Communications Final
Examples of successful nurse communication during the implementation phase of a new electronic medical record (EMR) include all of the following EXCEPT: "If you scroll down, you'll see an option to add a narrative note." "I filled out a feedback form to let someone know there is a glitch entering patient allergy data. Be careful in the meantime." "I'm having trouble logging in. Can you help me?" "I wish we could go back to the old paper system. I hate this new EMR."
"I wish we could go back to the old paper system. I hate this new EMR."
A learning organization can be described as all of the following EXCEPT: An organizational culture that embraces ongoing change and improvement An environment in which a deliberate commitment to learning is made A facility in which change and quality improvement are unrelated A place where staff are engaged with the purpose of what truly works best for the safest delivery of care
A facility in which change and quality improvement are unrelated
Examples of healthcare teams include: Select all that apply. Nurses in a home health agency Nurse managers from all patient care departments Staff in the central supply department
All
Changing an organizational culture from toxic to healthy: Involves leaving old perceptions, behaviors, and attitudes behind Requires creating a safe environment for change May take years to accomplish All of these answers
All of these answers
Quality improvement refers to any changes in the delivery of care that focus on doing a better job of: All of these answers Meeting the six aims promoted by the Institute of Medicine Ensuring care is timely, efficient, and effective Making sure care is safe, equitable, and patient-centered
All of these answers
Which of the following is NOT an example of a complex adaptive system? A nursing team A red blood cell A flock of birds An automatic external defibrillator
An automatic external defibrillator
All of the following are true about crew resource management (CRM) EXCEPT: CRM reinforces the importance of listening and speaking up as essential skills for effective teamwork. CRM involves training in group dynamics, leadership, and interpersonal communication. CRM is only applicable to teams that work in the field of aviation. CRM originated in the airline industry as an approach to improving safety.
CRM is only applicable to teams that work in the field of aviation
Leaders that focus on the complexity leadership model will (select all that apply): Emphasize a top-down command-and-control management style Create a positive culture Utilize communication strategies to support the properties of complex adaptive systems
Create a positive culture Utilize communication strategies to support the properties of complex adaptive systems
The Institute of Medicine (IOM) report Crossing the Quality Chasm: A New Health System for the 21st Century used principles of complex adaptive systems to describe a vision of a healthcare system in which care would be (select all that apply): Effective Exciting Equitable Efficient Timely Patient-centered Safe Compassionate
Effective Equitable Efficient Timely Patient-centered Safe
Potential benefits of an electronic medical record (EMR) include all of the following EXCEPT: Easy identification of a patient's need for health screening Elimination of potential for delayed treatment Ability to identify trends such as increase or decrease in weight Better tracking of patient information over time
Elimination of potential for delayed treatment
A healthy hierarchy is likely to promote all of the following behaviors EXCEPT: Leaders who value input from front-line caregivers Graduate nurses who are afraid that speaking up will lead to negative repercussions Staff who remind and are reminded by their colleagues to follow clinical protocols such as hand washing Patients who are comfortable speaking up to all members of the healthcare team about their concerns, ideas, and needs
Graduate nurses who are afraid that speaking up will lead to negative repercussions
All of the following statements are common in a culture of blame EXCEPT: "I need a few more minutes to finish documenting." "The reason the patient didn't get her pain medicine right away is because the nurse took too long with his admission." "If he had paid attention during the staff meeting, he would know how to use the glucometer." "The new nurse never restocks the med cart."
