Leadership Exam 1

D. Strategic management involves strategic planning and implementation.

*A business approach that ensures a competitive advantage over similar enterprises involves conducting an environmental scan, knowing the competition, establishing goals, setting targets, developing an action plan, implementing the plan, and evaluating success. Which of the following statements is correct?* A. The best strategic planning is from the top down. B. The strategic planning process is threatening to employees and creates decreased job satisfaction. C. A basic form of strategic planning is a detailed written business plan with a comprehensive market analysis. D. Strategic management involves strategic planning and implementation.

A, B

*A client becomes confused after surgery. He is in a room farthest away from the nurses' station. The client tries to get out of bed several times during the shift. The nurse informs the physician and obtains an order for soft restraints. In addition she moves the client close to the station and assigns a sitter to watch him. Which of the following did the nurse utilize? (Select all that apply.)* a. Clinical judgment b. Clinical decision making c. Autocratic decision d. Financial decision

A. Case management

*A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet multiple service needs of clients and families is known as:* A. Case management B. Total client care C. Private duty nursing D. Managed care

Transforming Care at the Bedside (TCAB)

*A continuous improvement process which engages clinicals at the bedside in the design and implementation of new work practices describes?* PDSA Transforming Care at Bedside (TCAB) Six Sigma LEAN

A planned change

*A deliberate effort to improve the system would be considered?* A planned change Transformation Change agent Resistance

B.

*A family member of a patient files a complaint that her mother's dentures were lost when the patient was transferred from one unit to another. The risk management department interviews the patient and the staff nurses who cared for the patient. Which of the following problem-solving techniques was used?* a. Delegation b. Direct intervention c. Indirect intervention d. Purposeful inaction

C

*A long-term care facility has been busy for several months with patients who have a very high acuity. Nurses have been working double shifts. The nurses have been given the task of determining whether they would like to implement an on-call program and determine guidelines for implementation, if most nurses believe that it is the best solution. This example depicts which type of decision-making tool?* a. Pilot project b. Simulation c. Shared governance d. Data analytics

B. Transforming the Care at the Bedside

*A med surg unit forms a team of nurses to implement bedside rounds at shift change. The nurses research the efficacy of bedside rounding and determine that this evidence based practice will lead to improved communication of client status. What type of change is described?* A. Second order change B. Transforming the Care at the Bedside (TCAB) C. Emergent change D. Organizational change

B

*A multidisciplinary team makes a decision to develop a plan for the use of thrombolytics in the emergency medical service system. Questions are asked such as, "Is the client a candidate for thrombolytic therapy? Does the client have a history of gastrointestinal bleeding? Has the client ever had a stroke? Does the client have any bleeding disorders?" Which of the following decision-making strategies would work best in this situation?* a. Fishbone diagram b. Decision tree c. Flowchart d. Data analytics

D. fish bone charts

*A number of decision-making strategies have been identified for clinical and managerial decision making. An effective strategy for nurse managers to select in examining possible causes related to delivery of services would be:* A. pilot projects B. cost-benefit analysis C. scenario planning D. fish bone charts

B.

*A nurse manager has ordered equipment for a new unit. The company has sent two notices that the equipment is on back order. The nurse manager is debating whether to wait for the equipment on back order or to cancel the order and go with another company. She discusses this issue with another nurse manager and they determine that the equipment is urgent for patient safety in the new unit. The manager orders the necessary equipment from another company even though it is slightly more expensive. This is an example of:* a. clinical decision making b. prioritization c. triage decision d. clinical reasoning

B. Clinical judgment

*A patient has arrived at the critical care unit with a head injury. On admission, the patient is talking and is a little drowsy but oriented. Two hours later, the nurse discovers that the patient is talking at a rapid pace and keeps repeating his words. When the nurse recognizes the change and deploys the rapid response team and physician, which skill is being demonstrated?* a. Leadership b. Clinical judgment c. Clinical decision making d. Management

C. authoritarian

*A patient just had a stroke and they are complaining of a massive headache. The nurse asks the unit coordinator to contact the healthcare provider. What kind of leadership style is this?* A. laissez faire B. servant C. authoritarian D. democratic

Six Sigma

*A quality and decision support technique that uses data to build process-improvement models with the goal to eliminate defects in safety and quality is?* Magnet Status LEAN Six Sigma HCHAPS

A. This leader tailors his or her leadership style based on the employee, experience, and circumstances.

*A situational leader can best be described by which of the following statements?* A. This leader tailors his or her leadership style based on the employee, experience, and circumstances. B. This leader requires minimal participation and directing, resulting in high productivity. C. This leader is one who motivates employees to their full potential. D. This leader advances innovative changes and sustains good care delivery processes.

Pilot Project

*A small trial prior to mass roll-out in an organization would be an example of which of the following?* Pilot Project Root Cause Analysis Clinical Reasoning Trial and Error

A. Decision making

*A staff RN is leading a quality improvement team on the care of the total hip replacement patient. The issue is an increased length of stay from 1 year ago. The nurse asks team members to reframe the problem statement from their perspective. Twenty different problem statements were developed. The team is focusing on four of the problem statements. This is an example of which of the following techniques?* a. Decision making b. Evaluating the consequences c. Inclusive judgment d. Problem processing

C

*A team consisting of preoperative, operative, and postoperative health care professionals and ancillary staff is examining the turnaround time from the preoperative area to discharge for patients having tonsillectomies. The goal is to decrease waiting times for clients. The team comes up with a solution and wants to test it on a small group of patients before rolling it out to the rest of the department. What type of decision-making tool is exhibited?* a. Shared governance b. Evidence informed c. Pilot project d. Trial and error

B. Economic perspective of decision making and maximum utility.

*A transformative leadership style influences the effectiveness of group decision making. The rational group decision-making model is based on which of the following?* A. Power, influence, negotiation, bargaining, and interest group influence B. Economic perspective of decision making and maximum utility C. Difficulty identifying and resolving problems due to ambiguity, complexity, and illogical step taking D. Use of standard operating procedures and guidelines

In the first stage

*Accepting the need for change when dealing with a planned changed should be done when?* As the last step Not needed In the first stage While implementing

C. It includes only financial goals.

*All of the following are true about strategic management except:* A. It involves establishing goals and setting targets. B. It allows an organization to obtain and maintain a competitive advantage. C. It includes only financial goals. D. It requires implementation and evaluation.

Shared governance

*An example of staff empowerment would be:* Analyzing data trends Providing "sandwich" feedback Shared governance

D

*An intravenous infusion center is considering switching intravenous pumps to another vendor. A team of nurses is gathered to examine the benefits and uses and to conduct a cost analysis of various intravenous pumps. After thoroughly reviewing the data and piloting several intravenous pumps, the team votes to determine which pumps to use. The nurses selected the pump which provides them with the most safeguards for safe infusion delivery. Which type of decision-making tool was used in this process?* a. Simulation b. Pilot project c. Data analytics d. Evidence informed

Clinical reasoning

*Analyzing and synthesizing cues about patients, also influenced by a nurse's experience and education* Clinical judgment Clinical reasoning Clinical decision making

B. Decision making is used to solve problems.

*Any decision in a chaotic health care delivery environment may cause an unanticipated future problem. Identify the true statement about decision making.* A. Decision-making strategies are interchangeable and can be used effectively in any situation. B. Decision making is used to solve problems. C. Decision making must be even more deliberative when problems require urgent action. D. Decision making is not a behavior but rather a method in selecting and implementing a course of action from alternative courses of action for dealing with a situation or problem.

A climate of safety

*Being able to report a near-miss adverse event without fear of repercussion would be an example of?* A climate of safety A fantasy JC requirement

Rapid Cycle Change

*Brainstorming ideas, trying a potential change, and testing its effectiveness would be an example of?* Rapid Cycle Change Lewin's Model of Change Kotter's Model of Change Roger's Diffusion of Innovation theory

A. Resistance can be useful and should be listened to and analyzed. D. Too much change is disruptive and can result in disorganization.

*Change behaviors displayed in a variety of ways. Identify the two correct statements (SATA).* A. Resistance can be useful and should be listened to and analyzed. B. Resistance most commonly arises because individuals are trying to gain more power. C. Changing individual behavior requires less time and energy. D. Too much change is disruptive and can result in disorganization.

D. Seeks out knowledgeable experts E. Comfortable w/ uncertainty

*Change behaviors displayed in a variety of ways. Identify the two correct statements on how leaders identify, support, and promote innovators. (SATA)* A. Resistance to questioning common practices B. Resistance most commonly arises because individuals are trying to gain more power. C. Changing individual behavior requires less time and energy. D. Seeks out knowledgeable experts E. Comfortable with uncertainty

C. Change is inevitable & is necessary for organizational viability. D. Individuals become aware of the need for change when needs are unmet.

