Leadership Test 1

Operational planning

extends from 1 hour to 3 years achieves specific tasks done in conjunction with budgeting develops departmental maintenance and improvement goals for the coming year

Transactional

focus on management task caretaker uses trade offs to meet goals does not identify shared values examines causes uses contingency rewards

SWOT

*Strengths* are those internal attributes that help an organization to achieve its objectives *Weaknesses* are those internal attributes that challenge an organization in achieving its objectives *Opportunities* are external conditions that promote achievement of organizations objectives *Threats* are external conditions that challenge or threaten the achievement of organizational objectives

*KNOW WORD FOR WORD* *How can one contain cost?*

*cost awareness* *cost avoidance* *cost reduction* *critical pathway development*

The most important responsibility of the nurse is to prioritize and ensure that routine nursing measures on non-critical clients are assigned. The nurse is performing which of the following functions? A. Delegation B. Networking C. Clinical coordination D. Advocacy

A. Delegation

Delegation is the process of transferring work to subordinates. A nurse-manager may appropriately delegate which task? A. Scheduling staff assignments for the next month. B. Terminating a nursing assistant for in subordination. C. Deciding on salary increases for nurses after they complete orientation. D. Telling a staff nurse to initiate disciplinary action against one of her peers.

A. Scheduling staff assignments for the next month.

A registered nurse should assign a nursing assistant to care for a client with inflammatory bowel disease who: A. requires assistance with ambulation. B. requires nasogastric suctioning. C. requires continuous pulse oximetry monitoring. D. is receiving patient-controlled analgesia.

A. requires assistance with ambulation.

Tasks that can be delegated to a UAP

Answering the phone Cleaning after procedures Transportation of patients Clerical tasks Assisting with procedures Data collection without analysis

Tasks that should not be delegated to a UAP

Any that involves nursing judgment or application of the nursing process Assessment of patients Assessment of pain Teaching Evaluation of treatment Interpreting test Identifying needs Triage Counseling

Cost avoidance

Avoidance of purchasing supplies, technology and services ...Supply and equipment cost analyzed ...Least expensive and most effective supplies, and equipment should be identified ...Expensive and less effective items should be avoided

Flexible budgeting

Budgets that flex up and down over the year depending on volume Automatically calculates what the the expenses should be given the volume Holds the manager accountable for expenses, especially the personnel budget

The charge nurse finds that a colleague is intoxicated while on duty. What appropriate action should the nurse take? A)Watch the colleague closely during the shift. B)Tell the colleague to take a 30-minute break C)Inform the nursing supervisor D)Inform the physician

C)Inform the nursing supervisor

Performance- based budgeting

Emphasizes outcomes and results instead of activities and outputs

A Nurse in a long-term care facility consistently administers clients' medications 60 to 90 minutes after the scheduled administration time. The nurse also leaves scheduled treatment procedures for nurses to complete on the next shift. Which of the following would be an appropriate strategy for this nurse to pursue? A. Reschedule treatment procedures for the next shift. B. Ask the nurse manager for a lighter load. C. Pre-pour medications for the shift to expedite the process D. Seek input and direction on time management and priority setting.

D. Seek input and direction on time management and priority setting.

Organizing

Determines the lines of authority, channels of communication, and where decisions are made

Controlling

Evaluation of staff performance and of unit goals to ensure that identified outcomes are being met

Great-Man Theory

Few people are born with the ability to be great able to organize, control, accomplish goals using subordinates allow participation and consultation from subordinates for decisions that affect them "leaders are born, not developed"

Cost awareness

Focuses the employees attention on cost Cost Fairs Awareness ...Frequent used items, actual cost vs patient costs ...Reviewing a patients itemized bill

Directing

Influencing and motivating* the staff to perform their assigned roles

Personnel budget

Largest expenditure in healthcare In order to handle the personnel budget managers must ...Use historical data for forecasting short and long term personnel needs ...Monitor the personnel budget closely to prevent overstaffing and understaffing ...Decrease personnel costs in relation to the decrease in volume (patient days or volumes) ...Monitor staffing mix ...Monitor acuity of clients ...Understand how to calculate Nursing Care Hours per Patient Day

Zero-Based budgeting

Managers justify their programs or needs every budgeting cycle Includes a comprehensive list of objectives for the program Alternative plans Cost of each alternative plan Advantages and disadvantages of continuing or discontinuing the program

Critical pathway development

One method of planning, assessing, implementing and evaluation of cost effectiveness of care Advantages ...Provides means of standardizing care ...Improves utilization of review

5 major management functions

Planning Organizing Staffing Directing Controlling

Capital budget

Purchases of buildings or equipment that has a long life (usually greater than 5-7 years) Equipment that cost more than a designated dollar (usually $500 or $1000) ...This depends upon the specific institution in which your work ...Managers usually have to complete a capital expense requisition ...Calculate how many times the equipment will be used on a specific type of client ...Cost charged to patient ...Estimated revenue per year ...Payoff value at the end of a designated time period

Operating budget

Reflects expenses that change in response to the volume of service ...Electricity ...Repairs ...Maintenance ...Supplies

