Professionalism (Chapters 8, 15, 16)

Which of the following nursing care models are hospital based? (Select all that apply.) a. Case management b. Functional c. Private duty d. Team

a. Case management b. Functional d. Team Case management, functional, primary, and team are nursing care models that are hospital based.

Which of the following components are common to all case management models? (Select all that apply.) a. Client identification and outreach b. Population management c. Monitoring service delivery d. Individual assessment and diagnosis e. Evaluation f. Environmental management

a. Client identification and outreach c. Monitoring service delivery d. Individual assessment and diagnosis e. Evaluation There are eight main service components common to all case management models. They are client identification and outreach; individual assessment and diagnosis; service planning and resource identification; linking clients to needed services; service implementation and coordination; monitoring service delivery; advocacy; and evaluation.

A nursing professional practice council is being formulated within an organization. Nurses from the three acute settings will meet monthly to discuss safety, policy, and practice needs within the organization. What are some of the reasons for this group formation? (Select all that apply.) a. To provide professional socialization b. To provide an exchange forum c. To provide a mechanism for independent work accomplishment d. To allow members to test a theory e. To create a sense of status and esteem

a. To provide professional socialization b. To provide an exchange forum e. To create a sense of status and esteem In nursing, formation of groups occurs primarily to provide a personal or professional socialization and exchange forum, or to provide a mechanism for interdependent work accomplishment. Groups are established within organizations to create a sense of status and esteem, they allow an individual to test and establish reality, and they function as a mechanism for getting a job done.

Which of the following governmental agencies tracks population and health trends? (Select all that apply.) a. U.S. Census Bureau b. The Joint Commission c. CDC d. Bureau of Labor Statistics (BLS) e. Health Resources and Services Administration (HRSA)

a. U.S. Census Bureau b. The Joint Commission c. CDC d. Bureau of Labor Statistics (BLS) e. Health Resources and Services Administration (HRSA) Population and health trends are tracked by governmental agencies such as the U.S. Census Bureau, CDC, BLS, and HRSA, as well as private foundations and organizations.

A population health approach: a. aims to improve the health of the entire population. b. is funded by local, state, and national governments. c. strives to care for people who already exhibit optimal health. d. treats community-acquired diseases in area clinics.

a. aims to improve the health of the entire population. Population health is an approach to health that aims to improve the health of the entire population and reduce health inequities among population groups.

A type of group that is stable, meets periodically, has an identified purpose, and is part of the organizational structure is called a: a. club. b. committee. c. group. d. meeting.

b. committee. A committee is a type of group that is stable, meets periodically, has an identified purpose, and is part of the organizational structure. An example of a committee is a policy and procedure committee.

Some of the major disadvantages to group decision making are negativity, individual focus, and: a. autonomous conclusion. b. disruptive conflicts. c. group synergy. d. inaccurate data interpretation.

b. disruptive conflicts. Ronco (2005) identified the six potential negative impacts groups can have on an organization, including negativity, passivity, individual focus, groupthink, vocal minority, and the ethical dark side. Veninga (1982) also suggested a seventh: disruptive conflicts.

Any collection of interconnected individuals working together for the same purpose is known as a(n): a. club. b. group. c. meeting. d. organization.

b. group. Any collection of interconnected individuals working together for the same purpose is known as a group.

Disadvantages of private duty nursing include: (Select all that apply.) a. private duty nurses have a great degree of autonomy. b. private duty being a costly model. c. job security being tenuous and irregular. d. the nurse's focus being entirely on one client's needs. e. nurses maintaining close relationships with colleagues.

b. private duty being a costly model. c. job security being tenuous and irregular. One disadvantage was that private duty is a costly model because of its low efficiency. Furthermore, job security was tenuous and irregular. Other disadvantages were that nurses had little job mobility and were relatively isolated from colleagues.

The stage of group development where control issues arise and disputes or disagreements begin to emerge is the _____ stage. a. orientation b. adaptation c. emergence d. working

c. emergence Emergence is the third stage of group development and occurs as control issues arise. Disputes, disagreements, confrontations, alliances, and power struggles mark this stage of determining control over the group in order to emerge with a more consolidated identity.

Stakeholders are informed of an organization's key goals through its: a. vision. b. values statement. c. mission statement. d. organizational philosophy.

c. mission statement. Publicly posted mission statements inform key stakeholder groups, such as the public and employees, of the organization's key goals.

