Management
The process of planning, organizing, directing, and coordinating the work within an organization.
Leadership
The ability to inspire others to achieve a desired outcome. Effective managers usually possess good leadership skills. However, effective leaders are not always in a management position. Leaders have a combination of personality traits and leadership skil
Qualities of leaders
Initiative.
Inspiration.
Energy.
Positive attitude.
Communication skills.
Respect.
Problem-solving and critical-thinking skills.
Leadership styles
Authoritative.
Democratic.
Laissez-faire.
Transformational.
Transactional.
Authoritative
Makes decisions for the group.
Motivates by coercion.
Communication occurs down the chain of command.
Work output by staff is usually high: good for crisis situations and bureaucratic settings.
Effective for employees with little or no formal education.
Democratic
Includes the group when decisions are made.
Motivates by supporting staff achievements.
Communication occurs up and down the chain
of command.
Work output by staff is usually of good quality: good
when cooperation and collaboration are necessary.
Laissez?faire
Makes very few decisions, and does little planning.
Motivation is largely the responsibility of individual
staff members.
Communication occurs up and down the chain of
command and between group members.
Work output is low unless an informal leader evolves
Transformational leaders
Empower followers to assume responsibility for a communal vision, and personal development is a secondary outcome.
Transactional leaders
Focus on immediate problems, maintaining the status quo and using rewards to motivate followers.
Emotional intelligence.
The ability of an individual to perceive and manage the emotions of self and others. The nurse must be able to perceive and understand his own emotions and the emotions of the client and family in order to provide client-centered care
The emotionally intelligent leader
Has insight into the emotions of members of the team.
Understands the perspective of others.
Encourages constructive criticism and is open to new ideas.
Is able to maintain focus while multitasking.
Manages emotions and channels them in a positive directi
Five major management functions
Planning.
Organizing.
Staffing.
Directing.
Controlling.
Planning
Decisions regarding what needs to be done, how it will be done, and who is going to do it.
Organizing
Organizational structure that determines the lines of authority, channels of communication, and where decisions are made.
Staffing
Acquisition and management of adequate staff and staffing mix
Directing
Leadership role assumed by a manager that influences and motivates staff to perform assigned
roles.
Controlling
Evaluation of staff performance and evaluation of unit goals to ensure identified outcomes are being met.
Characteristics of managers
Hold formal positions of authority and power.
Possess clinical expertise.
Network with members of the team.
Coach subordinates.
Make decisions about the function of the organization, including resources, budget, hiring, and firing.
Critical thinking skills
Interpretation.
Analysis.
Evaluation.
Inference.
Explanation.
Critical thinking
Reflects upon the meaning of statements, examines available data, and uses reason to make informed decisions.
Critical thinking is necessary to reflect and evaluate from a broader scope of view.
Sometimes one must think "outside the box" to find solutions
Clinical reasoning
Mental process used when analyzing the elements of a clinical situation and using analysis to make a decision. The nurse continues to use clinical reasoning to make decisions as the client's situation changes.
Clinical reasoning supports the clinical decision-making process by
Guiding the nurse through the process of assessing and compiling data.
Selecting and discarding data based on relevance.
Using nursing knowledge to make decisions about client care. Problem solving is a part of decision-making.
Clinical judgment
Decision made regarding a course of action based on a critical analysis of data.
Clinical judgment considers the client's needs when deciding to take an action, or modify an intervention based on the client's response.
The nurse uses clinical judgment to
Analyze data and related evidence.
Ascertain the meaning of the data and evidence.
Apply knowledge to a clinical situation.
Determine client outcomes desired and/or achieved as
indicated by evidence-based practices.
Prioritization principles in client care
Prioritize systemic before local ("life before limb"). Prioritizing interventions for a client in shock over interventions for a client who has a localized limb injury.
Prioritize acute (less opportunity for physical adaptation) before chronic (greater op
Priority setting frameworks
Maslow's hierarchy.
ABC framework.
Safety/risk reduction.
Assessment/data collection first.
Survival potential.
Least restrictive/least invasive.
Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable.
Maslow's hierarchy
Self actualization.
Self esteem.
Need for love and belonging.
Safety and security.
Physiological.
Using Maslow's hierarchy
The nurse should consider this hierarchy of human needs when prioritizing interventions. For example, the nurse should prioritize a client's:
Need for airway, oxygenation (or breathing), circulation, and potential for disability over need for shelter.
