LPN Leadership & Management - Chapter 13: Understanding Benefits of Change

The nurse is serving on a committee to implement new cardiorespiratory monitors in the unit. What actions can the committee recommend to avoid the common mistakes that can occur during the change process? (Select all that apply.) 1. Identify the pros and cons of the new system as compared to the old system. 2. Allow adequate time for the staff to learn how to work the monitors before installing them. 3. Provide a resource person knowledgeable about the new monitors when they are put in use. 4. Keeping the old procedure in place for use of the monitors to prevent confusion 5. Install the new monitors the day after informing the unit about the change.

1. Identify the pros and cons of the new system as compared to the old system. 2. Allow adequate time for the staff to learn how to work the monitors before installing them. 3. Provide a resource person knowledgeable about the new monitors when they are put in use.

The nurse is caring for a patient whose left leg was amputated below the knee following a skiing accident. The nurse recognizes the patient is experiencing a transition to his new body image when observing what characteristics? (Select all that apply.) 1. Irritability 2. Anxiety 3. Asking how he will do the things he used to do 4. Depression 5. Wanting to spend all his time in physical therapy

1. Irritability 2. Anxiety 3. Asking how he will do the things he used to do 4. Depression

Which of the following is a characteristic of effective people? 1. Opportunity-oriented 2. Problem-oriented 3. Management-oriented 4. People-oriented

1. Opportunity-oriented

The new graduate LPN accepts a position as a staff nurse in a hospice home-care unit. Upon attending the first staff meeting the nurse learns there has been a problem with keeping nurses safe when visiting certain areas of town, and the nurses are requesting improvement. What role can this new graduate expect to take in the change process? 1. Participate in the change process. 2. Identify needed changes. 3. Recommend changes to improve processes. 4. Evaluate the effectiveness of change.

1. Participate in the change process.

The LPN has worked on this unit at an acute care hospital for the past four years. It is announced that the hospital wants to change the process for admitting new patients. What roles can this nurse serve in the change process? (Select all that apply.) 1. Participate in the change process. 2. Identify needed changes. 3. Recommend changes to improve processes. 4. Participate in evaluating the effectiveness of change. 5. Act as the informal leader of the group researching the needed change.

1. Participate in the change process. 3. Recommend changes to improve processes. 4. Participate in evaluating the effectiveness of change.

The nurse working in a long-term care facility has joined a committee with the goal of implementing electronic medical records within the next six months. The committee is planning how best to prepare staff for the change. What type of change is occurring? 1. Planned change 2. Change by drift 3. Accidental change 4. Occidental change

1. Planned change

What has happened in the process of refreezing? 1. The change has occurred and has been formalized. 2. The change has met resistance and has been suspended. 3. The change has been discussed but has not been implemented. 4. All driving and restraining forces have been identified.

1. The change has occurred and has been formalized.

Kurt Lewin's theory of change involves three phases. He called these three phases unfreezing, moving, and __________. 1. refreezing 2. completed 3. restraining 4. driving

1. refreezing

The LPN manager must support the staff as they make the second phase of change, which is moving. In order for this stage to be effective, the manager should: 1. spend time teaching the staff. 2. implement the change prior to unfreezing. 3. criticize mistakes that are made. 4. pay attention to any signs of hyperenergy.

1. spend time teaching the staff. 4. pay attention to any signs of hyperenergy.

Which of the following is a common mistake that can be made during the change process? 1. Failure to provide adequate meeting time 2. Failure to provide psychological safety for the staff 3. Failure to identify a mentor 4. Failure to network

2. Failure to provide psychological safety for the staff

The staff nurses formed a committee to improve holiday scheduling. After several meetings they have designed a new schedule and are preparing to put it into action today. What phase of Lewin's change theory is this committee performing? 1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces

2. Moving

Which of the following is one reason why nurses often resist change? 1. A lack of assertiveness 2. The history of nursing 3. Many nurses are passive-aggressive. 4. Change often does not work.