Primary nursing is a type of care delivery in which the nurse: a. cares for a patient 24 hours a day. b. is responsible for the client's daily care. c. monitors care from admission to discharge. d. provides total care for the patient.

c. monitors care from admission to discharge. In the primary nursing model, the primary nurse has 24-hour-per-day accountability for the patient's plan of care from admission to discharge. Associate nurses oversee patient care delivery when the primary nurse is not on shift, although associate nurses are expected to follow the primary nurse's plan of care.

Which of the following factors best suggests an individual is motivated to engage in a disease management program? a. Mistrust of insurance companies b. Enrollment at initial contact c. Can afford the cost of enrollment d. Has a need that would benefit from the program

d. Has a need that would benefit from the program The results of a 2014 study that examined factors driving engagement suggest that individuals most motivated to engage are those who are well informed of the program benefits and have a perceived need that would benefit from said program (e.g., living alone, needing a supportive person to discuss ideas) (Hawkins et al., 2014).

Which nursing care model was prominent before the Great Depression? a. Functional nursing b. Group nursing c. Hospital staffing d. Private duty nursing

d. Private duty nursing Private duty nursing is the oldest care model in the United States. Between 1890 and 1929 in the United States, graduate nurses acted as private duty nurses, caring for patients in their homes (Shirey, 2008).

The brokerage model and the comprehensive service center model are examples of which type of care model? a. Collaborate b. Inter-professional c. Interdisciplinary d. Social work

d. Social work The brokerage model, the primary therapist model, the interdisciplinary team model, and the comprehensive service center model are all examples of social work models.

A multidisciplinary committee meets monthly to discuss medication safety issues within the acute care areas. The quality director consistently arrives late for meetings and spends her time in the meeting answering e-mails on her smart phone. What type of disruptive behavior does this exhibit? a. Compulsive talker b. Interrupter c. Squasher d. Unreliable

d. Unreliable Unreliable members are not committed to the work of the group and frequently arrive late, leave early, spend time checking e-mail or texting, and simply want to show up for the purpose of appearance.

A patient has a history of diabetes mellitus, myocardial infarctions, and hypertension. His HgbA1c level dropped from 7.8% to 6.2% 2 months after he began a walking exercise program. The nurse case manager had provided diabetic education and suggested ways to enhance his cardiac reserve. This is an example of: a. nursing empowerment. b. nursing knowledge. c. patient expertise. d. patient participation in care.

d. patient participation in care. The scenario depicts an example of a case manager's intervention resulting in a positive clinical outcome. This is the result of the patient's participation in his own care.

The core element common to all provider interventions in case management (CM), disease management (DM), and population health management (PHM) is: a. disease preventative care. b. care coordination. c. client-centered. d. population-focused.

d. population-focused. Care coordination is the core element common to all provider interventions in CM, DM, and PHM.

Team building is the process of _____ a group. a. forming b. identifying c. organizing d. unifying

d. unifying Team building is the process of deliberately creating and unifying a group into a functioning work unit so that specific goals are accomplished.

Organizations need to integrate the behaviors of employees to avoid random chaos and maintain some order, function, and structure. A(n) _____ is a guideline that has been formalized. It directs the action for thinking about and solving recurring problems related to the objectives of the organization.

policy

A patient is admitted with congestive heart failure, diabetes mellitus, and dementia. He has a new dark spot on the top of his toes on his right foot. The nurse contacts the primary care physician, consults with the wound care specialist nurse, writes a nursing order for a referral to the diabetic educator, and contacts the discharge planner to facilitate future discharge plans. Which of the following care delivery models best describes how the nurse is providing care? a. Case management b. Group nursing c. Functional nursing d. Private duty nursing

a. Case management The Case Management Society of America (CMSA) definition of case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes" (CMSA, 2016).

When teams are assigned, but not designed, dysfunction can occur. What are some characteristics of a dysfunctional team? (Select all that apply.) a. Confusion over the purpose of the team b. Lacks real authority c. Effective interpersonal communication patterns d. Team needs placed above individual needs e. Lack of evaluation criteria

a. Confusion over the purpose of the team b. Lacks real authority e. Lack of evaluation criteria Perils and pitfalls can occur when teams are assigned—not designed—including confusion about the team's work, the team lacks real authority, structural team building is not done, dysfunctional behavior occurs and team members don't know how to constructively deal with it, and team-based outcome measures and coaching are lacking.