Nee
Airway breathing circulation (ABC) framework
The ABC framework identifies, in order, the three basic needs for sustaining life.
An open airway is necessary for breathing, so it is the highest priority.
Breathing is necessary for oxygenation of the blood to occur.
Circulation is necessary for oxygena
Airway interventions
Identify an airway concern (obstruction, stridor).
Establish a patent airway if indicated.
Recognize that 3 to 5 min without oxygen causes irreversible brain damage secondary to cerebral anoxia.
Breathing interventions
Assess the effectiveness of breathing (apnea, depressed respiratory rate).
Intervene as appropriate (reposition, administer naloxone).
Circulation interventions
Identify circulation concern (hypotension, dysrhythmia, inadequate cardiac output,
compartment syndrome).
Institute appropriate actions to reverse or minimize circulatory alteration.
Disability interventions
Assess for current or evolving disability (neurological deficits, stroke in evolution).
Implement actions to slow down development of disability.
Exposure interventions
Remove the client's clothing to allow for a complete assessment or resuscitation.
Implement measures to reduce the risk for hypothermia by providing warm blankets and IV
solutions and using a heating device if needed.
Safety/risk reduction
Look first for a safety risk. For example, is there a finding that suggests a risk for airway obstruction, hypoxia, bleeding, infection, or injury?
Next ask, "What's the risk to the client?" and "How significant is the risk compared to other posed risks?
Assessment/data collection first
Use the nursing process to gather pertinent information prior to making a decision regarding a plan of action. For example, determine if additional information is needed prior to calling the provider to ask for pain medication for a client.
Survival potential
Use this framework for situations in which health resources are extremely limited (mass casualty, disaster triage).
Give priority to clients who have a reasonable chance of survival with prompt intervention. Clients who have a limited likelihood of surviv
Least restrictive/least invasive
Select interventions that maintain client safety while posing the least amount of restriction to the client. For example, if a client who has a high fall risk index is getting out of bed without assistance, move the client closer to the nurses' work area
Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable
A client who has an acute problem takes priority over a client who has a chronic problem.
A client who has an urgent need takes priority over a client who has a nonurgent need.
A client who has unstable findings takes priority over a client who has stable
Time management
Organize care according to client care needs and priorities.
What must be done immediately (administration of analgesic or antiemetic, assessment of unstable client)?
What must be done by a specific time to ensure client safety, quality care, and complian
Time management is a cyclic process.
Time initially spent developing a plan will save time later and help to avoid management by crisis.
Set goals and plan care based on established priorities and thoughtful utilization of resources.
Complete one client care task before beginning the next, s
Time savers
Documenting nursing interventions as soon as possible after completion to facilitate accurate and thorough documentation.
Grouping activities that are to be performed on the same client or are in close physical proximity to prevent unnecessary walking.
Es
Time wasters
Documenting at the end of the shift all client care provided and assessments done.
Making repeated trips to the supply room for equipment.
Providing care as opportunity arises regardless of other responsibilities.
Missing equipment when preparing to perfo
Licensed personnel
Nurses who have completed a course of study, successfully passed either the NCLEX-PN or NCLEX-RN exam, and have a nursing license issued by a board of nursing.
Assistive personnel
Specifically trained to function in an assistive role to licensed nurses in client care activities.
These individuals can be nursing personnel, such as certified nursing assistants (CNAs) or certified medical assistants (CMAs) or they can be nonnursing pe
Assigning
Process of transferring the authority, accountability, and responsibility of client care to another member of the health care team. Assigning is performed in a downward or lateral manner with regard to members of the health care team.
Delegating
Process of transferring the authority and responsibility to another team member to complete a task, while retaining the accountability.
Supervising
Process of directing, monitoring, and evaluating the performance of tasks by another member
of the health care team. RNs are responsible for the supervision of client care tasks delegated to APs and PNs.
Basis of delegation decisions
Individual client needs.
Facility policies and job descriptions.
State nurse practice acts.
Professional standards (ANA codes of standards).
Other legal/ethical concerns.
Categories of factors to consider in making assignments
Client factors.
Healthcare team factors.
Client factors in making assignments
Condition of the client and level of care needed.