I need a few more minutes to finish documenting
Which of the following characteristics, adapted from the IOM publication Best Care and Lower Cost: The Path to Continuously Learning Healthcare in America, are necessary in order to achieve a continuously learning healthcare organization? Select all that apply. Incentives that are aligned with improvement goals Longer clinical rotations for nursing students Leadership committed to a continuously learning culture Patient and clinician partnerships Science and informatics Shorter clinical internships for medical students Elimination of urgent care wait times
Incentives that are aligned with improvement goals Leadership committed to a continuously learning culture Patient and clinician partnerships Science and informatics
Each leadership track in the American Nurses Association Leadership Institute programs includes the following domains: Leading others, leading the organization, leading the world Leading self, leading others, leading the organization Leading self, leading the organization, leading the world Leading self, leading others, leading nurse associations
Leading self, leading others, leading the organization
The IOM report The Future of Nursing: Leading Change, Advancing Health contained all of the following messages about the roles nurses should play EXCEPT: Achieve higher levels of education Maintain command-and-control management over nurse assistants Practice to the full extent of their training and education Be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the United States
Maintain command-and-control management over nurse assistants
Developing or changing leadership styles may require all of the following EXCEPT: Holding a meeting to make any new expectations clear Setting new boundaries Making sure that everyone approves of the changes Temporarily avoiding an affiliative approach
Making sure that everyone approves of the changes
All of the following are examples of student nurses using communication and emotional intelligence to build a foundation for leadership EXCEPT: Asking questions about the side effects of beta blockers Accepting constructive feedback about catheter insertion technique Forming a study group to study anatomy and physiology Memorizing the anatomy of the lymphatic system
Memorizing the anatomy of the lymphatic system
The mechanistic and linear way of studying systems arose from: Newtonian physics and reductionist philosophy Newtonian philosophy and organic chemistry Astrophysics and theology Reductionist philosophy and Greek mythology
Newtonian physics and reductionist philosophy
The Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health recommends which of the following resources for preparing nurses to assume leadership positions across all levels? Nursing associations, departments of public health, and consumer organizations Public, private, and governmental healthcare decision makers Nurses, doctors, and hospital administrators Nurses, nursing education programs, and nursing associations
Nurses, nursing education programs, and nursing associations
The study of complex adaptive systems involves theories and research from which of the following disciplines? Select all that apply. Nursing Medicine Biology Economics Behavioral sciences English Computer programming Mathematics
Nursing Medicine Biology Economics Behavioral sciences Mathematics
Based on Tuckman's model of team development, the forming stage: Select all that apply. Is often when groups need help with closure Occurs when the team initially comes together Is when team leaders should be clear with goals and expectations
Occurs when the team initially comes together Is when team leaders should be clear with goals and expectations
Which of the following are necessary for creating a safe environment for effective communication and collaboration? Select all that apply. A clear and compelling vision of what the environment will look like Ongoing enforcement of good conduct Termination of staff at the first signs of poor conduct A list of explicit and consistent expectations for behavior Acknowledgement of inappropriate behaviors Creation of a list of implicit rules desired Opportunities for training and practicing communication skills
Opportunities for training and practicing communication skills Ongoing enforcement of good conduct Acknowledgement of inappropriate behaviors A list of explicit and consistent expectations for behavior A clear and compelling vision of what the environment will look like
All of the following about the plan-do-study-act (PDSA) model as a method of quality improvement are true EXCEPT: Impact of change can be determined quickly. Changes can be made on a small scale. PDSA should be used primarily by nurse managers. PDSA was made popular by W. Edward Demings.
