Leadership online course
Nurse leaders make use of quality control tools to identify various types of errors as outlined by the IOM report. What are some of the most common types of errors reported in today's health care system? Select all that apply. Medication errors Diagnostic errors Communication errors Equipment errors Spelling errors
2 equipment errors3. communication errors4. diagnostic errors5. medication errors
Which of the following competencies are important for the nurse leader to develop? Ability to diagnose a situation, adapt, and communicate Ability to tolerate a situation, influence, and communicate Ability to control a situation, adapt, and communicate Ability to influence a situation, suggest, and communicate
Ability to diagnose a situation, adapt, and communicate
A health care team has been challenged to determine what other facilities are doing to decrease the number of hospital-acquired infections so that an action plan can be created to decrease the rate in their facility. What will the health care team do to achieve this challenge? Benchmarking Best practices Root cause analysis Patient outcome evaluation
Benchmarking
The nurse is planning care with the family of an older adult who is recuperating on a rehab unit for injuries sustained in a fall due to postural hypotension. As part of a quality improvement (QI) project to reduce the number of the falls on this rehab unit, what will be most effective in preventing falls in this client?
Instruct the client to sit, obtain balance, dangle legs, and rise slowly.
Which of the following best describes the nurse leader in the role of negotiator? Mediates internal or external conflict with various stakeholders Resolves internal conflict with all team members Focuses on external conflicts that negatively impact the health care delivery system Focus is primarily resolving conflict between patient support system and staff
Mediates internal or external conflict with various stakeholders
Nurse leaders need to understand that in order to be effective, the quality control process must be _______. Ongoing Reflective Formative Cyclica
Ongoing
The nurse manager of an acute care unit determines the increase in the incidence of medication errors over the last six months and identifies this as a focus area for improvement. What is the next action by the nurse manager? Organize a total quality management (TQM) meeting Identify variations Implement action plan Assess results
Organize a total quality management (TQM) meeting
A nurse manager was reviewing patient care data to determine opportunities to improve the quality of patient care. The nurse manager identified that many clients were being admitted to the unit without a required allergy arm band. The nurse manager, working with a unit-based committee of nurses and nursing assistants, developed a plan including goals, objectives, and a timeline to address this problem. This is an example of which approach? Risk management project Performance improvement project Patient and family-centered care initiative Six-Sigma approach
Performance improvement project
Quality control tools used by the nurse leader include which of the following? Process audits and structure audits Outcome audits and structure audits Program audits and process audits Outcome audits and program audits
Process audits and structure audits
All people and organizational units that will be affected by a planned change should be included in the planning. TRUE FALSE
true
A nurse leader at a long-term care facility wants to determine if vital signs are being checked according to policy. What can the leader do to measure this process of care? A critical event analysis A process audit Patient outcome evaluation Benchmarking
A process audit
Which of the following qualities do nurse leaders possess that makes them obtain excellence in their role? Ability to provide clear visions, goals, and expectations Ability to be a reactive communicator Ability to provide occasional constructive feedback Ability to act in a positive and reactive manner
Ability to provide clear visions, goals, and expectations
A nurse manager would like to determine how well the team is doing in terms of meeting the hospital's goal of increased patient satisfaction. What action should the manager take after determining best practices? Reevaluate. Capture when the team is and is not using best practices and the outcomes. Take corrective action. Make a judgment about the quality of the team's work.
Capture when the team is and is not using best practices and the outcomes.
