Combo with LEADERSHIP midterm study guide and 5 others

THEORIES
Are group of related concepts that explain existing phenomena and predict events. It provides us with a frame of reference, the ability to choose concepts to study of ideas that are within ones practice.
MIDDLE RANGE THEORIES
A nursing theory that refers to a specific population or to specific situation, thereby making the theory easy to understand.
THEORY OF UNPLEASANT SYMPTOMS
Examines symptoms that are influenced by physiologic, psychologic, and situational factors as they relate to performance.
GRAND THEORY
is broad in scope and may describe and explain large segments of human experience.
DEVELOPMENTAL THEORY
is not a standard term applied to nursing theory.
FLORENCE NIGHTINGALE
investigated the effects of the environment on healing, and this serves as the foundation for nursing science.
Madeleine Leininger
proposed the theory of cultural care diversity and universality. This theory of transcultural nursing comprises concepts involving caring and the components of a cultural care theory: diversity, universality, worldview, and ethnohistory.
Martha Rogers’ theory
is based on the nurse’s promoting synchronicity between human beings and the universe/environment.
Dorothea Orem’s self-care deficit model
facilitates client self-care by measuring the client’s deficit relative to self-care needs. In __________ the nurse implements measures to assist clients in meeting self-care needs by matching them with an appropriate supportive intervention.
Hildegard Peplau’s theory
identifies feelings of the client as a predictor of positive outcomes related to health and wellness.
Peplau’s interpersonal relations model
explores the interpersonal relationship between the nurse and the client and identifies the client’s feelings as a predictor of positive outcomes related to health and wellness.
Watson’s theory of human caring
is a holistic outlook, proposed in 1978, that addresses the effect and importance of altruism, sensitivity, trust, and interpersonal skills.
King’s theory of goal attainment
proposed in 1971, addresses client systems and includes society, groups, and the individual.
Roy’s adaptation model
when the client incurs an insult that renders him or her in need of environmental modification, the nurse will be the change agent in assisting the individual with this adaptation.
stimuli frame
the client reacts to some stimulus in a negative manner.
The hypothesis
asks the question that is to be the main focus
The method
decides what data will be collected to answer the question.
evaluation
results are examined with the goal of determining the relevance of outcome data in answering the hypothesis; also the significance of the data and the potential for future research are explored.
Data collection
is a step-by-step procedure that is undertaken with the goal of answering the question.
The institutional review board (IRB) (also called the human subjects committee)
examines research proposals to ensure that the ethical rights of those individuals participating in the research study are protected. This board makes sure that persons who participate in research are assured that their right to privacy, confidentiality, fair treatment, and freedom from harm is protected.
Phenomenology
is a qualitative research design that uses inductive descriptive methodology to describe the lived experiences of study participants.
Utilization of research guides nursing practice.
Clinical agencies need to make a commitment to implementing research findings and then developing policies and procedures to guide the implementation process.
A needs assessment method
is a study in which the researcher collects data for the purpose of estimating the needs of a group; commonly used to prioritize the needs of an organization or community.
A pilot study
is a smaller version of a proposed study conducted to develop or refine methodology, such as treatment, instruments, or a data collection process, to be used in a larger study.
Survey
is a nonexperimental research design that focuses on obtaining information regarding the status quo of some situation, often through direct questioning of participants. A survey is a research design that is used to collect demographic information, social characteristics, behavioral patterns, and other information.
Quasi-experimental research design
is a type of quantitative research that lacks one of the components (randomization, control group, manipulation of one or more variables) of an experimental design.
Case study designs
are used to present an in-depth analysis of a single subject, group, institution, or other social unit. The purpose is to gain insight and provide background information for more controlled, broader studies.
The National Institute of Nursing Research
is a federal agency that provides federal funding for health care research.
Sigma Theta Tau International
is a nursing organization.
Qualitative data analysis
results in the organization of words or phrases, not numbers. Interviews are reviewed and are transcribed line by line in an effort to group common conceptual meanings. ___________ research involves ambiguous concepts. Analysis of interviews with participants who are experiencing the phenomena enables the researcher to describe unclear phenomena. ___________ research is time consuming and costly. One-on-one interviewing takes time, and the interviews must be recorded, typed, transcribed, and analyzed. Qualitative studies use small sample sizes that are not randomly selected. The small sample sizes used in ____________ research do not allow results to be generalizable to the whole population.
Descriptive statistics
consists of numerical data.
Inferential statistics
consists of numerical data.