*Change is inevitable in health care, just as it is in life. Which two statements are true about change? (SATA)* A. Change is a linear process requiring a series of discrete steps. B. Change occurs in a logical, planned manner. C. Change is inevitable and is necessary for organizational viability. D. Individuals become aware of the need for change when needs are unmet.

D. Culture and climate can both be measured.

*Climate is often confused with culture. Which statement best describes aspects of climate?* A. Culture is the perceptions of the work environment, and climate is the personality of the organization. B. Climate is the shared beliefs, values, and assumptions that exist in an organization. C. Climate enhances the stability of a social system, and culture is the voice of the organization. D. Culture and climate can both be measured.

to be a career-long development

*Clinical reasoning is considered* to be a career-long development occurs only after expertise has been gained

B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments.

*Critical thinking is central to decision making. Which of the following is a true statement?* A. Critical thinking and creative problem solving are the same. B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments. C. A critical thinker sustains the norm or status quo. D. Clinical decision making is the same thing as diagnostic reasoning.

D. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization.

*Culture is a concept that is best portrayed in nursing with which of the following statements?* A. Culture provides a common bond so members know how to relate to one another and what is valued. B. A relationship-based nursing care model is used, which represents a belief in patient-centered care. C. Culture is a multifaceted phenomenon, difficult to comprehend. D. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization.

Prioritization

*Deciding between providing routine hygiene being omitted in order to pass medications timely would be an example of?* Prioritization Patient abandonment Poor time-management

D. Critical pathways are a type of decision tree.

*Decision-making tools and strategies support the process for decisions. Select the one statement that is true.* A. Group decision making tends to be more ineffective for system problems. B. All decision tree questions have a yes or no answer. C. Managers who use trial and error as the usual strategy for decision making often are effective. D. Critical pathways are a type of decision tree.

B. Self-awareness

*Effective leadership is exemplified by values, confidence in employees, and a sense of security in the face of uncertainty. This aspect of leadership is known as:* A. Relationship management. B. Self-awareness. C. Social awareness. D. Self-management.

C. Six Sigma

*Effective managers utilize a wide array of data in making decision. Which of these techniques is used to build process improvement models?* a. Incrementalism b. Scenario planning c. Six Sigma d. Budgetary model

B. Learning organizations.

*Empowerment and shared decision making are practices found in:* A. Small organizations. B. Learning organizations. C. Innovative organizations. D. Stagnant organizations.

B. Communicating vision and strategy internally, translating vision into strategy, building effective teams, managing patient-centered customer focus, and managing conflict

*Five competencies were identified by nurse leaders in recent research. What are those competencies?* A. Building effective teams, empowering workers, decision making, communicating, and managing conflict B. Communicating vision and strategy internally, translating vision into strategy, building effective teams, managing patient-centered customer focus, and managing conflict C. Managing conflict, analyzing performance, guiding and empowering workers, sharing a vision with workers, and directing operations D. Focusing on patient and customer, directing and guiding workers, building effective teams, managing conflict, and analyzing performance

C. Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. D. Great leaders possess a combination of hardiness and the ability to grasp context, called "adaptive capacity."

*Great leaders possess four essential skills. Identify two statements that describe those skills. (SATA)* a. Great leaders possess popularity to establish followers to engage. b. Great leaders are visible, set examples, and share responsibility. c. Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. d. Great leaders possess a combination of hardiness and the ability to grasp context, called "adaptive capacity."

A. Diagnosing C. Adapting D. Communicating

*Hersey and colleagues identified three skills needed for leading or influencing workers. Identify three skills leaders must possess to influence people. (SATA)* A. Diagnosing B. Directing C. Adapting D. Communicating

D

*How is SBAR used in decision making?* a. Prevents cognitive errors b. Data management tool c. Financial tool d. Effective communication technique

A. The staff nurse adapts to a challenging patient assignment

*How is decision making at the staff nurse level exemplified?* a. The staff nurse adapts to a challenging patient assignment. b. The staff nurse refers issues to the performance improvement committee. c. The staff nurse accepts the status quo. d. The staff nurse questions current practice and refers to unit leadership for change.

B. A Root Cause Analysis

*Identify the process that is used to determine the origin of errors with the focus on prevention:* A. A simple investigation B. A Root Cause Analysis C. Volunteering Reporting Program D. Administrative review

A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships.

*Identify the statements about organizational culture that impact nursing practice. (SATA)* A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships. D. Organizational culture means there are hidden assumptions about care that should not be questioned.

C. Integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service.

*Implementation of a strategic plan can be accomplished when a priority order for achieving the strategic objectives or outcomes exists, responsibility for achieving these objectives has been determined, and some available financial support is provided within an expected timetable. The role of nurses would include:* A. Finding out who is responsible for the implementation. B. Waiting to implement until administration develops an action plan that breaks the plan into manageable parts. C. Integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service. D. Waiting until the workable action plan is presented by nurse leaders.

B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes. C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination.

*Important decisions are made by nurses. Which of the following are examples of collaborated decisions? (SATA)* A. Devise an array of plans to optimize client recovery, mobility, and self-care; maintain airway patency and hemodynamic stability; and prevent the development of decubitus ulcers. B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes. C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination. D. Diagnose and document client needs for health promotion, risks, and problems. E. Smart alerts and drug alerts within health information systems.

A. Challenge the process, inspire a shared vision, model the way, enable and trust others to act and encourage others work-outcomes

*In one research-based model, which of the following behaviors were core to clinical leadership success* A. Challenge the process, inspire a shared vision, model the way, enable and trust others to act and encourage others work-outcomes B. Build an interdisciplinary team, engage in strategic planning and data mining, motivate workers, develop culture and trust. C. Analyze processes and outcomes, model trust and honesty, engage in performance management and continuous improvement, and communicate the vision D. Build interdisciplinary team, model trust and honesty, motivate workers, guide performance management, analyze processes and outcomes, conduct stakeholder analysis, and strategically plan.

A. Visioning, interactive planning, workload complexity analysis, interdisciplinary team building, work process analysis, stakeholder analysis, and trust

*In one research-based model, which of the following behaviors were core to clinical leadership success?* A. Visioning, interactive planning, workload complexity analysis, interdisciplinary team building, work process analysis, stakeholder analysis, and trust B. Interdisciplinary team building, strategic planning, data mining, motivating workers, developing culture, and trust C. Analysis of process and outcomes, trust and honesty, performance management, continuous improvement, and communicating the vision D. Interdisciplinary team building, trust and honesty, motivating workers, performance management, analysis of processes and outcomes, stakeholder analysis, and strategic planning

B. Laggards

*Individuals in a nursing unit adapt to change at different rates. Identify which group will take the longest to adapt to change* A. Early adopters B. Laggards C. Late majority D. Innovators

Clinical judgment

*Interpreting information of patient problems and needs describes which of the following?* Clinical judgment Clinical reasoning Clinical decision making

C. Providing reliable information and details to those who are to implement the change and understand their view of expectations and plan adequate, timely education on the changed

*Leaders are change agents and have a role in change that includes which of the following?* A. Motivating staff through posting notes and expectations on the change for others to read in the usual communication place B. Avoiding having the groups participate with details until they have to implement the change C. Providing reliable information and details to those who are to implement the change and understand their view of expectations and plan adequate, timely education on the changed. D. Posting the change steps for others to read in the usual communication place and avoid setting expectations or promises.

