Responsibility
The reliability, dependability, and obligation to accomplished work. It is a two-way process that is allocated and accepted.
Authority
The ability to perform duties in a specific role. Must perform to the best of your ability and inform delegator about any limitations.
Accountability
Determines if actions were appropriate and provides a detailed explanation of what occurred.
Delegation
Achieving performance of care outcomes by sharing activities with others who have the appropriate authority to accomplish work. Has to have one person with accountability and one who has authority.
Individual Accountability
Component of delegation that refers to the individuals' ability to explain their actions and results.
Organizational Accountability
Component of delegation that places the accountability for the system of operations; the prime accountability is safety.
Span of control
The number of individuals delegator is ultimately responsible for
Authority is derived from this
State Nurse Practice Acts and institutional policies
Passive Delegation
Delegation that does not require a decision-making process. The decisions derive from job descriptions or policies and thus the tasks are not actively delegated. They are assumed by virtue of the policy or job description.
Active Delegation
RN assesses the situation, determines what is appropriate for patient care, directs a UNP to perform certain tasks and hold the individual accountable.
Hershey's Situational Leadership Model can be used to communicate with a Delegatee
Delegating, Participating, Selling, Telling
Assignment
Refers to work every individual is responsible to accomplish in a designated work period. Consists of patient care expectations and unit-related tasks. Also refers to transference of both responsibility and accountability among RNs (NOT UAPS)
Delegation is _________ based rather than ___________ based.
task; judgment
Accountability rests within the decision to ______________ while responsibility rests within the performance of the ______________.
delegate; task
Apply these elements when making a delegation decision
Safety, critical thinking, stability, and time
When you are looking at Agency for Healthcare and Research and Quality (AHRQ), this is what you are looking for.
Evidence-based reports geared towards providers and clients/patients
Institute of Medicine (IOM) aims of providing health care
Safe, effective, patient-centered, timely, efficient, equitable. Appears in the publication: Crossing the Quality Chasm. Other publications: To Err is Human, Health Professional Education: A Bridge to Quality; Keeping Patients Safe: Transforming the Work
Agency for Healthcare Research and Quality
Primary federal agency devoted to quality, safety, efficiency, and effectiveness of health care, and resource for providers, researchers, and consumers
National Quality Forum
Membership-based (NOT GOV.) organization designed to develop and implement a national strategy for healthcare quality measurement/management and reporting. Thirty-four practice areas (Consider patient care for pressure ulcer, CAUTI, ventilator pneumonia,
Magnet Recognition Program
The only national designation built on and evolving through nursing research that is designed to recognize nursing excellence of healthcare organizations through a self-nominating, appraisal process. Emphasizes outcomes.
Quality and Safety Education for Nurses
Institute devoted to providing resources related to the QSEN competencies for undergraduate and graduate practitioners. Six competencies are: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and info
Team STEPPS initiatives
Evidence-based teamwork system aimed at optimizing patient care by improving communication and teamwork skills among health care professionals, including frontline staff. It includes a comprehensive set of ready-to-use materials and a training curriculum
IOM Competencies of Health Professionals
Provide patient-centered care, work in interdisciplinary teams, employ evidence-based practice, apply quality improvement, utilize informatics
Five Steps to Safer Health Care (to tell the patient)
1. Ask questions if you have doubts or concerns. 2. Keep and bring a list of ALL medications you take. 3. Get the results of any test or procedure. 4. Talk to your doctor about which hospital is best for your health. 5. Make sure you understand what will
Goal for IOM's The Future of Nursing: Leading Change, Advancing Health (2010)
Have at least 80% of the registered nurse population at the baccalaureate level.
Institute for Healthcare Improvement (IHI)
Independent, not-for-profit sources of transforming care at the bedside (TCAB). Dedicated to rapidly improving care through mechanisms such as rapid cycle change projects.
Joint Commission and Accreditation (formerly JAHCO)
Key non-profit organization addressing safety and quality standards. It accredits healthcare organizations and has "deemed" status from the Centers for Medicare and Medicaid Services. (An organization that meets the standards of this organization meets CM
If JAHCO's assessment results in a healthcare facility losing its accreditation, this it the primary consequence.
Loss of funding because JAHCO has Medicaid and Medicare attained status.
The STAR approach for patient safety
Stop, Think, Act, Review
Crossing the Quality Chasm: A New Health System for the 21st Century (2001), by IOM
Emphasizes what care is provided and not who controls decisions, as well as the importance of rendering care with the client rather than to the client
Five Rights of Medication Adminstration
Route, time, dose, patient, drug
Nurse Case Manager (NCM)
Coordinates patient care throughout the admission process: facilitates access to needed health resources, monitors utilization of resources, measures outcomes and quality, Uses Critical Pathways or Care Maps
Critical Pathways (also called multidisciplinary care pathway, integrated care pathway, critical path, collaborative care pathway)
Patient-focused documents that describe the clinical standards, necessary interventions, and expected outcomes for the patient throughout the treatment process of hospital stay. (Usefulness of application, p. 243) Specific pattern of standardized care tha
Variance
Anything that occurs to alter the patient's progress through the normal critical path
Nurse Manager/Leader Role in differentiated nursing practice and the leadership theory that matches it
Role model, Collaborator, Coach, Teacher, Facilitator; Transformational
Primary Nurse
One RN functions autonomously in patient care