Leadership in Healthcare Systems Exam 1

lewin's theory of change

-3 phases: unfreezing, moving, and refreezing -unfreezing: creates the motivation to change. knowledge and awareness of problem. -moving: new concepts acquired and trial and error learning occurs -refreezing: change is internalized and becomes part of the culture. difficult phase!!

horizontal leadership

-decentralized power and/or control -more shared decision making, allowing staff to be engaged and empowered ** best for CNL

transformational or relationship leadership

-focus on connections formed between leaders and followers -inspire people by helping group members see the importance and higher good of the task -change their awareness of issues -develop full potential of employees -based in intrinsic motivation -produce enthusiastic commitment

inspired leadership

-instill optimism and hope in employees. -optimistic about future -resilient in response to setbacks -become role models by living their beliefs

laissez-faire leadership

-lack of guidance from leader -virtually all power is delegated to the followers -along with power the leader relinquishes responsibilities for the organization's success or failure -leader avoids clarifying expectations or resolving conflicts

democratic leadership

-leader shares power equally with followers -collaborative decision making -participation and teamwork

Autocratic/Authoritarian leadership

-maintain power by forcing their will on others -leader makes all decisions and expects obedience from others -minimal group participation

what did "to err to human" highlight

-medical errors and how they are a significant cause of harm and death -errors are largely systems based

4 basic ethic principles of healthcare

1. beneficence 2. autonomy 3. justice 4. non-maleficence

who created the CNL and when was it created and approved?

AACN, created in 2003 and approved in 2004

informed consent is part of which healthcare policy?

AMA code of ethics

which organization published guidelines for social media use by nurses

ANA

what legislature highlights the professional obligations, responsibilities, and practice standards related to advocacy in nursing?

ANA Scope and standards of practice and ANA code of ethics

what ANA policy includes advocacy as a primary responsibility with accountability to society for enacting this part of their professional role?

ANA nurse social policy statement

according to IOM , equity is cited as one of six essential components of quality care? this component aligns most closely with which bioethical principle? a. justice b. autonomy c. promise-seeking d. integrity

a

one example of a commonly cited ethical decision-making framework also described in your text, is: a. CORRECT b. MORAL c. BOOST d. CARING

b. MORAL

the "posture" of being a student, not putting your views over someone else's describes...

cultural humility

a powerful strategy to examine overall beliefs, values and behaviors within a microsystem, mesosystem, or macrosystem, especially when performed within the first year of nurse leader implementation

culture assessment

in the standards of professional performance (RN) standard 7 (ethics) defines "a primary commitment to the recipients of nursing and healthcare services" as: a. autonomy b. beneficence c. justice d. fidelity

d. fidelity

a CNL is the lateral integrator of care in this part of the health system (best answer): a. outpatient care (micro and macro systems) b. long term care (macrosystem) c. inpatient care center (macrosystem) d. point of care (microsystem)

d. point of care

based on your text choose the most accurate term to describe: the trained ability to discern how a host of issues defined clinically as symptoms, attitudes, or diseases also represent the downstream implications of a number of upstream decisions about such matters as health care, food delivery systems" etc. ? a. cultural humility b. personal autonomy c. structural competence d. political influencing

d. structural competence

T or F: a patient suffers a surgical complication that he was not made aware of prior to his surgery. this is a violation of the patient self determination act.

false

T or F: according to your text there is very little difference between leadership and management

false

T or F: an ethical dilemma is best described as a dilemma that occurs when the right course of action is known, but there are barriers to fulfilling that action.

false

T or F: the institute of medicine report of 2011 criticized nursing for overstepping its professional boundaries

false! this report challenged the profession to practice to the fullest extent of its scope of practice

T or F: nurse leaders and staff nurses are responsible for obtaining informed consent

false, responsible for ensuring the patient understands

toyota kata

gives structure to the incremental steps needed to address challenges/changes in any system. includes an overarching challenge, smaller target that is a step in the right direction, then obstacles are addressed, and a new target set.

patient care delivery model

have a specific microsystem in which they are responsible for patient outcomes that are nurse sensitive, ex. patient falls, hospital acquired infections.

authentic leadership

inclusive, transparent, and moral. demonstration of genuineness. becoming this type of leader requires reflection, renewal, self improvement, and self discovery. aware of emotion, strengths, and weaknesses. consistent!!

what right was adjudicated in Cobbs vs Grant in 1972

informed consent

what did Deficit Act of Reduction do?

initiated financial incentives for safety in hospitals

who released the report "to err is human"

institute of medicine

servant leadership

known for empowering people, placing importance on each person's expertise, and encouraging people to perform as teams to meet their own personal goals and objectives of the organization. followers tend to be devoted. values employees.

great man theory

leaders are born not made, and only men are leaders

the ____ systems approach to change is a people based change process

lean

ANA social policy statement

optimization of health and abilities, prevent illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. defines ADVOCACY as one of the foundational responsibilities within nursing.

behavioral leadership theory

people can learn to become leaders through teaching and observation - great leaders are made not born

trait leadership theory

people inherit certain traits that make them better leaders (Not proven in research) -identifies certain traits shared by leaders

professional development model

professional practice ownership and growth of nurses. improving patient outcomes through nurse development . based more on the process

_________ is the most effective tool for climbing from despair into self-empowerment during a role transition

relationship competence

transactional or management leadership

relies on rewards and punishments to get the performance that they want from subordinates. -do not exhibit true leadership -less concerned with future of organization or employees -not trusted by employees

patient self determination act of 1991

requires all federally funded healthcare institutions to inform patients that they have a right to provide advance directives

Greenleaf's 10 principles of ____________

servant leadership (listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, building community)

the standards of professional nursing practice are divided into which 2 components?

standards of practice and professional performance

5 p assessment

structured tool used by CNLs to perform culture or microsystem assessment. purpose, patients, professionals, processes, and patterns.