_____ has garnered considerable attention in health care in part because of the publication Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division). a. Disease management b. Development research groups c. Case management d. Diagnosis-related groups

a. Disease management Two major forces triggered the rise of a DM perspective: (1) the abundance of managed care systems as a prevailing form of organized health care delivery (the influence of health plans), and (2) the national attention generated by Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division).

Effective groups will have a variety of roles. Which of the following are examples of group-building roles? (Select all that apply.) a. Encourager b. Listener c. Summarizer d. Compromiser e. Recorder

a. Encourager b. Listener c. Summarizer Group-building roles include initiator, encourager, opinion giver, clarifier, listener, and summarizer.

Which of the following statements is true about the New England Medical Center (NEMC) case management model? a. It has a client-centered approach instituted during episodes of acute illness. b. It is known as a beyond-the-walls, medical-social, across-the-continuum of care model. c. It emphasizes the case manager's traditional linkage function. d. CM functions are undertaken as a part or an extension of therapeutic intervention.

a. It has a client-centered approach instituted during episodes of acute illness. The NEMC model is a client-centered approach instituted during episodes of acute illness. It focuses on resource utilization, nursing accountability, and outcomes.

What are some of the positive aspects of utilizing teams in a professional setting such as health care? (Select all that apply.) a. Teams have the potential to perform at higher levels than individuals on their own. b. Teams are a way to keep decision making at the management level. c. Teams may contribute to constraints within the budget. d. Teams can motivate individual members and provide encouragement, constructive criticism, and praise. e. Teams can make individuals feel more connected to the larger organization.

a. Teams have the potential to perform at higher levels than individuals on their own. d. Teams can motivate individual members and provide encouragement, constructive criticism, and praise. e. Teams can make individuals feel more connected to the larger organization. Groups have the potential for being a driving force for change in an organization. Ronco (2005) identified the potential positive impact groups can have on an organization: 1. Synergy: Groups have the potential to perform at higher levels than an individual would on his or her own. 2. Positive individual impacts: Groups have the potential to improve every member of the group or at least help each one reach his or her highest potential. 3. Motivation: Groups have the potential to motivate their individual members and provide encouragement, constructive criticism, and praise. 4. Diverse thinking: Groups have the potential to engage in diverse thinking, thereby identifying problems that might otherwise go unnoticed or ignored and exploring solutions. 5. Linkage to the larger organization: Groups have the potential to make individuals feel more connected to the larger organization.

Group interactions are composed of which of the following elements? (Select all that apply.) a. The unique way the group interrelates and begins to work together b. The values and norms of each individual c. The process of problem solving d. The communication that occurs among group members e. The roles played by each member

a. The unique way the group interrelates and begins to work together c. The process of problem solving d. The communication that occurs among group members e. The roles played by each member Group interactions are composed of the unique way the group interrelates and begins to work together, the standards that regulate the group's behavior, the process of problem solving and decision making, the communication patterns that occur among group members, and the roles played by each member.

What are some of the advantages to group work related to problem solving? (Select all that apply.) a. There is greater sharing of knowledge and information. b. Individuals are less likely to accept a solution. c. Complex problems are more manageable in a group. d. Groups discourage individual expression. e. Group decision making is cost-effective.

a. There is greater sharing of knowledge and information. c. Complex problems are more manageable in a group. e. Group decision making is cost-effective. The major advantages of group problem solving over individual problem solving are greater sharing of knowledge and information, increased acceptance of solutions, complex problems are more manageable, groups allow for individual expression, and group functioning is less expensive.

Policies and procedures are two functional elements of an organization that are extensions of the mission statements. The similarities between policies and procedures include: (Select all that apply.) a. a need for regular, periodic reviews. b. a means for accomplishing goals and objectives. c. general guidelines for decision making about actions. d. a need for the smooth functioning of any work group or organization. e. a need to be very detailed as to how to perform a specific procedure on a specific unit.

a. a need for regular, periodic reviews. b. a means for accomplishing goals and objectives. d. a need for the smooth functioning of any work group or organization. The similarities between policies and procedures are that both need regular, periodic reviews and that both are a means for accomplishing goals and objectives. Both are necessary for the smooth functioning of any work group or organization.

An example of a traditional nursing care delivery model is: a. case management. b. patient- and family-centered care. c. transitional care. d. patient-centered medical home.

a. case management. There are five traditional nursing models of care: (1) private duty, (2) functional, (3) team, (4) primary, and (5) case management. Of these, functional, team, primary, and case management were and are currently associated with hospital nursing practice. Private duty and case management were associated with public health, home health care, and community health but have been adapted to the inpatient setting.