Forensic nurses
focus on trauma, abuse, and violence. The ______ ______ provides direct services to clients and consults with and serves an expert witness for medical and law enforcement.
A change agent
is one who searches for possible alternatives regarding issues that involve patient care, safety, and motivation of the industry and who assesses cost-effective resources for use in health-related situations.
educator
A nurse functioning in the role of _______ helps patients understand the complications of their disease process.
care provider’s role
The primary focus of the ____ ____ _____ is to use the nursing process in caring for patients. Care is based on assessment of symptoms and the person as a whole.
The statue the Spirit of Nursing
was created to honor all military nurses.
According to the U.S. Bureau of Labor Statistics
the nursing profession is predicted to have only 64% of the RN workforce required to meet demands in 2020.
Nurse Reinvestment Act of 2002
funds $20 million to provide nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants.
Yale University
In 1924, ______ _______ offered the first separate Department of Nursing, whose graduates earned a baccalaureate degree.
Performance-based assessment
is the evaluation of abilities based on an objective demonstration of specific required competencies. This may include performance in actual or simulated situations.
Distant learning
occurs when courses are delivered through some electronic format such as a Web-based course. The course may be presented a great distance from the student, who is never required to attend a class at a physical location.
The NCSBN
coordinates licensure activities on a national level and creates and administers the licensure examination (NCLEX).
Core competencies
are those skills and elements that are fundamental and essential for safe competent practice.
ANCC
The nurse should contact the _____ to determine the education, experience, and examination requirements that must be met if one is to become certified.
ANA
is a professional organization that represents all nurses.
NLN
is a professional organization whose members represent multiple disciplines; this group conducts many types of activities, including accreditation of nursing education programs.
NCSBN
is an organization whose membership consists of the board of nursing from each territory of the state.
Protecting the public
is one of the essential purposes of the state board of nursing, which regulates licensure.
Nurse practice acts
represent the aims and concerns of many individuals and groups and are written and passed by legislators.
Sunset legislation
may be included in a state’s nurse practice act, and this means that the act must be reviewed by a specific date; if not, it is automatically rescinded.
NCSBN website
contains compact state information. Nurses who practice in a compact state are responsible for following the laws and regulations of each state in which they practice.
nurse anesthesia
In 1946 _____________ became the first field of nursing practice to certify advanced practitioners.
caregiving role
The most important role in community nursing.
Community setting
a nurse manages and cares for the community. Using the nursing process and critical thinking skills, a nurse develops appropriate, individualized nursing care for specific patients and their families. In addition, the nurse individualizes care within the context of the patient’s community to achieve long-term successful health care outcomes.
Efficiency
means using the right combination of resources—energy, time, and money—to accomplish a task, and effectiveness means doing the right thing right in health care.
Cost shifting
occurs when providers increase their charges against households and public and private insurers who pay for their own care while making some contribution to the care of the uninsured population.
Community health nursing
incorporates knowledge from published health sciences. It is broader than the focus of public health. A community-based nurse works in an established program that provides health services to specific populations in the community.
The Patient Self-Determination Act of 1990
is a federal statute that was established to support individuals in expressing their preferences about medical treatment and making decisions about end-of-life care.
Durable power of attorney
involves preselection by the client of a person who has been authorized legally to make health care decisions once the client becomes incompetent to do so.
A living will
is a formal document in which a competent adult makes clear his or her wishes regarding care that will be provided in the final stages of a terminal illness.
Informed consent
is information that is provided by the physician or advanced practice nurse so that the client can make intelligent health care decisions and must reveal expected benefits.
Libel
is defined as comments that are written about a person that are defaming. Nurses may be subject to a charge of libel for subjective comments meant to denigrate the client that are placed in the medical record or in other written materials read by others.
Negligence
Negligence is defined as failure to act in a reasonable and prudent manner. The most frequent allegations include failure to ensure client safety, improper treatment, failure to monitor the client and report significant findings, medication errors, and failure to follow the agency’s policies and procedures. Delegation of client care tasks falls within the role of the team leader, and inappropriate delegation of client care tasks could result in ________
The Emergency Medical Treatment and Active Labor Law (EMTALA)
is a federal statute that was enacted in 1986 to prohibit the transfer of unstable clients, including women in labor, from one facility to another. This law also prohibits refusal of care for indigent and uninsured clients who seek medical assistance in the emergency department.
Autonomy
is the principle of respect for the individual person. It is defined as personal freedom, the right to make choices.
Veracity
is telling the truth in personal communication as a moral and ethical requirement.
