Test I Review

1. The hospital was supportive and assistive as the nurse coped with this event. Nurses must be held accountable for errors but should be treated in a professional and assistive manner.

After 3 years of uneventful employment, the nurse made a medication error that resulted in patient injury. What hospital response to this event is ethical? 1. The hospital was supportive and assistive as the nurse coped with this event 2. The nurse was dismissed for incompetence 3. The hospital quality department advised the nurse not to tell the patient about the error 4. The nurse was reassigned to an area in which there is no direct patient care responsibility

1. The client is not sedated 5. The patient understands the procedure Before surgery, the nurse needs to ensure that the patient fully understands what the physician told him or her about the procedure and that the consent form has been signed before any preoperative sedation is administered.

An RN is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the RN must ensure which of the following? SATA 1. The client is not sedated 2. The doctor is present 3. A family member is a witness 4. The signature is in ink 5. The patient understands the procedure

3. Defamation of character Charting or saying unsupported defamatory statements can lead to tort litigation. (tort= A wrongful act or an infringement of a right leading to civil legal liability)

An RN new to the emergency department documented that "the patient was intoxicated and acted in a crazy manner". The team leader told the RN that this type of documentation can lead to: 1. Assault 2. Wrongful publication 3. Defamation of character 4. Slander

3. Good Samaritan law The good samaritan law protects persons who assist at an accident scene if they are in good faith. Professional insurance is not in effect because the actions were not performed while on duty.

An RN sees an older woman fall in the mall. The RN helps the woman. The woman later complains that she twisted and sprained her ankle. The RN is protected from litigation under: 1. Hospital malpractice insurance 2. Good faith agreement 3. Good Samaritan law 4. Personal professional insurance

BHAG page 62 (Big, hairy, Audacious Goals used in leadership for big ideas and visions for the future)

BHAG=

Informational: Managers represent employees, the organization, and they monitor public relations Interpersonal: Managers focus on networking, conflict negotiations and resolution, and employee development and coaching. They also look at rewards and punishment. Decisional: Managers complete employee evaluations, they allocate resources, do hiring and firing, planning and job analysis and redesign.

Describe Information, interpersonal, and decisional managers.

Situational Theories

Emphasize the importance of understanding all of the factors that affect a particular group of people in a particular environment.

(page 66-67). - IF you discover a problem, inform your team leader or manager right away - Even better, include a suggestion for solving the problem - Be supportive of new ideas -When you disagree, explain why - Listen carefully and reflect on what your leader or manager says - Continue to learn as much as you can about your specialty area - Share what you learn Being an effective follower will make you more of a valuable employee and increase your job satisfaction by giving you meaning and more satisfaction.

How would you become a better follower?

interpersonal, decisional, and informational

Managers activities include three categories:

Page 64. A winner says I'll give it my best, we can do it, and a whiner says do I have to, that will never succeed.

What are somethings you might hear a whiner say or a winner say?

A valuable follower is skilled, self-directed, professional, and participates actively in the group, thinks critically, and advocates for new ideas.

What type of behaviors followers would use to be effective in the workplace?

4. Resistance based upon fear of losing ones job Resistance based on fear of losing one's job is the most difficult type of resistance to overcome because the person perceives that there is a threat to his or her way of life, which the person will guard at all costs. The individual does not feel that he or she can speak freely without jeopardizing his or her job, so although the individual disagrees with the changes, he or she keeps silent to stay employed.

What type of resistance to a change is the hardest to overcome? 1. The resistance that comes from inertia: "We always do it this way". 2. Active resistance to changing a preferred procedure. 3. Passive resistance to an unpopular change 4. Resistance based upon fear of losing ones job

3. Unsupportive management Newly licensed nurses, in particular, need supportive management and may resign if it is not present.