A disease management program usually focuses on patients with: a. chronic conditions. b. mental health issues. c. outpatient procedures. d. surgical diagnoses.

a. chronic conditions. While CM programs serve a smaller percentage of the overall population, enrollees are complex from a medical-behavioral, health-social vulnerability perspective. DM programs serve a larger percentage of patients whose main problem is one or more chronic condition(s). These individuals generally have similar primary needs regarding health condition education and accommodation strategies.

Community health means meeting the: a. collective needs of a group by identifying problems and managing interactions. b. needs of an individual within the community by identifying problems and managing interactions. c. needs of the health care system within a population or area. d. needs of a population by identifying problems and managing interactions.

a. collective needs of a group by identifying problems and managing interactions. Community health means meeting the collective needs of a group by identifying problems and managing interactions within the community and between the community and larger society.

A professional practice model is a: a. conceptual framework and philosophy of nursing within an organization. b. staffing grid that outlines nursing unit work schedules. c. mechanism by which care is actually provided to patients and families. d. blueprint for developing specific measurable objectives and actions.

a. conceptual framework and philosophy of nursing within an organization. Professional practice models (PPMs) refer to the conceptual framework and philosophy of nursing within an organization.

The presence of a nurse professional practice model (PPM) is the nurse's: (Select all that apply.) a. control over practice. b. career focus. c. job satisfaction. d. psychological needs.

a. control over practice. c. job satisfaction. One important predictor of RN job satisfaction is the presence of a nurse professional practice model (PPM). Nurse job satisfaction is directly associated with nurse turnover, a significant human resource challenge for management (Hayes et al., 2012). Professional practice models consist of structures, processes, and values that support nurse control over practice and enhance job satisfaction and retention (Erickson & Ditomassi, 2011).

Functional nursing: a. divided and distributed nursing tasks. b. enhanced client-oriented care. c. provided a smooth care delivery system. d. was expensive once implemented.

a. divided and distributed nursing tasks. Functional nursing focused on task accomplishment rather than individualized and holistic care. The division of labor was assigned according to specific tasks and technical aspects of the job, such as medication administration and taking vital signs.

The determination of a care delivery model or system of care delivery depends on: (Select all that apply.) a. fiscal responsibility. b. accountability to the consumer. c. government reimbursement. d. the organization's philosophy. e. quality and safety considerations.

a. fiscal responsibility. b. accountability to the consumer. e. quality and safety considerations. Care delivery model redesign is influenced by fiscal responsibility, accountability to the consumer, available resources, and quality and safety considerations. The appropriate care delivery model is the one that maximizes existing resources while meeting organizational goals and objectives (i.e., the mission).

Population health management (PHM) is viewed as a major health care strategy to improve health outcomes. This is because effective population health management programs: (Select all that apply.) a. have proactive interventions. b. promote client satisfaction through advocacy. c. coordinate care for chronic conditions. d. have consistency of care for at-risk populations. e. customize care support. f. encourage adherence to treatment.

a. have proactive interventions. c. coordinate care for chronic conditions. d. have consistency of care for at-risk populations. e. customize care support. f. encourage adherence to treatment. PHM is now being viewed as a major health care strategy to improve health outcomes across multiple populations while lowering costs and improving patient satisfaction. PHM has demonstrated effectiveness across disease states, including integrated behavioral health, chronic illness (e.g., diabetes, congestive heart failure), and assorted payers (e.g., Medicare, Medicaid, third-party populations) (Fortney et al., 2015; Lyles, 2016; Rushton, 2015; Sidorov & Romney, 2016). Attractive features include effective population management, coordination of care for chronic conditions, consistency of care for at-risk populations, customization of care support, encouragement of adherence to treatment, and proactive interventions.

The critical care unit of a hospital utilizes team huddles at change of shift. This is an opportunity for the clinical supervisors to connect with team members and review the upcoming shift or any quick topics that need to be communicated. This is an example of a(n) _____ meeting. a. information-sharing b. opinion-seeking c. problem-solving d. strategy

a. information-sharing An information-sharing meeting occurs when a group is gathered to disseminate information.

