E2 leadership

Primary Nursing Model

A nurse is accountable for planning, evaluating, and directing the care of a pt 24/7 throughout stay. Same nurse during the entire stay

reverse delegation

A subordinate delegates to someone with authority Example registered nurse makes the charge nurse take care of her admission and her new medication's due

What are the essential traits of a leader?

A vision for the future Trust of colleagues and coworkers Excellent communication skills Motivates your peers

What is a teamwork

Active interpersonal process of participating by following a leader/manager

The nurse has just received report on her patient. Which task can she not delegate to an LVN that is IV certified?

Admission assessment Initiate bowel protocol on the patient and give Colace Initiate care plan

What is under delegation?

Afraid to delegate, delegates, less, An example would be an RN, having an LVN feed a patient and not pass meds

What are standardized procedures?

Allow nurses to do skills independently without an order like an IV site

Three steps for good time management

Allow time for planning Complete the highest priority task first Finish one task before starting another Reprioritize based on the rest of the tasks and new information

What are RN case managers?

Aryans, who develop, implement, and evaluate individualized. Patient care plans.

Six steps of care planning

Assessment Nursing diagnosis Planning Interventions Evaluation Advocacy

CNA tasks

Bathing Ambulation Assist with meals Taking vital signs

BSN

Beginning leadership and research, nurse scolding is more geared towards public health/leadership

What does an effective follower display?

Cooperation Collaboration Teamwork Action aligned with leader Being on board with everyone

What is staff development for?

Cost-effective method of increasing productivity

Multidisciplinary team models

Daily patient rounds Are in, dietitian, RT, PT, pharmacy

What is improper delegation?

Delegating the wrong task, or to the wrong person, or at the wrong time Example is a charge nurse asking a staff nurse to discuss attendance problems with another staff as well as a disciplinary action

MSN nurse

Depends on specialty Masters program

education

Designed to develop staff, is broader and more formal

Authoritarian (or autocratic) leadership

Directive behaviors Decisions made solely by the leader Characterized by giving orders Activities determined by leader, dictated by followers Do as I say, because I am the leader!

What is the disease management nurse?

Early detection and intervention, often case managers

Transformational leadership

Empower people Inspire positive change Importance of relationship between leader/follower Interactive leader ship

How often should you do an ongoing assessment?

Every shift and receiving a new patient

What is capitation?

Fixed rate fee to a provider or group of members of certain insurance regardless, if they use the services or not

What does a leader focus on?

Focuses on relationships rather than on tasks are required to accomplish a goal

What are the standards of competent performance?

Formulates nursing diagnosis Formulates care plan Perform skills Delegates to subordinates Evaluates effectiveness of care plan Act as client advocate

Teamwork and collaboration (QSEN)

Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.

What are the variety of strategies to lower costs and optimize value?

Gatekeeping Prior authorization Capitation

What is the function of a leader

Guide people and groups to accomplish common goals

What core measure does not have to be an acute diagnosis at the time

Heart failure

What is core measure compliance show?

How often a hospital provides each recommended treatment for certain medical conditions, in order to be accredited and paid for their services

LVN tasks

IV Starts Wound Care Hang IV Bags Without Additives I&O NG Tube Placement and Feedings D/C IVs Insert & D/C Foleys Suctioning Tracheostomy Care Charting Dressing Changes Specimen Collection (Urine, Stool, Wound Culture) Data Collection -Not Assessment! Medications - PO, SQ, IM, NG, PEG NG or Peg Tube Feedings Can check and hang blood products Wound care

The NPSGs are

Identify patient correctly Improved staff communication Use medicine safely Use alarm safely Prevent infection Identify patient safety risks Improve healthcare equity Prevent mistakes in surgery

evidence-based practice QSEN

Integrate best current evidence and clinical expertise and patient/family preferences, and values for delivery of optimal healthcare Is it appropriate?

Who's responsibility is it for developing skills of their employees?

It's the hospitals responsibility to keep the skills up-to-date

Adult Learning Theory

Learner is self-directed, internally motivated, past experience are valued/varied, and our problem/task centered

Safety (QSEN)

Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.

Total Patient Care Model

Model of care in which one nurse provides total care to assigned patients. Typical bedside nurse Nurse assumes 100% of the responsibility

Key points of leadership

More people focused More process focused More concerned with motivation More based on the use of self and personality

Key points of management

More task focused More goal focused Or concerned with plans, policies, rules, and procedures More based on position

What is NPSG?

