unit 3/week 4

The nurse manager is implementing a new staffing strategy, and identifies that which response from a team member may indicate that change management strategies may be needed? "This is exactly what I've wanted to do! Sign me up." "I'd like to read more about this new plan before I agree to try this." "Could you tell me exactly what you want us to do?" "I really don't see the need for this—our current staffing plan works fine."

"I really don't see the need for this—our current staffing plan works fine."

The new evening charge nurse recalls that there are both internal as well as external forces that influence changes on a unit. In a staff meeting, she explains that what is NOT an external force? Demands from the collective bargaining union to increase wages of unlicensed assistive personnel A patient safety report from the Hospital Safety Officer revealing that medication errors have increased by 15% across all inpatient units Low morale of the unit staff due to several unexpected resignations A memo from the Director of Nursing requesting staff consider carpooling to cut down on overfilled parking lots

Low morale of the unit staff due to several unexpected resignations

Which activity would the nurse manager expect in the unfreezing stage of change? Setting target dates for the implementation of the change Being present to support others through the implementation of the change Making others aware of the need for the change to be implemented Developing appropriate strategies to implement the change

Making others aware of the need for the change to be implemented

The nurse leader should not only understand the change process but also understand how to adapt to various methods in order to become an effective change agent in their organizations.

TRUE

After attending a health care research seminar, a registered nurse who works in the transplant unit became very interested in the ability of 3D printing to help save lives. The nurse would really like to raise awareness and see the hospital invest in a 3D printer. What are the different technical reasons for resistance that the nurse may encounter? (Select all that apply.)

-budget issues -unqualified personnel -lack of resources

The chief nursing officer (CNO) at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. This CNO is part of what type of organization? Mission Flat Matrix Traditional

Flat

The new nurse manager identifies what reason for the need to thoughtfully use a change management process? If all critical human and organizational elements are addressed in a structured manner, it increases the likelihood of sustainable change. The nurse manager can follow change management instructions step-by-step from a manual so as not to forget any critical element. Staff members are more likely to agree to the change if they know it comes from a recent management theory. Since change is infrequent in a health care organization, this is a new skill that managers may not have to use frequently

If all critical human and organizational elements are addressed in a structured manner, it increases the likelihood of sustainable change.

The charge nurse of a step-down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the "Movement stage" can be more successful if certain things are considered by the change agent. (Select all that apply.)

Implement the change Include all stakeholders Set target dates

What is the effect on a nurse who experiences a disconnection between personal and organizational values? Change that leads to effective leadership Intrapersonal conflict and burnout Unrealistic expectations Leads to goal evaluation

Intrapersonal conflict and burnout

A nurse leader is working in the ER when a patient presents with a deep head laceration requiring immediate suturing. The nurse leader went to the medical supply area for antibacterial ointments, gloves, and bandages. However, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. The next morning, the nurse leader began to ask team members if they had any input regarding the organization of the medical supplies, and then began to brainstorm a few different ideas, such as rearranging the supplies and relabeling items. What is the next stage of change the nurse leader should address?

Plan

1A nurse leader is thinking about approaching their manager with a new idea. To be properly prepared, the nurse leader should recognize this as a natural and expected response to change

Resistance

A nursing staff member in the ED has noted where improvement of a procedure would bring about more efficiency. The staff member wants to share their idea with their supervisor. What would be the best option to facilitate the possibility of change?

Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration.

A nurse on a busy medical-surgical unit must delegate some care assignments to an experienced nursing assistant. What factor(s) does the nurse consider prior to delegating the care to the nursing assistant? Organizational mission State or national standards Organizational structure Organizational philosophy and values

State or national standards

Which response by the nurse manager is most appropriate when overhearing staff complaints about a new hospital-wide process to improve patient ID band identification? I understand your concerns, but since patient safety is our number one goal, we have to learn to make this work. Let's start today with addressing these new patient ID bands in every huddle, and then I'll send a memo before calling a special meeting to discuss this by the end of the week. I hear your concerns and they are important to me, but this is a hospital mandate, so we have to work together to figure out how our unit can comply. I've put this topic on the agenda for next month's staff meeting so we can discuss it there.