The CM dyad team model—composed of a nurse case manager and social worker—has been widely adopted in hospitals. Through its unique structure, the nurse and social work dyad provides the implementation of collaborative interventions that focus on: (Select all that apply.) a. minimization of inpatient transitions. b. promotion of patient and family satisfaction through efforts of advocacy. c. maximization of health care benefits. d. reduction of cost by decreasing the length of stay. e. enhanced discharge planning.

a. minimization of inpatient transitions. b. promotion of patient and family satisfaction through efforts of advocacy. d. reduction of cost by decreasing the length of stay. e. enhanced discharge planning. Through its unique structure, the nurse and social work dyad provides the implementation of collaborative interventions that focus on (1) minimization of inpatient transitions, (2) reduction of cost by decreasing the length of stay, (3) promotion of patient and family satisfaction through efforts of advocacy, and (4) enhanced discharge planning (Carr, 2009).

The Collaborative Care Model of CM is best used for: a. patients with co-occurring physical and mental health needs. b. individuals and small systems. c. hospital-based case management programs focusing on episodic care. d. the transition of high-risk clients from acute care to community or long-term care settings.

a. patients with co-occurring physical and mental health needs. In the Collaborative Care Model, dedicated team members address the needs of patients through a comprehensive and strategic care delivery process. Included in the team are a primary care provider, a case manager who is trained in behavioral health, and psychiatric consultants and/or behavioral health specialists (Unützer et al., 2013). This comprehensive approach to care serves as a proactive means to screen and track mental health conditions within the primary care setting.

Nursing outreach programs are the core element of: a. population health management. b. disease management. c. case management. d. care management.

a. population health management. The newest generation of PHM programs involves proactive outreach. Nursing outreach programs are the core element. Personal communications (usually via telephone) between an expert nurse and the health plan participant build a personal relationship, help identify knowledge deficits and counseling needs, facilitate close monitoring and progress toward goals, enhance treatment adherence, and promote clinical and cost stabilization.

Positive work environments are often found in Magnet-designated organizations. Organizational structures associated with Magnet-like healthy work environments are: (Select all that apply.) a. professional development opportunities. b. interdisciplinary collaboration. c. top-down approach to governance. d. decreased workloads. e. culture of safety.

a. professional development opportunities. b. interdisciplinary collaboration. e. culture of safety. Organizational structures associated with Magnet-like healthy work environments include effective leaders at all levels of the organization, professional development opportunities, staffing structures that consider nurse competencies, patient needs, and teamwork; interdisciplinary collaboration; empowered, shared decision making; patient-centered culture/culture of safety; quality improvement infrastructure; evidence-based practice; and a visible acknowledgment of nursing's unique, valued contributions (e.g., professional practice model, vision/mission/philosophy statements).

A well-known conceptual framework by Donabedian (1988) is used to promote positive outcomes in an organization. The framework is composed of concepts related to: (Select all that apply.) a. structure. b. outcomes. c. processes. d. values. e. quality.

a. structure. b. outcomes. c. processes. One well-known conceptual framework by Donabedian (1988) frequently is used to "map" or determine what structures and processes promote positive outcomes. The three-concept framework is composed of structures, processes, and outcomes (S-P-O), and these three components are causally linked.

Which of the following scenarios would require disease management? a. A blood pressure screening clinic is started at the senior citizen center. b. A person with multiple chronic illnesses is admitted to the hospital. c. A program is started to address diabetes in the Native American population. d. An initiative is developed to promote fluoride treatments in schools.

b. A person with multiple chronic illnesses is admitted to the hospital. DM programs serve a larger percentage of patients whose main problem is one or more chronic condition(s). These individuals generally have similar primary needs regarding health condition education and accommodation strategies. Assessments focus on health condition-specific issues, and programs take a more standardized approach to education and resources (Chen et al., 2000).

Team dynamics can become dysfunctional over time. What are some factors that can contribute to team dysfunction? (Select all that apply.) a. Taking accountability b. Absence of trust c. Negotiating expectations d. Fear of conflict e. Lack of commitment

b. Absence of trust d. Fear of conflict e. Lack of commitment Dysfunctional team behaviors can occur related to an absence of trust, fear of conflict, lack of commitment, avoiding accountability, and inattention to results. Articulating and negotiating expectations for healthy interpersonal behavior benefits team development.

Which of the following collaborative processes assesses, plans, facilitates, coordinates, advocates, and evaluates options and services required to meet an individual's comprehensive health needs? a. Care management b. Case management c. Disease management d. Population health management

b. Case management Case management (CM) is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote patient safety, quality cost-effective outcomes" (Case Management Society of America, 2016a).