Which of the following is a major reason why newly licensed nurses resign? 1. Poor pay scales 2. Needlestick injuries 3. Unsupportive management 4. Lack of advancement opportunities

Unfreezing; change; refreezing pg 151

___ stage or comfort zone involves actions that create readiness to change, then the _____ stage or the discomfort zone, involves implementation, and the refreezing stage, the new comfort zone, is where the change has been made and becomes a regular part of everyday functions. ___ is the new comfort zone

sentinel event

an unexpected occurrence involving death or serious or permanent physical or psychological injury or risk thereof. They signal the need for immediate investigation and response.

Confidentiality

anything the patient says held in strictest confidence

maleficence

demands that good be done for the benefit of others

autonomy

freedom to make decisions for oneself

Accountability

means accepting responsibility for one's own actions

fidelity

principle that involves loyalty, promise to fulfill all commitments

veracity

requires nurses to be truthful

evidence-based practice

the integration of clinical expertise/expert opinions, external scientific evidence, and client/patient/caregiver perspectives.

-Provide best evidence for EBP -Support nursing as a separate professional discipline -Define current best practice standards of nursing care

three major benefits of nursing clinical research

Structured Care Methodologies (SCM's)

tools designed to track outcomes. They are used to identify best practices, facilitate standardization of care, quality enhancement, and outcome measurements. Examples are clinical practice guidelines, protocols, algorithms, and standards of care.

Trait Theory

(theory that believes given the necessary knowledge and opportunity anyone can develop leadership skills. They also feel you can build on your strengths and improve upon your weaknesses to become a better leader.

Four common traits based on trait theories include: management traits of attention: These leaders have a sense of goals and attract followers management traits of meaning: These leaders create and communicate meaning and purpose management traits of trust: They are reliable and consistent management traits of self: These leaders are aware of themselves, and know their strengths and weaknesses

4 common traits based on trait theories

3. Share leadership with the group Democratic or participative leaders are characterized by their inclusion of team members in important decisions.

A democratic nurse leader consistently works to: 1. Move the group toward the leaders goals 2. Make little or no attempt to move the group 3. Share leadership with the group 4. Dampen creativity

3. Prizing a value Prizing a value means being satisfied with a choice and being willing to declare the choice to others. The patient made her choice clear to her family and provider. (To affirm means to strongly state a fact, not indicating satisfaction with the choice; choosing is to decide what is important; reflecting means considering it)

A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and health-care provider. The nurse realizes that this is an example of: 1. Affirming a value 2. Choosing a value 3. Prizing a value 4. Reflecting a value

2. Share information about the new schedule and discuss the impact on the unit. Sharing information about the new scheduling process and how it can benefit the staff offers them time to learn about the new process and possibly have input into the proposed change.

A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the current scheduling process. How can the nurse manager lower their resistance to this change? 1. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule. 2. Share information about the new schedule and discuss the impact on the unit. 3. Post the schedule and deal with staff on an individual basis. 4. Ask the staff to come up with an alternative for the nurse managers consideration.

1. Justice All patients are entitled to the best possible care regardless of their socioeconomic status, culture, or situations.

A nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. Under which ethical principle should the nurse practice? 1. Justice 2. Veracity 3. Autonomy 4. Nonmalieficence

4. Write the order down and read it back to the provider The Joint Commission on National Safety Goals requires that all telephone orders be written down and read back. This ensures the accuracy of the order. Failure to follow this procedure leaves the nurse and the facility open to negligence because it is a standard of care.

An RN calls a healthcare provider to report that a patient's condition is deteriorating. The physician gives orders on the telephone to draw arterial blood gases. What should the nurse do next when receiving telephone orders from a healthcare provider? 1. Call the respiratory therapist to obtain the blood gases 2. Give the order to the unit secretary to ensure its entered quickly 3. Enter the order directly into the system as it was given to the RN 4. Write the order down and read it back to the provider

3. Give orders and make decisions without consulting the team Autocratic leaders frequently give orders and make decisions without consulting team members.

