accountable care organization
a collaboration among primary care clinical, a hospital, a specialists, and other health professionals who accept joint responsibility for the quality and cost fo care provided to its patients
care delivery system
a system for the delivery of care that delineates the nurse' authority and accountability for clinical decision making and outcomes
(it is integrated with the professional practice model and promotes continuous, consistent, efficient and accountable nursi
medical home
a mechanism to provide patients with a central primary care practice or provider who coordinates the patient's care across settings and providers
nurse managed clinics
nurse run facilities that provide comprehensive primary care
professional practice model
a schematic description of a theory, phenomenon or system that deice how nurses practice, collaborate, communicate, and develop professionally to provide the highest quality care for those served ty the organization
average daily census (ADC)
average number of patients cared for per day for the reporting period
Average length of stay (ALOS)
average number of days that a patient remained in an occupied bed
block scheduling
using the same schedule repeatedly
centralized scheduling
scheduling done in one location
decentralized scheduling
scheduling done in local areas
Full time equivalent (FTE)
equal to the equivalent of a full time person
nursing home per patient
total paid hours for burins personnel for a specific time period divided by the number of patient day sin the same period
patient acuity
measure of nursing workload that is generated for each patient
permanent shifts
personnel working the same hours repeatedly
rotating work shifts
alternating work hours among days, evening, and nights
self scheduling
staff coordinating their own work schedules
staffing pattern
plan that articulates how many and what kind of staff area needed by shift and day to staff a unit or department
staffing ratios
number of nursing staff per patient
staffing schedules
work schedules for personnel
variable staffing
determine the number and mix of staff based on patient needs
variance reports
noting difference in budgeted or planned staffing and costs
accountability
acknowledgement and assumption of responsibility for actions, decisions, and policies within the scope of role or employment position and encompassing the obligation to report, explain and be answerable fo resulting consequences
assignment
delegation of work to a selected group of patient care givers.
(the coward or lateral transfer of the responsibility of an activity from one individual to another while retaining accountability for the outcome)
delegation
transferring the authority to perform a selected nursing task in a selected situation to a competent individual
direct patient care activities
activities such as hygienic care, feeding patients, taking vital signs , and so on that are performed on the patient
indirect patient care activities
routine activities of the patient unit that deal with the day to day functioning of the unit
(ie restocking supplies)
supervision
active process of directing, guiding, and influencing the outcome of an individual performance of an activity
unlicensed assistive personnel
individuals who are not licensed by the state but are trained to assist nurses by performing patient care tasks as allowed by the organization
(aka nurse assistant, NA; patient care associate, PCA; unlicensed assistive personnel, UAP)
5 rights of delegation
right task
right circumstance
right person
right direction/communication
right supervision
orientation
proces sin which initial job training and information are provided to staff
mandatories
mandatory education educational sessions and competencies that are required by accrediting agencies
competencies
areas in which employees are judged to be qualified to perform
peer review
the process by which practicing registered nurses systematically assess, monitor, and make judgements about the quality of nursing care provided by peers a measured against professional standard of practice
performance appraisal
process in an organization by which employees are routinely evaluated according to performance standards
preceptor
experienced individual who assists new employees in acquiringthe necessary knowledge and skills to function effectively in a new environment
preceptor functions
assist new nurse sot acquire knowledge and skill
tailor program specifically to needs
orient to unit
socialize within group
orient to unit functions
teach unfamiliar procedures
assist in development of skills
act as resource person
familiarize with polici
6 principals of peer review
a peer is someone fo the same rank
peer review is practice focused
feedback is timely, routine, and continuous expectation
peer review fosters a continuous learning culture of patient safety and best practice
feedback is not anonymous
feedback incorporate
nurse supervisor responsibilities
conduct the interview
states judgements about the nurse's performance
provides justification for salary
encourages new goals
agrees upon future goals
cohesiveness
the degree to which group members are attracted to each other and are motivated to stay in the group and wish to retain membership in it
committees
group that deal with specific issues involving several service areas
competing groups
Groups in which members compete for resources or recognition.
group
aggregate of individuals who interact and mutually influence each other
(several individuals assemble together or who have some unifying relationship)
real (command) groups
groups that accomplish tasks in an organization and are recognized as legitimate organizational entities
task group
several individuals who work tother to accomplish specific time limited assignments
teams
real groups in which people work cooperatively with each other to achieve a goal
clinical informational systems
system used for the collection, integration, and distribution of information to the appropriate department
decision support
Provision of assistance via a computer application for the purpose of assisting the nurse in decision making
electronic health record
information relating to the past or future physical/mental health, or condition of an individual that resides in electronic systems used to capture, transmit, receive, store, or manipulate data for the primary purpose of providing health related services
electronic medical record
Information relating to the medical care received by an individual;
(usually institution specific, residing in electronic systems that are hospital or health-system based.)