Specific care needs (cardiac monitoring, mechanical ventilation).
Need for special precautions (isolation precautions, fall precautions, seizure precautions).
Procedures requiring a significant time commit
Healthcare team factors
Knowledge and skill level of team members.
Amount of supervision necessary.
Staffing mix (RNs, PNs, AP).
Nurse?to?client ratio.
Experience with similar clients.
Familiarity of staff member with unit.
Actions to take when a nurse receives an unsafe assignment
Bring the unsafe assignment to the attention of the scheduling/charge nurse and negotiate a
new assignment.
If no resolution is arrived at, take the concern up the chain of command.
If a satisfactory resolution is still not arrived at, the nurse should fi
Role of licensed nurse for delegating and supervising:
A licensed nurse is responsible for providing clear directions when a task is initially delegated and for periodic reassessment and evaluation of the outcome of the task. RNs must be knowledgeable about the applicable state nurse practice act and regulati
Who RNs may delegate to
Other RNs, PNs, and APs.
Who PNs may delegate to
Other PNs and APs.
...
Things an RN cannot delegate to PN or AP
Nursing process.
Client education.
Tasks that require clinical judgment.
Any tasks not appropriate for the skill and education level of that particular health care team member.
Task factors to consider in delegating client care
Predictability of outcome: Will the completion of the task have a predictable outcome? Is it a routine treatment? Is it a new treatment?
Potential for harm: Is there a chance that something negative can happen to the client (risk for bleeding, risk for as
Examples of tasks nurses may delegate to PN
Monitoring findings (as input to the RN's ongoing assessment).
Reinforcing client teaching from a standard care plan.
Performing tracheostomy care.
Suctioning.
Checking NG tube patency.
Administering enteral feedings.
Inserting a urinary catheter.
Adminis
Examples of tasks nurses may delegate to AP
Activities of daily living (ADLs).
Bathing.
Grooming.
Dressing.
Toileting.
Ambulating.
Feeding (without swallowing precautions).
Positioning.
Routine tasks.
Bed making.
Specimen collection.
Intake and output.
Vital signs (for stable client).
Considerations for selection of an appropriate delegatee
Education, training, and experience.
Knowledge and skill to perform the task.
Level of critical thinking required to complete the task.
Ability to communicate with others as it pertains to the task.
Demonstrated competence.
The delegatee's culture.
Agency
5 rights of delegation
Right task.
Right circumstance.
Right person.
Right direction/communication.
Right supervision/evaluation.
Right task
Identify what tasks are appropriate to delegate for each specific client.
A right task is repetitive, requires little supervision, and is relatively noninvasive for the client.
Delegate tasks to appropriate levels of team members (PN, AP) based on standar
Right circumstance
Assess the health status and complexity of care required by the client.
Match the complexity of care demands to the skill level of the health care team member.
Consider the workload of the team member.
Examples: Delegate an AP to measure the vital signs o
Right person
Assess and verify the competency of the health care team member.
The task must be within the team member's scope of practice.
The team member must have the necessary competence/training.
Continually review the performance of the team member and determine
Right direction/communication
Communicate either in writing or orally.
Data that needs to be collected.
Method and time line for reporting, including when to report concerns/findings.
Specific task(s) to be performed; client?specific instructions.
Expected results, time lines, and exp
Right supervision/evaluation
Provide supervision, either directly or indirectly (assigning supervision to another licensed nurse).
Provide clear directions and expectations of the task to be performed (time frames, what to report).
Monitor performance.
Provide feedback.
Intervene if
Supervision
Occurs after delegation. A supervisor oversees a staff member's performance of delegated activities and determines if:
Completion of tasks is on schedule.
Performance was at a satisfactory level.
Unexpected findings were documented and reported.
Assistanc
Staff education
Nurse's involvement in the orientation, socialization, education, and training of fellow health care workers to ensure the competence of all staff and to help them meet standards set forth by the facility and accrediting bodies. The process of staff educa
Orientation
Helps newly licensed nurses translate the knowledge, skills, and attitudes learned in nursing school into practice.
Orientation to the institution
The newly licensed nurse is introduced to the philosophy, mission, and goals of the institution
and department.
Policies and procedures that are based on institutional standards are reviewed.
Use of and access to the institution's computer system is a sig
Orientation to the unit
Classroom orientation usually moves onto the unit and is continued with an assigned preceptor.
