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