Facilitating Change

The nurse manager is contemplating introducing new measures to increase patient satisfaction. Which considerations must the nurse manager make to properly prepare for employee response to a suggested change? Select all that apply. A. Employee conflicts of interest B. How the staff will respond to the change C. How long it will take to implement and adjust to change D. Acknowledgement that minor change will not affect the staff E. Focus on responding to the negative reactions to change from staff

A. Employee conflicts of interest B. How the staff will respond to the change C. How long it will take to implement and adjust to change

A group of newly hired nurses are consistently late for work, creating dissatisfaction among the night shift. Which action by the nurse manager can facilitate change in the new nurses and improve satisfaction among other staff? Select all that apply. A. Be present on the floor at the beginning of every shift. B. Harshly discipline one nurse to set an example for the others. C. Outline a plan for disciplining tardy staff and stick to the plan for every staff member. D. Explain to the nurses that they must follow the schedule even if they did not have any input in it. E. Immediately discuss the issue with each new nurse individually and the consequences of repeated tardiness.

A. Be present on the floor at the beginning of every shift. C. Outline a plan for disciplining tardy staff and stick to the plan for every staff member. E. Immediately discuss the issue with each new nurse individually and the consequences of repeated tardiness.

An anonymous report evaluating responses to change shows that in the critical care unit the majority of nurses are resistant to change. How should the nurse leader proceed? Select all that apply. A. Communicate with resisters. B. Allow resisters input on all aspects of the change. C. Identify and address any confusion regarding the change. D. Hold a joint meeting to discuss change with both resisters and supporters. E. Explain in complex detail of the need for change to put it in perspective for resisters.

A. Communicate with resisters. C. Identify and address any confusion regarding the change. D. Hold a joint meeting to discuss change with both resisters and supporters.

A nurse leader is working to improve safety measures on the geriatric unit after an increase in patient falls. Which strategies should the nurse leader use to expedite this change process? Select all that apply. A. Develop a plan to reduce patient falls by 50% over the next year. B. Attend national safety meetings to discuss new advances in patient safety. C. Volunteer to head a committee to investigate innovative safety strategies. D. Ensure that all plans for change are kept confidential within the unit until final decisions are made. E. Identify short-term safety updates that can be implemented quickly.

A. Develop a plan to reduce patient falls by 50% over the next year. B. Attend national safety meetings to discuss new advances in patient safety. C. Volunteer to head a committee to investigate innovative safety strategies.

Which strategies can nurse manager Adam use to obtain staff support for his suggested changes? Case Study: Adam was recently hired as manager of an orthopedic unit. As he becomes familiar with the unit and the facility, he is questioning some of the policies and procedures. One policy in question is the policy that only orthopedic technicians trained in physical therapy can apply and change traction set-ups on the beds. As he explores with his staff the history behind this policy, he is told the nurses do not have time to "fiddle" with the traction. He also is informed that it has always been done that way.He suggests developing a task force to review the policy and make recommendations for change. He hears rumblings among the staff that "every new boss wants to do something different." Bill, his nurse specialist, informs him that they tried that once before, but the staff wasn't interested. Because the current policy has resulted in several incidents and delays in treatment, Adam does not feel he can avoid the issue. He suggests a proposal in which the orthopedic aides are trained in the application of traction and a sequencing of whom to call in the event traction needs to be set up, adjusted, or changes. Staff members don't think it will work because the unit aides are just as busy as the nurses; besides, they contend physical therapy will never agree to the change. Several nurses suggest waiting, that "things have a way of working themselves out." Select all that apply. A. Establish necessary changes, but ask for feedback on the negotiable details. B. Sit down with the nurses as a group to discuss their core reasons for resisting change. C. Explain to the nurses how "waiting for things to work out" can negatively affect patient safety. D. Put the suggested changes in place immediately to allow the staff to experience the benefits. E. Separate those who support the change from those who do not so that the resistors can be addressed directly.

A. Establish necessary changes, but ask for feedback on the negotiable details. B. Sit down with the nurses as a group to discuss their core reasons for resisting change. C. Explain to the nurses how "waiting for things to work out" can negatively affect patient safety.