A. Allocating resources, negotiating contracts, handling disturbances, and proposing new services are decision-making roles

*Management is often described in three core roles. Select the statement that is true.* A. Allocating resources, negotiating contracts, handling disturbances, and proposing new services are decision-making roles. B. Monitoring processes, disseminating guidelines, and motivating nurses in organizations, states, and nationally or internationally are interpersonal roles. C. Representing nurses, leading nurses, and associating information technologies are informational roles. D. Providing care, coordinating time for patients, and interacting with physicians, pharmacists, and clients are caregiving roles.

direct intervention

*Management making a decision, such as requiring disciplinary action would be an example of?* direct intervention indirect intervention delegation

B. Communicating accurate information to engage staff and overcome misunderstanding regarding the need for change

*Managers who proceed with a change can best engage staff and prevent resistance by doing which of the following?* A. Assisting the executives with controlling change communication and limiting the staff involvement B. Communicating accurate information to engage staff and overcome misunderstanding regarding the need for change C. Expecting that frustration, aggression, or indifference is a phenomenon of the change experience for staff D. Determining what the resistant person is trying to protect, such as employment or control of processes

A. Rising rates of obesity, patient-centered care, and accountable care organizations

*Many trends will impact health care in the United States and foster leaders to innovate and change. Which trends require innovation towards preventive and wellness health care services?* A. Rising rates of obesity, patient-centered care, and accountable care organizations B. Aging population, increased numbers of veterans with posttraumatic stress disorder (PTSD) and traumatic brain injury, pay-for-performance, focus on safety and quality, and medical homes C. Advances in genomics, integrative medicine, and increased emphasis on evidence-based interventions D. Advances in technology with HIE networks, personal health records, EHRs, and telehealth

A. 2 B. 7 C. 6 D. 3 E. 1 F. 4 G. 5

*Match the letter with the correct response* A. Leadership B. Management C. Followership D. Empowerment E. Authoritarian F. Democratic G. Laissez-faire 1. Decisions made by the leader, and followers told what to do 2. Process of Influencing people to accomplish goals 3. Instilling in people belief and confidence in their own ability to achieve 4. Coordinating and facilitating teamwork and group decision making 5. Complete freedom of individuals to make choices without direction or interference 6. Interpersonal process of participation 7. Coordination of resources by planning, organizing, coordinating, directing, and controlling

Change Agent

*Modeling behavior and encouraging others to adapt would be an example of?* Laggard Resistor Change Agent Followers

nurse managers

*Name this position* Concentrate on day-to-day administration and coordinate services provided by a group of nurses by integrating human, fiscal, and other nursing resources to accomplish nursing practice with 24-hour accountability for client care units or areas. Vest Study Guide

nurses

*Name this position* Coordinate, integrate, provide care, restore health and nurture human beings in their experiences of health and illness.

clinical nurse leaders and APRNs

*Name this position* Provide leadership in the care transitions of individuals and populations while providing expertise in specialty areas to guide other nurses through process, measurement, and evidence-based practice changes.

A. Strategic management is the processing of an organization's vision or mission. B. Strategic planning is a process of developing an action plan for actualizing the mission. E. Nurses use the principles of strategic planning with other stakeholders to explore programs, projects or services to promote population health, patient satisfaction, and decrease health care costs.

*New policies, programs, projects, and services are developed to meet the needs of patients. Which statements are descriptions of when nurses take steps to use these items? (SATA)* A. Strategic management is the processing of an organization's vision or mission. B. Strategic planning is a process of developing an action plan for actualizing the mission. C. Strategic management is nurses making decisions about the delivery of care. D. Nurses use strategic planning to help them meet personal and professional goals. E. Nurses use the principles of strategic planning with other stakeholders to explore programs, projects or services to promote population health, patient satisfaction, and decreased health care costs.

B. An approach to an occupation that distinguishes it from being merely a job, focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime commitment

*Nurse leaders must possess competency in five domains: (1) leadership, (2) communication and relationship management, (3) professionalism, (4) knowledge of the health care environment, and (5) business skills and principles. Which of the following statements best describes the domain of professionalism?* A. Guiding, directing, teaching, and motivating to set and achieve goals B. An approach to an occupation that distinguishes it from being merely a job, focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime commitment C. Coordination and integration of resources to accomplish specific goals D. Ethical fitness and moral courage form the backbone of making necessary and hard—but right and unpopular—decisions.

ACDE

*Nurse managers in patient care areas must manage staffing on a daily basis. The degree of work needed for any patient is known as nursing intensity and includes which of these other variables? (Select all that apply.)?* a. Severity of illness b. Complexity of patient's condition c. Amount of time needed with patient d. Complexity of care e. Patient's dependency

D. They should include staff nurses in the development and selection process of the professional practice model.

*Nurse managers, in collaboration with nursing leadership, design nursing systems for the provision of client care and the betterment of the organization. Nurse managers should consider which of the following as important?* A. Two factors that nurse managers must consider when designing a care delivery system are the type of nursing skilled staff and turnover. B. Mixed model approaches offer a confusing type of nursing care delivery system, with trying to balance nurse's needs with those of clients, physicians, and organizations. C. Models that promote professional practice have implications for job satisfaction, the character of professional practice, and the amount of control staffing leading to turnover. D. They should include staff nurses in the development and selection process of the professional practice model.

A. Fiscal accountability, client characteristics, staffing composition, case mix severity, and clinical service intensity B. Practice guidelines and new medication information and technology C. Role of the RN, practice expectations, accountability of nurses, decision making about care, and provider competencies and experience D. Direct and indirect client nursing care interventions, end of shift reporting, physician-prescribed care, and communication

*Nurses involved in the selection or development of a nursing care delivery system should consider which of the following as important? (SATA)* A. Fiscal accountability, client characteristics, staffing composition, case mix severity, and clinical service intensity B. Practice guidelines and new medication information and technology C. Role of the RN, practice expectations, accountability of nurses, decision making about care, and provider competencies and experience D. Direct and indirect client nursing care interventions, end of shift reporting, physician-prescribed care, and communication E. Reimbursement models within the Affordable Care Act and American Health Care Act that cover preexisting diseases and other illness across a larger insured population

D. Nurse executives

*Nurses who challenge assumptions, consolidate a purpose, build the culture, and move a vision forward are more likely within which role?* A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives

C.

*Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?* a. Establishment of solution evaluation criteria b. Evaluation of the alternative solutions c. Identification of a problem, issue, or situation d. Search for alternative solutions or actions

B. Accomplishing tasks the rest are for a nurse LEADER

*One of the things a nurse manager would focus on on their unit?* A. Inspiring the staff B. Accomplishing tasks C. Human relations D. Mentoring

B. Monitoring care from admission to discharge

*Please select what you think would describe how we would deliver care in the role of a primary nurse:* A. The nurse is responsible for the daily care B. Monitoring care from admission to discharge C. Caring for a client 12 hours a day D. Providing total care for the client

B. Accepting the need for change

*Please select which is the first stage that is involved in a planned change:* A. Cognitive re-definition B. Accepting the need for change C. Integration and stabilization D. Problem solving

D. Empowerment, shared governance, shared decision making, and self-direction. another quizlet said A??????

*Porter-O'Grady and Malloch (2015) emphasized four practices for current workplaces that foster learning organizations. Examples of practices would include:* A. Population-based care, case management, patient-centered care, and patient safety initiatives. B. Medical home payment for physicians, relative value units, pay-for-performance, and pay based on outcomes. C. Electronic health records (EHRs), health information exchange (HIE) networks, and clinical decision support. D. Empowerment, shared governance, shared decision making, and self-direction.

D. Critical skills in leadership are interpersonal, decision making, and problem finding and solving.

*Principles of leadership and management are best described by which of the following statements?* A. Followership is a process whereby leaders participate in group decisions. B. Empowerment is the ability to lead a group successfully. C. Important skills for leading include diagnosing, adapting, and directing. D. Critical skills in leadership are interpersonal, decision making, and problem finding and solving.

Management

*Process of coordination and integration of resources through activities of planning, organizing, directing and controlling to accomplish specific institutional goals and objectives defines which of the following?* Transformational leader Transaction leader Management Chaos Theory

C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care system

*Quality & Safety Education for Nurses (QSEN) was initiated to accomplish which of the following? (SATA)* A. Implementing patient-centered care, teamwork, and collaboration that support quality improvement, safety, and informatics on nursing units B. Geared toward nurses who have been practicing 20 years and need new competencies through continuing education C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care system

B. Patient care requires a high degree of interdependence on other care providers.

*Relationship management is a key leadership skill because:* A. Being liked by staff makes it easier to get things done. B. Patient care requires a high degree of interdependence on other care providers. C. Transferring negative moods to staff can decrease productivity. D. Helping staff cope with change is important.

A. Negotiation

*Resolving conflict requires interventions. One type of intervention requires preparation and planning, ground rules, clarification and justification, bargaining and a closure with implementation. Which of the following is this type of conflict management?* A. Negotiation B. Win-win strategy with problem solving C. Restrict or isolate the conflict D. Compromise

A. The degree to which the change is thought to be better than the status quo B. The degree to which the change is compatible w/ existing values of the individuals or group another quizlet said D, E????

*Rogers (2003) described five factors to determine successful planned change: relative advantage, compatibility, complexity, trialability, and observability. The statements below relate to these success factors. Leaders will present information on two of these to explain the necessity for the change and the expectations. Which of the following are those two? (SATA)* A. The degree to which the change is thought to be better than the status quo B. The degree to which the change is compatible with existing values of the individuals or group C. The degree to which a change is perceived as difficult to use and understand D. The degree to which a change can be tested out on a limited basis E. The degree to which the results of a change are visible to others

B. Long-term care patients

*SBAR is used in health care institutions to improve health team communication. Which patient population benefits most from clinicians who use SBAR?* A. Acute care patients B. Long-term care patients C. Surgical patients D. Rehabilitation patients

D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, whereas managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals.

