NURS 2602 EXAM #3

The Joint Commission (TJC)

• Accredited Hospitals

National Quality Forum (NQF)

• Sets standards to measure and improve healthcare quality

Centers for Disease Control and Prevention (CDC)

• Protects public health and prevents disease

Centers for Medicare & Medicaid Services (CMS)

• Runs major health insurance programs and sets care rules

Institute of Medicine (IOM) / National Academy of Medicine (NAM)

• Gives expert advice to improve healthcare

QSEN (Quality and Safety Education for Nurses)

• Teaches nurses how to provide safe, high-quality care

Serious Reportable Event

• Clearly preventable, serious adverse event that results in harm or death

• Defined by NQF

• Example: surgery on wrong body part 

Never Events

• Preventable, egregious errors

• e.g. wrong-patient surgery

Adverse Events

• Any harm caused by medical care

• May or may not be preventable

Sentinel Event

• Unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.

• Requires immediate investigation

• Examples:

1. Patient suicide in hospital

2. Infant abduction

3. Wrong-site surgery

SBAR

• Standardized communication tool:

1. Situation

2. Background

3. Assessment

4. Recommendation

• Improves clarity, reduces errors

NPSG (National Patient Safety Goals)

• Purpose: Improve patient safety and reduce errors

• Established by TJC

• Examples:

1. Correct patient identification

2. Improve communication among caregivers

3. Safe medication use

4. Reduce infection risk (hand hygiene)

Failure to Rescue Phenomenon

• Inability to recognize/respond to patient deterioration

• Leads to preventable complications or death

• Often due to poor monitoring or communication 

Medication Reconciliation

• Comparing patient’s medication list across transitions of care

• Ensures accuracy (admission, transfer, discharge)

Barcode Systems

• Verify right patient, drug, dose, route, time

• Reduce medication errors

QSEN Competencies

• Quality Safety Education Nurses

• Patient-centered care

• Teamwork & collaboration

• Evidence-based practice (EBP)

• Quality improvement (QI)

• Safety

• Informatics

Promote and Support Culture and Safety in Healthcare

• Encourage reporting errors (no blame culture)

• Use checklists and protocols

• Effective communication (SBAR, handoffs)

• Continuous education

• Leadership support for safety

Community Based Nursing

• Health promotion and disease prevention

• Care in community settings (homes, schools, clinics)

Primary Prevention

• Prevent disease from ever occuring

• Example: vaccines, education

Secondary Prevention

• Early detection of health problems

• Example: screenings (BP, cancer)

Tertiary Prevention

• Preventing long-term disability; restore functional capacity

• Example: rehab, chronic disease care

Healthy People 2030

• National (federal) initiative

• Goals:

1. Improve health outcomes

2. Eliminate disparities

3. Promote health equity

4. Improve access to care

SDOH (Social Determinants of Health)

• Conditions where people live, work, learn

5 Domains of SDOH (Social Determinants of Health)

• Economic stability

• Education access/quality

• Healthcare access/quality

• Neighborhood & built environment

• Social/community context

Health Equity

• Fair opportunity for everyone to be healthy

Complementary Therapies

• Used WITH conventional medicine

Alternative Treatments

• Used IN PLACE of conventional medicine

Integrative Medicine

• Combines conventional + complementary therapies

• Focuses on whole person (mind, body, spirit)

CAM (Complementary and Alternative Medicine) Examples

• Acupuncture

• Herbal medicine

• Massage therapy

• Meditation

• Yoga

Leadership/Leader

• The ability to persuade others to follow your direction, to motivate, to inspire, and to instill vision and purpose

• inspires, motivates, creates vision

Management/Manager

• Performing activities such as planning, organizing, directing, and controlling with the purpose of accomplishing specific goals and objectives within an organization

• organizes, plans, controls processes

Accountability

• Refers to the obligation to answer for one's actions and to do what is promised

• Responsibility for actions/outcomes

• Used synonymously with responsibility

Authority

• The power or right to give directions, take action, and make decisions

Great Man Theory

• Leaders are born with natural qualities that make them effective, not made through training

Attribution Theory

• People judge a leader’s actions by assigning causes, which affects how they view the leader

Charismatic Theory

• Leaders inspire and motivate others through their personality and vision

Transformational Leadership

• Inspires and motivates others to achieve a shared vision and grow professionally

Transactional Leadership

• Focuses on tasks, rewards, and consequences to manage performance

Autocratic/Authoritative Leadership

• Leader makes decisions alone with little input from others

• Only the leader makes decisions

Democratic Leadership

• Leader includes team members in decision-making and values their input

• Team involvement

Laissez-Fair Leadership

• Leader gives minimal direction and allows team members to make their own decisions

• Hands-off

Multicratic Leadership

• Leader uses a mix of leadership styles depending on the situation

• Shared decision making

Powers of a Nurse Leader

• The ability to do, act, or produce; the ability to control others

• Legitimate power (position)

• Referent power (charisma and relationships)

• Reward power

• Coercive power

• Expert power

• Informational power

• Connection power

• Motivational power

Emotional Intelligence (EI)

• Ability to understand/manage emotions

• Improve EI:

1. Self-reflection

2. Active listening

3. Stress management

4. Empathy development

Performance Appraisal

• Evaluation of employee performance against established standards

• Effective system:

1. Clear criteria

2. Fair and consistent

3. Ongoing feedback

4. Goal-oriented

Team

• A group of individuals working together toward a common goal (patient care)

Team building (IMPORTANCE)

• Improves patient outcomes

• Enhances communication

• Reduces errors

• Increases job satisfaction

• Promotes efficiency and collaboration

Coach/Team Leader

• Guides and supports team members

• Provides constructive feedback

• Encourages professional growth

• Promotes teamwork and collaboration

• Models professionalism and accountability

• Helps resolve conflicts

• Delegates appropriately

Delegation

• Assigning tasks appropriately based on:

1. Skill level

2. Scope of practice

3. Patient condition

• Providing clear instructions

• Supervising and following up

• Ensuring patient safety

5 Rights of Delegation

• Right task – appropriate for delegation

• Right circumstance – patient condition is stable

• Right person – competent individual

• Right direction/communication – clear instructions

• Right supervision/evaluation – monitor and evaluate outcome

Lewin’s Theory of Change

1. Unfreezing

• Recognize need for change

• Prepare people (awareness)

2. Movement (changing)

• Implement the change

• Provide support and education

3. Refreezing

• Stabilize the change

• Make it part of routine practice

Intrapersonal Conflict

• Within oneself

Interpersonal Conflict

• Between individuals

Intergroup Conflict

• Between groups

Conflict Resolution (Coping with Conflict)

• Avoiding: ignoring the issue (temporary)

• Accommodating: giving in

• Competing: assertive, win-lose

• Compromising: both sides give up something

• Collaborating: win-win (best approach)