Case management and disease management are similar because both are interventions designed to coordinate care for better outcomes and lowered costs. Which statements are true regarding the differences between the two terms? (Select all that apply.) a. Disease management is client focused. b. Case management focuses on coordinating care of individuals and families. c. Disease management is more population-based than client-centered. d. Disease management is more episodic in its approach. e. Case management is more population-focused.

b. Case management focuses on coordinating care of individuals and families. c. Disease management is more population-based than client-centered. Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote patient safety, quality cost-effective outcomes. Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant.

Which of the following statements accurately describe disease management? (Select all that apply.) a. Disease management is care coordination that is organized to achieve specific client outcomes, given fiscal and other resource constraints. b. Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. c. Disease management relies on a structured system of interventions that focus on a specific condition. d. Disease management program content and interventions are evidence and guideline based. e. Disease management is the medical management of chronic disease.

b. Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. c. Disease management relies on a structured system of interventions that focus on a specific condition. d. Disease management program content and interventions are evidence and guideline based. Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. DM programs usually focus on a single condition, rely on a structured system of interventions that focus on a single condition; and program content and interventions are evidence and guideline based.

Why is an interdisciplinary, team-based approach essential in health care? (Select all that apply.) a. Reimbursement protocols and government regulations require them. b. Diverse team's enhanced ability to adapt to continuous or sudden change. c. A collective pool of thinking styles allows for greater exchange of information, ideas, and problem solving. d. Rapid information dissemination is most efficient with multidisciplinary teams. e. Engaging teams in this process allows for diverse points of view, creativity, and innovation.

b. Diverse team's enhanced ability to adapt to continuous or sudden change. c. A collective pool of thinking styles allows for greater exchange of information, ideas, and problem solving. e. Engaging teams in this process allows for diverse points of view, creativity, and innovation. Health care leaders recognize that an interdisciplinary, team-based approach is essential for high-quality, patient-centered, coordinated, and effective health care. Teamwork allows for greater exchange of information, ideas, and problem solving to address the complex issues of health care. Engaging teams in this process allows for diverse points of view, creativity, innovation, and an enhanced ability to adapt to continuous or sudden change.

Which of the following is true about team nursing? a. It includes only registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs). b. Each team member has his or her own patient assignments. c. Team members must have dual degrees. d. The nurse with a bachelor's of science in nursing degree is the leader of the team.

b. Each team member has his or her own patient assignments. Team nursing is a delivery approach that provides care to a group of patients by coordinating a team of RNs, licensed practical nurses, and care aides under the supervision of one nurse, called the team leader. Each team member has his or her own patient assignments, and team members are expected to assist and support each other as needed.

A concept involving a system that guides and tracks patients over time through a comprehensive array of health services to span all levels of intensity of care is known as: a. transition of care. b. continuum of care. c. rounds. d. disease management strategies.

b. continuum of care. Continuum of care is a concept involving a system that guides and tracks patients over time through a comprehensive array of health services to span all levels and intensity of care (Young et al., 2014). The services incorporated in each patient's unique continuum vary based on the individualized health and/or behavioral health needs of each person.

A health care management continuum: a. deals strictly with health promotion. b. controls problems at the population level. c. is a linkage of health services across settings. d. provides another health care option for the homeless.

b. controls problems at the population level. The health care management continuum is better known as population health management (PHM). One definition of population health management is "the process of addressing population health needs and controlling problems at a population level" (Nash et al., 2016).

Group problem solving is known to be more effective over individual problem solving because of a larger knowledge and information base, increased acceptance of solutions, more approaches to a problem, lower economic costs, and the ability for: a. group development. b. individual expression. c. hierarchical bonding. d. organizational team building.

b. individual expression. Individual expression is one of the major advantages of group problem solving (Veninga, 1982).

The hospital's disease management program has gathered data collected from health assessments in order to categorize patients into like groups with the intention of providing population management interventions. This practice or strategy is referred to as: a. analogizing. b. stratification. c. comparing. d. data exchanging.

b. stratification. In population health management, stratification has two meanings (PHA, 2015): a method of randomization and a process for sorting a population of eligible members into groups relating to their relative need for total population management interventions. The stratification process harvests information that can be used to divide the patient population into different levels to ensure a return on investment (ROI) based on resources allowed.