Deontology
is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontologic theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty.
Accountability
is an ethical duty that states that one should be answerable legally, morally, ethically, or socially for one’s activities.
Paternalism
is an action and an attitude wherein the provider tries to act on behalf of the client and believes that his or her actions are justified because of a commitment to act in the best interest of the client. _________ is a reflection of the “father knows best” way of thinking.
The first step in the situational assessment procedure
is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions. Trying to understand the full picture of a situation is time consuming and requires examination from many different perspectives, but it is worth the time and effort that is required to understand an issue fully before moving forward in the assessment procedure.
second step in the situation assessment procedure.
Identify all possible alternatives _____________________. A set of alternatives cannot be established until an assessment has been completed.
the third step in the situation assessment procedure
Selecting the best option is actually _________________. Options cannot be selected until an assessment has been done to define the issue.
Justifying the action or inaction is the final step in the situational assessment procedure. No justification can be made until the assessment and action phases have been completed
Utilitarianism
is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. On the basis of this principle, an attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the situation.
Veracity
is the principle of telling the truth in a given situation.
Autonomy
is the principle of respect for the individual person; this concept states that humans have incalculable worth or moral dignity. Within the concept of autonomy, people are free to form their own judgments and perform whatever actions they choose. They are self-determining agents who are entitled to decide their own destiny
The Hill-Burton Act, also known as the Hospital Survey and Construction Act
was enacted in 1950. This act provided funding that resulted in a boom in the construction of hospitals across the country. As the number of hospitals increased rapidly, so did the need for nurses to staff the hospitals. Thus the nurse’s role was shifted from community and public health settings to the acute care setting.
A constituent
is a citizen who has the opportunity to vote for candidates in elections for representation at local, state, and federal government levels.
The legislative branch
possesses the sole federal power to enact legislation; the ________________ originates and promotes major policy initiatives and has the power to override a presidential veto.
diagnosis
step in the nursing process is consistent with identification of the targeted issue in the political process
assessment
step would involve collecting information and understanding the information collected prior to actual identification of the issue.
Planning
occurs after the information has been collected and the issue has been identified; generally, an effective policy plan involves input from many sources and perspectives.
Implementation
occurs after an issue has been identified and a plan has been developed; this plan is then implemented through political action and a set of strategies
A political action committee (PAC)
is an arm of an organization, association, or labor union that is formed to persuade a policy maker to support a certain policy or program or, more often, to ensure the election or re-election of policy makers who support the organization’s goals.
American Nurses Association Nurses Strategic Action Team (N-STAT).
keeps members up to date about background information and the platforms of candidates who are running for national office; ____________ also provides updates about key bills as they move through the legislative process.
Asian culture
The median family income is slightly higher than that of non-Hispanic whites; because their income is higher, _____ have better access to health care. In _________, individuals tend to be present oriented and time is viewed as being more flexible than in the Western culture; being on time for appointments is not seen as a priority.
Asian
usually have close, extended family ties, and emphasis is on family needs rather than individual needs; all members participate in health care decisions. The _________ culture is present oriented and _______ individuals are often late for appointments because they are less concerned with planning ahead. Males often make decisions.
In this culture it is important for an individual to agree with those in authority and to appear compliant, even if there is no intention of complying with instructions or plan of care.
Southeast Asian culture
touching a burning cigarette or piece of cotton to the skin, usually the abdomen, is done to compensate for “heat” lost through diarrhea. This type of burning is a common part of self-care.
Mexican-Americans
at 40%, they have one of the highest uninsured rates
mal ojo
The child has what is referred to as ________, which can lead to diarrhea, fever, and even death. It is associated with “evil eye,” which causes fever, diarrhea, and restlessness.
vista fuerte
A child said to have been exposed to __________ would experience diarrhea.
Susto
is an emotion-based illness that is common among Mexicans. An unexpected fall, a barking dog, or a car accident could cause ______. Symptoms include colic, diarrhea, high temperature, and vomiting.
Empacho
is a disease that can affect children or adults and is caused by food particles that become lodged in the intestinal tract, causing sharp pains
Bilis
is a disease that is brought on by anger. It primarily affects adults and commonly occurs a day or two after a fit of rage.
cultural self-assessment
The first step to becoming a culturally sensitive and competent health provider is to conduct a _____________________. Through identification of health-related attitudes, values, beliefs, and practices, the nurse can better understand the cultural aspects of health care from the client’s perspective.
African-American culture
In this culture, women, especially “Granny,” play a key role in health care decisions.