Autocratic leaders: 1. Postpone decision making as long as possible 2. Share leadership with members of the team 3. Give orders and make decisions without consulting the team 4. Encourage creativity when problem-solving

2. Skilled and self-directed employees The most effective followers are not only competent by self-directed.

Effective followers are those who are: 1. Passive employees 2. Skilled and self-directed employees 3. Less valuable employees 4. Employees who are never supportive of new ideas

1. Review the patients medication administration record during bedside shift report Review of the medication administration record (MAR) with the off-going nurse allows you to review the list of medications and learn of any issues, possible reactions to medication, or missed doses,

Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error? 1. Review the patient's medication administration record during bedside shift report 2. Ask your colleagues to get your medication so that you can give it on time 3. Call the pharmacist 4. Review the medication administration policy

Laissez-faire leaders

Nondirective, They provide little planning and decision making, and lack enthusiasm to participate team members in decision making. It is essentially leaders with a lack of leadership. Team members feel confused, frustrated because there is no goal, guidance or direction.

4. All of the above

Nursing standards of care and the organizations policies and procedure greatly decrease risk to patient safety. Which of the following steps can a nurse take to further reduce risk? 1. Submit event or incident reports for near misses 2. Follow medication administration policies and procedures 3. Always report significant data on care to patients and providers in a timely manner 4. All of the above

4. Efficiency The focus on increasing efficiency is the hallmark of scientific management.

Scientific management focuses on: 1. Interpersonal relationships 2. Servant Leadership 3. Staff development 4. Efficiency

1. Respecting the patient's privacy and confidentiality when caring for him. The ANA code of ethics is designed to guide nurses toward quality, ethical care of patients. There may be times when it is difficult to discern the most ethical action, particularly when the lines are blurred as to the correct decision. The Code of Ethics provides some guidance that nurses can follow as part of the profession of nursing to uphold standards of ethical care.

The ANA Code of Ethics with Interpretive Statements guides nurses in ethical behaviors. Provision 3 of the ANA Code of Ethics says: "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient". Which of the following best describes an example of this provision? 1. Respecting the patient's privacy and confidentiality when caring for him. 2. Serving on a committee that will improve the environment of patient care. 3. Maintaining professional boundaries when working with a patient 4. Caring for oneself before trying to care for another person.

1. Both followers and the task The situational leadership approach considers the complexity of a situation, which would include followers and the task at hand.

The Situational Leadership Model focuses on: 1. Both followers and the task 2. The task 3. The follower 4. The behavior of others

2. Preparing a patient for discharge Preparing a patient for discharge is a care delivery process that consists of care interventions and decision-making between the care team and the patient.

When evaluating the quality of care, a healthcare organization must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organizational process? 1. Budgeting adequate money for nursing 2. Preparing a patient for discharge 3. Monitoring for infections 4. Increasing time between clinic visits

2. In an emergency In an emergency, there is little time for discussion or debate around taking action. In this situation, it is appropriate for someone in authority to take charge and dictate how the department will proceed. This is most common during life-threatening events such as Code Blue, a fire, or natural disaster.

When is it most important to dictate (order) change? 1. When the change is very complicated 2. In an emergency 3. When resistance is very high 4. If the change is unimportant

1. Shift in Medicare payment policies Macro-level changes happen on a large scale. Changes to national Medicare payment policies are large and far reaching because Medicare encompasses the U.S. health-care system.

Which of the following is a macro-level change? 1. Shift in Medicare payment policies 2. Change in shift differentials 3. Opening a new unit 4. Changing visiting hours

1. When no one talks about it anymore When a change has truly been incorporated into the daily routine, it has been integrated. Usually staff will no longer refer to the practice as new or a change because they have integrated it into their work. Results of the change will be present too.

Which of the following is the best indication that a change has been integrated? 1. When no one talks about it anymore 2. If adoption occurred rapidly 3. When resistance turns from active to passive 4. When a full year has passed since the change was introduced.