*Select the statement that describes how clinical decision making differs from managerial decision making.* A. Professional nurses in clinical practice are making clinical decisions about client diagnoses and care plan orders, whereas technical nurses are making managerial decisions about containment of costs and maximizing health care delivery. B. Clinical decision making involves the collection of information, selection, and evaluation of an action, whereas managerial decision making involves the processing of existing information to select an action. C. Clinical decision making by nurses is far less sophisticated than managerial decision making by nursing executives, nurse managers, and directors. D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, whereas managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals.

C. Developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results.

*Similarities between the nursing process and the strategic planning process allow nurses to shortcut the learning curve and begin to move forward with the implementation phase. Strategic management involves:* A. Assessing the nursing mission, diagnosing outcomes for needed services, developing a plan to achieve the outcomes, implementing the strategies, and evaluating the changes toward the outcome. B. Identifying the organization's needs, establishing the purpose for new services, planning the action steps, and evaluating the outcomes for the new services. C. Developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results. D. Assessing the service needs, planning goals and objectives, implementing the action plan, and evaluating the goals and objectives.

Followers

*Supporting leaders to take the vision and achieve the goals describes which of the following?* Workers Doers Followers Innovators

A. Clinically competent peers, education support, adequate staffing, and nurse manager support D. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships

*The 14 Forces of Magnetism has directed research on Hospital Magnet Standards, which measure certain characteristics. Select the answers that best reflect those measures of Magnet standards. (SATA)* A. Clinically competent peers, education support, adequate staffing, and nurse manager support B. Perceptions of work environment, nursing hours per patient day, and medication errors and near misses C. Customer satisfaction, patient discharge disposition, and patient complaints D. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships

B. Balancing reliability and efficiency in service delivery C. Creating and sustaining a trustworthy learning, and evidence-based organization E. Involving workers to manage and sustain change

*The Institute of Medicine (IOM) identified 5 areas of management practice for leaders to attend to during turbulent times. Which of the following are included in those areas? (SATA)* A. Maintaining and sustaining quality and safety in service delivery B. Balancing reliability and efficiency in service delivery C. Creating and sustaining a trustworthy, learning, and evidence-based organization D. Managing change through manager involvement and bi-directional communication E. Involving workers to manage and sustain change

A. Bring teams together D. Direct activities

*The areas where leadership and management overlap are explained by which of the following statements? (SATA)* A. Bring teams together. B. Spark innovation. C. Inspire a vision. D. Direct activities.

A. the Affordable Care Act (09). B. The Future of Nursing: Leading Change, Advancing Health (11). C. the Institute of Medicine's Crossing the Quality Chasm (01). D. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (02).

*The culture of patient care must transition from care that is driven by providers to care that is patient-centered & family-centered in which patient & family norms, values, and preferences are respected. This direction in health care services has been sited within: (SATA)* A. the Affordable Care Act (2009). B. The Future of Nursing: Leading Change, Advancing Health (2011). C. the Institute of Medicine's Crossing the Quality Chasm (2001). D. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (2002).

B.

*The decision support department has been asked to create balanced scorecards for each nursing unit. Nurse managers work with decision support on the data elements which will be useful in assessing financial, quality, and other measures in order to improve what?* a. Staff turnover b. Organizational performance c. Physician satisfaction d. Reimbursement

C. The manager focuses on systems and structure, and the leader focuses on people and innovation.

*The difference between the focus of managers and leaders is best described by which one of the following statements?* A. The processes and strategies look similar and are employed for different goals. B. The manager focuses on people, and the leader focuses on systems and structure. C. The manager focuses on systems and structure, and the leader focuses on people. D. Management and leadership are not equally important processes to accomplish outcomes.

B. Innovation refers process of bringing any new or problem-solving idea into use, whereas change is a process for reducing variation within an existing process w/ a problem. C. Innovation is often linked with creativity and viewed as the use of a new idea to solve a problem, whereas change means improving incrementally. D. Change is disruption; innovation is systematic, takes hard work, and has little to do with genius and inspiration.

*The distinction between change and innovation is best described in which of the following statements? (SATA)* A. Leaders are necessary to help create the environments that encourage creativity to innovate, whereas the opportunities for change can be accomplished in most environments. B. Innovation refers to the process of bringing any new or problem-solving idea into use, whereas change is a process for reducing variation within an existing process with a problem. C. Innovation is often linked with creativity and viewed as the use of a new idea to solve a problem, whereas change means improving incrementally. D. Change is a disruption; innovation is systematic, takes hard work, and has little to do with genius and inspiration. E. Change is a new practice that can be implemented quickly and an innovation is a new device or medication that is added to existing services.

Evaluate

*The last step in the DECIDE model is?* Establish Encourage Evaluate

a

*The nurse manager is dealing with a situation between two nurses who disagree on patient assignments. The nurse manager decides to allow the two nurses to work out their differences between themselves because the patient needs and the needs of the unit are being met. After the situation is resolved, the nurse manager praises the two nurses for making autonomous decisions about staffing. What will be the likely outcome of praising the nurses in this situation?* a. higher job satisfaction b. Lower job satisfaction c. Lower patient satisfaction d. Increased staff turnover

C. Functional nursing

*The registered nurse performs assessment, the licensed practical nurse administers medications, while the certified nursing assistant bathes the patient. This is an example of what type of nursing care delivery model?* A. Private duty nursing B. Group nursing C. Functional nursing D. Primary nursing

A. The effects of nursing interventions are facilitated by organizational characteristics at the unit level. C. Mortality rates in Magnet hospitals had a significantly lower mortality rate for Medicare patients than that of control hospitals.

*The research leading to the gold standard for nursing excellence has produced which of the following findings? (SATA)* A. The effects of nursing interventions are facilitated by organizational characteristics at the unit level. B. A health care administrator can nurture a professional nursing environment and advocate for excellence in nursing practice. C. Mortality rates in Magnet hospitals had a significantly lower mortality rate for Medicare patients than that of control hospitals. D. Magnet hospitals' cultures provided lower levels of autonomy and control of practice and fostered stronger professional relationships among nurses and physicians than did those of non-Magnet-designated hospitals.

B. Hersey and Blanchard's model

*The research of which team states that the leader needs to be flexible in behavior, able to diagnose the leadership style appropriate to the situation, and able to apply the appropriate style?* A. Fiedler's contingency model B. Hersey and Blanchard's model C. Blake and Mouton's attitudinal model D. Ohio State model

B. empowerment

*The type of power exhibited when providing the opportunity for others to take responsibility and accountability for their work is:* A. referent power B. empowerment. C. expert power. D. legitimate power.

B. The right reason

*These are the items for clinical reasoning: the right reason, the right cue, the right client, and the right time. Which of these four would be the last step in a clinical reasoning process?* A. The right cue B. The right reason C. The right client D. The right time

A. New laws and regulations from the Affordable Care Act (ACA) to cut costs and improve indicators of quality and staffing challenges.

*Trends in 21-century health care in the US are described as revolutionary by Longenecker and Longenecker (2014). Leaders will innovate and change toward preventive and wellness health care services because of which of these trends?* a. New laws and regulations from the Affordable Care Act (ACA) to cut costs and improve indicators of quality and staffing challenges. b. Aging population, increased numbers of veterans with posttraumatic stress disorder (PTSD) and traumatic brain injury, pay-for-performance, focus on safety and quality, and medical homes c. Advances in genomics, integrative medicine, and increased emphasis on evidence-based interventions d. Advances in technology with HIE networks, personal health records, EHRs, and telehealth e. Strain on emergency services, "never events," accountable care organizations, pay-for-performance, the Human Genome Project, and nurse shortages followed by a flood of new nurses have all affected and led to changes in the health care system over the last decade.

False

*True or false:* A critical thinker preserves the norm or status quo.

True

*True or false:* Adaptors seek solutions to problems in accepted ways.

False

*True or false:* Administrative decision making focuses on clinical problems.

False

*True or false:* Administrative decisions tend to be clear-cut and easy to solve

False

*True or false:* As professional autonomy and responsibility increase, the level of accountability and liability decreases.

False

*True or false:* Clinical decision making is the same thing as diagnostic reasoning.

True

*True or false:* Creative thinking can be described as follows: knowledge is received as a whole, awareness of knowledge is immediate, and knowledge is acquired independently of linear reasoning.

True

*True or false:* Critical pathways are a type of decision tree.

False

*True or false:* Critical thinking and creative problem solving are the same

True

*True or false:* Decision making is used to solve problems.

False

*True or false:* Decision-making strategies are interchangeable and can be used effectively in any situation.

True

*True or false:* Ethical decision making is influenced by each person's values.

True

*True or false:* Group decision making tends to be more effective for system problems.

