NRSG Leadership and Management

The nurse leader is executing quality improvement (QI) processes in a team. Why are QI processes important?

They review the nursing activities. QI processes improve quality by reviewing nursing activities. Quality assurance (QA) processes involve chart audits. QI will only review nursing activities and does not inspect. Inspection of nursing activities is done during the QA process. The QA process discovers and corrects errors, whereas the QI process prevents errors.

After observing a client waiting for food, the nurse leader instructs the nurse to make arrangements for food. Which statement used by the nurse to the client appropriately makes his or her positive intent explicit?

"I want to make you comfortable, here's your food" The nurse makes the client comfortable by providing the food, and verbally makes this known. Therefore this action is related to the nurse making his or her positive intent explicit. The act of ordering the food for the client clearly shows that the client is the focus for the nurse. However it may not relate to positive intent explication. The apology for the food delay is an example of a blameless apology. The expression of admiration of the client's patience is a way of expressing appreciation.

The nurse as a leader assists multidisciplinary leaders to achieve optimal functioning to benefit client care delivery. Which Gardner's task is the nurse applying?

Achieving workable unity When the nurse assists multidisciplinary leaders to achieve optimal functioning to benefit client care delivery, it indicates the Gardner's task of achieving workable unity. Relating to and inspiring staff, management, and community leaders to achieve desired levels of health and well-being indicates Gardner's task of managing. When the nurse is honest in role performance, it indicates Gardner's task of developing trust. When the nurse represents the values and beliefs of the organization to internal and external constituents, it indicates Gardner's task of serving as a symbol.

What is the application of Roger's diffusion theory?

Engages key leaders in a change to infuse the energy from early adopters Roger's diffusion theory states that the key leaders should be involved in a change to infuse the energy from early adopters. Balancing short-term and long-term objectives is a principle of system thinking theory that balances decision making for quality outcomes. Establishment of the foundation for organizational behavior modification is applicable in organizational behavior of modification by Luthans. Eoyang and Holladay use performance appraisal as an example to bring change in leadership.

Which behavior of the nurse as a leader would be considered a smart trust action according to Covey?

Focusing first on developing character Covey's smart trust actions help leaders develop high trust in a low-trust world. Focusing first on developing one's character is a smart trust action of a leader. Leading a balanced life, engaging in self-renewal, and seeing life as an adventure are Covey's characteristics of leadership.

How does the nurse leader, being in an executive position, perform Gardner's motivating task?

Inspiring the staff and community leaders to achieve desired levels of health and well-being The nurse leader can apply Gardner's motivating task by inspiring staff and community leaders to use clinical services appropriately. Inspiring the staff to achieve the mission of the organization indicates that the nurse leader is accomplishing the managing position of Gardner's task. The nurse leader fulfills Gardner's task of envisioning goals by assisting staff in formulating a vision of enhanced clinical and organizational performance. The nurse leader executes Gardner's task of explaining by teaching and interpreting organizational and community-based health information.

In evaluating risks, what does the nurse understand is the responsibility of risk managers?

Involving perspectives from numerous disciplines Involving perspectives from numerous disciplines helps to discover underlying problems that a single discipline might miss. Risk managers should use multiple data sources, multiple data collection techniques, and multiple perspectives to collect and interpret data accurately. Both qualitative and quantitative data should be assessed and analyzed for implementing actionable plans to prevent adverse events.

The nurse manager evaluates the performance of a group of nurse leaders on a project. One nurse leader performs exceedingly well by assuring that change happens and is promoted as the leader. Which quality attributes would have been shown by the nurse? Select all that apply.

Taking initiative Going beyond the role Thinking outside the box Assuring change is a result of taking initiative. The nurse who assures change also has to go beyond his or her role. When the nurse thinks outside the box, change is assured. The caring aspect of a nurse relates to being committed to the clients and their welfare. When the nurse is courageous in challenging power, he or she gets closest to the work.

The nurse leader is planning for the integration of evidence into practice. In which order are the required activities of Roger's diffusion of innovations for starting an evidence-based innovation?

Correct order: 1. seeking and analyzing information 2. developing positive or negative attitude 3. adopting the innovation 4. providing support for the innovation process 5. continuing the innovation The first step of Roger's diffusion of innovations is knowledge, which involves getting exposure to an innovation and gaining knowledge about how it functions. This includes seeking and analyzing information. The second step is persuasion, which involves developing attitudes about an innovation through physiological involvement and selective perception. The attitude can be positive or negative. The third step is decision, which involves commitment to adoption, which means adopting the innovation. The fourth step is implementation, which involves taking innovation into the practice by providing support for the innovation process. The final step is confirmation, which involves evaluation of the innovation in which the innovation may continue or discontinue.

The nurse manager is implementing a change in evening care for clients to include back rubs to promote sleep. The nurse manager convinces the managers of various nursing units and also supports nursing staff who are willing to implement the change. Which component of Kotter's eight step model is involved in this scenario?

Forming a powerful coalition Building momentum and supporting individuals in an organization is achieved by developing a core group of advocates who bring about the change. According to Kotter's eight-step model, the component that reflects this principle is formation of powerful coalition of nurse managers who support the change and the staff who are willing to implement the change. Creating short-term wins involves the leader creating short-term targets to accomplish certain tasks. Creating a vision for change involves creating small alterations connected to a larger, inspiring vision. Anchoring the changes in the culture involves reporting the differences the change is making and honoring the people who make it happen.