Change Management
The nurse manager witnessed the charge nurse reply to the nursing staff about the change in holiday schedule assignments for the following year. Which response to the nursing staff by the charge nurse would the nurse manager need to intervene? "I would like to hear everyone's thoughts on the holiday schedule to ensure fairness." "Any staff that does not come in on their scheduled holiday shift will be immediately fired." "If nursing staff increases, there may be a chance to revert to the normal holiday schedule." "Please plan to work an extra holiday next year due to nursing staff shortages."
"Any staff that does not come in on their scheduled holiday shift will be immediately fired."
The medical-surgical floor has installed scanners for medication administration. A registered nurse (RN) overseeing a licensed-vocational nurse (LVN) witnesses the LVN override a medication scan because the client was asleep. Place in order the steps the RN should take to resolve this issue.
1. Consult the policy on medication administration overrides.. 2. Explain the importance of upholding the policy.The registered nurse will want to explain the policy in how it pertains to practice. 3. Discuss the importance of quality improvement practices. 4. Strategize how to prevent this from happening in the future.
The nurse manager is invited to an upper leadership meeting to strategize how to implement daily interdisciplinary team meetings on all floors and units of the hospital to remain cost-effective and uphold safe and effective continuity of care. Nurse A is complaining to the nurse manager that Nurse B is not watching their patients during the Interdisciplinary Team Meeting. Nurse A claims that their patients always require care after 30 minutes to report on the meeting. Place in order the steps the nurse manager should take to resolve this conflict.
1. Urge Nurse A and Nurse B to find a solution together.Within conflict resolution, the two parties should be encouraged to work it out themselves. 2. Approach Nurse B about the accusations.If that fails, approaching the other person will be necessary. 3. Review expectations of watching each other's patients with both nurses.Not taking a side is important, so reviewing the expectations with both nurses will be essential not to assert blame. 4. Collaborate through mediation to establish common goals and solutions.Setting aside differences and forming common goals will help these nurses solve their problem.
The dress code policy on artificial nails is changing to include all different types of nails. Staff members are restricted to wearing only nail polish that is not chipped or damaged. Match each scenario to the correct stage of change. The nurse removes their gel nails and uses regular nail polish instead. The nurse is questioned as to why they have not removed their gel nails. The nurse has decided to wear their gel nails since no evidence has been provided. The nurse researches the impact of artificial nails on the frequency of central line bloodstream infections and finds a significant correlation. The nurse encourages others to use nail polish as evidence shows a positive correlation to artificial nails and central line bloodstream infections.
Action Contemplation Precontemplation Preparation Maintenance
Today is the first Interdisciplinary Team Meeting for the unit, and there are already additional barriers identified. The nurse manager is generating solutions to barriers discovered on that first day. For each potential solution to the barrier, click to specify if the solution is indicated, nonessential, or contraindicated. Dismiss proposals from staff nurses to change the meeting to 30min earlier Reinforce efforts of the charge nurses with conflict resolution skills with the staff Support the staff during the change process by passing patient medications Assume staff members are resisting change when asking questions about the change Emphasize the benefit of shorter lengths of stay and increased resources Explain in detail the list of departments involved in the meetings Role model a positive attitude during the change processes Discipline staff that are gossiping about the change
Contraindicated Indicated Nonessential Contraindicated Indicated Nonessential Indicated Contraindicated
The nurse manager presents the plan to the entire unit about the change to implement Interdisciplinary Team Meetings. The hospital has designated specific times that each unit or floor will conduct its Interdisciplinary Team Meetings, and this unit is scheduled at 09:45 a.m. This plan aims to uphold the continuity of care and increase cost-efficiency, which is supported with evidence. All key staff members are there to promote the need for this change and provide strategies on how best to cover each nurse's patients while they are presenting their patients during the Interdisciplinary Team Meeting. Based on this information, which areas does the nurse manager need to address with the unit before implementing this plan? Select all that apply. Make others aware of the need for change Identify support and resistance Set target dates Set goals and objectives Include all that are involved with this change Develop a plan Develop appropriate strategies
Identify support and resistance Set target dates