1. The hospital has a good catch program for staff who recognize errors and near misses The good catch program is a strategy designed to identify system improvement opportunities aimed at reducing risk or harm to patients by staff reporting errors or near misses without fear of punishment or reprisal.

You are a new nurse, the hospital where you work is committed to providing safe, high-quality care. Which of the following activities would let you know that your organization is committed to improving patient safety? 1. The hospital has a good catch program for staff who recognize errors and near misses 2. The hospital subscribes to TJC safety publications 3. The hospital measures performance every month, monitors quality indicators and regularly reports on quality. 4. All of the above

4. All of the above. The nurses use evidence-based research to guide care-delivery There are six characteristics of quality health care. The use of evidence-based research (EBR) ensures that care delivery is effective and efficient, which avoids overuse and waste. The nurses are respectful and responsive to their client's individual preferences Respectful and responsive to client preferences is patient-centered The nurses perform an independent double check when administering chemotherapy medication. The independent double checks avoid possible injury to the patient, making the call safe.

Your new organization is committed to quality patient care. Which of these are considered characteristics of quality health care? 1. The nurses use evidence-based research to guide care-delivery 2. The nurses are respectful and responsive to their client's individual preferences. 3. The nurses perform an independent double check when administering chemotherapy medication. 4. All of the above.

Page 63 figure 4-1 review qualities and behaviors to be an effective leader. Listed are keys to effective leadership. Qualities include: Integrity, courage, initiative, energy, optimism, perseverance, balance, ability to handle stress, and self-awareness. Behaviors include: Think critically, solve problems, communicate skillfully, set goals, share visions, and develops themselves and others.

qualities and behaviors to be an effective leader.

Non-maleficence

requires no harm be done, either deliberately or unintentionally

Justice

treat everyone equally

2. The nurse can compare the benefits of one choice over another. Creating a list of positives and negatives helps when difficult choices need to be made. The list outlines the positive and negative aspects of a decision. It allows the nurse to compare the benefits of making a choice versus the potential disadvantages. When compared side by side, it could help the nurse to make a difficult decision through an easier method.

A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision? 1. The nurse can back up her reasons for why she has decided to provide a certain type of care. 2. The nurse can compare the benefits of one choice over another. 3. The nurse can communicate the best choice of action to the interdisciplinary team. 4. The nurse can provide care based on developed policies and standards.

2. Access to the chart requires a signed release form Unless the significant other has authorized any access to information, the only people entitled to information without written consent are the client and those providing direct care.

A nurses's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. Which practice is most appropriate? 1. The nurse is an employee; therefore access to the chart is permissable. 2. Access to the chart requires a signed release form 3. The relationship with the client provides the nurse special access to the chart. 4. The nurse can ask the surgeon to discuss the outcome of the surgery

2. Autonomy The principle of autonomy indicates that the client has independence to make decisions and take action for himself or herself. When the nurse asks the patient about his concerns, the nurse is exploring the reasons and allowing the patient to make his own decision.

A patient asks a nurse if he has to agree to the health provider's treatment plan. The nurse asks the patient about his concerns. Which ethical principle is the nurse applying in this situation? SATA 1. Beneficence 2. Autonomy 3. Veracity 4. Justice

1. Malpractice Malpractice occurs when an unintentional tort causes an injury to a client

A patient is transported to the emergency department by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating he is having trouble breathing. Oxygen is started, but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: 1. Malpractice 2. Negligence 3. Nonmaleficence 4. Equipment failure

1. Decisions regarding treatments 2. When to take the patient to the hospital 3. Do not resuscitate orders 5. Durable power of attorney for health care The advanced directive provides instructions for future healthcare decisions if the patient becomes unable to make personal treatment choices.