2. The history of nursing

Your long-term care facility is making a change to the team method of caregiving. Administration holds planning meetings for all shifts and keeps all involved employees informed in writing, as well. Which of the following explains the actions of the administrator? 1. Planned change 2. Unfreezing 3. Refreezing 4. Moving

2. Unfreezing

Forces that tell you not to take part in certain behaviors are: 1. subjective forces. 2. restraining forces. 3. objective forces. 4. good forces.

2. restraining forces.

Planned change usually comes from which of the following people? 1. An individual supervisor 2. An administrator 3. An administrative group 4. The director of nursing

3. An administrative group

What is the LPN's role related to evidence-based practice? 1. Analyze the research to determine its credibility for changing practice. 2. Recommend changes to practice based on the credibility of research. 3. Be aware of research that could influence how care is delivered. 4. Ask peers to provide evidence-based research.

3. Be aware of research that could influence how care is delivered.

The nurses have performed a comprehensive literature review and used their findings to change the facility's policy for performing tracheostomy care to make it more evidence-based. The new procedure is put in place, and they are receiving a good deal of positive feedback about the new approach. What phase of the change process are these nurses involved in? 1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces

3. Refreezing

The nurse works on a unit that did not have time to fully implement the change process before changing from written time cards to a time clock. What might the nurse experience as a result of this improper preparation of staff nurses? 1. Reduction in overtime and fewer payroll mistakes 2. Effective use of the time clock and reduced staff morale 3. Vandalism to the time clocks and poor morale 4. Effective use of time clocks and complaints at staff meetings

3. Vandalism to the time clocks and poor morale

Licensed practical nurses (LPNs) need to be able to identify both driving and restraining forces because they: 1. allow the LPN to be a better nurse. 2. allow the LPN to be a better manager. 3. are key factors in making planned changes. 4. allow the LPN to be more qualified for a job.

3. are key factors in making planned changes.

The nurse reads a research article concluding that patients newly diagnosed with diabetes should receive a referral to a nutritionist to avoid complications. What is the nurse's priority action related to evidence-based practice after reading this article? 1. The nurse should share the article with the nurse manager and suggest changing the procedure to give referrals to all newly diagnosed diabetic patients. 2. Form a committee to talk with the physicians suggesting the need for a referral to a nutritionist for all diabetic patients on the unit. 3. Talk to the dietician and suggest he or she talk to diabetic patients who are admitted to the unit from now on. 4. Conduct a literature search to see if more articles can be found recommending the involvement of a nutritionist in care of the diabetic patient.

4. Conduct a literature search to see if more articles can be found recommending the involvement of a nutritionist in care of the diabetic patient.

The nurse has worked as a staff nurse in the acute care facility for three years and is considering quitting and taking a job at a large clinic in town. The nurse draws up a list of pros and cons related to the job change. What part of Lewin's change theory is the nurse demonstrating? 1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces

4. Identifying driving and restraining forces

The nurses make walking rounds with the physician on the long-term care unit. At the completion of rounds several nurses gather in the break room and agree that they need to be more effective and efficient the next time rounds are performed. What is the first step these nurses need to take? 1. Review the process and define the problem. 2. Suggest ways to improve walking rounds. 3. Develop a plan to change the way walking rounds are performed. 4. Select an informal leader to organize the group.

4. Select an informal leader to organize the group.

Caring theory practice requires: 1. kindness on the part of the nurse manager 2. frequent staff meetings 3. patience by the nurse 4. an awareness of the implications of change on both you and others

4. an awareness of the implications of change on both you and others

Another term for accidental change is: 1. unintentional change. 2. unplanned change. 3. short-term change. 4. change by drift.

4. change by drift.

Making a planned change in your job depends on your ability to: 1. be selective in your choices. 2. be the first to apply for a position. 3. effectively use your network. 4. make meaningful decisions.

4. make meaningful decisions.