LPD Unit 1 Exam

Leadership

the ability to inspire others to achieve a desired outcome.

Management

the process of planning, organizing, directing, and coordinating the work within an organization.

Authoritative leadership

Leaders make decisions for the group.

Authoritative leadership is best used during

crisis situations or bureaucratic settings

Authoritative leadership is effective with employees with

little to no education

Democratic leadership

Includes the group in decision-making. Motivates by supporting staff achievements.

Benefit of democratic leadership

good quality work output

Laissez-faire leadership

Motivation is largely the responsibility of individual staff members. Effective with professional employees.

Laissez-faire leadership is best suited for

nurses who are motivated and work independently

Transformational leaders empower followers to

change, align values, hopes and expectations of others to be a part of a team

Transactional leaders focus on

tasks rules and prevention/reward or punishment

Emotional intelligence

the ability to perceive and manage the emotions of self and others.

Characteristics of an emotionally intelligent leader

manages emotions, insight into emotions of the team, refrains from judging, understands others perspective, delivery of high-quality care, encourages constructive criticism, open to new ideas

Major Management Functions

planning, organizing, staffing, directing, controlling

Planning

decisions regarding what, how, and who needs done

Organizing

lines of authority, channels of communication

Staffing

acquisition of adequate staff and staffing mix

Directing

leadership by manager motivates staff to work

Controlling

evaluation of staff performance and unit goals

Clinical Thinking Concepts

questioning, synthesis, intuition, application, creativity, interpretation, analysis, evaluation, inference, inductive, deductive

Critical Thinking

Used when analyzing client issues and problems.

Clinical Reasoning

The mental process used to analyze the elements of a clinical situation and make sense of what is happening.

Clinical Judgment

The decision made regarding the best course of action after analyzing client data.

Priority Setting Frameworks

Need for airway, oxygenation (or breathing), circulation and potential for disability over need for shelter. Need for a safe and secure environment over a need for socialization.

A (ABC framework)

Airway (open, free of obstruction)

B (ABC framework)

Breathing (oxygenation)

C (ABC framework)

circulation (blood perfusion to tissues)

Acute vs Chronic priority goes to

acute

Urgent vs Nonurgent priority goes to

urgent

Stable vs Unstable priority goes to

unstable

Safety/Risk Reduction priority goes to

whatever poses the greatest (or most imminent risk) to the client’s physical well-being

Least Restrictive / Least Invasive priority goes to

which is the safest and least amount of restriction/invasive for the patient.

First priority interventions

Airway (established patent airway; 3-5 mins w/o O2 causes brain damage)

Second priority interventions

Breathing (effectiveness of breathing, intervene as needed, reposition or administer naloxone if opioid toxicity)

Third priority interventions

Circulation (identify concern–hypotension, dysrhythm, inadequate cardiac output, compartment syndrome)

Fourth priority interventions

Disability (assess neuro- deficits, stroke); initiate interventions to slow development of disability

Fifth priority interventions

Exposure (remove clothing, implement measures to reduce hypothermia – warm blankets, IV solutions, cooling measures for patients exposed to extreme heat)

Maslow’s Hierarchy in order

(1) Physiological Needs; (2) Safety/Security; (3) Love/belonging; (4) Self-esteem; (5) self-actualization

List 4 time management strategies nurses can use

Documenting as soon as possible; grouping activities on the same client/are in close physical proximity; planning accordingly and taking priorities into consideration; gathering all equipment prior to entering client’s room; delegate activities to other staff; avoid interruptions and learn to say “no” to unreasonable/poorly-timed requests; complete one task before beginning another task

How does teamwork improve time management?

Teamwork improves time management by allowing people to divide tasks, communicate effectively, and complete work more efficiently together.

How does self-care improve nursing performance?

Self-care improves nursing performance by reducing stress and fatigue, helping nurses stay focused, healthy, and able to provide safe, effective patient care.

Assignment

process of transferring authority, accountability and responsibility of client care to another care member.