A patient tells a nurse that he has an advance directive from 6 years ago. The nurse looks at the medical record for the advanced directive. What content should the nurse expect to find in the advanced directive? (SATA) 1. Decisions regarding treatments 2. When to take the patient to the hospital 3. Do not resuscitate orders 4. Who should be notified in the case of illness, injury, or death 5. Durable power of attorney for health care 6. HIPPA protocols

2. Laissez-fair leader Laissez-fair leaders are passive, inactive leaders who would not provide direction.

A unit team leader who fails to provide direction to his or her nursing care team is a(n): 1. Democratic leader 2. Laissez-fair leader 3. Autocratic leader 4. Situational leader

4. Malpractice Malpractice occurs when an unintentional tort causes an injury to a client

An RN has asked a licensed practical nurse (LPN) to trim the toenails of a diabetic patient. The LPN trims them too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital, the RN, and the LPN. What might all three be found guilty of? 1. Unintentional tort 2. Intentional tort 3. Negligence 4. Malpractice

1. Courage and Integrity 2. A critical mind-set 3. The ability to set priorities 4. The ability to provide feedback

An effective leader will have: (SATA) 1. Courage and Integrity 2. A critical mind-set 3. The ability to set priorities 4. The ability to provide feedback

4. Welcomes constructive criticism Emotionally intelligent leaders welcome criticism that is constructive and acknowledges other team members' perspectives.

An emotionally intelligent nurse leader: 1. Seeks the emotional support of others 2. Cannot juggle multiple demands 3. Works alone without help 4. Welcomes constructive criticism

3. Ability to communicate effectively with others Ability to communicate effectively with other people is one of the 3 competencies identified by Hersey and Campbell.

An important competency that nurse leaders need to develop in order to lead effectively is the: 1. Ability to be firm and inflexible 2. Ability to be close-minded and to ignore negative feedback. 3. Ability to communicate effectively with others 4. Ability to follow orders without questioning them.

1. Are also good followers 2. Effectively work together with shared goals Every leader is at times a follower. Effective leaders work with their teams on shared goals.

Effective nurse leaders: (SATA) 1. Are also good followers 2. Effectively work together with shared goals 3. Never act on their ideas 4. Have master's degrees

1. Leadership capabilities 2. Clinical expertise 3. Business sense 4. Budgeting savvy To be maximally effective, nurse managers need a constellation of skills: people skills (leadership), expertise (clinical experience), and financial skills (business sense and budget savvy)

Effective nurse managers have: (SATA) 1. Leadership capabilities 2. Clinical expertise 3. Business sense 4. Budgeting savvy

Transformational Leadership

Emphasize people need a sense of mission that goes beyond interpersonal relationships or an appropriate reward for a job well done. They communicate their vision that is meaningful to staff which creates staff engagement, reduces negativity, and inspires commitment.

autonomy (freedom to make decisions for oneself), non-maleficence (requires no harm be done, either deliberately or unintentionally), beneficence (demands that good be done for the benefit of others), justice (treat everyone equally), fidelity (principle that involves loyalty, promise to fulfill all commitments), confidentiality (anything the patient says held in strictest confidence), veracity (requires nurses to be truthful), and accountability (means accepting responsibility for one's own actions).

Ethical principles include:

Chapter 10, look at major sources of resistance to change on page 152 (technical concerns, personal needs, position and power) and recognizing resistance on page 153. Especially review providing psychological safety on page 155, to help with lowering resistance to change.

For change, what elements need to be met in order for everyone to accept one changes occur?

2. That he is still learning too, and values their input This is an accurate description of his situation and is likely to engage staff in supporting his growth and development as a nurse manager.

George S. has just become a nurse manager in a long-term care facility. He knows he has a lot to learn-what should he tell his staff? 1. Nothing, he should pretend he has experience 2. That he is still learning too, and values their input 3. That the staff needs to manage themselves 4. How little he knows about management

2. The situation involves child abuse 3. An injury occurred from a firearm Although HIPPA provides protections for patient privacy, there are some cases in which health care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, or when a patient is injured because of a firearm or other weapon.