PDSA should be used primarily by nurse managers
Which of the following strategies could be used for building a sense of community at work? Select all that apply. Encourage an environment of trust Look for opportunities to celebrate Avoid constructive feedback loops Remind everyone about the importance of purpose Value individual difference Urge coworkers to share their stories Be inclusive Embrace conflict
Remind everyone about the importance of purpose Value individual difference Embrace conflict Be inclusive Encourage an environment of trust Look for opportunities to celebrate Urge coworkers to share their stories
Inappropriate use of the pacesetting style of leadership may lead to: Resentment Burnout Unsafe acts
Resentment Burnout Unsafe acts
The Transforming Care at the Bedside (TCAB) program resulted in nurses doing all of the following EXCEPT: Generating ideas for solutions Resorting to tried-and-true methods Spreading successful methods to other departments Identifying problems
Resorting to tried-and-true methods
Ways of applying knowledge of team development to busy and constantly changing nurse practice settings include all the following EXCEPT: Consideration of continuity of staff for patient care assignments Scheduling teambuilding exercises during the nurses' meal breaks Standardizing communication Empowering team members to share responsibility for clarity of team goals
Scheduling teambuilding exercises during the nurses' meal breaks
The core principles of applied improvisation have valuable learning experiences that involve all of the following EXCEPT: Assertiveness and listening Critical thinking and emotional intelligence Starting IV therapy Development of positive relationships
Starting IV therapy
TeamSTEPPS stands for: Team Strategies and Tools to Enhance Performance and Patient Safety Team Strategies and Tools to Evaluate and Promote Patient Safety Team Strategies and Tasks that Enable Professionals to Perform Safely Team Satisfaction and Tools that Enhance Performance and Patient Satisfaction
Team Strategies and Tools to Enhance Performance and Patient Safety
Which of the following factors complicate teamwork in healthcare? Select all that apply. Team members with varied educational backgrounds Differences of opinions among clinicians A very high-stakes system A culture of safety Professionals who have the same agenda Organizational tensions Responsibilities that are often urgent
Team members with varied educational backgrounds Differences of opinions among clinicians A very high-stakes system Organizational tensions Responsibilities that are often urgent
Examples of digital communication being used in healthcare include (select all that apply): Face-to-face conversations Telenursing Texting E-mail Twitter Blogging Handwritten prescriptions
Texting E-mail Twitter Blogging Telenursing
Team intelligence refers to: The active capacity of individual members of a team to learn, teach, communicate, reason, and think together irrespective of position in any hierarchy, in the service of realizing shared goals and a shared mission The collective educational background of individuals who make up a team and their respective commitment to achieving a shared goal and mission The understanding that individual expertise and position in any hierarchy is key to team performance in accomplishing a shared mission The potential capacity for team members to communicate and share their respective expertise with other team members
The active capacity of individual members of a team to learn, teach, communicate, reason, and think together irrespective of position in any hierarchy, in the service of realizing shared goals and a shared mission
All of the following are true about complicated systems EXCEPT: They have many distinct parts that exist separately They can be controlled and are predictable The parts adapt to changes in the environment If they break down, they are often fixed by repairing broken parts
The parts adapt to changes in the environment
Respectful listening and speaking up assertively are communication strategies related to complex adaptive systems in what way? They are properties of linear systems that are well understood. They are simple rules that humans can follow. They are behaviors arising from command-and-control management. They are theoretical proposals associated with complexity science.
They are simple rules that humans can follow.
According to Boonstra and Broekhuis, main categories of barriers to implementing an electronic medical record (EMR) include (select all that apply): Time Visibility Decorative Technical Social Organizational tensions Psychological Biological
Time Technical Social Organizational tensions Psychological
An open and fair environment that encourages learning and managing behavioral choices is descriptive of: None of these answers A hospital department with hierarchal power dynamics A facility in which differences exist because of status A just culture
a just culture
In an organization with a healthy culture, patients and families are likely to experience all of the following EXCEPT: A sense of being welcome A sense that staff are too busy to help Timely and compassionate answers to questions Staff working together respectfully and effectively