National Patient Safety Goals Goals set every year based on how we are doing Focuses on concerns

What are core measures?

National standards of care and treatment processes for common conditions. They are processes proven to reduce complications and lead to better patient outcomes. Evidence based practice

Assessing Staff Development Needs

Nurse, managers, education, department, and staff nurses themselves involved in this process Helps people work together and be responsible to everyone

Coaching as a Teaching Strategy

One person helping another meet optimum level of performance

Who has a scope of practice defined by law

Only licensed individuals

What what is a delegator?

Person making the delegation Registered nurse

What is a delegate

Person receiving the delegation like a CNA or LVN

functional nursing model

Personnel are assigned certain tasks and not a specific patient

What are the five factors to assess when making a decision to appropriately delegate?

Potential for harm Complexity of task Problem-solving Innovation required Level of patient interaction

Proper time management

Prioritize! Identify activities, tasks and goals to be accomplished

What is prior authorization?

Process used by some health insurance companies to determine if they will cover a prescribed procedure, service or medication

Leadership versus management

Processes and people vs. Tasks and productivity.

Self-assessment of time management Why time is lost or is not used effectively

Procrastination? Perfectionism? Inability to prioritize?

Laissez-faire leadership style

Promotes complete freedom for group Minimum of leader participation This style is based on non-interference Let events take their own course Passive decision maker Do what you think is best Hands off

What does BRN do

Protect and advocate for health and safety of public by regulating Registered nurses Set standards in develops legislation Approves nursing programs Disciplinary action Nclex

Planning with managed care

Provides structure and focus for managing the use, cost, quality and effectiveness of healthcare services

What is the hospital quality in initiative?

Providing and promoting quality, patient care via evidence based practice Through core measures

What is QSEN?

Quality and Safety Education for Nurses It helps nurses be prepared to have the knowledge skills and attitudes necessary to continuously, improve the quality and safety of healthcare systems within which they work

patient centered care

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs.

Democratic leadership style

Relationship and person oriented Leader encourages and assist with discussion and group decision-making Move slower than authoritarian style Leader will ask for their staff ideas, and invite them to be a part of the solution We are going to talk about this and decide together

What does time management start with?

Self-awareness Analyze time wasting behaviors Develop better time management skills Allow time to plan your schedule

What do case managers act as?

Social workers, advocate, patient welfare, and serve as a liaison between patients, their families and the healthcare providers

What core measure needs to be initiated immediately until proven otherwise

Stroke precautions

Nurses, ensure accountability and supervision by what three things?

Supervision of performance Any necessary intervention Evaluation of task performance

What is important when delegating a task to an insubordinate

Supervision, providing guidance, direction, and evaluation of the task

Training

Teaching knowledge and skills to perform job duties

Team and modular Nursing Model

Team leader, direct, less skilled workers Nursing homes RN/LVN/CNA

Definition of management

The coordination and integration of resources through planning your clinical day, organizing, what needs to get done, coordinating, or directing and communicating and delegating, controlling, monitoring quality of care

Managed care emphasis

They emphasize on preventative care like screenings, physicals, immunizations

What are some of the goals in case management?

Timely discharges Prompt, efficient use of resources Achievement of expected outcomes Collaborative practice Performance improvement, activities, which lead to optimal patient outcomes Home health? Walker? Follow up appointments? Income questions to ensure best outcomes.

over delegation

Too much responsibility to delegatee. Example would be admitting and patient or doing most of the tasks

What is delegation?

Transferring to a competent individual that authority to perform a nursing task

Quality Improvement (QI) QSEN

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems Monitoring and collecting data for a better outcome

social learning theory

We learned from our interactions with others People learn from: Direct experiences Observing others By judgment voiced from others By evaluating the soundness or logic of new information

The five rights of delegation

a) Right Task b) Right Circumstance c) Right Person d) Right Direction/Communication e) Right Supervision

What is the nursing practice act?

defines nursing practice and establishes standards for nurses in your state

What are the four steps of the management process?

planning, organizing, leading, controlling

What is gatekeeping?

screens, if patients qualify for a service

Informatics (QSEN)

use information and technology to communicate, manage knowledge, mitigate error, and support decision making