An experienced nurse using contingency theory is orienting a new graduate to the unit. What needs will the nurse meet with the new graduate using this theory? (Select all that apply.) Coaching Counseling Developing Discipline Team-building
Coaching Counseling Developing
An older adult patient fell out of bed 2 days after a hip replacement and had to return to surgery. What process should be done in order to prevent future negative outcomes such as this? Patient outcome evaluations Benchmarking An audit Critical event analysis
Critical event analysis
A nurse is tasked with performing an audit on patients in the long-term care facility who are developing pressure ulcers. After identifying the information relevant to the criteria, what is the nurse's next action? Determine ways to collect data Analyze the data Make a judgment about quality Reevaluate
Determine ways to collect data
The six aims for improving quality health care as directed by the Institute of Medicine include safe, effective, patient-centered, timely, efficient, and _____. Equitable Holistic Naturalistic Alternative
Equitable
What is the effect on a nurse who experiences a disconnection between personal and organizational values?- Unrealistic expectations- Leads to goal evaluation- Change that leads to effective leadership- Intrapersonal conflict and burnout
Intrapersonal conflict and burnout
Which of the following are behaviors associated with effective leaders?Priority setting, critical thinking, skillful communication Critical thinking, fostering self-improvement, tentative Problem solving, priority setting, self-development Priority setting, skillful communication, passive listening
Priority setting, critical thinking, skillful communication
A nurse on a busy medical-surgical unit must delegate some care assignments to an experienced nursing assistant. What factor(s) does the nurse consider before delegating the care to the nursing assistant? Organizational mission Organizational philosophy and values Organizational structure State or national standards
State or national standards
A nurse in a leadership role is committed to a vision for retention in the medical-surgical unit and is able to empower others with this vision. What form of leadership is this nurse demonstrating? Transactional Transformational Interactional Bureaucratic
Transformational
A nurse manager is implementing a quality control tool that is systematic and will allow the official examination of a record for patients with postoperative infections. What type of tool is the nurse manager using to collect and evaluate this data? An examination An evaluation A review An audit
an audit
Health care shifted focus from patient care to issues of cost and quality. TRUE FALSE
true
Total quality management is referred to as continuous quality improvement and is used to meet the Healthy People Living 2020 goals. TRUE FALSE
true
A nurse leader is having a discussion with a team member about changes that will be made on the unit. Which statement by the team member demonstrates the greatest problem for the leader? 'Your plans for the changes will be difficult to implement.' 'I don't think you heard what the rest of us had to say.' 'Do you have an idea what direction we need to go?' 'Can you tell me why my suggestion will not work?'
'I don't think you heard what the rest of us had to say.'
A staff nurse informs the nurse manager that the nurse would like to gain broader experience in other departments of the acute care facility. What response by the nurse manager demonstrates effective leadership? 'Getting broader experience isn't as valuable as specializing.' 'I would like you to be a preceptor for the new nurse that was just hired.' 'Would you be willing to help on another unit? They need a shift leader for a couple weeks.' 'Would you be willing to work with one of the senior nurses for a while, until you learn how we operate here?'
'Would you be willing to work with one of the senior nurses for a while, until you learn how we operate here?'
A nurse manager is attempting to ensure adequate resources are available in order to meet changing patient needs. What would be the best type of audit for the manager to perform? A structure audit An outcome audit A process audit A quality audit
A structure audit
A nurse leader is performing a process audit. Which would be a consideration on a process audit? (Select all that apply.) Assessing the availability of fire extinguishers in patient care areas Checking the completeness of a patient's medical record Comparing a patient's medication order to the medications the patient has been taking Ensuring that machines are recalibrated according to department policy Ensuring that a patient has access to television in their room
Checking the completeness of a patient's medical record Comparing a patient's medication order to the medications the patient has been taking Ensuring that machines are recalibrated according to department policy
What are the focus areas of the To Err is Human recommendations? (Select all that apply.) Enhance knowledge Identify errors and provide solutions for prevention Set performance standards for safety Implement safety systems Enhance leadership
Enhance knowledge Identify errors and provide solutions for prevention Set performance standards for safety Implement safety systems Enhance leadership
Before developing a procedure on prevention of falls in older adult patients, a nurse reviews all current research-based literature on this topic. What type of nursing will be practiced based on this review? Expert practice Evidence-based practice Data-driven practice Standards of care practice
Evidence-based practice
A nurse leader works at a facility that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. Which activity reflects how the leader can practice TQM on their unit? Encourage employees to think of a unit slogan. Develop a quota system for number of patients cared for. Explain to the staff that 'if it's not broke, don't fix it.' Promote teamwork rather than individual accomplishments.