A low tone of voice
is consistent with the American Indian culture, and touching another’s hand is not common among Asians or American Indians.
Cancer
is identified as the cause of excessive death among minority group members. The six leading causes are cardiovascular disease and stroke, chemical dependency, diabetes, homicides/accidents, and infant mortality.
Chronic obstructive pulmonary disease
is not identified as one of the six leading causes of death among minority groups.
Marginalized populations
include recently arrived immigrants. Their lives and health care needs often are kept secret and are understood only by them.
Cultural competence
is the responsibility of all nurses to become knowledgeable about the values, beliefs, and health care practices of the culturally diverse groups that are dominant in the nurse’s particular practice area.
Ethnocentrism
is the belief that one’s own ethnic group, culture, or nation is best.
Prejudice
is a preconceived, deeply held, usually negative judgment that has been formed about other groups.
Stereotyping
is defined as assigning particular beliefs and behaviors to specific groups without recognition of individuality.
Biologic variations
include denser bones in African-Americans. ________________ such as body build and structure, genetic variations, skin characteristics, susceptibility to disease, and nutritional variations exist among different cultures. Other common variations include skin color, eye shape, hair texture, and adipose tissue deposits.
moxibustion
Applying heat to the acupoints
Biofeedback
is a type of mind-body intervention that is based on techniques in which the client is taught to alter specific bodily functions such as heart rate, blood pressure, and muscle tension. The client uses various relaxation and imagery exercises to produce desired responses.
Ayurveda
consists of a group of noninvasive approaches that are used to achieve balance; these include yoga, massage, diet, purification regimens, breathing exercises, meditation, and herbs.
homeopathy
the care provider provides small quantities of remedies that produce symptoms similar to those of the illness being treated.
chiropractor
corrects misalignments of the spine, called subluxations, by putting pressure on the nerves that are causing pain. are licensed in the state in which they practice.
Chiropractic medicine
is performed by a licensed professional with reimbursement privileges and is an accepted complementary alternative medicine (CAM) therapy. It is covered by most insurance companies. ____________________ has been practiced for longer than 100 years.
Atropine
is derived from the Atropa belladonna plant, which primarily affects the parasympathetic nervous system.
The drug digitalis (Lanoxin)
is derived from the Digitalis purpurea plant; it increases contractility of the heart, making it a popular choice for patients in heart failure.
ipecac
The drug __________ is derived from the plant Cephaelis ipecacuanha, which is used to induce vomiting in some cases of poisoning.
reserpine
The drug ___________ is derived from the plant known as Rauwolfia serpentina and was used in the past to treat patients with depression; currently, it is used in the treatment of those with hypertension.
Ginkgo
reduces the efficacy of anticonvulsants, which may lead to increased seizure activity. ________ decreases coagulation of blood by prolonging bleed time. _________ has no known effect on sodium regulation.
Calcium
results in kidney stones and malabsorption of other essential minerals
Magnet therapy
is thought to relieve pain by creating a slight electrical current that stimulates the nervous system; it is also thought to speed wound healing by dilating vessels and increasing circulation to an area and is even purported to boost the immune system. The effect of magnets on fetal growth has not been determined.
imagery and relaxation
Both are used to reduce anxiety and stress. ________ begins with a goal that is to be achieved and a picture that is formulated by the person under treatment. Imagery is self-constructed. ____________ is incorrect because it is not contraindicated and can actually be used to reduce stress and discomfort associated with pregnancy.
A hypnotist
conjures up a desirable image
Hypnosis
can recall both positive and negative images/memories.
Aromatherapy
is safe throughout pregnancy, unless the patient is allergic to particular scents.
Therapeutic touch requires only light or no physical contact.
pre-impact stage
Every disaster begins as a local event known as the ____________________, which consists of planning, preparedness, prevention, and warning.
At the impact stage
all efforts are directed to responding to the disaster, initiating the emergency management system, and limiting the effects of the hazard
post-impact stage
the focus is on recovery, rehabilitation, and reconstruction; this occurs about 72 hours after the disaster and not before. Evaluation of the disaster plan is a major part of the post-impact phase.
Rehabilitation
is part of the post-impact stage.
The biologic category
refers to diseases such as plague or smallpox.
chemical category
includes diseases that are easily spread through the air and require decontamination.
Radioactive dirty bombs
results in burns and poisoning
nuclear category
consists of thermal burns due to nuclear blasts.
MMRS
responds to disaster with trained individuals who have expertise in this type of situation and who have the equipment required to be effective. funded by local and state governments until funds are exhausted; then federal funds are contributed.