The nurse educator is considering changing the new nurse orientation to include concepts of change management that better prepare them for the rapid changes in healthcare. Click to specify if each topic should be included or not included in a new nurse orientation. Becoming a change agent Resistance to change Quality improvement practices Driving versus restraining forces Budgetary needs of the floor Evidence-based practices Appropriate staffing Conflict resolution Client insurance
Included Included Included Included Not included Included Not included Not included Not included
The assistant manager nurse is preparing to implement the standardized hand-off report sheets to decrease hand-off report time and increase patient outcomes. For each change function, click to specify if that function belongs in the unfreezing, movement, or refreezing phase of Kurt Lewin's Change Theory. Uses appropriate conflict management strategies with staff who do not use hand-off report sheets Continues to remain supportive until the report sheets are part of the standard workflow Inspires the staff by using common goals, such as the saved time during hand-off report Evaluates the effectiveness of the change Reinforces the efforts of the staff using the hand-off report sheet Seeks support from the staff on the most effective hand-off report sheets
Movement Refreezing Unfreezing Refreezing Movement Unfreezing
The nurse manager suspects that the Interdisciplinary Team Meeting change to the unit is becoming a normal part of the unit's workflow. Click to highlight the findings below that would indicate the unit has implemented change effectively. All nursing staff completed training before the implementation of Interdisciplinary Team Meetings. Performance audits of staff nurses revealed combined compliance of 96%. Performance audits of healthcare providers do not revealcollective compliance. The average length of stay for the unit decreased by 0.5 days. Staff satisfaction of Interdisciplinary Team Meetings was 29%. Patient satisfaction scores increased from 82.3% to 89.1%.
Performance audits of staff nurses revealed combined compliance of 96%. The average length of stay for the unit decreased by 0.5 days. Patient satisfaction scores increased from 82.3% to 89.1%.
The nurse manager should schedule introductory meetings to start disseminating information related to this change with which four staff positions on their unit? Unlicensed assistive personnel Staff nurses that are known role-models Charge nurses Assistant nurse managers New nurses orienting to the unit Nurse educator Unit secretaries
Staff nurses that are known role-models Charge nurses Assistant nurse managers Nurse educators
Identifying and minimizing restraining forces is essential to drive change. The nurse manager wants to decrease restraining forces to implement a new supplier brand of intravenous (IV) catheters. Which restraining forces should be minimized before switching to the new IV catheters? Select all that apply. Staff prefer to use the current catheters. Less materials are used in manufacturing. Cannula does not stick to the needle. Decrease the cost of the previous catheters. Catheters have blood control technology. In-services are not provided by the supplier.
Staff prefer to use the current catheters. In-services are not provided by the supplier.
The nurse manager is creating a budget for the next fiscal year to include scanners for medication administration. What planning steps should the nurse manager review to evaluate if the budget will allow this added expense? Select all that apply. Staffing needs of the floor Accreditation standards Staff compliance to change Overall operating budget Client census over the past year Reimbursement services
Staffing needs of the floor Overall operating budget Client census over the past year Reimbursement services
The nurse manager notices that the floor decreases in compliance with the new laboratory label machines. Which barriers to change may be related to the change in compliance? Select all that apply. The charge nurse encourages the staff to use the new machines Travel nurses are hired to the floor Shifts are changed from 12 hours to 8 hours The nurse-to-patient ratio is increased by one Two machines are being repaired Secretaries have been eliminated from the floor
Travel nurses are hired to the floor The nurse-to-patient ratio is increased by one Two machines are being repaired Secretaries have been eliminated from the floor
To decrease the time staff is away from the bedside during hand-off report, the nurse manager plans to change the unlicensed assistive personnel (UAP) shift time to start 30 minutes earlier. Having this off-set of hand-off report will ensure staff is available for patient needs between shift change hours. The nurse manager knows that a longer ________ phase will help decrease _____ , and for staff to acclimate to this change, _______ will be needed to ensure effective implementation.
Unfreezing Resistance Inspiring Others
After implementing Interdisciplinary Team Meetings, the nurse manager knows that the staff has moved into the ________ phase when they participate without _______ and knows the change to be effective when audits show improvement in _____.
refreezing resistance patient outcomes
The nurse manager is invited to an upper leadership meeting to strategize how to implement daily interdisciplinary team meetings on all floors and units of the hospital to remain cost-effective and uphold safe and effective continuity of care. The nurse manager understands that the unit is at increased risk for ________ is _______ are not identified early within the change process to _____ the group's need for change.
resistance driving forces inspire