False

*True or false:* In most cases, satisfaction leads to effective decision making.

False

*True or false:* Innovators focus on resolving problems.

False

*True or false:* It is inappropriate for a manager to use indirect intervention to solve problems

False

*True or false:* Leadership is more important than management in a turbulent health care environment.

True

*True or false:* Management is a discipline that uses a set of tools to achieve desired outcomes.

True

*True or false:* Nurse managers usually have 24-hour accountability for the coordination and delivery of care.

False

*True or false:* Nursing management is the coordination and integration of resources using a process that involves politics and information technology.

True

*True or false:* One critical aspect of both problem solving and decision making is to determine the desired outcome

True

*True or false:* Organizational decision making focuses on system problems

False

*True or false:* Organizing is determining long- and short-term objectives and corresponding actions to take to achieve these objectives.

False

*True or false:* Pilot projects are full-scale implementations of a solution.

False

*True or false:* Problem solving is a high-level skill used only by health care professionals.

True

*True or false:* Problem solving is a rational and logical thought process

False

*True or false:* Purposeful inaction is a valuable tool in most situations.

False

*True or false:* Tactical planning is a broad-range process of establishing the purpose and direction of the organization.

True

*True or false:* The first step in the problem-solving process is to define the problem

True

*True or false:* The new role of leader-manager is to facilitate the development of effective support systems to generate efficiencies directed to improving processes.

False

*True or false:* The team problem-solving method is a slow process and is a poor method for making decisions.

True

*True or false:* The two cognitive processes used in critical thinking for nursing judgments are analytical and intuitive.

True

*True or false:* Traditional management functions include planning, organizing, controlling, and coordinating.

False

*True or false:* Transformational leaders focus on the maintenance of quality and quantity of performance.

True

*True or false:* Transformational leadership is necessary in periods of growth, change, and crisis.

A, D

*Two cognitive processes that nurses use in clinical reasoning include: (Select all that apply.)* a. education. b. acuity. c. staffing ratios. d. experience.

indirect intervention

*Using conflict management and persuading others to solve the problem themselves would be an example of?* direct intervention indirect intervention delegation

C, D

*Utilizing the DECIDE acronym for the process of decision making, what are the first and final steps in the process? (Select all that apply.)* a. Develop and implement an action plan for problem solution. b. Establish criteria for what you want to accomplish. c. Define the problem and determine why anything should be done about it. d. Evaluate the decision through monitoring, troubleshooting, and feedback. e. Determine the best choice or alternative.

B. Skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nursing education and experience, and technology level.

*Variables that influence nursing practice & client care delivery include* A. Client-centered versus task-focused versus provider-focused perspective. B. Skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nursing education and experience, and technology level. C. Medical home structure for more integrated or coordinated between acute and primary care. D. RN preparation, critical thinking, and delegation skills.

A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance

*What habits are characteristics of critical thinking by nurses? (SATA)* A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance D. Quick, concise, purposeful, systematic, within a frame of reference, grounded in information E. Experience, uses database resources and searches

A. Strategic Management

*What is the administrative and systematic process to be responsive to environment-related and future-oriented changes that are sensitive to the correct positioning of the organization known as?* A. Strategic management B. Tactics C. Strategy D. Performance effectiveness

D. Task Oriented

*What is the best leadership style to handle an unfavorable condition in healthcare?* A. a leader member B. laissez faire C. position power D. task oriented

C. Decision making

*What is the definition of the process of making choices that will provide maximum benefit?* a. Critical thinking b. Problem solving c. Decision making d. Leading

C. Decision making question says MAKING CHOICES

*What process involves making choices that provide a benefit to client care outcomes?* A. Critical thinking B. Problem solving C. Decision making D. Leading

C. This principle stresses the importance of not arguing who is right or who is wrong, but rather understanding that each one of us filters what is real through our own lenses.

*Wheatley identified four core principles of change. One principle states that we do not see reality; we create our own interpretation of what is real. Select the statement that aligns with this principle:* A. This principle is based on a strong respect for systems, and it supports the leader's task of strengthening communication and connections within the system. B. This principle suggests offering invitations for others to work with the team, rather than issuing directives, orders, or visionary messages. C. This principle stresses the importance of not arguing who is right or who is wrong, but rather understanding that each one of us filters what is real through our own lenses. D. This principle stresses engaging people in the change from the beginning to prevent unintended consequences

C. Group nursing

*When clients are grouped together and cared for by one nurse, this is known as:* A. Functional nursing B. Team nursing C. Group nursing D. Primary nursing.

Authoritarian

*When dealing with a crisis, what type of leadership model may work best?* Transformational Democratic Authoritarian Laissez-faire

D. All of the above

*When nurse leaders are pressured to implement organizational change from powerful economic and political interests, the purpose for change is driven externally and not internally. Nurse leaders can implement changes to alleviate immediate problems and:* A. Evaluate and quantify the external imposed changes for long-term effects. B. Speak up, articulate, and support the value of a nurses role C. Use positional influence to outline nursing's own destiny and prevent destructive practices. D. All of the above

ACDEF another quizlet says NO to choice F

*Which behavior indicates that a nurse manager is excellent and supportive? (SATA)* A. They know their nursing staff and address them by name. B. Has a consistent style that never changes. C. Fosters collaboration on the unit. D. Is visible on the nursing unit, on all shifts, on a frequent basis. E. Evaluates the problem before making a decision. F. Uses decisions by consensus to resolve conflicts.

BCD

*Which behaviors would build trust between peers and employees? (SATA)* A. Encouraging competition B. Sharing relevant information. C. Reducing controls. D. Meeting expectations. E. Avoiding discussing sensitive issues

A. A process of coordination and integration of resources through group activities of planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives

*Which is the statement that best defines management?* A. A process of coordination and integration of resources through group activities of planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives B. A process of planning and directing human effort to attain established objectives C. A process by which organizational goals are met through the use of the right resources D. A process of working with executives to allocate capital, technology, and equipment resources to accomplish organizational goals

Feminist perspective

*Which leadership style reflects wanting to build relationships, empowering others, and promoting personal growth?* Authoritarian Democratic Feminist perspective Republican

D. Contingency theory

*Which management theory's principle is to consider the situation and all elements when making a management decision?* A. Complexity theory B. Chaos theory C. Systems theory D. Contingency theory

B. The staff nurse who adapts to challenging client assignments

*Which nursing staff member would demonstrate an improvement in their decision making process?* A. The staff nurse who wants to keep the status quo. B. The staff nurse who adapts to challenging client assignments C. The staff nurse who refers issues to quality improvement committee. D. The staff nurse who questions current practices and refers to the unit manager for change.

a. Shared governance c. Pilot projects d. Evidence-informed decision making e. Simulation

*Which of the following are examples of formal decision-making tools? (Select all that apply.)* a. Shared governance b. Anchoring c. Pilot projects d. Evidence-informed decision making e. Simulation

C.

*Which of the following scenarios is an example of clinical reasoning?* a. A nurse ignores a client's requests to stop his dialysis. b. A nurse is scheduled to work over the weekend, and she has a family outing to attend. c. A nurse is counseling a woman with breast cancer about terminating her pregnancy and receiving chemotherapy or completing the pregnancy and possibly not surviving. d. A nurse has been offered an exciting new position with a dramatic increase in salary, but she would have to move out of state, away from her ailing parents

D. Problem solving is a rational and logical thought process.

*Which of the following statements is true about problem solving?* A. Problem solving is a high-level skill used primarily by health care professionals. B. Critical thinking and problem solving are the foundation of effective decision making. C. The team problem-solving method is a slow process and is a poor method for making decisions. D. Problem solving is a rational and logical thought process.

B. Staff retention, workplace safety, and patient outcomes are directly affected by the organizational climate.

*Which of the following statements regarding organizational culture is true?* A. Staff are unaffected by organizational climate. B. Staff retention, workplace safety, and patient outcomes are directly affected by the organizational climate. C. Organizational leadership does not affect organizational culture. D. Working in an organizational culture that values continuous learning has been found to decrease nurses' job satisfaction.

D

*Which of these clinical decisions poses the greatest risk for committing an error?* a. Verifying medication dose prior to administration b. Charting by exception c. Prioritizing patient care activities d. Independent interpretation of a medication order

B. reflection

*Which of these concepts is key to refining clinical judgment capabilities?* a. Critical judgment b. Reflection c. Management experience d. Nursing expertise

C. Influencing behavior of either an individual or a group in an effort to achieve goals in a given situation

*Which process best describes leadership?* A. Giving people the authority, responsibility, and freedom to act on their expert knowledge and skills B. Planning, organizing, coordinating, directing, and controlling resources to accomplish specific institutional goals C. Influencing behavior of either an individual or a group in an effort to achieve goals in a given situation D. Working with and through individuals and groups and other capital and technology resources to accomplish organizational goals

D. Leadership and management have discrete skill sets.

*Which statement regarding leadership and management is false?* A. Leadership focuses on people while management focuses on systems and structures. B. Both leadership and management processes seek to accomplish goals. C. Strategies used to accomplish goals may be different in leadership and management. D. Leadership and management have discrete skill sets.