Let's start today with addressing these new patient ID bands in every huddle, and then I'll send a memo before calling a special meeting to discuss this by the end of the week.

The mission of the acute care facility is, "We are dedicated to creating a healthy community, one person at a time." What nursing leadership activities would correlate with that mission? (Select all that apply.) Mediating a dispute between two nurses about the shift schedule Notifying nursing staff of an upcoming CEU seminar on healthy eating for low-income families Mentoring a nursing student who is interested in introducing smoking cessation to patients and patient families without being preachy Placing a staff member on probation for tardiness and excessive break times. Reviewing health care provider orders to guarantee the nursing staff is appropriately carrying them out

Notifying nursing staff of an upcoming CEU seminar on healthy eating for low-income families Mentoring a nursing student who is interested in introducing smoking cessation to patients and patient families without being preachy Reviewing health care provider orders to guarantee the nursing staff is appropriately carrying them out

A nurse leader has an idea for changing the intake flow in the ER to leverage more of the nursing staff. The leader knows that if they could implement the idea as a pilot program, they could prove its effectiveness and then use it in all the ERs in the region. The nurse leader is frustrated, however, because in order to implement even a pilot of the idea, a proposal must be submitted to the ER Supervisor with a start-to-finish scenario that details not only the process but also the risks, liabilities, and cost estimates. If the supervisor approves, the proposal would then be sent to the Chief Nursing Officer, who would then send it to the Administrator and Board of Directors for review and approval. Which of these factors are influencing the nurse leader's ability to implement the pilot program? State or National standards Organizational mission Organizational structure Organizational philosophy and values

Organizational structure

A nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. After working in the new hospital for a month, the nurse leader believes it would be a great idea to brighten the rooms with a lighter paint job, obtain newer hospital beds and curtains, and hang some fun artwork. However, the nurse leader doesn't want to be perceived as a threat to the team. How could these ideas be presented to minimize resistance? (Select all that apply.)

-Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea., -Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics., -Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful.

A new nurse manager on a med-surg unit is not satisfied with the consistently low scores on patient-satisfaction surveys in the area of staff responsiveness. The manager has also noticed that staff morale is quite low compared to other units. Which strategy is a priority for this new nurse manager? Develop an action plan to address the patient safety results. Inquire about strategies being used in other areas of the hospital to improve patient satisfaction. Request assistance in dealing with this situation from another nurse manager on a similar unit. Schedule a special staff meeting to address the survey results and add "patient survey results" as a standing agenda item for each monthly staff meeting.

Schedule a special staff meeting to address the survey results and add "patient survey results" as a standing agenda item for each monthly staff meeting.

What is the role of the change agent?

Seeks to lead or create change

Which of these changes is likely to encounter the least resistance?

Introducing a new type of IV pump

A newly employed nurse is reviewing the organizational chart of the facility, observing that there is shared governance. What type of organizational chart does the nurse recognize the facility follows? Magnet Matrix Flat Traditional

Matrix

The charge nurse for a post-op treatment center believes that change needs to take place to make the nursing process smoother and the treatment center safer. The nurse's rationale for making change would include which reasons? (Select all that apply.)

-To reduce unnecessary workload -To improve staff productivity -To solve an existing problem

A nursing staff member who is on a unit committee to bring about a planned change is currently in the integrating phase of change. What activities are associated with the integrating phase? (Select all that apply.)

-Assessing how well the new process is accepted and becoming the norm, -Assessing how well the change is working against an established measurement for success

1A few months ago, a new nurse leader at a hospital discovered via evidence-based practice that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of planning stage? (Select all that apply.)

-Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval., -Anticipating resistance to the change by less tech-savvy staff.

The nurse leader is a change agent and needs to identify factors that lead to resistance of change. Identify the factors of resistance. (Select all that apply.)