a sense that staff are too busy to help
Keeping a patient's identification barcode on a stethoscope for easy access is an example of: Nurse feedback A great way to save time Nurse initiative A workaround
a workaround
All of the following are used in the Agency for Healthcare Research and Quality's (AHRQ) description of a culture of safety EXCEPT: A blame-free environment Organizational commitment to provide resources necessary for safe care Acceptance of mistakes as a cost of doing business Encouragement of collaboration across ranks and disciplines
acceptance of mistakes as a cost of doing business
Sharing and learning are inherent in which property of complex adaptive systems? Adaptability Conformity Diversity Agility
adaptability
A nurse manager says to a nursing assistant, "Are you okay? I know you were close to Mrs. Jones during her dying process." The nursing manager is demonstrating which style of leadership? Commanding Affiliative Transformative Visionary
affiliative
Areas in which nurses can make quality improvement efforts that have a positive impact include: Select all that apply Direct care processes Teaching methods in nursing education Shifting organizational cultures from toxic to healthy Healthcare financing
all
Organizational culture contributes to: A.The way people interact B.How things get done C.What kinds of feelings are evoked in observers D.All of the above
all of the above
self care should be an inherent part of every nursing: -recommendation -treatment -intervention -all of the above
all of the above
A command-and-control hierarchy: Select all that apply: Makes sense in some situations and is contraindicated in others Has roots in the military Is often accompanied by a false sense of superiority on the part of leaders and inferiority on the part of followers
all of these
subcategories of human factors involved in root causes of sentinel events tracked by The Joint Commission that may involve communication and human behavior include which of the following? Select all that apply -complacency -staff supervision -distraction -rushing -staff orientation -fatigue -staffing levels -assessment
all of these
Advances in health information technology: Offer the possibility of safe, more informed, and streamlined care Present challenges in terms of implementation, standardization, utilization, and patient safety All of these answers Provide easy access to huge volumes of rapidly evolving information
all of these answers
Linear thinking has contributed to: Hierarchal business structures The development of separate departments in hospitals Discipline-specific educational programs for healthcare professionals All of these answers
all of these answers
New nurses should expect to be treated respectfully by all seasoned nurses while also keeping in mind that many seasoned nurses may: Have witnessed much heartache and grief Try to seek validation of their own bad experiences by exposing new nurses to similar ones Have been treated disrespectfully All of these answers
all of these answers
The behavioral approach to communication is relevant to relationships in complex adaptive systems where nurses practice because it promotes: Forgiving self and others, being assertive, and listening respectfully All of these answers Appreciating differences, receiving constructive feedback, and behaving respectfully Learning from mistakes, asking for help, and offering constructive feedback
all of these answers
as a subcategory under leadership as a root cause of sentinel events, resource allocation may involve communication and behavior in terms of: -all of these answers -the skills that stage have to ask for the resources they need -the relationships between management and staff -the skills that managers have to listen to requests for resources
all of these answers
the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health highlights the value that nurses bring to healthcare in which of the following ways? Direct interfaces with patients along the continuum of care All of these answers Prevention of illness Managing chronic illness
all of these answers
All of the following must take place in order to shift from a toxic to a just culture EXCEPT: Ancillary staff remaining passive Physicians sharing leadership power Nurses taking on more responsibility Effective and respectful communication becoming the norm
ancillary staff remaining passive
Differences in status in a just culture are: Select all that apply. Reflected in bullying behaviors Based on expertise Not fueled by unhealthy egos Randomly assigned
based on expertise, not fueled by unhealthy egos
since the late 1900s until now, the overall changes associated with patient safety would best be described as: -none of these answers -significantly improved -significantly worse -better in some areas and worse in others
better in some areas and worse in others
All of the following statements are common in a culture of bullying EXCEPT: "Can you cover for me while I take my break?" "Stop complaining. Dr. Smith has favorites and that's the way it is." "Jillian, as usual, is not capable of getting out on time." "If you want this job, you'll have to stop being so sensitive."
can you cover for me while I take my break?
