Test 2

What are fixed staffing models?

they are built on a set number of nurses for a particular unit on shift and frequent changes are not considered

What is flexible staffing?

it considers variations like changes in the severity of patient conditions, volume, or procedural requirements more responsive to a complex healthcare environment

What is acuity?

it is the measurement of patient severity of illness related to the amount of nursing resources required

What is the prototype evaluation system?

• older approach

• subjective and descriptive

• patients are classified into broad categories

What is the factor evaluation system?

• more objective

• each task, thought process, and patient care activity has a time or rating

What are the 5 components of the American Nurse Association (ANA) staffing principles?

• consumer

• interprofessional team

• work culture

• practice environment

• evaluation

What are the seven concepts within the Nursing Intellectual Capital theory (NIC)?

• nursing intellectual capital

• nursing human capital

• nursing structural capital

• nursing performance

• organizational performance

• nursing capital investment

• nursing human capital depletion

What is units of service (UOS)?

it is the measurement of activity that defines the unit workload determined by number of inpatients admitted by midnight census

What is forecast?

it projects the volume of work that will be performed during the upcoming year

What is Hours Per Patient Day?

it is the budgeted standard of productive, direct care hours for inpatient units

How is Hours Per Patient Day calculated?

it is determined by dividing the total production in hours by the number of patients

What is nursing productivity?

• units of service (UOS) x volume = hours available to create direct productive staffing plans

What is a variance report?

it shows changes in productivity resulting in a difference between projected staffing plan and actual schedule

What is centralized scheduling?

• staffing coordinator

• aware of abilities, qualifications, and availability of supplemental personnel

What is decentralized scheduling?

managers develop the schedule in isolation from all other units

What is staff self‑scheduling?

it promotes autonomy and increases staff accountability

What are informal performance appraisals?

• might be as simple as immediately praising an individual

• ‘thank you for all your hard work today”

What are formal performance appraisals?

it is written documentation according to specific organizational guidelines to measure employee performance

What are some key behaviors for the performance appraisal session?

• provides a quiet environment

• allows employee to express opinions

• reviews specific examples

• sincere and constructive

What is appropriate feedback from appraisal behavior?

be sincere and constructive in both praise and criticism

What is inappropriate feedback from appraisal behavior?

• eye rolling

• eyebrow raising

• sarcastic comments

What is absenteeism?

it is staying away from work without a good reason

What are some things that contribute to absenteeism?

• uncooperative/unproductive employees

• immature employees

• emotional problems

• substance abuse · incivility

What is emotional intelligence underdevelopment?

• lack of maturity

• socially inept

• unable to control impulses

What are some emotional intelligence underdevelopment characteristics?

• defiance

• testing guidelines

• passivity or hostility

• negative judgments

What is clinical incompetence?

• may surface immediately

• coworkers may cover for them

What is incivility?

• disruptive behavior

• interferes with patient care

• eye rolling

• sarcastic comments

What is role stress?

it is anxiety produced by being unable to meet all role requirements at the same time

What is role strain?

• reduced involvement

• decreased commitment

• job dissatisfaction

What are the steps in clarifying role expectations?

1. remind employee of policies

2. put it in writing

3. day of decision

4. termination if standards not met

What are the in progressive discipline?

• counsel

• reprimand

• suspension

• return with stipulations

• termination

How do you administer progressive discipline?

• verbal warning

• written warning

• final warning and suspension

• termination

What are the guidelines for effective termination?

• manager must be confident everything possible has been done

• employee aware of wrong behavior

• check with HR for rights to termination

What are the steps for documentation of problems?

• description of incident

• actions

• follow up dates and time

What are the licensed nurse's responsibilities from the National Council State Board of Nursing (NCSBN)?

• determine patient needs and when to delegate

• ensure availability to delegatee

• evaluate outcomes and maintain accountability for delegated responsibility

What is a delegatee?

they are individuals who is delegated a nursing responsibility by a licensed nurse, competent to perform the task or activity, and must verbally accept responsibility

What is a delegator?

it is a licensed nurse who delegates nursing responsibilities or allocates a portion of work related to patient care

Who are Unlicensed Assistive Personnel (UAP)?

they are nursing assistants who do not hold a nursing license

What is responsibility per the American Nurses Association (ANA)?

• reliability, dependability, and obligation to accomplish work

• task is transferred from a licensed nurse to a delegatee

What is authority per the National Council of State Boards of Nursing (NCSBN)?

it is the ability to perform duties in a specific role

What does the American Nurses Association (ANA) define accountability as?

• "to be answerable to oneself and others for one's own actions."

• if actions were appropriate, include a detailed explanation

What is legal authority to delegate?

it is the ability to delegate a nursing responsibility to a competent individual

What are the three parts of legal authority to delegate?

• nurse retains accountability

• legally responsible

• person must be supervised if we fail at any of these three, we can be held liable

What are the five rights of delegation of the staff nurse?

• right task

• right circumstances

• right person

• right direction/communication

• right supervision/evaluation

How is effective communication used in successful delegation?

• it's a two-way exchange between the delegator and delegatee

• the nurse must provide communication that is clear, concise, timely, and reliable to produce safe and efficient person-centered care

What are the four parts of communication in delegation?

• giving information

• giving direction

• seeking clarity

• seeking advice

What should we do as nurses before delegating a task?

you should assess the patient to make sure they are stable

Can an unstable patient be delegated to someone else?

no, the patient must be stable before delegation can occur

What is under delegation?

it happens when people aren't comfortable delegating and most of the time has to do with confidence of the person delegating or poor communication skills

What is over delegation?

it happens when units are overwhelmed and give too many assignments to one personnel; it can create problems

What is improper delegation?

it happens whenever someone is given an assignment that is out of their scope of practice

Does the Nurse Practice Act (NPA) have jurisdiction of delegation?

yes, they do have jurisdiction

Is the National Council State Board of Nursing (NCSBN) used to protect the nurses or the public?

they regulate our nursing practice to protect the public

What is Rule 224 within the Texas Board of Nursing?

RN delegation of nursing tasks by registered nurses to unlicensed personnel for clients with acute conditions or in acute care environments

What is Rule 224.8 (a) within the Texas Board of Nursing?

they are tasks commonly delegated

What is Rule 224.8 (b) within the Texas Board of Nursing?

they are discretionary tasks

What is Rule 224.8 (c) within the Texas Board of Nursing?

they are tasks prohibited from delegation

What is Rule 225 within the Texas Board of Nursing?

RN delegation to UPA for clients with stable and predictable conditions in independent living environments

What are the four key concepts of teams?

• conflict management

• singleness of mission

• willingness to cooperate

• commitment

What is synergy?

it is when people work together to produce extraordinary results that could not have been achieved by any one individual

What is interprofessional communication?

it is when healthcare providers communicate with each other and with patients and their families in an open, collaborative, and respectful manner

What are the core competency domains of interprofessional teams?

• values/ethics

• roles/responsibilities

• interprofessional communication

• teams and teamwork

What are the three components of smoothly functioning teams?

• mutual trust among members

• strong sense of team identities

• sense of team efficacy

What is conflict?

it is a disagreement with one's values or beliefs

What are the behaviors of great team members?

• establish a clear purpose

• use active listening

• tell the truth

• be compassionate

• be flexible

• commit to resolution

• acknowledge

What is active listening?

it is completely focused on the individual who is speaking, without judgment

What are acknowledgments?

they validate others and the importance of their contribution

What are the guidelines for acknowledgment?

• must be specific

• must be "eye to eye" or personal

• more powerful when given in public

• need to be timely