Promote teamwork rather than individual accomplishments.
Which of the following delineates the set of values and beliefs of an organization's goals and guides the development of the philosophy statement?- Purpose or mission statement- Unit philosophy- Organizational statement- Department philosophy and mission
Purpose or mission statement
A nurse on the acute care unit demonstrates the positive traits of a good leader when working with new employees. What trait does the nurse manager cite when performing the nurse's evaluation? The assigned position Role modeling Planning a unit's goals Decides daily patient assignments
Role modeling
When a new nurse executive identifies the goal of creating a 'just culture' environment in their healthcare organization, the staff understands that such an environment is characterized by a culture where: All team members share culpability for an error committed by one member of the team. Constant questioning of the status quo is encouraged to prevent errors. Each department reviews the work processes of another department. The focus is on system processes that caused an error, not on individual blame.
The focus is on system processes that caused an error, not on individual blame.
The new nurse recalls that which strategies promote evidence-based practice? (Select all that apply.) Use and encourage use of multiple sources of evidence. Collaborate with other nurses locally and globally. Interact with other disciplines to bring nursing evidence to the table. Continue to use older and outdated practices if requested by the patient and family. Use sources that are only authored by nurses to stay true to nursing practice.
Use and encourage use of multiple sources of evidence. Collaborate with other nurses locally and globally. Interact with other disciplines to bring nursing evidence to the table.
A nurse leader wants to ensure that the team is always practicing proper hygiene after caring for a patient. A complaint was filed against a nurse for not washing the hands before examining a wound on a child's knee. What is the nurse leader's control criteria? Why the team is not practicing proper hygiene Whether the team is practicing proper hygiene Who on the team is not practicing proper hygiene If there are enough hygiene reminders in each patient's room
Whether the team is practicing proper hygiene
What would the new nurse identify as an example of evidence-based practice (EBP) in action on a medical-surgical nursing unit? Implementation of a new telemetry monitoring system with all staff attending in-services. The nurse manager working with the dietary manager to share patient concerns about cold food. The evening charge nurse posting an 'article of the month' in the staff breakroom. A group of staff from the dietary department and the med-surg unit, organized by the Director of Nursing, meeting monthly to address the issue of cold food.
A group of staff from the dietary department and the med-surg unit, organized by the Director of Nursing, meeting monthly to address the issue of cold food.
The nursing student recalls that evidence-based practice (EBP) is defined as: Nursing care based on historical nursing tradition and history Scholarly inquiry into the nursing and medical research literature A problem-solving approach to clinical practice based on best practices Quality nursing care provided in an efficient and economically sound manner
A problem-solving approach to clinical practice based on best practices
Which of the following is considered a nursing leadership role with regard to quality control? Embraces, supports, and champions the quality improvement process Uses findings to determine educational staff needs Selects and uses quality control tools Establishes measurable patient outcomes
Embraces, supports, and champions the quality improvement process
A nurse educator in a college setting has developed leadership skills as a result of attaining further education and sharing positive change within the department. What transformational leadership characteristic is this nurse educator demonstrating? Influencing others Guiding others Directing others Empowering others
Empowering others
A health care team is implementing the Toyota Production System (TPS) because the facility is having financial difficulty and may have to consider minimizing its workforce. Prior to implementing TPS, what should the team consider? (Select all that apply.) How it will allow for problem solving How it will change the organization's culture, values, and roles The commitment of time and resources from the facility's leadership The level of staff preparation and involvement that will be required The ease with which the transition will take place
How it will change the organization's culture, values, and roles The commitment of time and resources from the facility's leadership The level of staff preparation and involvement that will be required
A root cause analysis (RCA) is a process during which participants: Identify the individuals who are at fault in the incident. Include consideration of all relevant literature related to the incident Identify risk points before, during, and after the event and the impact on the incident Identify one primary factor that may have contributed to the event
Identify risk points before, during, and after the event and the impact on the incident
What are recent examples of National Patient Safety Goals as identified by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO)? (Select all that apply.) Improve staff communication Identify patients correctly Reduce blood transfusion reactions Use medications safely Identify patient safety risks Prevent falls in our older adult population
Improve staff communication Identify patients correctly Use medications safely Identify patient safety risks
A nurse leader is trying to bring about change on the unit. Which intervention is associated with the nurse leader role? Inspiring staff to maintain high standards regarding patient care Being aware of the changes in quality control regulations Reviewing research results upon which to base changes Identifying outcomes that support quality nursing care
Inspiring staff to maintain high standards regarding patient care
Which statement about total quality management is correct? It is a process with a definitive endpoint. It involves only a select few employees in an organization. It considers the individual as the focal element on which production and service depend. It emphasizes that profit should be considered before quality.