Preceptors assist in orienting newly licensed nurses to a unit and supervising their performance and acquisition of skills.
Preceptors are usually assigned to n
Socialization
Process by which a person learns a new role and the values and culture of the group within which that role is implemented.
Successful socialization helps new staff members fit in with already established staff on a client care unit.
Staff development educ
Staff education
Also called staff development. Process by which a staff member gains knowledge and skills. The goal of staff education is to ensure that staff members have and maintain the most current knowledge and skills necessary to meet the needs of clients.
Steps in providing educational programs
Identify and respond: To identify need for knowledge or
skill proficiency.
Analyze: Deficiencies, and develop learning objectives to meet need.
Research: Resources available to address learning objectives based on evidence?based practice.
Plan: Program to
Competence
Ability of an employee to meet the requirements of a particular role at an established level of performance. Nurses usually progress through several stages of proficiency as they gain experience in a particular area. Patricia Benner (1984) identified five
5 stages of nursing ability
Novice nurse.
Advanced beginner.
Competent nurse.
Proficient nurse.
Expert nurse.
Novice nurse
Can be students or newly licensed nurses who have minimal clinical experience.
They approach situations from theoretical perspective relying on context?free facts and established guidelines.
Rules govern practice.
Advanced beginner
Most new nurses function at the level of the advanced beginner.
They practice independently in the performance of many tasks and can make some clinical judgments.
They begin to rely on prior experience to make practice decisions.
Competent nurse
These are usually nurses who have been in practice for 2 to 3 years.
They demonstrate increasing levels of skill and proficiency and clinical judgment.
They exhibit the ability to organize and plan care using abstract and analytical thinking.
They can ant
Proficient nurse
These are nurses who have a significant amount of experience upon which to base their practice.
Enhanced observational abilities allow nurses to be able to conceptualize situations more holistically. Well?developed critical thinking and decision?making sk
Expert nurse
Expert nurses have garnered a wealth of experience so they can view situations holistically and process information efficiently.
They make decisions using an advanced level of intuition and analytical ability.
They do not need to rely on rules to comprehe
Quality improvement
Also called performance improvement or quality control. Process used to identify and resolve performance deficiencies. Quality improvement includes measuring performance against a set of predetermined standards. In health care, these standards are set by
Outcome (clinical) indicators
Reflect desired client outcomes related to the standard under review. Measures whether a procedure is effective in meeting the desired benchmark.
Structure indicators
Reflect the setting in which care is provided and the available human and material resources.
Process indicators
Reflect how client care is provided and are established by policies and procedures (clinical
practice guidelines). Provide important information about how a procedure is being carried out.
Benchmarks
Goals that are set to determine at what level the outcome indicators should be met.
Steps in quality improvement process
A standard is developed and approved by a facility committee.
Standards are made available to employees by way of policies and procedures.
Quality issues are identified by staff, management, or risk management department.
An interprofessional team is deve
Root cause analysis
Focuses on variables that surround the consequence of an action or occurrence.
Is commonly done for sentinel events, but can also be done as part of the quality
improvement process.
Investigates the consequence and possible causes.
Analyzes the possible c
Sentinel event
Client death or client care resulting in serious physical injury.
Types of audits
Structure audit.
Process audit.
Outcome audit.
Structure audits
Evaluate the influence of elements that exist separate from or 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 as a result of the nursing care provided.
Nursing?sensitive outcomes
Those that are directly affected by the quality of nursing care. Examples include client fall rates and the incidence of nosocomial infections.
Timing of audits
Retrospective audits occur 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 current level of services.
Nurse's role in quality improvement
Serve as unit representative on committees developing policies and procedures.
Use reliable resources for information (Centers for Disease Control and Prevention, professional journals, evidenced?based research).
Enhance knowledge and understanding of the
Performance appraisal
Process by which a supervisor evaluates an employee's performance in relation to the job description for that employee's position as well as other expectations the facility can have.
Performance appraisals are done at regular intervals and can be more fre
Peer review should
Begin with an orientation of staff to the peer review process, their professional responsibility in regard to promoting growth of colleagues, and the disposition of data collected.