The emergency room doctor and nurses work together with paramedics to get a trauma victim off the ambulance gurney. Simultaneously, the paramedics and nurses continue CPR while the doctor orders stat x-rays, blood work, and an ortho-surgical consult. This set of activities is an example of all of the following EXCEPT: Emergence Self-organization Command-and-control hierarchy Diversity
command and control hierarchy
the definition of patient safety as defined by the Quality and Safety Education for Nurses (QSEN) Institute includes all of the following EXCEPT: -system effectiveness -comprehensive data review -minimizing risk of harm to patients and providers -individual performance
comprehensive data review
The following communication strategies and behaviors are likely to contribute to successful implementation of any health information technology EXCEPT: Conflict is avoided Staff are collaborating to solve problems Opportunities exist for quick and meaningful feedback loops between users and developers Stakeholders are engaged
conflict is avoided
The leadership style that focuses on engaging everyone's knowledge and skills, and creating a group commitment to intended goals is called: Coaching Pacesetting Democratic Visionary
democratic
for the purposed of Successful Nurse Communication, specific sentinel even data is being isolated with the explicit intention of: -building the reputation of the joint commission -teaching students how to track sentinel events -demonstrating links among patient safety, sentinel events, and communication and human behavior -all of these answers
demonstrating links among patient safety, sentinel events, and communication and human behavior
A commanding leadership style has negative consequences to consider but can be appropriate (select all that apply): During clinical emergencies When time isn't available for coaching If everyone on the unit is expected to work overtime When someone is too tired to be a visionary leader To demonstrate to consumers the value of command-and-control management If staff are bombarding the nurse with non-essential questions
during clinical energies if staff are bombarding the nurse with non-essential questions if time isn't available for coaching
Implementing the action plan on a pilot basis and installing an ongoing measuring/monitoring system to ensure success represents which step in the focus-analyze-develop-execute (FADE) model for quality improvement? Develop Execute Analyze Focus
execute
T/F: A nurse who resists change covertly or overtly has no power
false
T/F: Applying the principals of team development are not feasible given the endless emergent tasks and constant change involved in nursing practice
false
T/F: Making people with less power responsible for equalizing power is an effective way to shift out of a culture of bullying.
false
T/F: When complex adaptive systems break down, it is most effective to get them under control so the parts can be analyzed and fixed.
false
T/F: the phrase "do no harm" was first expressed by Florence Nightingale in the mid-1800s
false
root cause analysis is a process of inquiry and review that is initiated after an error and seeks to answer the question: -who is responsible for the error? -how and why did this error take place? -what information do patients need to know about what happened? -how much is it going to cost to prevent future errors like this?
how and why did this error take place?
an examination of sentinel events data reported by The Joint Commission in 2011, 2012, and 2013 reveals which of the following are the leading root causes involving all types of events? -communication, human factors, unintended retention of a foreign body -leadership, delay in treatment, human factors -leadership, human factors, post-operative infections -human factors, leadership, and communication
human factors, leadership, and communication
Communication and collaboration are vital to a culture of safety because speaking up and listening leads to: Select all that apply. Finding the right person to blame for errors Identification of problems Opportunities for learning Prevention of errors
identification of problems, opportunities for learning, prevention of errors
the institute of medicine (IOM) considers quality of care to be: -expensive -inseparable from patient safety -a low priority -a luxury
inseparable from patient safety
an operating nurse who does not speak up to a surgeon before a wrong site sentinel event happens: -may indicate a symptom of underlying negative dynamics and poor communication within the operating room team -is incompetent and should be discriminated -is probably responsible for many errors for which the surgeon will be blamed -all of the above
may indicate a symptom of underlying negative dynamics and poor communication within the operating room team
Teams are characterized by all of the following EXCEPT: Goals Meeting times Membership roles Norms
meeting times
At-risk and intentional behavior is: Often insidiously developed as a bad habit over time The same as reckless behavior A method nurses use to provide quality and safe care None of these answers
often insidiously developed as a bad habit over time
Senge's concepts about learning organizations, continuing education, sharing ideas, and listening respectfully to others are most strongly associated with: Mental model Team learning Shared vision Personal mastery