A. 7 B. 3 C. 5 D. 6 E. 4 F. 2 G. 1 H. 8 I. 9 J. 14 K. 13 L. 16 M. 17 N. 15 O. 12 P. 10 Q. 11 R. 18 S. 19

*Write the letter of the correct response in front of each term* A. Problem Solving B. Actual Problem C. Adaptor D. Innovator E. Delegation F. Potential Problem G. Critical Problem H. Critical Thinking I. Creative Problem Solving J. Trial & Error K. Pilot Projects L. Problem Critique M. Creativity N. Decision Tree O. Fish Bone P. Group Decision Making Q. Cost-Benefit Analysis R. Satisfying Decision S. Optimizing Decision 1. A situation that is highly urgent and needs urgent and needs crisis intervention 2. A situation that is tenuous, and difficulties can occur at any time 3. A situation that occurs in real time and needs prompt action 4. Assigning responsibilities and tasks to others 5. Using tried and accepted solutions to problems 6. Using innovative, creative solutions to problems 7. Using a process to identify obstacles and to achieve goals 8. Reasoning that generates and examines questions and problems 9. A novel approach to thinking to accomplish a goal accomplish a goal 10. The leader calls the group together to discuss and participate in solving a problem 11. A formal process of examining driving and restraining forces 12. Graphic figures used to help assess potential causes of problems being introduced 13. Experiments using a solution on a limited basis to identify problems 14. The first solution that seems promising is tried 15. Graphic model depicting options, risks, and outcomes 16. A one-on-one approach in which two individuals sit down and discuss a problem 17. Openly generating ideas and solutions with all ideas considered 18. Selecting a decision that is adequate to meet the required objective 19. Selecting the best option after reviewing competing alternative solutions

C. democratic

*You are leading a team who's working together on a prior project. It was very successful. It's an interprofessional team. Which of the following leadership styles would work best?* A. authoritarian B. transactional C. democratic D. transformational

A. Interview each nurse about his or her perspective

*You are the nurse manager working on a unit and you have two staff that are not getting along. One staff member states that the other staff member is "bullying" and it is affecting the staff member's self confidence. What would you do as a nurse manager to respond?* A. Interview each nurse about his or her perspective B. Assign mentors to the new nurses C. Determine the role of each nurse D. Suspend the bullying nurse for harassment

B. change agent

*You have a chief nursing officer of a healthcare organization that is working with your leadership to develop a health record (?). That CNO recruits a nursing information specialist and an informatics officer to start the planning of education within this organization. Which of the following would describe the CNO in this situation?* A. resistor B. change agent C. innovator D. strategist

A. A planned change key word is GOING TO

*You're going to introduce a new EHR product. Which is the best way to describe the implementation process?* A. A planned change B. An emergent change C. Transformation D. Innovation

B. Omitting personal hygiene to ensure timely medication administration

*You're working on a unit and it's short staffed, you don't have a CNA. Which is an example of prioritizing patient care?* A. Charting by exception. B. Omitting personal hygiene to ensure timely medication administration. C. Failing to deploy rapid response team when the patient is found on the floor bleeding. D. Timely medication administration without scanning the client arm band.

B. Rapid Cycle Change

*You've got a team of ICU nurses that implement a way to reduce the infection rates related to catheters by completing assessments every shift to look at if the catheters can be discontinued early, and collaborating with physicians. After they put these small changes into place, they will have found the data to determine the effectiveness of change. Which of these best describes what is going on in the unit?* A. Rapid Response Team B. Rapid Cycle Change C. Failure Motive Analysis D. Root Cause Analysis

*Planning* • Identify the mission • Conduct an environmental scan • Analyze the situation • Establish goals • Identify strategies to reach goals • Set objectives to achieve goals • Assign responsibilities and time lines • Write a planning document • Celebrate success and completion • Manager looks to identify the following questions: what, when, why, where, how, & by whom. The manager identifies the priority to meet the goals of the organization for achieving to create or improve processes. *Organizing* • Organize the work • Organize the people • Organize the environment • Organizing resources to meet the goals & objectives of the organization. The resources include personnel, money, & equipment needed to meet the goals of the organization. The phase of organizing relates to budgeting, hiring, staffing, scheduling, orienting, & developing staff. *Directing* • Coordinating • Motivating • Coaching • Directing the staff through coaching & mentoring. The manager is responsible for monitoring situations & ensuring the correct nurse mix & assistive personnel to provide safe, effective staffing. *Controlling aka evaluating* • Coordinating activities within organizations • Ensures processes are followed. This function also evaluates the processes to compare actual w/ projected results to identify areas to improve. During this phase, the nurse manager focuses on quality improvement process.**

Briefly describe the four steps of the management process Mod 1, Ch 1

*Leadership* ▪ focuses on people ▪ influencing people to accomplish goals ▪ innovates ▪ cope with change ▪ human relationship aspects ▪ inspiring a vision *Management* ▪ focuses on systems and structures ▪ influencing employees to meet an organization's goals and is focused primarily on organizational goals and objectives ▪ administers ▪ cope with complexity ▪ task accomplishment *Similar:* ▪ bring teams together ▪ direct activities ▪ seek to accomplish goals

Compare Leadership and Management- what similar and what is different? Mod 1, Ch 1 Vest Study Guide

**Transactional** • focus on the day-to-day operations and tasks for the organization. • this leader works to ensure the work is completed and rewards the followers when tasks are finalized. • if the follower needs to be corrected for something that was not done properly, this leader is there to correct them. • this leader is effective and has a positive impact on the organization. • this leader is very effective in a crisis. • focus on tasks to ensure daily work gets done *Decision - Making:* Assists group to make decisions *Advantage:* Focus on the group; provides clear direction; motivate the team with rewards *Disadvantage:* The leader may lack flexibility and group input may be limited to none **Transformational** • this leader is one who motivates others and promotes positive changes with individuals and organizations. • focus on the needs of the follower, while challenging the team, inspiring others, and serving as role models during a change. • this leader is one who looks at the vision of the organization and focuses on accomplishing the goals. • this leader focuses on growing and developing the team and make a change in the effort, effectiveness, and satisfaction of the team. • the team with this leader focuses on higher order and cultural changes of the organization *Decision - Making:* Engages others in the decision-making process *Advantage:* Inspires and motivates the group so the leader can look at the whole picture *Disadvantage:* The leader may have something in mind, but the group may not agree; progress may not occur

Compare transactional leader and transformational leader- what are some example behaviors of each? Mod 1, Ch 1

• Concern for family • Concern for community • Concern for culture • More people oriented & supportive; build relationships; promote personal growth; different approach to challenges & tasks.

Describe Feminist Leadership Perspective Mod 1, Ch 1

• Effective leaders at all levels of the organization • Professional development opportunities • Staffing structures that consider nurse competencies, patient needs, and teamwork • Interdisciplinary collaboration • Empowered, shared decision making • Patient-centered culture/culture of safety • Quality improvement infrastructure, evidence-based practice • Visible acknowledgment of nursing's unique, valued contributions (e.g., professional practice model, vision/mission/philosophy statements)

Describe Healthy Work Environment Mod 3, Ch 3, 15

▪ represents the middle ground between patient safety and a culture that supports error reduction ▪ expectations for system and individual learning and accountability are transparent When an organization can freely discuss mistakes with the intention of learning from them, and when it takes the time and resources needed to understand the mistakes using root cause analysis, the organizational culture changes from punitive to respectful and open to learning.

Describe Just Culture Mod 3, Ch 3

three elements for a successful change: *(1) unfreezing* ▪ the first stage of change, can be characterized as a process of "thawing out" the system and creating the motivation or readiness for change. ▪ An awareness of the need for change occurs. This first stage is cognitive exposure to the change idea, diagnosis of the problem, and work to generate alternative solutions. ▪ The unfreezing stage is considered to be finalized when those involved in the change process understand and generally accept the necessity of change. ▪ is like assessing in the nursing process and like problem identification and definition in the problem-solving process. *(2) moving* ▪ This means proceeding to a new level of behavior, which implies that the actual visible change occurs in this stage. ▪ When the individuals involved collect enough information to clarify and identify the problem, the change itself can be planned and initiated. ▪ As a first step to launch a change, a pilot test may be done so that the change can be pretested and a transition period launched. ▪ is similar to planning and implementing in the nursing process and similar to problem analysis and seeking alternative solutions in the problem-solving process. *(3) refreezing* ▪ In this stage, new changes are integrated and stabilized. ▪ Reinforcement of behavior is crucial as individuals integrate the change into their own value systems. ▪ It is important to reward change behavior. Leadership strategies of positive feedback, encouragement, and constructive criticism reinforce new behavior. Leaders point the way throughout the process of change. ▪ is like evaluation in the nursing process and like implementation and evaluation in the problem-solving process.

