Organizational Structure
Who may be considered a first level manager?
Charge nurse, team leader, and primary nurse are concerned about their specific unit’s workflow.
What takes up most of a budget: What is the difference between personnel and operating budget?
Personnel: labor intensive field. To handle fluctuating patient census and acuity, managers need to use historical data about unit census fluctuations in forecasting short- and long-term personnel needs. As patient-days or volume decreases.
Operating Budget: expenses that change in response to the volume of services. (cost of electricity, repairs, and maintenance)
Benefits of media as a tool for nursing and patient support?
Can enhance practice, education and research (information is being shared on a large scale, and people tune into it).
Provide an example of Moral Distress?
Moral distress occurs when the individual knows the right thing to do, but organizational constraints make it difficult to take the right course of action.
What is one thing you can do for yourself when you are feeling burned out?
SELF CARE
Focus on what you can do to change your situation ( review from previous chapters).
Strategic Planning: What is included in this process & How long does it last?
Strategic planning typically examines an organization's purpose, mission, philosophy, and goals in the context of its external environment.
Complex organizational change 3-7 years
Unit level: 6 months in the future.
How does the utilization of critical pathways help with budgets?
Critical pathways provide means of standardizing cases for patients with a similar diagnosis.
ANA Guidelines for Social Media use?
▪Nurses may not transmit or place online individually identifiable patient information
▪Nurses must understand that patients, colleagues, institutions, and employers can view posts.
▪Nurses must observe ethically prescribed professional patient-nurse boundaries.
▪Nurses must take advantage of privacy setting and separate personal from professional information online.
▪Nurses must bring content that could harm patient privacy, rights, or welfare to attention of appropriate authorities
▪Nurses should participate in developing institutional policies that govern online conduct.
Provide an example of negligence.
Is the omission to do something that a reasonable person, guided by the considerations that ordinarily regulate human affairs, would do — or as doing something that a reasonable and prudent person would not do.
What are nurse leaders focused on when implementing workplace advocacy?
work environment is both safe and conducive to professional and personal growth for subordinates.
Examples: assuring OSHA guidelines are followed, educating about proper body mechanics, and reducing workplace exposure to hazards (needle sticks, violence, bodily fluids).
What is the benefit of a nurse manager utilizing committees?
Committees can facilitate upward communication and assist with management functions. Committees may pave the road to increased staff participation in organization governance.
Strategies nurses can implement to promote cost-effective care:
Providing clients with needed education to decrease or eliminate future medical costs associated with future complications.
Promote the use if evidence-based care = improved client outcomes
Promoting cost-effective resource management (ex. delegating effectively, using equipment properly to prevent waste, returning equipment for credit).
How are you going to educate your patient on credible health information online?
.ORG
.Gov
.edu
What are the five elements that must be present for a medical professional to be held liable for malpractice?
Standard of care must have been established
There must have been a breach of duty
Nurse must had had knowledge of availability of information that not meeting the standard of care could result in harm - Foreseeability of harm
Failure to meet the standard of care must have the potential to injure the patient
actual patient injury must occur.
How can a nurse leader foster an environment supporting subordinate advocacy?
Health care administrators must maintain an effective and efficient chain of command, so that nurses know where to report concerns and how to access the chain of command.
ANA (2016) Nursing Administration: Scope of Standards of Practice asserts that nurse administrators should advocate for other healthcare providers (including subordinates) as well as patients, especially in concerning issues of health and safety.
Explain SWOT Analysis
Identification of strengths, weaknesses, opportunities, and threats.
Strengths are those internal attributes that help an organization to achieve its objectives.
Weaknesses are those internal attributes that pose barriers to an organization achieving its objectives.
Opportunities are external conditions that promote the achievement of organizational objectives.
Threats are external conditions that challenge or threaten the achievement of organizational objectives
Budgetary Process
Assess - identify what needs to be covered in the budget.
Diagnose - the diagnosis is the goal of what needs to be accomplished in order to meet the budget.
Plan - identifying the time period of the budget.
Implementation - ongoing monitoring and analysis of budget plan.
Evaluation - Determining if the budget was met.
Benefits of EHR?
To have access to a patient's information. It is a digital record of the patient’s health history that may be made up of records from many locations and/or sources, such as hospitals, providers, clinicals, and public health agencies.
Might include important information such as immunization status, allergies, patient demographics, laboratory test, and radiology results, advance directives, current medications taken, and current health appointments. It’s also available 24/7, 365 days.
How can you protect yourself against malpractice claims?
Practice within the scope of the Nurse Practice Act
Observe agency policies and procedures
Model practice after established standards by using evidence-based practice
Always put patient rights and welfare first
Be aware of relevant laws and legal doctrines and combine such with the biologic, psychological, and social sciences that form the basis of all rational nursing decisions.
Practice within the area of individual competence
Upgrade technical skills consistently by attending continuing education programs and seeking specialty certification
How can you, as a nurse, advocate for your profession?
When nurses find a discrepancy between their perceived role and society’s expectations, they have a responsibility to advocate for the profession.
Advocating for patient and nurse safety by reaching out to legislation. Protests and strikes are also ways of advocating and taking a stand in the profession
What is case management and why is it important in nursing?
Collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost-effective outcomes.
Use of critical pathways: A strategy for assessing, implementing, and evaluating the cost-effectiveness of patient care.
Pathways are a clinical management tool that helps medical care providers coordinate the delivery of patient care for a particular case type or condition.
Medicare & Medicaid: How do you contribute to care coverage as a nurse? What is required by you?
Medicare: a federally sponsored health insurance program for individuals older than 65 and for certain groups of people with catastrophic or chronic illness regardless of age.
Medicaid: a federal-state cooperative health insurance plan created primarily for low-income children and adults, although it also provides medical and long-term coverage for people with disabilities and assistance with health and long-term expenses for low income seniors.
How will you combat the challenges that managers face in balancing patient centered care and information technology?
Face to face communication takes longer to do than just quickly sending a message to the team but is more personable.
Managers are often pulled away to meetings, or have paperwork they need to get done, communicating via technology is much quicker.
However, there needs to be a balance in face to face and technologically communicating, to develop more meaningful and personal relationships between coworkers
Problem Solving Process: The Moral Decision-Making Model or (MORAL)
This can be used to help determine a solution for an ethical dilemma:
Moral decision-making model (MORAL)
Massage the dilemma: Collect data about the ethical problems and who should be involved in the decision-making process
Outline the option: Identify alternatives and analyze the causes and consequences of each
Review the criteria and resolve: Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid
Affirm position and act: Develop the implementation strategy
Look back: Evaluate the decision making.
Let’s Talk about Unions!
An organization of workers, often in a trade or profession, is formed to protect their rights and interests and improve their economic status and working conditions through collective bargaining with employers regarding wages, hours, working conditions, and benefits.
Some critics suggest that mandatory staffing ratios create significant opportunity costs that may restrict employers and payers from responding to market forces and may cause conflicts between nurses and hospitals that might otherwise not exist.
Pro Unionization?
Against Unions?