Term | Definition |
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 |