Describe Lewin's Change Process- what happens in each stage? Mod 3, Ch 2 p. 35 Vest Study Guide

Both use the plan-do-study-act (PDSA) model as a basis *Rapid Change Cycle* • based on the idea that changes should first be tried on a small scale to see how they work. • uses a small, focused, rapid process to make process improvements • staff are encouraged to brainstorm new ideas, try a potential change, and test its effectiveness. *TCAB* • goal was to improve quality and safety on medical-surgical acute care units by engaging in changes to improve practice. The idea was to create a small test, evolve the idea, get feedback, and proceed. • not a top-down approach but engaged clinicians at the bedside in the design and implementation of new work practices and systems emphasized that the improvement process was continuous, not a one-time occurrence.

Describe Rapid Change Cycle and Transforming Care at the Bedside (TCAB)...what is used? Mod 3, Ch 2

• is a quality and decision support technique that uses data to build process-improvement models. • The goal is to eliminate defects in safety and quality in health care delivery • Essentially Six Sigma is a variant of the plan-do-study-act (PDSA) cycle promoted by the Institute for Healthcare Improvement

Describe Six Sigma Mod 1, Ch 1

*Diagnosing* - involves being able to understand the situation and the problem to be solved or resolved. This is a cognitive competency. *Adapting* - involves being able to understand the situation and the problem to be solved or resolved. This is a cognitive competency. *Communicating* - Communicating is used to advance the process in a way that individuals can understand and accept. This is a process competency. • Self-awareness (EI) • Self Regulation, aka discipline (EI) • Self-management (EI) • Social awareness (EI) • Relationship management (EI) • The ability to engage others in shared meaning • A distinctive and compelling vocal tone • A sense of integrity • A combination of hardiness and ability to grasp context, called "adaptive capacity"

Describe a leader- what skills/traits should they possess? Mod 1, Ch 1 Vest Study Guide

*Direct Intervention* • decisions requiring disciplinary action *Indirect Intervention* • negotiation; manager does not actually decide what should be done to deal with an issue but rather persuades others to solve the problem themselves EX: a unit manager might ask a team of staff nurses and the unit secretary to figure out when the best time is to order supplies for the unit. *Watchful Waiting* EX: A particular staff member might be causing some interpersonal difficulties. If the staff member has submitted his or her resignation, dealing with the behavior might not be worth the energy. *Collaboration and Consultation* • takes place within an interprofessional context. Patient care requires a team approach between nursing, medicine, and other disciplines such as physical therapy. Working in an interprofessional context is an essential skill for both clinicians and managers • result in high-quality patient care delivery systems.

Describe direct intervention, indirect intervention, watchful waiting, collaboration and consultation- what could be some examples of these in practice Mod 2, Ch 4

*Relative Advantage* ▪ The degree to which the change is thought to be better than the status quo. *Complexity* ▪ The degree to which a change is perceived as difficult to use and understand. *Compatibility* ▪ The degree to which the change is compatible with existing values of the individuals or group. *Trialability* ▪ The degree to which a change can be tested out on a limited basis. *Observability* ▪ The degree to which the results of a change are visible to others.

Describe the components of a *successful planned change*: Relative advantage, complexity, compatibility, trialability and observability Mod 3, Ch 2

Individual members of a group or social system will adopt an innovation at different rates. This time element of the adoption of an innovation usually follows a normal, bell-shaped curve when plotted over time on a frequency basis. However, if the cumulative number of adopters is plotted, an S-shaped curve appears. *Innovators* ▪ the first individuals to adopt an innovation; willing to take risks *Early Adopters* ▪ this is the second fastest category of individuals who adopt an innovation. These individuals have the highest degree of opinion leadership among the other adopter categories. ▪ left side of bell curve *Early Majority* ▪ individuals in this category adopt an innovation after a varying degree of time. This time of adoption is significantly longer than the innovators and early adopters. ▪ right before the peak of the bell curve *Late Majority* ▪ individuals in this category will adopt an innovation after the average member of the society. These individuals approach an innovation with a high degree of skepticism and after the majority of society has adopted the innovation. ▪ other side of the bell curve *Laggards* ▪ individuals in this category are the last to adopt an innovation. Unlike some of the previous categories, individuals in this category show little to no opinion leadership. ▪ at the end/right of curve; don't take the change

Describe the different rates people can change at: innovators, early adopters, early majority, late majority and laggards Mod 3, Ch 2 (nothing here)

*Planned Change* • a decision to make a deliberate effort to improve the system. *Innovation* • the use of a new idea or method. *Transformation* • the use of new ideas, innovations, and creativity to change fundamental properties or the state of a system. *Resistance* • to refuse to accept or be changed by something, a force that acts to stop the progress of something or make it slower. *Change Agent* • a person or thing that encourages people to change their behavior or opinions. The term has come to be used for a person who functions as a change facilitator

Describe the following: planned change, innovation, transformation, resistance, change agent Mod 3, Ch 2

Nursing management is defined as the coordination and integration of nursing resources by applying the management process to accomplish nursing care and service goals and objectives.

How does "nursing management" vary from management in general? Mod 1, Ch 1 Vest Study Guide

Prioritization occurs not only in triage situations but also across the care spectrum. Thus decisions have to be made regarding what care has to be delivered and when the care is to be delivered.

How does prioritization play a role in clinical decision making? Mod 2, Ch 4 Vest Study Guide

▪ Organizations that focus on sustaining a healing culture rebuild organizational trust by focusing on trust in relationships with employees. ▪ *Behaviors that build trust include sharing relevant information, reducing controls, and meeting expectations.* ▪ Trust-destroying behaviors include being insensitive to beliefs and values, avoiding discussion of sensitive issues, and encouraging competition via winners and losers. ▪ Trust goes both ways and needs to be nurtured. ▪ Nurses can start by examining their own behaviors and then taking deliberative actions to strengthen trust in the environment. *How is it built?* ▪ reliability ▪ honesty ▪ share ▪ meet expectations ▪ communication

How does trust impact leadership? How is it built? Mod 1, Ch 1

• Using this model can help prevent cognitive errors in high-stress environments because it can help prevent missing cues and thus choosing the wrong course of action. *Define* - Define the problem - determine why something should be done. *Establish* - Establish desirable criteria for what you want to accomplish. *Consider* - Consider all possible alternatives choices. Identify - Identify the best alternative. *Develop* - Develop & implement an action plan for problem solutions. *Evaluate* - Evaluate decision through monitoring, trouble shooting, and feedback

How would the DECIDE model be implemented? Mod 2, Ch 4 Vest Study Guide

▪ Competency: Transformational leadership, Structural empowerment (resource management), Exemplary professional practice ▪ New knowledge, innovations, & improvements (relationship and communication management) ▪ Empirical outcomes. ▪ Nurses: Knowledge of healthcare system & environment, Communication & relationship management, Business, Professionalism **gold standard of nursing**

Magnet Recognition Program Vest Study Guide

Shared decision making

On a day shift a few nurses are upset that supplies are not delivered on time. The nurse manager recommends that the nurse collaborate as a team to produce a plan to fix this issue. What attribute is the nurse manager suggesting?

Risk Analysis and Management

Potential for adverse to happen again, minimize risk, all about money (could not find in chapters)

*Shared Governance* • an organizational structure that promotes empowerment and autonomous decision making at the point of care, accountability that is shared among all parties in a decision, and organizational processes that promote an egalitarian environment in decision-making processes. *EX*: a committee within a shared governance organization could develop and test a new fall-prevention protocol, exhibiting nursing practice empowerment. *Pilot Projects* • carefully defined trials that are used to experiment by trying out a solution alternative on a small or restricted basis to reduce risk and to see whether major problems will occur. *EX*: research projects linked to quality improvement initiatives. *SBAR* • a communication technique that helps members of the health team communicate effectively so that appropriate decisions can be made. *EX*: particularly useful in long term care facilities *Simulation* • used to teach skills and verify competencies and to improve management decision making *EX*: used to study clinical decision making

Provide examples of decision-making tools: shared governance, pilot projects, SBAR, Simulation Mod 2, Ch 4

▪ A strategic plan provides direction, clarity, & a focus for all involved in the organization to take measured steps to assure success. ▪ In health care systems, success is the caliber of the services offered to patients, families, & the community. ▪ The strategic planning process is not merely the development of goals. ▪ The plan reflects the foundations of the organization. steps: (1) Schedule a meeting with stakeholders, leaders, & managers (2) Complete a SWOT analysis (3) List tactics that will be needed to address the challenge that is driving this strategic plan. (4) Ensure that they align with the organization's mission, vision, & philosophy. (5) Determine how the plan will be evaluated to reflect the level of success needed to address the potential change. (6) Identify who will implement the plan, including the timelines and deadlines for the implementation to take place. (7) Evaluate the plan to determine its effectiveness. (8) Follow-up — after these steps, the implemented plan may need to be modified and monitored to make sure the steps are effective.