The Strategic National Stockpile
is a national repository, supplies antibiotics, chemical antidotes, antitoxins, IV administrations, airway supplies, and other medical-surgical items as needed to replenish supplies of local and state agencies during a time of emergency. The _________ _____________ __________ provides antibiotics, antidotes, and medical and surgical items when local and state supplies have been exhausted.
The National Disaster Medical System
arranges for the use of federal hospitals.
The Commissioned Corps Readiness Force
is a group of health care professionals who can be deployed to respond to a disaster, as a large group or in small numbers.
The Department of Homeland Security
is the agency responsible for coordinating efforts to protect the United States against terrorism.
The local YMCA
is a large nonprofit community organization that meets the health and human needs of the community through established programs but would not provide the means to obtain medications and supplies.
Trained responders triage care,
so those who have the greatest chance of survival are given priority. Care is shifted from categorizing patients at low, intermediate, and critical risk to using resources to serve those with the greatest likelihood of survival.
Only one
______________ The Hospital Incident Command System has responsibility for determining common terminology.
The facility information officer
determines the effect of the incident and communicates honestly to calm and reassure staff and consumers of the facility and the news media.
The Federal Bureau of Investigation
determines whether a credible threat is present.
Community awareness
occurs during the pre-impact planning stage.
Evaluation of the DMAT
occurs during the post-impact stage.
The Commissioned Corps Readiness Force
is an initiative led by the surgeon general that consists of trained health care professionals who can be deployed to support the DMAT.
The National Disaster Medical System
is the lead federal agency for medical response under the National Response Plan; this system provides supplies and equipment, assists with evacuation, and arranges for hospitalization in federal and voluntary nonfederal acute care facilities.
The crisis communication officer
is the first contact for patients, families, and employees within the facility or news media, so they may better understand the situation and know how to react and protect themselves.
The crisis communication officer
communicates with the news media, as well as with individuals who work at or are consumers of the health care facility. must calm the public and consumers of the facility.the voice to the public that supplies known facts
The MRC
are local volunteers trained to respond to local emergencies.
The NDMS
is a federal emergency system for major emergency and federally declared emergencies.
the Office of the Surgeon General
The CCRF emergency teams are led by _______________________________when emergencies exceed the capability of the local and state services.
Blocking
occurs when the nurse responds with noncommittal or generalized answers.
Open communication
It reflects openness between two parties.
Filtration
is the unconscious exclusion of extraneous stimuli in communication.
False assurance
is showing a lack of concern or a lack of knowledge by responding with meaningless answers such as “don’t worry.” The patient might even conclude that the nurse is trivializing his concern or is patronizing.
Personal perception
is awareness achieved through excitation of all the senses. can be described as all that the person knows about a situation or circumstance according to what each of the senses—taste, smell, sight, sound, touch, and intuition—discovers and interprets. Empathy is the ability to mentally place oneself in another person’s situation to better understand the person and to share the emotions or feelings of that person.
Preconceived ideas
are conceptions, opinions, or thoughts that the receiver has developed before having an encounter. Such ideas can dramatically affect the receiver’s acceptance and understanding of the message.
An appeal to common practice
occurs when the argument is made that something is okay because most people do it.
An appeal to emotion
is an attempt to manipulate other people’s emotions for the purpose of avoiding the real issue.
An appeal to tradition
is the argument that doing things a particular way is best because they’ve always been that way.
A red herring
is the introduction of an irrelevant topic for the purpose of diverting attention away from the real issue.
A straw man
occurs when a person’s position on a topic is misrepresented.
A slippery slope
is the belief that one event will inevitably follow another without any real support for that belief.
Cause and effect
are confused when one assumes that one event must cause another just because the two events often occur together.
(1) providing undivided attention, (2) giving feedback (rephrasing), (3) making eye contact, (4) noting nonverbal messages (body language), and (5) finishing listening before one begins to speak.
In active listening, a number of techniques can be used by the receiver to enhance the ability to listen; these include
Assertive communication
is an overall communication style in which the person displays the presence of positive declaration and persistently demonstrates confidence; he or she has obtained the facts, carefully considered the options, and exuded confidence while forming a point of view; active listening may be a component of assertive communication.
Empathy
is the ability to mentally place oneself in another person’s situation for the purpose of better understanding a person and sharing the emotions or feelings of that person.
Passive communication
is a form of communication in which the individual fails to say what is meant.
