482 Exam 2

delegation

As the planned learning of new skills and opportunities for an individual that transfers duties or tasks to that individual for a purpose that is mutually beneficial for the individual and delegator.

what are the reactions of people to change

fear sadness outrage stress disorientation eroded loyalty lack of commitment low risk taking

second step of decision making process

gather info

Transforming care at bedside

goal to improve quality and safety on med-surg units by engaging in changes to improve practice

job stress

harmful physical and emotional responses that occur when the requirements of the job do not match capabilities, resources, or needs of the worker.

how do you measure culture

has been measured both qualitatively and quantitatively * one believed it is only qualitatively

vicarious liability

held liable for a wrong action you did not commit. attachment of responsibility to a person for harm or damages caused by another person in either a negligence lawsuit or criminal prosecution

seventh step of decision making process

implement and evaluate outcome

climate

individual perception of what it feels like to work in an environment

who can help the effectiveness of change process?

involvement of those directly effected by change. view recipients of change as assets rather than barriers

clinical decision making

involves clinical judgements that result in interventions at the point of patient care

5 dimensions of culture

leadership group behavior/relationship communication quality of work/life healthcare worker outcomes

sixth step of decision making process

make decision

Hierarchy of needs prioritization

meet physiological needs first

justice

norm of being fair to all and giving equal treatment including distributing benefits, risk, and cost equality

veracity

norm of telling the truth and not intentionally, deceiving, or misleading comments

who is responsible for the errors that occur because of delegation

nurse is accountable for supervision, follow-up, intervention, and: a. corrective action of the event

clinical judgement

o Involves forming, refining, and evaluating hypothesis based upon recognizing and analyzing cues

stress

o Negative emotional experience associated with biological changes that trigger the body to make adaptions. Can be physical, mental, psychological, or spiritual. Response to a stressor experience that is evaluated by individual as taxing or exceeding resources and threatening to one's sense of well-being.

how do personal values impact decision making

o Values drive behavior, drive the way resources are distributed, and reflect how the organization treats staff.

moral distress

occurs when clinicians know the ethical action to take but are prevented from doing so by either internal or external obstacles.

autonomy

patients right of self-determination and freedom of decision making

moving/changing

planning and implementing. problem analysis and seeking alternatives

civil law

private law; law between individuals - includes malpractice

culture

set of values, beliefs, and assumptions that are shared by members of an organization

Innovation

the introduction of a new process or new way of doing something

safety culture

the outgrowth of the larger organization culture and emphasizes the deeper assumptions and values of the organization toward safety

safety climate

the shared perception of employees about the importance of safety within the organization

other actions to support response to change

- active listening - promote action/solutions - staff informed decisions - solicit input and encourage participation - reframe difficult messages

actions for change agents

- articulate a clear need for change - get group participation - get reliable info to the implementers - motivate through rewards - do NOT make promises you can't deliver

stratigies to manage stress

- journaling to track stressors - set boundaries - take time to recharge - relaxation techniques - express gratitude - reflect - self care

what can managers do to improve job satisfaction

- leaders with a vision - value contribution - managers who empower not control - values lived not just spoken - employees who can voice concerns

how can managers help with time management

- time audit self-assessment - prepare for the next workday - engage in projects - complete routine tasks - meetings only when necessary - model self care

combat change fatigue

- use effective communication - support staff in where they are in accepting change - forfeit control and involve staff in process - identify where and how staff can fit in process - model positive outlook/energy

5 stages of innovation process (rogers theory)

1. knowledge of innovations existence 2. persuasion to form an attitude toward it 3. decision to adopt/reject 4. implementation 5. confirmation to reinforce/reverse it

what are the stages of planned change

1. readiness 2. justification of need 3. assessment 4. planning 5. implementation 6. measurement 7. evaluation 6. sustaining goals

Criminal law

Based on public statue or common law, which consists of federal or state laws that make specific behaviors illegal - misuse of narcotics, practicing without a license, stealing, intentional patient harm

piolet project

Carefully defined trials used to try out a solution alternative on a small or restricted basis to reduce risk and see whether major problems will occur

tort

Civil or personal wrong, Wrongful act (other than breach of contract) committed against another person or organization or their property that cause harm and can be remedied by a civil lawsuit, Civil personal wrong purpose is to adjust losses by compensating one person because of actions of another. Only remedy available in civil lawsuit based on tort is monetary damages.

clinical reasoning

Decision making process that is grounded in professional thought process

intentional tort

Deliberate invasions of a person's legal rights, Represents direct interreference with a person's physical integrity or right to property, Common civil lawsuits include assault, battery, false imprisonment, property conversion, trespassing, intentional infliction, emotional distress.

time management

Deliberative process of identifying and focusing on the activities needed to accomplish tasks and goals in the time available.

D

Develop and implement plan of action

four components of neglegence

Duty, Breach of duty, Cause, Harm- results from breach of duty. Burden of proof is on plaintiff, must prove there was a well-established duty and an obvious breach of such duty. Must prove connection to harm claimed.

what is the most important reference for delegation

Effective leadership and role management. Nurse leaders need to role-model proper and effective delegation through role management.

E

Establish desirable criteria for what you need to accomplish

E

Evaluate and monitor situation

I

Identify best alternatives

confidentiality

Prohibits some disclosures of some information gained in certain relationships to some third parties without consent of the original source of the information.

unintentional tort

Result from negligent, Occur when the defendant's actions or inactions were unreasonably unsafe

five rights of delegation

Right task Right condition Right individual Right instruction Right supervision and assessment

why are manager rounds/accessibility important

Role modeling leader access, visibility at all levels and support of creative and innovative ideas that translate into change initiatives will inspire and gain commitment from the change team.

magnet organizations must meet what components

Transformational leadership Structural empowerment Exemplary professional practice New knowledge innovations improvement Empirical outcomes

Three stages of Lewins Change Theory (planned change)

Unfreezing Moving/changing Refreezing

what is root cause analysis

a collective term that describes a wide range of approaches, tools, and techniques used to uncover causes of problems.

Transformation change

a complete change in the appearance or character of something/someone, especially so that thing or person is improved

privacy

a right of limited physical or informational inaccessibility

ABC prioritization

airway breathing circulation

Planned Change

any kind of alteration or modification which is done in advance and differently for the improvement of present position into a brighter one

what is the first appropriate response to concerns regarding change

assess the situation

unfreezing

assessing, problem identification and definition

Emergent Change

assumes that change is a continuous open-ended and unpredictable process of aligning and realigning an organization to its changing environment

fidelity

being loyal and faithful to commitments and accountable for responsibilities

is culture or climate easier to change

climate

C

consider all possible alternatives and steps to be taken

fifth step of decision making process

consider consequences

CURE prioritization

critical urgent routine extra

first step of decision making process

define problem

D

define the problem/urgency need

third step of decision making process

determine overall goal/desired outcomes

fourth step of decision making process

develop solutions

nonmaleficence

do no harm to paitnets

beneficence

doing good for patients and providing benefit balanced against risk

refreezing

evaluation, implementation,

negligence

failure to exercise the care toward others that aa reasonable or prudent person would do in the circumstances, taking action that such a reasonable person would not