It considers the individual as the focal element on which production and service depend.
A newly employed nurse is reviewing the organizational chart of the facility, observing that there is shared governance. What type of organizational chart does the nurse recognize the facility follows? Traditional Matrix Flat Magnet
Matrix Matrix organizations typically have some hierarchy to them but if there is a change initiative that impacts a nursing procedure across the board, the communication will be more direct.
The nurse manager may use which quality assurance or performance improvement technique to identify underlying process flaws in the reporting of suspected child or elder abuse? Small group process Root cause analysis People at fault process Cause and effect
Root cause analysis
The manager of several related departments brings the team together to inform them that they will all be cross training to other units for the purpose of increasing productivity. What form of leadership does this manager demonstrate? Transactional Transformational Contingency theory Laissez-faire
Transactional
What did the first known leadership theory assume about leaders?
either you are born with it or not
what is the final step of the quality improvement process that the nurse leader must complete in order to improve patient care?
evaluation
The new graduate nurse recalls that when looking at a model for evidence-based practice, what is the final step of the process? Implementation of the new practice Evaluation of the new practice change Submitting a description of the new practice change for publication Including the practice change in all the unit policies
Evaluation of the new practice change
The chief nursing officer (CNO) at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. This CNO is part of what type of organization? Traditional Matrix Flat Mission
Flat Flat organizations are characterized by the accessibility of upper management and a flow of information that is both top-down and bottom-up.
A nurse leader has an idea for changing the intake flow in the ER to leverage more of the nursing staff. The leader knows that if they could implement the idea as a pilot program, they could prove its effectiveness and then use it in all the ERs in the region. The nurse leader is frustrated, however, because in order to implement even a pilot of the idea, a proposal must be submitted to the ER Supervisor with a start-to-finish scenario that details not only the process but also the risks, liabilities, and cost estimates. If the supervisor approves, the proposal would then be sent to the Chief Nursing Officer (CNO), who would then send it to the Administrator and Board of Directors for review and approval. Which of these factors are influencing the nurse leader's ability to implement the pilot program? Organizational mission Organizational philosophy and values Organizational structure State or National standards
Organizational structure
n older adult patient recently had a hip replacement with an indwelling catheter inserted. The patient developed symptoms of a urinary tract infection (UTI) postoperatively, and the nurse placing the catheter was reeducated by the nurse leader regarding avoidance of UTIs when inserting catheters. Which quality approach did the nurse leader use? Quality assurance techniques Total quality management techniques Continuous quality improvement techniques Continuous quality management techniques
Quality assurance techniques
The new graduate is hoping to get his first job in a hospital that has a shared governance organizational structure. What describes shared governance? A process by which the Chief Nursing Office consults with all nurse managers before making patient care delivery decisions. The governance of the hospital is shared among board members, nurses, providers, and management, which emphasizes the empowerment of nurses. The governance of a unit occurs by unit councils who make recommendations to the nurse manager. A process by which nurse managers from all units in the hospital work together to implement the same processes to assure that all staff are treated equally.
The governance of the hospital is shared among board members, nurses, providers, and management, which emphasizes the empowerment of nurses.
Choose one of the following words to complete this statement: "Effective leadership in nursing requires the individual to be self-aware in order to ________ the motivation of others." Limit Inhibit Discourage Understand
Understand