T or F: in virginia, the regulations governing practice of nursing are spelled out in Statute 54.1-2400. this is sometimes also referred to as the nurse practice act of the commonwealth. these regulations include detailed criteria for delegation of nursing tasks.

true

T or F: supporting patient autonomy is the critical element of patient advocacy

true

T or F: when goleman calculated the ratio of technical skills, IQ, and emotional intelligence as ingredients of excellent leadership, emotional intelligence proved to be twice as important as the others.

true

from a theory perspective, role application is about how one....

uses a role

which ethics theories rely less on the value of one guiding principle

virtue ethics, ethics of care, casuistry (case based ethics)

moral distress

when nurses feel powerless to act after witnessing improper behavior, if organizational constraints make doing the right thing difficult or impossible

moral dilemma

when the right course of action is known but there are barriers to fulfilling that action. often leads to moral distress.

ethical dilemma

when there seems to be more than one right answer, and the best answer may depend on multiple factors. ex. should a feeding tube be placed in a patient with end stage dementia

moral courage

willingness to stand up for and act according to one's ethical beliefs when moral principles are threatened, regardless of perceived or actual risk.

1. background in humanities and sciences 2. quality improvement 3. organizational leadership 4. translate and integrate scholarship into practice 5. informatics and healthcare management 6. health policy and advocacy 7. interprofessional collaboration for improvement of patient and population outcomes 8. clinical prevention and population health 9. masters level nursing practice

CNL essentials and related core competencies

T or F: self care and self reflection are specifically included in the standards of professional practice

T

what does hippa stand for

Health Insurance Portability and Accountability Act

which code delineates 4 domains of ethical responsibility? and what are they?

ICN code of ethics. obligation of nurses to 1. promote health 2. prevent disease 3. restore health 4. alleviate suffering

MORAL ethical decision making framework

M: massage the dilemma O: outline the options R: resolve the dilemma A: act by applying the chosen option L: look back and evaluate the entire process

the type of leadership most promoted for nursing in current theories is: a. horizontal structure b. classic structure c. laissez-faire structure d. vertical structure

a. horizontal

Teological vs Deontological schools of thought

actions that result in the greater good or most happiness vs an action is inherently good or bad regardless of consequences

situational/contingency leadership theory

adapting leadership style to the group and situation. someone might be a good leader in one situation but not fit to be a leader in another

lewin's 3 leadership styles

autocratic/authoritarian, democratic, laissez-faire

according to goleman, the components of emotional intelligence include: 1) self awareness 2) self regulation 3) motivation 4)sympathy 5) presence a. 1 and 2 only b. 1, 2, and 3 c. 1, 3, and 5 d. all of the above

b

while working in coordination with the interdisciplinary team, the best leadership approach for the CNL is: a. vertical leadership b. horizontal leadership c. detached leadership d. structural leadership

b. horizontal

according to the IOM, professional advocacy by CNLs may include: a. redesign of care delivery structures b. involvement on state and national healthcare boards c. a and b d. none of the above

c

an example of an ethical theory that relies on one guiding principle is: a. virtue ethics b. casuistry c. utilitarianism d. bioethics

c

barriers to effective advocacy, according to your text, include: a. healthcare professionals who allow the institution to burden them in a way that leads to a role of powerlessness b. the hierarchical status between physicians and nurses c. both a and b d. none of them

c

the CNL is working with a client who asks, "why are you pressuring me? aren't nurses just supposed to make patients happy?". before answering, the CNL reflects on the bioethical principle that in the past has led many healthcare providers down a "slippery slope" leading to paternalism/maternalism. what is this principle? a. nonmaleficence b. fidelity c. beneficence d. fairness

c

MJ uses a leadership style that focuses on motivating and empowering other team members. this leadership style is best described as: a. transactional leadership b. authentic leadership c. transformational leadership d. laissez-faire leadership

c. transformational

-effective onoing communication with all team members -collaboration across multiple disciplines -coordination of care services -ongoing evaluation of processes and outcomes

components of effective lateral integration

Consider this scenario from your text: "The staff nurses and CNL are aware that patient Joey is in the end stages of AIDS but his sister does not know. Joey has clearly stated that he does not want his family to know about his HIV status, including his sister, who is also Joe's healthcare agent. His sisters demand that nurses "do everything possible," and she doesn't understand how Joey can be so ill. Nursing staff feel that the sister should be told about Joey's HIV/AIDS status in order to make decisions in his best interest. Hospital lawyers are consulted and they advise to withhold the diagnosis from Joey's sister, because sharing the information would be a violation of: a. FERPA b. SQEN c. IHI d. HIPPA

d

according to the text, the foundational responsibility for healthcare advocacy in nursing derives from which of the following documents: a. IOM Report on the Future of Nursing b. ANA scope and standards of practice c. AACN code of ethics d. ANA social policy statement

d

which organization identifies these five critical leadership behaviors: person-centeredness, frontline engagement, relentless focus, transparency, and boundarylessness? a. AACN b. CCNE c. AHRQ d. IHI

d. IHI