Health Insurance Portability and Accountability Act (HIPPA) regulations guard confidentiality. In several situations, confidentiality can be breached and information can be reported to other entities. Which of the following meets these criteria? SATA 1. The patient is from a correctional institution 2. The situation involves child abuse 3. An injury occurred from a firearm 4. The patient is a physician 5. The breach of information was unintentional

4. Give them time to learn the new procedure Allowing time to learn or practice the new procedure lets staff gain confidence and reduces the threat of failure. This can make the staff more receptive to the proposed change.

How can you increase your staff's receptivity to an important change in procedures? 1. Assign the new procedure to the newest staff member 2. Apologize for making their work more complicated 3. Provide them with a booklet on preparing for change 4. Give them time to learn the new procedure

During literature reviews for EBP, you will seek out scientific merits in each journal article to ensure it is a professional research article. In a research article you will typically see it organized with a title, abstract, introduction, study conducted, results of the study, conclusion and references.

How do literature reviews help to confirm your findings with evidence based practice? What is involved with literature searches? What are the elements you are looking for?

2. If the benefits will be realized years from now If the benefits will not be realized for several years (e.g. going back to school so that you can advance your career), it makes it harder to make the change because there may be more at risk (e.g., your dream job may not be available).

In which of the following situations would a personal change probably be the hardest to make? 1. When the need is immediate 2. If the benefits will be realized years from now 3. When the reward is immediate 4. If it is change that keeps you in your comfort zone

4. Being a spokesperson Being a spokesperson for staff, patients, and administration is an information activity.

Informational aspects of a nurse manager's job include: 1. Evaluation 2. Resource allocation 3. Being a coach 4. Being a spokesperson

quantitative is objective and number/fact based, qualitative is subjective and less measurable, independent is conducted by an individual in areas of specific interest, and Translational Research is emerging as a systematic approach of converting research knowledge into application of healthcare.

Know the different types of research including quantitative, independent, qualitative, and translational

1. Managing people Managing people is probably the most challenging task for nurse managers. It is fundamental to good management.

Mara Z. wants to become a nurse manager. She has been offered an opportunity to take a nursing management course. Which topic is most important for her to learn? 1. Managing people 2. Managing the units budget 3. Planning for the future 4. Redesigning the units workflow

3. Creating a supportive work environment Servant leadership employs a "people first" approach to improving how employees are treated.

Servant leadership focuses on: 1. Helping patients care for themselves 2. Removing incompetent managers 3. Creating a supportive work environment 4. Resolving conflicts quickly

Servant: "empathetic aware and healing" The Servant leader-style manager believes that people have value as people, not just as workers. The attitude is "employee first" not "manager first"

Servant leadership: review box 4-2 distinctive styles of leadership and page 63 and the paragraph on page 73 detailing servant leadership. Managers see themselves as being there for the employees, supporting them. They do not have a manager first attitude.

5. Higher education People are more likely to complete advanced directives about their care when they are informed and they understand the ramifications of doing so. Higher levels of socioeconomic status, higher levels of education, and those who have already suffered from a chronic disease are more likely to follow through with completing advanced directives.

Several studies have shown that although care planning and advanced directives are available to clients, only a minority actually complete them. Which of the following has been shown to be related to completing an advance directive? SATA 1. African American race 2. Younger age 3. History of chronic illness 4. Lower socioeconomic status 5. Higher education

2. Used to create a stable set of performance indicators to measure outcomes SCMs facilitate the standardization of patient care and provide a mechanism for quality enhancement, and research that informs nursing practice.

Structured care methodologies (SCM) are: 1. Nursing tools designed to identify best practices and facilitate standards of care 2. Used to create a stable set of performance indicators to measure outcomes 3. Used to assist employees with wellness and injury prevention 4. Helpful when making staffing assignments

3. Near miss event Near misses are potential errors interrupted before they occur. They are useful in identifying and remedying vulnerabilities in the system before harm can occur.