Lewin’s stages of change
education and involvement are keys to successful change. People must believe that improvement is possible before they will be willing to consider change.
leadership and management
these terms are used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves.
The manager
is the coordinator of resources (time, people, and supplies) needed to achieve outcomes. _________ are assigned responsibility for accomplishing the goals of an organization.
Authority
is the legitimate right to direct others that is given to a person by the organization through assignment to an authorized position such as a nurse manager.
nurse leader
who has the ability to guide or influence, as well as to motivate and inspire, others on the team.
The nursing process,
which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision making and problem solving.
“Referent”
refers to a type of power that comes from followers’ identification with the leader and is not a leadership style.
seven
How many are the primary sources of power are known.
Expert power
is based on knowledge, skills, and information.
Rewards power
comes from the ability to reward others for complying; it may include such rewards as money, desired assignments, or recognition.
Coercive power
is based on fear of punishment or failure to comply. _________________ fits well into the authoritative behavioral style because authoritative managers dictate the work with much control, usually ignore the ideas or suggestions of subordinates, and provide little feedback or recognition for work accomplished.
Legitimate power
is based on holding an official position within the organization.
Informal leaders
may distribute a considerable amount of power among the workers. They can influence the attitude of the group, and significantly affect the efficiency and effectiveness associated with workflow, goal setting, and problem solving.
An organizational chart
chart is a visual picture of an organization that identifies lines of communication and authority.
Productivity
is the amount of output or work that is produced with a specific quantity of input or resources.
Resources
include personnel, time, and supplies needed to accomplish the goals of an organization.
Staffing
is the manpower needed to complete the work.
Leadership trait theory
describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.
Chaos
is an organizational theory that attempts to account for complexity and randomness in organizations.
Bureaucracy
is part of the organizational theory that provides an understanding of authority within organizations.
Weber’s concept of bureaucracy
revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, by virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place.
Organizational theory
provides the framework for an understanding of leadership and management, and for an understanding of complex organizations
The transactional leader
is concerned with the day-to-day operations of the facility.
Situational theory
has attempted to integrate the dynamics of the interaction between the leader, the worker, and elements of the leadership situation, arguing that effective leadership depends on several variables.
The transformational leader
is committed to organizational goals, has a vision, and is able to empower others with that vision.
The contemporary theories
attempt to integrate the dynamics of the interaction between the leader, the worker, and elements of the leadership situation, arguing that effective leadership depends on several variables
the systems theory
This theory has two types; open and close
Closed systems theory
views the system as being totally independent of outside influence.
Open systems theory
suggests that the organization is affected not only by internal change but also by external environmental changes that can have a direct or an indirect influence on the organization.
Trait theory
which describes intrinsic traits of leaders, is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.
A strategic plan
is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. It generally looks 3 to 5 years into the future.
RN
Only the ________ can perform and sign the admission assessment, although some components such as vital signs may be delegated. The assessment must be completed and signed by the __________; however, some components may be delegated to the LPN/LVN.
NAPs
are not licensed.
LPN/LVN
The scope of practice of the ___________ varies significantly from state to state; RNs should know the _________ nurse practice act in the state in which they practice and should understand the legal scope of practice of the __________ prior to delegating any assignments.
The Joint Commission
The purpose of ____________________ is to increase the safety and quality of care provided to consumers by providing voluntary accreditation that certifies that a hospital meets established standards.
Right circumstance
involves the delegation of tasks that do not require independent nursing judgments.
Right supervision of delegation
involves providing feedback to monitor how the process is working and to suggest improvements to the process.
Right communication
involves giving clear explanations about tasks and expected outcomes.
Right person
involves delegating to someone who is qualified and competent.
The NAP
can increase productivity of the RN by performing those tasks that fall within their scope of practice.
The NAP
cannot supplement staffing when the RN is not available but can assume responsibility for tasks that are simple and routine and do not require adherence to the nursing process.
Dietary consults
are independent nursing orders that only the RN can initiate.
Obtaining a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system
is not an invasive procedure, and risk to the patient is minimal, making the task appropriate for delegation.
Assisting a patient who is ambulating after surgery is not an appropriate task to delegate.
An RN will have to assess the patient’s tolerance and coordinate care on the basis of this assessment.
Supervision is always a required component of delegation.
The state’s nurse practice act
is the deciding factor regarding what can legally be delegated. NAPs are responsible for accepting tasks for which they are competent to perform, but accountability remains with the RN.