Nurses still struggle to create a healthy work environment. The standards of a healthy work environment include: (Select all that apply.) a. staffing ratios. b. true collaboration. c. powerful leadership. d. meaningful recognition. e. skilled communication.

b. true collaboration. d. meaningful recognition. e. skilled communication. The six standards of a healthy work environment are skilled communication, true collaboration, effective decision making, meaningful recognition, appropriate staffing, and authentic leadership. They have direct relevance to PPMs.

Group as well as individual accountability exists within a: a. work group. b. true team. c. pseudoteam. d. committee.

b. true team. A true team occurs when there is a collective entity in which leadership rotates and is shared by various members of the team. There is group as well as individual accountability.

Professional practice models (PPMs) refer to the conceptual framework and philosophy of nursing within an organization. The core elements of a PPM include: (Select all that apply.) a. goals. b. values. c. leadership. d. collaborative relationships. e. care delivery model.

b. values. c. leadership. d. collaborative relationships. e. care delivery model. The core elements of a PPM include nursing values, leadership, the care delivery model, collaborative relationships and decision making, and professional development opportunities (Luzinksi, 2012).

Work group disruption has been shown to be linked to negative outcomes. What are some factors that can contribute to work group disruptions? (Select all that apply.) a. Budget constraints b. Multidisciplinary attendance c. Reorganization d. Absenteeism e. Turnover

c. Reorganization d. Absenteeism e. Turnover Work groups can be disrupted by factors such as downsizing, reorganization, absenteeism, and turnover.

Mary Lou is a nurse in the critical care unit. She works 12-hour shifts. Each shift she is assigned to one or two critical care patients. She is responsible for planning and delivering the care and treatment for each one of the patients she is assigned to. This is an example of which nursing model? a. Team nursing b. Managed care c. Total patient care d. Functional nursing

c. Total patient care The term total patient care has come to mean the assignment of each client to a nurse who plans and delivers care during a work shift (Minnick et al., 2007).

To be effective at population care management, both CM and DM need to: a. assess and plan health initiatives within an area. b. implement and evaluate health programs within a community. c. assess and define the populations to be served. d. organize and regulate health professions across the country.

c. assess and define the populations to be served. To be effective at individual and population-based care management, both CM and DM programs need to identify, assess, and define the populations to be served early in the program planning effort.

Critical paths: a. are designed only for critical care or trauma patients. b. determine lifesaving interventions for a specific population. c. outline optimal care and time milestones for the routine patient. d. provide a list of supplies and equipment needed for care.

c. outline optimal care and time milestones for the routine patient. A critical path is a written plan that identifies key, critical, or predictable incidents that must occur at set times to achieve client outcomes during an appropriate length of stay in a hospital setting.

A small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent is known as a: a. committee. b. group. c. team. d. unit.

c. team. A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent (Katzenbach & Smith, 1993; Manion et al., 1996).

The first step in the development of a case management program is: a. to identify high-volume or high-risk case types. b. to develop a pilot program. c. to assess the organization and the client population served. d. to form an interdisciplinary care team.

c. to assess the organization and the client population served. The general process for the development of a case management is to assess the organization and the client population served; identify high-volume or high-risk case types; determine the usual client care problems, issues, or difficulties related to the high-volume or high-risk case types, with desired goals; form an interdisciplinary care team of the interrelated care providers who will be involved with the case types; develop and design an interdisciplinary critical pathway for each selected case type; develop a pilot program or trial site; and then evaluate the pilot program and consider system-wide implementation.

The hospital's regulatory department is experiencing The Joint Commission survey. The surveyors want to review hospital policies for infection control before they leave for the evening. The regulatory team leader states that she can stay past her regular hours to wait for them and acknowledges that there will be a need for a policy change before the surveyors return the following day. All of the department managers stay to assist the regulatory team leader with the required documentation. This is an example of a: a. work group. b. committee. c. true team. d. group.

c. true team. A true team is a group where there are collective work products. There is group as well as individual accountability. If one member is having a problem, it is not only that person's problem but that of the whole team to resolve.

A(n) _____ is the operational mechanism by which care is actually provided to patients and families.

care delivery model

A(n) _____ is a written plan that identifies key, critical, or predictable incidents that must occur at set times to achieve client outcomes within an appropriate length of stay in a hospital setting.

critical path

According to the Centers for Disease Control (CDC), chronic diseases account for _____% of deaths in the United States. a. 20 b. 40 c. 50 d. 70

d. 70 Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States. Chronic diseases account for 70% of all deaths in the United States, which is 1.7 million each year. These diseases also cause major limitations in daily living for almost 1 out of 10 Americans, a total of about 25 million people.