Studying error and identifying how they occur helps organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in an organization? 1. Sentinel event 2. Adverse event 3. Near miss event 4. Wrong procedure event

(Page 60) An effective leader their focus between tasks and relationships with employees. They attend to both the tasks, like administering medications, and relationships working together, such as the attitude of physicians towards nursing staff. They are able to balance both.

Task vs relationship Leadership

1. Post-acute care reform initiative Post-acute care reform is a health and human service (HHS) initiative aimed at reducing care fragmentation and unsafe transitions of care such as from acute care hospitals to skilled nursing facilities.

The HHS is charged with protecting the health of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently underway? 1. Post-acute care reform initiative 2. National healthcare research and quality indicators aimed at helping improve access to care 3. NDNQI 4. Health IT

1. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency. 3. This statement is a branch of the Code of Ethics for Nurses Because nurses have a greater ability to provide care, their obligation to provide care is higher than that of a layperson. According to the Code of Ethics, nurses need to care for patients without judgement.

The healthcare facility has sponsored a continuing education offering and emergency management of pandemic influenza. At lunch, a nurse is overheard saying "I'm not going to take care of anyone who might have the flu. I have kids to think about." What is true of this statement? (SATA) 1. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency. 2. This statement reflects defamation and may result in legal action against the nurse 3. This statement is a branch of the Code of Ethics for Nurses 4. The nurse has this right as no nurse-patient contract has been established

2. It is a data-driven approach to improving process Data are used to identify opportunities for improvement and to monitor performance.

The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? 1. It is independent of teamwork 2. It is a data-driven approach to improving process 3. Common safety indicators are not used to evaluate the quality of care 4. Opportunities for QI are selected by organization leadership

1. Guidance, development, and reward A theory Y manager employs staff guidance, staff development, and rework as opposed to Theory X's emphasis on control, close monitoring, and punishment, if needed.

Theory Y emphasizes: 1. Guidance, development, and reward 2. Leadership, not management 3. Supervision, monitoring, and reprimands 4. Evaluation, budgeting, and time studies

3. Tell a compelling story about why change is needed Telling a story about a patient gives the nurse manager an opportunity to appeal to the staff members' emotions, which compells staff to act, can increase receptivity to change, and may even cause a sense of urgency for change.

There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on Jane's unit. What is the best way for Jane to persuade the staff to implement a new Foley catheter care protocol? 1. Tell them the change has been ordered by the administration 2. Present statistics proving the need to change 3. Tell a compelling story about why change is needed 4. Explain the importance of the change in simple terms.

Emotional Intelligence (EI)

These leaders recognize their own emotions, and are able to manage their emotions when a crisis occurs, and are able to suspend judgement until all the facts are in. They also welcome constructive criticism, ask for help when needed, turn problems into opportunities, and can multitask without losing focus.

1. Transparency, openness, reporting of errors is rewarded, blame-free environment A culture of safety requires a blame-free environment where error reporting is rewarded; this promotes trust, honesty, and transparency, which have been shown to reduce cases of adverse events.

To achieve safe patient care, a culture of safety must exist. What are the characteristics of an organization with a culture of safety? 1. Transparency, openness, reporting of errors is rewarded, blame-free environment 2. Honesty, studying of serious events 3. Privacy, reporting of errors appreciated 4. Blame-free environment, openness, error reporting is encouraged

3. Define the group's mission and communicate that mission to others Transformational leaders help their teams define their mission and see how their work helps them achieve their mission.

Transformational nursing leaders have the ability to: 1. Increase the negativity of the team 2. Work best alone 3.Define the group's mission and communicate that mission to others 4. Pay close attention to the weakness and shortcomings of others.