Focus on the peer's performance in relation to the job description or an a
Disciplinary action
Deficiencies identified during a performance appraisal or the course of employment should be presented in writing, and corrective action should be based on institutional policy regarding disciplinary actions and/or termination of employment. Evidence rega
Steps in progressive discipline
First infraction: Informal reprimand. Manager and employee meet. Discuss the issue. Suggestions for improvement/correction.
Second infraction: Written warning. Manager meets with employee to distribute written warning. Review of specific rules/policy viol
Conflict
Result of opposing thoughts, ideas, feelings, perceptions, behaviors, values, opinions, or actions between individuals.
Inevitable part of professional, social, and personal life and can have constructive or destructive
results. Nurses must understand con
Common causes of conflict
Ineffective communication.
Unclear expectations of team members in their various roles.
Poorly defined or actualized organizational structure.
Conflicts of interest and variance in standards.
Incompatibility of individuals.
Management or staffing changes.
Categories of conflict
Intrapersonal.
Interpersonal.
Intergroup.
Intrapersonal conflict
Occurs within the person and can involve internal struggle related to contradictory values or wants.
Example: A nurse wants to move up on the career ladder but is finding that time with her family is subsequently compromised.
Interpersonal conflict
Occurs between two or more people with differing values, goals, or beliefs.
Interpersonal conflict in the health care setting involves disagreement among nurses, clients, family members, and within a health care team. Bullying and incivility in the workpl
Intergroup conflict
Occurs between two or more groups of individuals, departments, or organizations and can be caused by a new policy or procedure, a change in leadership, or a change in organizational structure.
Example: There is confusion as to whether it is the responsibi
5 stages of conflict
Stage 1: Latent conflict.
Stage 2: Perceived conflict.
Stage 3: Felt conflict.
Stage 4: Manifest conflict.
Stage 5: Conflict aftermath.
Latent conflict
The actual conflict has not yet developed; however, factors are present that have a high likelihood of causing conflict to occur.
Example: A new scheduling policy is implemented within the organization. The nurse manager should recognize that change is a
Perceived conflict
A party perceives that a problem is present though an actual conflict might not actually exist.
Example: A nurse perceives that a nurse manager is unfair with scheduling. The nurse might not be aware that in reality it is only because the nurse manager mi
Felt conflict
Those involved begin to feel an emotional response to the conflict.
Example: A nurse feels anger towards the nurse manager after finding out that she is scheduled to work two holidays in a row.
Manifest conflict
The parties involved are aware of the conflict and action is taken. Actions at this stage can be positive and strive towards conflict resolution or they can be negative and include debating, competing, or withdrawal of one or more parties from the situati
Conflict aftermath
Conflict aftermath is the completion of the conflict process and can be positive or negative.
Example: Positive conflict aftermath: the nurse manager and nurses on a unit are satisfied with the newly revised scheduling system and feel valued for being inc
Actions to promote open communication and de?escalate conflicts
Use "I" statements, and remember to focus on the problem, not on personal differences.
Listen carefully to what others are saying, and try to understand their perspective.
Move a conflict that is escalating to a private location or postpone the discussion
Steps of the problem?solving process
Identify the problem.
State it in objective terms,
minimizing emotional overlay.
Discuss possible solutions.
Brainstorming solutions as
a group can stimulate new solutions to old problems.
Encourage individuals to think outside the box.
Analyze identified
Negotiation
Process by which interested parties:
Resolve ongoing conflicts.
Agree on steps to take.
Bargain to protect individual or collective interests.
Pursue outcomes that benefit mutual interests.
Negotiation can involve the use of several conflict resolution st
Conflict resolution strategies
Avoiding/withdrawing.
Smoothing.
Competing/coercing.
Cooperating/accommodating.
Compromising/negotiating.
Collaborating.
Avoiding/withdrawing
Both parties know there is a conflict, but they refuse to face it or work toward a resolution.
Can be appropriate for minor conflicts or when one party holds more power than the other party or if the issue can work itself out over time.
Because the confli
Smoothing
One party attempts to "smooth" another party by trying to satisfy the other party.
Often used to preserve or maintain a peaceful work environment.
The focus can be on what is agreed upon, leaving conflict largely unresolved.
This is usually a lose?lose so
Competing/coercing
One party pursues a desired solution at the expense of others.
Managers can use this when a quick or unpopular decision must be made.
The party who loses something can experience anger, aggravation, and a desire for retribution.