Customer satisfaction
_________________ is primarily based on relations with employees. Patients may fear or dislike invasive procedures, but the important consideration in __________________ is the quality of interactions with employees.
total patient care
nurses provide all aspects of patient care.
modular care delivery
a small team is assigned to a geographic location during their assigned shift.
Partnership nursing, or co-primary nursing
pairs the RN with a partner, usually a licensed practical/vocational nurse (LPN/LVN) or nursing assistive personnel (NAP), allowing the RN to spend more time on tasks such as assessment and patient education.
team nursing
an RN directs the other members of the team, which can consist of care providers at various levels.
functional nursing
members of the team are assigned specific tasks such as assessment or medication administration
primary nursing
the RN assumes 24-hour responsibility for the care of assigned patients
The case manager, in collaboration with an interdisciplinary team, oversees the use of health care services by clients throughout a course of illness.
The nurse manager
is responsible for handling the day-to-day operations of the nursing unit and for ensuring that the unit’s philosophy and mission are congruent with those of the parent organization.
The coordinator of patient-centered care delivery
works with an interdisciplinary team in providing a wide range of services.
The team leader
coordinates and delegates care for a specific group of patients.
A variance
is a deviation from the planned path.
The patient outcome
is the end result of care, not just a single specific incident or deviation.
The goal
is to provide high-quality cost-effective care.
A standard
is the criterion from which safe, effective care is derived.
A clinical pathway
is a plan that specifies the timing and sequencing of major patient care activities and interventions by the interdisciplinary team for a particular diagnosis, procedure, or health condition.
A classification system
categorizes patients according to specific criteria and care requirements and thus helps to quantify the amount and level of nursing care needed.
Patient centered
as used in this chapter, refers to a nursing care delivery model that is focused on interprofessional care, with the patient as the focus.
A DRG
places patients into a predetermined reimbursement rate on the basis of diagnosis.
Staffing
is the activity that is involved in determining that an adequate number and mix of health care team members are available to provide safe, quality patient care.
Assignment
is the distribution of work that each staff member is responsible for during a given work period; assigned activities must fall within the individual’s scope of practice and/or job description.
Output
is the work produced, such as the number of patient care hours provided.
Productivity
is the ratio of the amount of output produced, such as patients receiving care or home visits, to the specific amount of input (i.e., nursing hours worked) and is the measure of staffing efficiency.
Patient acuity
is measured by determining the amount and intensity of care required.
Patient satisfaction
is based on interactions or experiences while the patient is receiving care, although staffing can affect patient satisfaction.
delegation of care.
Examination of the skill mix and educational preparation of the staff is the criterion for _______
The number of hospital days required by the patient
is the criterion that is used on care pathways to predict required resources.
The use of temporary, part-time, or agency nurses
can result in a lack of continuity of care, thereby decreasing patient satisfaction, which affects employee satisfaction.
Hiring more part-time employees and the use of “float” nurses
has not been demonstrated to be an effective method of increasing nurse retention.
honeymoon phase
the novice nurse has a positive image of nursing that coincides with the reason for becoming a nurse; this feeling is experienced immediately after the nurse begins work and often while still in orientation. During the honeymoon phase, the novice nurse has not yet been faced with complicated tasks that he or she feels uncomfortable or incompetent to perform. The novice nurse lacks confidence in himself or herself.
Although becoming more organized and improving communication is part of resolving the shock phase, the novice should focus on positive accomplishments and should remember that a nurse cannot learn everything in school—many skills are learned after graduation. Expectations of new graduates are often unrealistic.
shock or rejection phase
the novice nurse is overwhelmed by fear and a sense of incompetence. During this phase, there is inconsistency with what was learned in school and the work environment, and the novice nurse lacks many of the skills needed to be independent in this new role.
***novice nurses must ask themselves what they must do to become the type of nurse envisioned and to make a contribution.***
recovery phase
the novice nurse regains some confidence and begins to heal.
resolution phase
the novice nurse has adjusted to the work environment and can work through change.
“Fitting in”
comes with gaining confidence, which is the issue faced by the graduate.
Symptoms of burnout
include extreme fatigue, headaches, difficulty sleeping, mood swings, anxiety, poor work quality, depression, and anger. ***more common among nurses with type A personalities and those who are overachievers.***
Prioritizing obligations
and retaining friendships outside the work environment can reduce stress, thus reducing the likelihood of burnout.
The novice nurse lacks proficiency, which may be exaggerated by feelings of being overwhelmed by the new environment, causing him or her to not get the facts before asking for help.
Outcomes
are based on meeting existing criteria rather than on knowing how the outcome was achieved.