personal mastery
The following progressive leadership tracks are promoted by the American Nurses Association Leadership Institute EXCEPT: Advanced Preparing Developing Emerging
preparing
the mission of the Agency for Healthcare Research and Quality (AHRQ) is to: -provide technological advances that support safe care -produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable -produce evidence to make healthcare safer, while maintaining quality and cost effectiveness -eliminate wasted resources and optimize research data
produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable
A nurse sees a patient wandering in the hall with an IV pole and stops to find out if he needs anything. This nurse is: Select all that apply. Interfering with another nurse's patient assignment Reflecting behavior typical in an organization that has a positive culture Giving a positive message to the patient that he is cared about and for Wasting time
reflecting behavior typical in an organization that has a positive culture, giving a positive message to the patient that he is cared about and for
The leadership model that emphasizes collaboration, community, and inclusion in decisionmaking, and promotes respect of self and others is: Professionals who have the same agenda Servant Transformational Complexity
servant
Tension, conflict, and competition for status occur during the following stage of team development: Performing Adjourning Storming Norming Forming
storming
A nurse reminds a colleague about a family member's concern about a patient's hydration. On the way to assess the patient, the colleague grabs a juice for the patient, which leads to the family member feeling assured that the team is listening to his concerns. The patient's hydration status stabilizes, contributing to the IV being discontinued, a shorter hospital stay, and positive responses on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This series of actions is an example of: Adaptability The butterfly effect Self-organization The mysterious nature of complexity science
the butterfly effect
All of the following statements describe explicit rules in an organizational culture EXCEPT: They are visible to staff an visitors. They are designed to ensure safe and quality care. They are not discussed openly. They provide clear expectations about what the culture should be.
they are not discussed openly
In an ideal healthcare organizational culture, which of the following are likely to be common occurrences? Select all that apply. Timely and compassionate response to patient needs Gossiping Ownership of mistakes Disrespectful communication Offers to help Requests for help Timely response to patient needs and requests
timely and compassionate response to patient needs, ownership of mistakes, offers to help, requests for help, timely response to patient needs and requests
which of the following are important reasons for gaining a firm grasp on the interrelationship between sentinel events and communication? Select all that apply. -to prevent errors -to raise awareness about the many categories of root causes of sentinel events -to promote nursing students' commitment to practicing effective communication -to become familiar with the joint commission web site -to help in discovering all contributing factors to medical errors
to prevent errors, to promote nursing students' commitment to practicing effective communication, to help in discovering all contributing factors to medical errors
the Joint Commission...(select all that apply) -tracks mandatory reports of adverse events -tracks root causes of sentinel events -tracks voluntary reports of sentinel events -does not track sentinel events
tracks root causes of sentinel events and tracks voluntary reports of sentinel events
T/F: All practicing nurses must be prepared to take on leadership roles and responsibilities
true
T/F: An understanding of systems thinking, according to the Institute of Medicine (IOM) report The Future of Nursing: Focus on Education, "must become part of every nurse's professional formation."
true
T/F: By choosing a career in nursing, students are already on a leadership path
true
T/F: In a toxic culture, poor behaviors and lack of effective conflict management are ongoing phenomena.
true
T/F: Nurses who practice effective communication and understand their roles as potential change agents will be better prepared for initiating, supporting, and evaluating ongoing quality improvement efforts.
true
T/F: Reasons that contribute to groups getting stuck in the storming stage of team development include previous unresolved conflicts among team members and lack of clear expectations
true
T/F: making long-term meaningful improvement in patient safety requires changing the underlying human dynamics involved in individual and organizational behavior
true
T/F: the Joint Commission is an independent organization that accredits and certifies healthcare organizations and programs in the United Stated
true
Leaders who are learning to share power and staff members who are learning to take on more power during a culture change must learn to deal with: All of these answers Technology Vulnerability Dependency
vulnerability
TeamSTEPPS is taught in a three-phased process involving all of the following steps EXCEPT: Workload management A pre-training assessment Implementation and sustainment Training for on-site trainers and staff
workload management