Strategic Planning Process

D

The nursing education department is revising its orientation curriculum for nurse externs. The curriculum includes a module on clinical reasoning skills. What is the expected time frame for mastery of clinical reasoning? a. Nurse externs should master clinical reasoning within 6 months. b. Clinical reasoning is mastered in nursing school. c. Clinical reasoning is never mastered. d. Clinical reasoning is a career-long process.

*Authoritarian* • make all of the decisions without the input of others in the organization. • focus on tasks and may blame others • to ensure goals are met, there are often threats of punishment. • gives orders and also uses rewards as incentives. • this type of leader is effective when there is a crisis and inexperienced nurses. • these leaders may be hard to work with as they may demand loyalty. adherence to rules, and are controlling. *Democratic* • encourages a group to assist with discussions and shares decision making with the team. • they focus on the team and ensure all people in the group feel valued as they are trying to problem solve. • this style is best when the team has the experience to be able to contribute to the discussion. • the team feels valued and is committed to the goal. • this leadership style requires a strong commitment and support from the leader to ensure all on the team are involved. • everyone is collaborating together *Laissez-faire* • more hands off and provide little direction for the team. • these leaders do not interfere, so decision making may be non-existent. • this leader will let things happen and not make things happen. • this leader may wait until a crisis occurs before they become involved in decisions. • can lead to chaos and inefficiency. • this leader does work well for teams who have experience, are independent, professional employees, and work together well.

What are some examples of authoritarian, democratic, and laissez-faire leadership styles? What situations could they be useful in? Mod 1, Ch 1

The seven steps of the problem solving process are (1) define the problem (2) gather information (3) determine the overall goal or desired outcome (4) develop solutions (5) consider the consequences (6) make a decision (7) implement and evaluate the solution.

What are the basic steps in problem-solving process? Mod 2, Ch 4

task oriented, day-to-day management of the unit or area

What are the characteristics that a nurse manager possesses?

*Self-awareness* - Ability to read one's own emotional state and be aware of one's own mood and how this affects staff relationships *Self-management* - Ability to take corrective action so as not to transfer negative affect to staff relationships *Social awareness* - An intuitive skill of empathy and expressiveness in being sensitive and aware of the emotions and moods of others *Relationship management* - Use of effective communication with others to disarm conflict and the ability to develop the emotional maturity of team members

What are the components of emotional intelligence? Describe each section Mod 1, Ch 1 Vest Study Guide

*Clinical Judgment* • is the interpretation of the information of patient problems and needs *Clinical Reasoning* • is the process of analyzing and synthesizing both objective and subjective cues about patients. The nurse's level of analysis is influenced by experience and education *Clinical Decision Making* • involves decisions made at the point of care. The decisions are a result of clinical reasoning and clinical judgments

What are the differences between clinical judgement, clinical reasoning, clinical decision making? Mod 2, Ch 4 Vest Study Guide

organization that is defined by excellence shared governance grow staff from within engage their staff high retention rates how is it required? from the ANCC

What are the elements of magnet hospitals? How is it required?

*(1) The Leader* ▪ The values, skills, and style of the leader are important. His or her internalized pattern of basic behaviors influences actions and the ability to lead. ▪ Leaders' perceptions of themselves, their roles, and their expectations have an impact on their followers. ▪ Self-awareness is crucial to leadership effectiveness. ▪ Among the internal forces in leaders that impinge on leadership style are values, energy level, confidence in employees, leadership inclinations, motivation for leadership, and sense of security in uncertainty. ▪ Interpersonal, emotional, and social intelligence skills contribute to the effective leadership of knowledge workers. *(2) The Follower* ▪ Accept or reject the leader and determine the leader's personal power. ▪ Effective followers show characteristics of assertiveness, determination, willingness to challenge ideas, an ability to act, and openness to new ideas. ▪ Followers also need self-awareness to know themselves and their expectations. ▪ Followership is based on trust *(3) The Situation* ▪ Elements such as work demands, control systems, amount of task structure, degree of interaction, amount of time available for decision making, and external environment shape the differences among situations *(4) The Communication Process* ▪ Communication processes vary among groups regarding the patterns and channels used and the degree to which the communication flow is open or closed. ▪ Communicating is basic to the process of influencing and thus to leadership. Through communication, the leader's vision and message are received by the followers. *(5) The Goals* ▪ Organizations have goals, and individuals working in organizations also have goals. These goals may or may not be congruent. Goals may thus be in conflict, in which case there is tension and a need for leadership.

What are the five aspects of leadership? Briefly describe each part Mod 1, Ch 1 p. 7 Vest Study Guide

Resistance

What do most organizations expect that they will encounter with their staff when implementing a change?

• objective and subjective cues *the Five Rights:* • the right cues or clinical data • the right patient or setting priorities • the right time or capability of identifying high risk patients • the right action or clinical decision that results from the clinical reasoning process • the right reason.

What is included in clinical reasoning? Mod 2, Ch 4

▪ Empowerment ▪ Shared decision making ▪ Self-direction ▪ Shared governance A learning organization uses systems thinking, mental models, personal mastery, team learning, and shared vision when intending to change the behavior of the organization using the ability to learn. The focus is to embed a culture with the ability to continuously adapt and learn. Learning is infused through all levels. Essentially the creation, acquisition, and transference of knowledge is used to adapt behavior to reflect new evidence, new knowledge, and new insights. The learning organization is seen as key to facilitating change by using an infrastructure that supports ongoing learning and knowledge acquisition.

What is involved in a learning organization? Mod 3, Ch 2

*Patient Acuity* • the need severity (physical and psychological) • a rating of the complexity of the patient's condition. *Nurse Intensity* • the degree of work needed for any patient • a combination of the severity of illness, the patient's dependency, the complexity of care, and the amount of time needed.

What is the difference between patient acuity and nurse intensity? Mod 2, Ch 4

• safety climate is the shared perception of employees about the importance of safety within the organization • refers to keeping both patients and nurses safe. ▪ Leadership ▪ Involvement ▪ Blameless culture ▪ Communication ▪ Teamwork ▪ Commitment to safety ▪ Beliefs about errors and their cause ▪ Strong surveillance skills regarding patients

What promotes a "safe climate"? Mod 3, Ch 3

Six Sigma

___________ is a quality and decision support technique that uses data to build process-improvement models. The goal is to eliminate defects in safety and quality in health care delivery Make every process lean, using numbers & data to make decisions & build models

Pilot Project

___________ is used to experiment by trying out a solution alternative on a small or restricted basis to reduce risk and to see whether major problems will occur. Decide to implement a solution, decide to try it out on a limited group to see if it helps, trial run

Shared Governance

_______________ is an organizational structure that promotes empowerment and autonomous decision making at the point of care, accountability that is shared among all parties in a decision, and organizational processes that promote an egalitarian (all ppl are equal) environment in decision-making processes. Staff nurses have voice to create solutions, everyone has part in process, managers don't have much to do with it

Root Cause Analysis

finding origination of problem to prevent from happening again to minimize risk (could not find in chapters)

clinical judgment

the ability for the nurse to recognize any changes in a patient, potentially contacting the physician, and invoking a rapid response team when needed

Primary nursing

▪ 24-hour-per-day accountability for the patient's plan of care from admission to discharge. ▪ Nurse does everything ▪ Not much support staff because the nurse does everything ▪ This model enhances continuity of care; maximizes RN utilization of professional competencies, such as critical thinking, collaboration, and teaching; and philosophically complements holistic, patient-centered care. ▪ Implementation of this model is threatened when nurses are required to care for too many patients

Team nursing

▪ A care model that uses a group of people led by a knowledgeable nurse. ▪ Provides care to a group of patients by coordinating a team of RNs, LPNs, and CNAs under the supervision of one nurse, called the team leader. ▪ Designed to make use of each member's capabilities to meet the nursing needs of his or her group of clients. ▪ Blurring of scopes of practice along with educational preparation and training in professional and specialty silos are significant challenges for this nursing model ▪ Used by home health