defined in the study
research A systematic investigation to determine the truth or falsehood of a hypothesis
research utilization Process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices
translating research into practice (TRIP) Approaches that integrate the use of evidence into patient care
Created by: Laura ridenour
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