Smart goals

Set specific, clear goals Record your progress Identify the steps needed to accomplish your goals What time constraints exist What can you do to accomplish the goals within these constraints

Incremental budgeting

Simplest form of budgeting Multiplies current year expenses by a designated figure and that number is the projected budget for the next year. Designated figure is usually the inflation rate or consumer price index Usually inefficient fiscally because there is no motivation to contain cost

Cost reduction

Spending less on goods and services Volume buying Conservation of supplies Reduction of repair cost

Staffing

The acquisition and management of the staff and mix of employees to provide 24/7 care of patients ... Hiring/ firing ... Discipline

Management

The activities needed to plan, organize, motivate, and control the human and material resources needed to achieve outcomes consistent with the organization's mission and purpose

Leadership

The use of personal traits to constructively and ethically influence patients, families, and staff through a process in which clinical and organizational outcomes are achieved through collective efforts ALSO a process of persuading and influencing others toward a goal and is composed of a wide variety of roles

Planning

What needs to be done? How will it be done? Who is going to do it?

Which document states that clients have a right to confidentiality of medical records and a right to privacy limiting access to that information to health care providers associated with their care? a Medical private acts b. State boards of nursing c. Healthcare power of attorney d. Living will

a Medical private acts

Preactivism

accelerates change, future oriented

Full-Range Leadership

articulate and are able to represent their vision well has charisma, is able to create emotional ties with the followers, and builds trust and confidence is able to create a collective sense of mission and values and prompts others to act on these values challenges and analyzes subordinates' problems and possible solutions recognizes and appreciates the staff's unique needs, strengths, and challenges

A Client on a surgical unit provided consent for a liver biopsy. The nurse is in the process of taking the client to the operating room when the client states, "I've changed my mind." Which of the following responses by the nurse is accurate? a. "You signed a consent form yesterday. It is too late to change your mind." b. "I m sure you are anxious about the procedure. But everything will be fine." c. "You have the right to withdraw consent. Would you like to discuss this further." d. "Unfortunately the OR is ready for you. We must proceed."

c. "You have the right to withdraw consent. Would you like to discuss this further."

In which ways does a nurse play a key role in error prevention? a. Notifying the Occupational Safety and Health Administration (OSHA) of workplace violations b. Never questioning a physician's order because the physician is ultimately responsible for the client outcome c. Identifying incorrect dosages or potential interactions of ordered medications. d. Informing the client of the Patient's Bill of Rights

c. Identifying incorrect dosages or potential interactions of ordered medications.

Proactive planning

considers the past, present, and future dynamic anticipatory promotes growth within an organization adaptable to the changing environment

Transformational

identifies common values is committed inspires others with vision has long-term visions looks at effects empowers others

Interactional Leadership

leadership is determined by the relationship between the leader's personality and the specific situation the leader must be able to problem solve, maintain group effectiveness, communicate well, be fair, competent, dependable, and creative must foster autonomy by valuing dan empowering followers focuses on leadership as a process of influencing others within the organizational culture

Democratic leaders

maintain less control ask questions and make suggestions get the group involved in planning, problem solving, and decision making encourage creativity and motivation communicate up and down use constructive criticism use awards uses "WE" rather than "I" or "ME"

Reactive planning

occurs after a problem

Laissez-Faire leaders

permissive, nondirective, passive, and inactive do not plan or coordinate provide little direction do not criticize motivates by support when requested provides upward and downward communication between members disperses decision making throughout the group

*5 rights of delegation*

person task circumstance direction/communication supervision/evaluation

Strategic planning

plans spanning 3-10 years focus is on purpose, mission, philosophy, and goals of the organization

Cost effective

providing good results for the amount of money being spent

Cost containment

providing quality services while maintaining revenues for the organization

Inactivism

status quo

Organizational planning

strategic planning extends 3-10 years into the future analysis of the environment, strengths, weakness, and threats to the organization determines the direction of the organization allocation of resources assigns responsibilities and determines time frames for accomplishments to be completed

Authoritative leaders

strong control do the planning, make decisions, give orders are directive, critical, and punitive decisions are not made in the best interest of the entire group think of themselves as being of higher level than the group do not develop personnel do not stimulate creativity, autonomy, or self-motivation

Task structure

the ability of a task to be defined and measured

Position power

the authority inherent in a position, the power to use rewards and punishment, and the organization's support of one's decision

Assigning

the process of transferring the authority, accountability, and responsibility of client care to another member of the healthcare team

Supervising

the provision of guidance, direction, oversight, evaluation, and follow up by the licensed nurse for accomplishment of a nursing task delegated to a NAP directing, monitoring, and evaluating

Situational and Contingency

the traits required of a leader differ according to the situation person may be a leader in one situation and a follower in another leader may be effective or ineffective based on the situation leader/member relations involve the amount of confidence and loyalty the followers have with their leader

*Things a manager should never delegate*

their own accountability discipline praise/recognition

Strategic planning involvement

top level managers board of directors input from subordinates from all levels

Delegating

transferring the authority to perform a selected nursing task in a selected situation *the nurse retains accountability for the delegation!*