-Poor timing -Personal energy needed -Lack of trust -Comfort with the current way of completing goals or tasks

Which theories does the student nurse recognize as evidence-based theories of planned change? (Select all that apply.) Stages of Change Model Complex Adaptive Systems Theory Transformational Leadership Theory Maslow's Hierarchy of Needs Theory Transactional Leadership Theory Chaos Theory

-Stages of Change Model -Complex Adaptive Systems Theory -Chaos Theory

The nurse manager for a medical-surgical unit is implementing a change in unit procedures as it relates to patient discharge. During the fourth phase of change known as "action," the manager should incorporate the major component known as:

Communication

A new nursing graduate has just started working in a hospital unit that has had difficulty in staff retention. Which type of resistance may be a result of changes that will occur despite the beliefs of the workforce?

Cultural

Last month, two nursing units were merged to save on staffing costs. The nursing manager is now inquiring among the staff about how the change is working and if any barriers remain. What stage of change is this?

Integrate

Which statement is an example of Lewin's "refreezing" phase of change management? Gathering data Deciding if the change is needed Implementing the change Supporting others so that the change can continue

Supporting others so that the change can continue

Which would the student nurse recognize as phases in Lewin's Theory of Planned Change? (Select all that apply.) Resistance Unfreezing Movement Education Reluctance Refreezing

Unfreezing Movement Refreezing

A single parent raising two children and relying on public transportation, is determined to become a registered nurse. What are the restraining forces in this situation? (Select all that apply.)

Being a single mother relying on public transportation stress of being away from children

It is important for nurse leaders to establish a trusting relationship with those involved in the change process.

TRUE

A nurse manager notices that supply carts are unorganized and could use some attention. What strategy can the manager use to help implement change in this area?

Encourage input from subordinates for potential options.

Select the classic change strategies that nurse leaders use to apply the change process. (Select all that apply.)

Rational-empirical Power-coercive strategy Normative-reeducative

The nurse leader should identify ______________forces prior to attempting to implement change.

restraining

Which of the following is not included in the contemporary change process?

Evaluation

Choose other factors that may evoke resistance to change. (Select all that apply.)

Anxiety Timing Weak proposal Feelings of losing control

All people and organizational units that will be affected by a planned change should be included in the planning.

TRUE

As the nursing manager of a unit, which key steps should be performed before implementing a change effort? (Select all that apply.)

-Encourage input from team members who would be impacted by the change., -Use a roadmap as a guide to complete the change., -Investigate the magnitude and complexity of the intended change.

The charge nurse of a step-down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the "Movement stage" can be more successful if certain things are considered by the change agent. (Select all that apply.)

Withdrawal Discontentment Anger

A nurse manager is assigned to a new unit due to issues of administrative mismanagement, which had resulted in staff becoming disillusioned as to the mission of the unit. As the unit manager, you are expected to develop new policies for the staff to follow. What is one of the greatest factors that may contribute to resistance of change on this unit?

lack of trust

You are the nurse manager of a medical-surgical unit that is in need of a change in staffing rotation patterns, which will lead to major changes in how the unit is staffed. According to Lewin's Change Theory, what forces are in play to enact these changes?

Driving forces

The nurse is a member of the nursing staff at a hospital that is undergoing significant organizational change. Which factor is the greatest contributor to the resistance encountered with organizational change?

Employee mistrust of management

Change should be immediately implemented if the need for change has been identified.

FALSE

developed a theory which included the stages unfreezing, movement, and refreezing.

Kurt Lewin

Which of the following delineates the set of values and beliefs of an organization's goals and guides the development of the philosophy statement? Organizational statement Departmental philosophy and mission Purpose or mission statement Unit philosophy

Purpose or mission statement

Resistance to change should be expected.

TRUE

The unit manager of a medical-surgical unit is transitioning the unit to electronic charting. According to Lewin's model, which of the following roles describes you as the change agent?

The unfreezer

Which restraining force would the nursing leadership team identify when planning to implement a new self-scheduling system? The possibility of additional days off when two weekly schedules are combined into one schedule The vacancies of two full-time night employees The opportunity to work twelve-hour shifts for those that are interested in doing so A staff-based committee comprised of rotating staff members who oversee the self-scheduling process

The vacancies of two full-time night employees