This is usually a win?lose
Cooperating/ accommodating
One party sacrifices something, allowing the other party to get what it wants. This is the opposite of competing.
The original problem might not actually be resolved.
The solution can contribute to future conflict.
This is a lose?win solution.
Compromising/negotiating
Each party gives up something.
To consider this a win/lose?win/lose solution, both parties must give up something equally important. If one party gives up more than the other, it can become a win?lose solution.
Collaborating
Both parties set aside their original individual goals work together to achieve a new common goal.
Requires mutual respect, positive communication, and shared decision?making between parties.
This is a win?win solution.
Assertive communication
Can be necessary during conflict negotiation.
Allows expression in direct, honest, and nonthreatening ways that do not infringe upon the rights of others.
A communication style that acknowledges and deals with conflict, recognizes others as equals, and pr
Elements of assertive communication
Selecting an appropriate location for verbal exchange.
Maintenance of eye contact.
Establishing trust.
Being sensitive to cultural needs.
Speaking using "I" statements and including affective elements of the situation.
Avoiding "you" statements that can i
Grievances
A wrong perceived by an employee based on a feeling of unfair treatment that is considered grounds for a formal complaint.
Grievances that cannot be satisfactorily resolved between the parties involved can require management by a third party.
Facilities h
Typical steps of the grievance process
Formal presentation of the complaint using the proper chain of command
Formal hearing if the issue is not resolved at a lower level
Professional mediation if a solution is not reached during a formal hearing.
Resource management
Includes budgeting and resource allocation. Human, financial, and material resources must be considered.
Budgeting is usually the responsibility of the unit manager, but staff nurses can be asked to provide input.
Resource allocation is a responsibility o
Cost?containment
Strategies that promote efficient and competent client care while also producing needed revenues for the continued productivity of the organization
Example: Use of managed care strives to provide clients with a plan designed to meet the needs of their ind
Cost?effective
Strategies that achieve optimal results in relation to the money spent to achieve those results. In other words cost?effective means "getting your money's worth."
Example: Spending increased money on staff training for transmission?based precautions resul
Cost-effective strategies
Providing clients with needed education to decrease or eliminate future medical costs associated with future complications. Example: The teaching a client who has a new diagnosis of diabetes mellitus how to adjust the dosage of insulin depending on activi
1. A nurse enters the room of a client
who is on contact precautions and
finds the client lying on the floor.
Which of the following actions
should the nurse take first?
A. Call the provider.
B. Ask a staff member for assistance getting the client back in
A. The nurse should notify the provider to determine whether
the client needs further examination and treatment, but
there is another action the nurse should take first.
B. The nurse should seek assistance in returning the
client to bed to prevent further
2. An RN on a medical?surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the PN?
A. Obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization.
B.
A. CORRECT: It is within the scope of practice of the PN to monitor a client who is 2 hr postprocedure for a cardiac catheterization.
B. The RN is responsible for administering blood components including
packed RBCs because this outside of the scope of pr
3. A PN ending her shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take?
A. Complete an incident report.
B. Delegate this task to the PN,
C. Ask the A
A. An incident report is indicated when a critical incident has occurred. It is not necessary to complete an incident report in this situation.
B. The nurse should not redelegate a task.
C. CORRECT: The nurse should find out what the AP knows about perfor
4. A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? (Select all that apply.)
A. Skill proficiency
B. Assignment to a preceptor
C.Budgetary principles
D.
A. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. The nurse manager should include evaluation of skill proficiency and provide additional instruc
5. A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? (Select all that apply.)
A. A structure audit evaluates the setting and resources avai
A. CORRECT: A structure audit evaluates the setting in which care is provided and includes resources such as equipment and staffing levels.
B. CORRECT: An outcome audit evaluates the effectiveness of nursing care. It should include observable data, such a
6. A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure?
A. Frequency with which procedure is performed
B. Cli
A. The frequency with which the procedure is performed is important. The team can take the frequency in which the procedure is performed under consideration in the planning process, but this information does not address the efficacy of the procedure.
B. T
7. A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the follo
A. CORRECT: The goal in resolving conflict is a win?win situation. The unit manager is using an ineffective strategy, avoidance, to deal with this conflict. She is aware of the conflict but is not attempting to resolve it.
B. The goal in resolving conflic