Which strategies should Nurse Buckingham discuss with the staff to improve patient satisfaction? Case Study: Nurse Buckingham, the nurse manager on a medical-surgical unit, has received information from patient satisfaction surveys that indicates that patients are dissatisfied with their health care outcomes. The patients have expressed concern over the lack of communication between patients and the nursing staff regarding patient care. Nurse Buckingham has scheduled a meeting to speak with the nursing staff. A. Get to know each patient on a more personal level B. Follow up with patients regularly to ensure patient comfort and safety C. Discuss common drug reactions before administering to patients D. Communicate with the primary health care provider about special patient needs E. Allow the patient to participate in assessments; explain what is happening and what to expect

B. Follow up with patients regularly to ensure patient comfort and safety C. Discuss common drug reactions before administering to patients E. Allow the patient to participate in assessments; explain what is happening and what to expect

To improve patient satisfaction, Nurse Buckingham ensures there is more staff on the floor to allow for longer nurse-patient interactions. She also discusses with each nurse potential personal barriers to patient communication and how they can be overcome. Finally, she drafts a budget projection to determine how much money the extra staff will cost to compare it to the benefit of increased patient satisfaction. Which personal skills is Nurse Buckingham using to address this issue? Case Study: Nurse Buckingham, the nurse manager on a medical-surgical unit, has received information from patient satisfaction surveys that indicates that patients are dissatisfied with their health care outcomes. The patients have expressed concern over the lack of communication between patients and the nursing staff regarding patient care. Nurse Buckingham has scheduled a meeting to speak with the nursing staff. A. Ethical B. People C. System D. Political E. Business F. Analytical

B. People D. Political E. Business F. Analytical

Several nurses on the unit are frustrated because they were not notified ahead of time about a mandatory online training that must be completed by the following week. How should the nurse leader respond to this outcome of change? Select all that apply. A. Show support to nurses who can attend the training to avoid further conflict. B. Request feedback from the nurses about how this change was communicated. C. Allow nurses scheduled to work to switch days with other nurses who already completed the training. D. Explain in a different way that the nurses need to complete the training as part of a requirement for employment. E. Sit with the nurses who are frustrated and allow them time to explore ways that they can complete the training.

B. Request feedback from the nurses about how this change was communicated. C. Allow nurses scheduled to work to switch days with other nurses who already completed the training. E. Sit with the nurses who are frustrated and allow them time to explore ways that they can complete the training.

The nurse leader is evaluating ways to increase patient safety on the unit and implements a fall prevention program involving collaboration with physical and occupational therapists. The staff nurses are reluctant to collaborate with staff with whom they are not familiar and do not have an established history. In which way should the nurse leader respond to ensure a successful collaboration? A. Implement the change without the support of all the staff nurses. B. Talk to the staff nurses about why they feel uncomfortable working with the other departments. C. Explain to the nurses that they must collaborate with the other departments or they cannot work in the unit. D. Ask the nursing staff for different ideas for fall prevention that can be implemented with only the nursing staff.

B. Talk to the staff nurses about why they feel uncomfortable working with the other departments.

Recently, the medical-surgical unit has been short staffed because of numerous sick calls. Often, many patients are waiting for hours to be admitted to the unit from the emergency department. What can the nurse do to facilitate the change process? Select all that apply. A. Ask the current staff to work overtime at the end of the shift to help the next shift with patient load. B. Work with health care providers and discharge planners to help develop ways to facilitate earlier discharges from the unit. C. Hire temporary staffing to help alleviate the staffing problem while examining reasons why there may be so many sick calls. D. Encourage the health care providers to avoid admitting patients who are not very sick and can go to another hospital to receive care. E. Move staff hired to work on the unit to the emergency department to help care for patients there to prevent them from waiting too long.

B. Work with health care providers and discharge planners to help develop ways to facilitate earlier discharges from the unit. C. Hire temporary staffing to help alleviate the staffing problem while examining reasons why there may be so many sick calls.

The nurse manager attempts to improve patient care by fostering mentorships between veteran and newly graduated nurses. As part of this endeavor, the nurse manager has reassigned several nurses to different shifts. This resulted in sadness and anger among the staff who were forced to acclimate to new colleagues during shifts. Which strategies can the nurse manager use to support the staff and encourage acceptance of the change? Select all that apply. A. Explain in detail the consequences of not supporting the change. B. Explain the complex details of the reasoning behind the decision. C. Ensure the staff is made aware of any schedule changes well in advance. D. Ask for feedback on the new system and engage in constructive criticism. E. Explain in layman's terms how working with a veteran nurse can support a new nurse's career and ease the transition into the workforce.

C. Ensure the staff is made aware of any schedule changes well in advance. D. Ask for feedback on the new system and engage in constructive criticism. E. Explain in layman's terms how working with a veteran nurse can support a new nurse's career and ease the transition into the workforce.

Match the change leadership strategy with the appropriate example. Form a team of nurses and dietitians to develop patient education materials Attend the American Nurses Association's annual conference Complete and distribute staff schedules on time - Be employable - Expand the profession - Remain connected

Form a team of nurses and dietitians to develop patient education materials - Expand the profession Attend the American Nurses Association's annual conference - Remain connected Complete and distribute staff schedules on time - Be employable