“determining whether steps are logical”
This step represents the school environment in which steps are performed on the basis of sound rationales.
“formulating increments in correct order”
This step represents the school environment evaluation, which stems from the “correct step” aspect.
“appraising outcomes according to policy”
This step represents the school environment, in which each step is evaluated, rather than indicating the overall outcome.
The experienced nurse knowingly enters into a relationship to advocate for and to enhance the self-esteem of the novice nurse.
Mentoring
requires an interactive process.
A preceptorship
is usually a short-term relationship.
Socialization
is the desired outcome of mentoring but not of actual interactions.
Planning
is the most important step in time management. This allows people to better use their time and can lead to closure in relation to those goals that will produce the greatest internal satisfaction.
Delegating
is giving other people tasks to be accomplished.
The benefits of delegation
1) assisting in developing the initiative, skills, knowledge, and competence of others; (2) maintaining the level of responsibility and decision making of others; (3) freeing time for more important tasks; (4) extending results that can be accomplished from what one person can do alone to what he or she can manage through others; and (5) ensuring that completing the task is cost effective.
Procrastination
is evident when a person is faced with an unpleasant task, a difficult task, or a difficult decision. Usually procrastination is easily recognizable because it involves completing low-priority tasks rather than high-priority ones, and it always welcomes interruptions. The result consists of less productivity, less internal satisfaction, and increased stress.
Energy management
means ensuring that the right amount of effort matches the right task so that outcomes can be optimized, while the amount of personal energy expended/taxed to achieve the desired result is gauged.
Priority setting
is establishing superiority in rank, a preferential rating, or the state of “coming first” in order or ahead of others in a process by which that order will represent the execution of the raked items.
Introspection
is the act of examining one’s own thoughts and emotions by concentrating on the inner self
Fear of completion
is a time management obstacle that may occur if you are afraid of completing a project that is creative and fun. To overcome this obstacle, take the time to understand why you are not completing the task or major project that has been with you for some time.
Mental energy
is the ability to maintain sustained concentration on a task, to move flexibly between broad and narrow issues, and to be internally and externally focused, as needed by the situation. It includes mental preparation, visualization, positive self-talk, effective time management, and creativity.
Physical energy
consists of the key components of successful transition to a productive, highly energizing experience by paying attention to physical energy through routine or proper eating, adequate sleep and exercise, and frequent breaks during long shifts, as well as by drinking plenty of water and focusing on one activity while collecting thoughts about what to prioritize next.
Spiritual energy
requires presence in a quiet place, often to help one identify his or her vision of life as well as purpose and direction.
Emotional energy
is dependent on physical, mental, and spiritual energy for building emotional capacity.
emotional intelligence.
Managing emotions skillfully in the service of high positive energy and full engagement is called….
use the nursing process in caring for patients.
The primary focus of the care provider’s role is to
nurse researcher
Advancing nursing practice through research is the role of the ___________. The basic premise is to ensure that outcomes in client care services are consistent with established standards.
The coordinator
is responsible for coordinating clinical and administrative requirements for the patient. The ___________ also does not provide acute care patient education but coordinates care on an inter-professional plan.
The role of the counselor
is to emphasize to the patient health promotion and maintenance.
The occupational health nurse
organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities.
Infection control nurses
assess the total incidence of infections within the hospital.
Informatics
deals with data management for decision making
informatics specialist
The role of the ___________ ____________ includes managing and processing health care information.
The role of the case manager
includes coordination of resources to achieve the best outcomes based on quality, access, and cost.
The educator role
includes teaching and does not include coordination of resources. A nurse functioning in this role helps patients understand the complications of their disease process.
The quality manager
addresses the need for health care providers to assess opportunities for process improvement, to implement changes, and to measure outcomes.
The forensic nurse
provides direct services to clients and consults with and serves an expert witness for medical and law enforcement.
The role of the flight nurse
is to care for diverse clients in an autonomous practice while using the opportunity to apply advanced skills.
A triage nurse
provides a decision on what level of care a client may need after performing telephone or physical assessment.
A change agent
is one who searches for possible alternatives regarding issues that involve patient care, safety, and motivation of the industry and who assesses cost-effective resources for use in health-related situations. The role of the ____________ consists of assessing health care delivery issues and creating solutions to improve health care delivery.
The nurse manager
does not provide education to patients, as the acute care nurse would. The manager is the one who assesses the need for staffing and must justify this in a substantial way.
Interprofessional
as related to member roles, involves members of many disciplines working together to provide patient care to a distinct population.