The nurse manager within a small department has requested that the staff decide department coverage over the holidays. The department is not associated with patient care and serves as a supportive role to the organization. The staff is to present the manager with the coverage plan during the month of December. This is an example of which type of decision? a. Autocratic decision procedure b. Consultative decision procedure c. Joint decision making d. Delegated decision procedure

d. Delegated decision procedure A delegated decision procedure occurs when the leader allows participants to make the final decision. An autocratic decision procedure occurs when the leader makes all of the decisions. A consultative decision procedure occurs when decisions involve employee participation but the leader still makes the decision. Joint decision making occurs when the entire group decides by vote or consensus.

The nurse who uses collaboration to coordinate care for an individual's and family's comprehensive health needs through communication and available resources to promote patient safety and quality, cost-effective outcomes is performing: a. population health management. b. managed care. c. disease management. d. case management.

d. case management. Case management (CM) is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote patient safety, quality cost-effective outcomes" (Case Management Society of America, 2016a).

The responsibility for making decisions about and designing strategies to create a climate and environmental context around the provision of nursing and health care services lies with: a. staff nurses. b. care councils. c. the nurse manager. d. executive leadership.

d. executive leadership. Executive leadership is responsible for making decisions about and designing strategies to create a climate and environmental context around the provision of nursing and health care services.

Janice is assigned to pass medications this shift. Mary is assigned to do wound care, Jennifer will give all the baths, and Jim will take all the vital signs. This model of nursing care is called _____ nursing. a. team b. primary c. modular d. functional

d. functional In functional nursing the division of labor is assigned according to specific tasks and technical aspects of the job. It has been defined as work allocation by functions or tasks, such as passing medicine, changing dressings, giving baths, or taking vital signs. Under functional nursing, the nurse identifies the tasks to be done for a shift. The work is divided and assigned to personnel, who focus on completing the assigned tasks.

A group of tenured nursing faculty at a major university votes on whether a faculty member should receive tenured status. This type of decision making is referred to as: a. autocratic decision procedure. b. consultative decision procedure. c. delegated decision procedure. d. joint decision making.

d. joint decision making. Joint decision making occurs when the entire group makes the decision by two-thirds vote, a simple majority, consensus, or some other process. In this process, the group members have as much power as the leader.

Lilly, an RN, works full time in her client's home providing total care for him. She bathes and dresses him, provides tracheostomy care and wound care, and feeds him. She is paid directly by her client. This type of nursing care is commonly known as: a. primary nursing. b. functional nursing. c. case management. d. private duty nursing.

d. private duty nursing. Private duty nursing, sometimes called case nursing, is the oldest care model in the United States. Private duty nursing is defined as one nurse caring for one client. In this model, complete and total care is provided by one nurse, but the nurse carries only one client assignment.

The conceptual framework and philosophy under which the method of delivery of nursing care is a component is known as: a. core values. b. mission statement. c. care delivery model. d. professional practice model (PPM).

d. professional practice model (PPM). PPMs refer to the conceptual framework and philosophy under which the method of delivery of nursing care is a component. PPMs describe the environment and serve as a framework to align the elements of care delivery. The PPM can be thought of as a link between the problems presented by client populations, the purposes of professional occupations, and the purposes of health care organizations.

In nursing, the reason groups form is: a. monetary rewards. b. mandatory obligations. c. physical needs. d. professional socialization.

d. professional socialization. In nursing, the formation of groups occurs primarily for one of two reasons: (1) to provide a personal or professional socialization and exchange forum, or (2) to provide a mechanism for interdependent work accomplishment.

A temporary group of individuals formed to carry out a specific mission or project is known as a: a. club. b. group. c. meeting. d. task force.

d. task force. A task force is a temporary group of individuals formed to carry out a specific mission or project. Task forces may solve a problem that requires a multidisciplinary approach.

A collection of individuals who are led by a strong, clearly focused leader and who come together to share information and ideas and possibly make decisions is known as a: a. committee. b. pseudoteam. c. team. d. work group.

d. work group. A collection of individuals who are led by a strong, clearly focused leader and who come together to share information and ideas and possibly to make decisions is known as a work group. In a work group, there is little or no collective accountability.