Leadership & Safety
What is a near miss?
a potential error or event or circumstance that could have caused harm but was caught and avoided; should still be documented.
What is collaboration?
Two or more people working toward a common goal by combining skills, knowledge, and resources while avoiding duplication of effort.
Define conflict:
A struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands.
What is a delgation?
A transference of responsibility and authority for an activity to a competent individual.
Which of the following is NOT one of the Five Rights of Delegation? A) Right reason B) Right person C) Right task D) Right communication
A)
A nurse is planning care for a hospitalized client who is immobile and in a continuous mitten restraint. Which of the following interventions should be included in the client's care plan? (Select all that apply.) A) Document restraint checks and client status every 2 hr. B) Educate the client's family about restraint use. C) Obtain the provider's prescription renewal every 72 hr. D) Implement passive range-of-motion exercises.
A), B), D)
What is a referral?
An authorization for a patient to receive specialized services from another practice when the problem is beyond the initial provider's expertise.
What is safety culture?
An environment in which mistakes are acknowledged, there is no retribution/fear, and there are resources dedicated to improve.
Define delegator:
An individual that assigns a task yet still retains accountability for ensuring its completion.
What is responsibility?
An obligation to perform work, duties, or tasks using sound professional judgement.
What are the five rights of delegation?
1. Right Task 2. Right Circumstances 3. Right Person 4. Right Communication 5. Right Supervision
A nurse is caring for an older adult client who was alert and oriented at admission but now seems increasingly restless and intermittently confused. Which of the following actions should the nurse take to address the client's safety needs? A) Call the family and ask them to stay with the client. B) Move the client to a room closer to the nurses' station. C) Apply wrist and leg restraints to the client. D) Administer medication to sedate the client.
B)
What is accountability?
Being answerable for the outcomes of a task or assignment.
A charge nurse is reviewing the list of tasks that have been delegated to the assistive personnel (AP) by the staff nurse. Which of the following tasks should the charge nurse reassign to a licensed nurse? A) Transporting a client who experienced a stroke 72 hr ago to the radiology department B) Providing a back rub to a client who has right-sided paralysis C) Removing and cleaning the cannula of a client who has a new tracheostomy D) Performing oral hygiene for a client who is 1-day postoperative following amputation of the right arm
C)
A nurse is delegating client care assignments for the shift. Which of the following tasks should the nurse delegate to assistive personnel (AP)? A) Perform wound irrigation for a client. B) Evaluate pain relief for a client following the administration of pain medication. C) Measure and record intake and output for a client. D) Teach a client about low-sodium foods
C)
A nurse in an acute care setting is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the assistive personnel (AP)? A) Application of antibiotic ointment to the arm of a client who has dermatitis B) Obtaining medical history information from a stable client who is being admitted C) Monitoring vital signs of a client who had an appendectomy 12 hr ago D) Removal of the nasogastric tube of a client who has been receiving enteral feedings
C)
A nurse is caring for a client who frequently attempts to remove his IV catheter. A family member requests that the nurse apply restraints. Which of the following responses should the nurse make? A) "I'll provide more stimulation in his environment." B) "I will call the doctor and get the prescription." C) "I will cover the catheter so he cannot see it." D) "Let's wait until tonight to see if he continues this behavior."
C)
True or False. A licensed nurse cannot delegate any activity that requires clinical reasoning, nursing judgement or critical decision making.
True.
Define delegate:
A capable individual that assumes responsibility for a task.
What is a formal leader?
A leader selected by an organization, and given official authority to make decisions, etc. (ex: manager).
What is an informal leader?
A leader who is not officially appointed but recognized by a group as a leader because of a combination of factors (such as talent, ability, seniority, or age).
A nurse manager is providing an in-service program about delegation to assistive personnel (AP) with staff nurses on the unit. Which of the following statements by a staff nurse indicates an understanding of the teaching? A) "The nurse relinquishes accountability for client outcomes when care is delegated to an AP." B) "The AP can provide client education about how to perform basic self-care to the client." C) "The nurse should consider the AP's level of experience when making delegation decisions." D) "The AP can re-delegate a task to another AP who has similar work experience."
C)
What is an intergroup conflict?
Conflict amongst multiple people in a group.
What is an interorganizational conflict?
Conflict amongst two different organizations/facilities.
What is an interpersonal conflict?
Conflict amongst two people.
A nurse checks with assistive personnel on the unit throughout the shift to determine if they are completing tasks. The nurse is demonstrating which of the following rights of delegation? A) Right circumstances B) Right communication C) Right person D) Right supervision
D)
A nurse is teaching a client who has a history of falls about home safety. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A) "I will keep my walker at the end of my bed." B) "I will keep the fluorescent ceiling light on in my room at night." C) "I will place an area rug at the entrance of my bathroom." D) "I will place a bath seat in my shower to use when I bathe."
D)
At the beginning of the shift, an RN is preparing assignments for a licensed practical nurse (LPN) and assistive personnel (AP). Which of the following tasks should the nurse assign to the LPN? A) Providing postmortem care for a client B) Measuring a client's I&O C) Obtaining a client's weight D) Inserting a nasogastric tube for a client
D)
Who is ultimately accountable for the outcome of delegation? A) The health care provider B) The health care employer C) The nurse leader D) The nurse who delegates the activity
D)
What is safety?
Decreasing risks of dangers or hazards to prevent accidents, injuries, mistakes, and harm.
What is an intrapersonal conflict?
Internal conflict within a person.
What can be delegated to the LPN?
Monitor findings Reinforce teaching Perform trach care and suction Insert a urinary catheter Insert an NG tube Administer medication (may exclude IV medications - per state guidelines)
What is the Joint Commission's Speak Up acronym?
Speak up Pay attention Educate Ask Know Use Anticipate
What can be delegated to a UAP?
Taking VS Measuring, recording I&Os Patient transfers and ambulation Postmortem care Bathing Feeding Weighing
What is leadership?
The process by which nurses use a set of skills that direct and influence others in the provision of individualized, safe, quality client care.
What is Zero Harm?
The workplace itself has been designed in a way that ensures there's little to no risk involved in any and all operations.
What are some causes of conflict?
miscommunication inaccurate information mistrust ambiguous role expectations ineffective leadership resistance to change lack of accountability role of boundary issues
The goal of collaboration in healthcare is to ______ patient outcomes.
improves