Table 5-2 page 76 has a list of bad management styles. -Know it all's- self-appointed experts on everything, these managers do not listen to anyone else -emotionally remote- isolated from staff and the work going on, these managers do not know what is going on in the workplace and cannot inspire others -purely mean- mean, nasty, and dictatorial, these managers look for problems and reasons to criticize. They diminish people instead of developing them -overly nice- desperate to please everyone, these managers agree to every idea and request, causing confusion and spending too much money on useless projects -afraid to decide.- Indecisive managers may announce goals for their unit but fail to be clear about their expectations, assign responsibility, or set deadlines for accomplishment. In the name of fairness, these managers may not distinguish between competent and incompetent or hardworking and unproductive employees, thus creating an unfair reward system.

What are some poor qualities of nurse managers?

Theory X managers believe employees feel like work is something to be avoided, they want to do as little as possible, and use control supervision punishment. These managers employ strict rules, do constant supervision, and they threaten punishment.

What attitudes do theory X managers display?

Theory Y managers believe the work itself can be motivating, people want to do a really good job, and they use guidance development reward. These managers use guidance rather than control, development rather than close supervision, and reward rather than punishment.

What attitudes do theory Y managers display?

there are four phases listed of bringing about change including: designing the change, planning, implementing and integrating the change.

What can you do to help make change more successful in your organization?

2. Management is an assigned position Everyone can exert leadership at various times, but manager is a designated position, assigned by upper-level administration.

What is the difference between management and leadership? 1. Management focuses on budget 2. Management is an assigned position 3. Leadership is not concerned with getting work done 4. Leadership is more focused on people

4. All of the above Will it work better the old way? It is important to know whether the process really warrants change. IF the process under review is working well as part of current practice, there may be no benefit to making a change. Rather, this would exhaust resources and create unnecessary stress. Is this change needed? It is important to examine whether the change is needed. Is the change part of a bigger change that will better prepare the organization for the future? Research could support the need for change and allow the department to make a more informed decision Is there a simple way to do this? The proposed change should address the problem to be solved. Confirming the easiest merit of the initiative and understanding the easiest way to make the technical change are important.

When designing a technical change, which of the following should be considered? 1. Will it work better the old way? 2. Is this change needed? 3. Is there a simple way to do this? 4. All of the above

2. After developing clinical expertise Development of clinical expertise is an essential part of preparing to be a nurse manager.

When should a new graduate consider taking on management responsibilities? 1. As soon as they are offered 2. After developing clinical expertise 3. After 15 years on the job 4. Before developing leadership expertise

2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a persons information

Which best describes the difference between patient privacy and patient confidentiality? 1. Confidentiality occurs between persons who are close, whereas privacy can affect anyone. 2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a persons information 3. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection. 4. Privacy involves protection from being watched, whereas confidentiality involved protection from verbal exchanges.

1. During care, the nurse reveals information about the patient to those in the room. Giving out information about a patient without permission is an invasion of privacy.

Which common practice puts the nurse at liability for invasion of patient privacy? 1. During care, the nurse reveals information about the patient to those in the room. 2. The nurse releases information about the patient to nursing students who will be caring for the patient the next day. 3. The nurse conducts a patient care session about a patient whose care is difficult and challenging. 4. Confidential information regarding an admitted patient is released to third-party payers.

2. Tasks shes done many times The nurse is accustomed to the daily routine, knows what to expect, and understands what is expected. This puts the nurse in his or her comfort zone.

Which of the following best describes what is most likely to be within a nurses comfort zone: 1. A new assignment 2. Tasks she's done many times 3. Change to a different shift 4. Addition of several new tasks

4. assesses the client's point of view and prepares to articulate this point of view Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the clients point of view.

Which of the following demonstrates a nurse is advocating for a patient? The nurse 1. calls a nursing supervisor in conflicting situations 2. reviews and understands the law as it applies the client's clinical condition. 3. documents all clinical changes in the medical record in a timely manner 4. assesses the client's point of view and prepares to articulate this point of view