Delegation

transferring authority and responsibility of tasks to another care member while retaining accountability

Supervision

directing, monitoring, and evaluating performance of tasks by another care member

Licensed Personnel

Nurses (completed study courses, passed the NCLEX, and has a nursing license from BON)

Assistive Personnel

CNAs, CMAs, or non-nursing personnel to whom nursing activities can be delegated

Assistive personnel CANNOT

Assess, Diagnose, Teach, Evaluate

APs CAN

Assist pt. in ADLs, Bathe stable patients, Obtain routine vital signs

Five Rights of Delegation

Right task, circumstance, person, directions/communication, supervision/evaluation

Client factors (delegation)

acuity level, specific care needs, needs for special considerations, procedures requiring a significant time commitment

Task factors (delegation factors)

predictability of outcome, potential for harm, complexity of care, need for problem solving/innovation, level of interaction with client

Delegatee factors (delegation factors)

education, training, experience; knowledge and skill; level of criticial thinking required; communication skills; demonstrated competence; delegatee’s culture; agency policies and procedures and licensing legislation (state nurse practice acts)

Staff Education / Orientation

helps nurses translate knowledge, skills and attitudes learned into practices

Institution Orientation includes

nurse intro to philosophy, mission, goals of the institution & department; policies/procedures; use of and access to computer system; safety & security protocols

Unit Orientation includes

classroom orientation by experienced nurse; preceptors assist and supervise performance and acquisition of skills; coaches to establish goals; mentors focus on assumption of professional relationship + socialization to practice

Socialization

The process by which a person learns a new role and the values and culture of the group within which that role is implemented.

Expert (stages of nursing ability)

Highly intuitive clinician

Novice (stages of nursing ability)

No experience; rule-based

Competent (stages of nursing ability)

Organized and efficient

Proficient (stages of nursing ability)

Sees the big picture

Advanced Beginner (stages of nursing ability)

Some experience; still needs guidance

Purpose of Quality Improvement

identify issues and improve the delivery of quality care based on evidence

Steps in Quality Improvement

Standards, policies, and procedures help identify quality issues, which are reviewed by an interprofessional team. Data is collected, analyzed against benchmarks, and if needed, a root cause analysis is performed. Solutions are implemented and later reevaluated.

Structure audits

influence of elements that exist separate from/outside of the client-staff interaction

Process audits

review how care was provided and assume a relationship exists between nurses and the quality of care provided

Outcome audits

determine what results, if any, occurred because of the nursing care provided

Retrospective audits

occurs after the client receives care

Concurrent audits

occur while the client is receiving care

Prospective audits

predict how future client care will be affected by the current level of services

Common causes of conflict

Poor communication, unclear expectations, Role confusion, conflicts of interest and variance in standards, incompatibility of individuals, management or staffing changes, diversity r/t age, gender identification, race, ethnicity

Intrapersonal Conflict

occurs within the person and can involve internal struggle r/t contradictory values or wants

Interpersonal Conflict

between 2 or more people with differing values, goals, or beliefs

Intergroup Conflict

between 2 or more groups of individuals, departments, or organizations and can be caused by a new policy/procedures, a change in leaderships, or a change in organizational structure

Stages of Conflict (put in order)

(1) Latent Conflict; (2) Perceived Conflict, (3) Felt Conflict; (4) Manifest Conflict; (5) Conflict Aftermath

Conflict resolution strategies

problem-solving, open-communication, identify problem, discuss possible outcomes, analyze identified solutions, select a solution, implement selected solution, evaluate the solution ability to resolve problem

Assertive communication means

expression in direct, honest, non-threatening ways that do not infringe

Grievance means

a wrong perceived by an employee based on a feeling of unfair treatment that is considered grounds for a formal complaint.

List 3 strategies for cost-effective care

providing education to decrease/eliminate future cost, promoting use of evidence based care, promoting cost-effective resource management, providing needed equipment and properly charging clients, using equipment properly to prevent wastage

(SCENARIO) A client has shortness of breath, another needs discharge teaching, and another requests pain medication for chronic back pain. Who is priority FIRST and why?

SOB d/t ABC framework, urgent v nonurgent, and acute v chronic