advance directive
document that allows the competent patient to make choices regarding health care before it is needed
autonomy
provides for the privilege of self determination in deciding what happens to one's body in health
beneficence
The duty to do good to others and to maintain a balance between benefits and harms
(to provide every patient with respect and courtesy, to contribute to the health and welfare of the patient and not merely attempt to avoid harm to the patient or client)
bioethics
ethics specific to health care
corporate liability
responsibility of an organization for its own wrongful conduction
durable power of attorney for health care decisions
document that permits an individual to give a surrogate or proxy the authority to make decisions for the person in the even that they become incompetent
ethics
science that deals wit the principal of right and wrong and good and bad and governs our relationship with others
(based on personal beliefs and values)
informed consent
consent for treatment given by a patient after three requirements are met
the 3 requirements of informed consent
voluntary
patient has capacity to consent
patient is educated in procedure
institutional review board (IRB)
group that has been formally designed to approve, monitor and review biomedical and behavioral research involving humans with the alleged aim to protect the rights and welfare of the subjects
justice
principal of fairness in which an individual received what is due, owed, or legitimately claimed
(the treating of all parties equally, regardless of economic or social background, and learning the state's and organizations laws for reporting abuse, requir
living will
advance directive that indicates what an individual dictates regarding treatment or lifesaving measure in the future
morality
behavior in accordance with custom or tradition that usually reflects personal or religious beliefs
nonmaleficience
principle of doing no harm, observing safety rules and precaution sand keeping skill sup to date
(prohibits deliberate harm and demands weighing risks with the benefits of treatment)
omnibus budget reconciliation act (OBRA) of 1987
provide patients wit ht the right to be free from any physical or chemical restraint imposed for the purpose of discipline or convenience and not required to treat medical symptoms
patient self determination act
federal law requiring every health care facility receiving medicare or medicaid to provide written intonation to adult patients concerning their right to make health care decisions
personal liability
responsibility and accountability of individuals for their own actions or inactions
policies and procedures
written standardized protocol that is authorized by the heal care organization
restraint
direct application of physical force to a patient with or without the patient's permission
(to restrict freedom of movement, the physical force may be human, via mechanical device or a combination thereof)
risk management
organized program to prevent the incidence of preventable accidents, injuries and errors
clinical and administrative activities that organize undertake to identify, evaluate, and reduce the risk of injury to patients, staff and visitors and the risk of lo
tort
private or civil wrong or injury, including action of bad faith breach of contract, for which the court will provide a remedy in the form of an action for damages
utilitarianism
decision based on what will proceed the greatest good for the greatest number of people
teleology
(aka consequentialist theory)
the value of a situation is determined by its consequences
(the outcome, not the action, is what counts, all is well that ends well)
deontology
(aka formalism)
an act is good only if it springs from good will
the end justifies the means
malpractice
any misconduct or lack of skill in caring out professional responsibilities
failure of a professional person to act as other prudent professionals with the same knowledge, and education would act under similar circumstances
negligence
failure of an individual to perform an act (omission) or to perform an act (commission) that a reasonable prudent person would not perform in a similar set of circumstances
failure to exercise the proper degree of care required by the circumstance
examples of negligence
med errors
patient falls
improper use of restraints
equipment injury
failure to take appropriate nursing action
failure to follow hospital procedure
failure to supervise treatment
What are the components of FLAT charting?
Factual (what you see)
Legible (no erasures, corrections made with single line drawn thru)
Accurate and complete (ie. color of tracheostomy sections)
Timely (completed as soon after the occurrence)
lean management
performance improvement model dealing with minimization of waste in process
national patient safety goals
set of nationwide goals set by the joint commission to focus performance in areas of patient safety
outcome
measurable result related to a strategic objective
retrospective review
analysis fo past events, usually through a chart audit
root cause analysis
retrospective review of the event,
used[to evaluate potential causes of the problem or source of variation in the process
sentinel event
unexpected occurrence involving death or serous physical or psychological injury
six sigma
performance improvement model based on the idea of minimal defects and concerns
lean
a way to do more and more with less
(less human effort, less equipment, less time, and less pace while coming closer to providing customers with what they want)
correlation study
a study examining the relationship between, or among two or more variables in a single group
it does not examine cause and effect
descriptive study
used to identify tan describe variables and examine relationships that exist in a situation
provides an accurate portrayal of the phenomenon of interest
evidence based practice
conscientious use of current best practice or research evidence in making clinical decisions
nonrandomized clinical trial
same as reendowed clinical trial but patient placement in treatment or non treatment group depends on study variables, with no every individual having gan opportunity for selection
observational study
use of structured and unstructured observations to measure study variables
randomized clinical study
effects of an intervention are examined by comparing the raiment group with the non treatment group
patients are placed in treatment or non treatment group through random sampling
research
generation of new knowledge through the rigorous study of variables
research use
findings from a single study or a set of studies for the development of patient care
Appropriate IV catheter for blood transfusion for adults
22-14G
(size may be adjusted depending on infusion rate, the bigger the gauge the smaller the needle)
Appropriate IV catheter for blood transfusion for infants and toddlers
24-22G
(size may be adjusted depending on infusion rate, the bigger the gauge the smaller the needle)
What does P.I.C.O.T stand for and what is it used for?
Population, Intervention, Comparison intervention, Outcome, Time
framework for formulating evidence based questions
Benchmark
comparison information that allows an organization to evaluate its own performing in relation to others
dashboard
visual representation of performance using colors to represent levels, usually green (on target) or red (below target)
graph
visual representation of levels of performance
trend
three data points moving in same direction
What does ANCC stand for?
American Nurses Credentialing Center
home state
the nurse's primary state of residence
interview
formal consultation to evaluate qualifications of a potential employee
NCLEX stand for?
national council licensure examination
NCSBN stand for?
national council of State Boards of Nursing
Nursing Licensure compact
states recognizing the license regulation of other states
party state
any state that has adopted this compact
pearson VUE
company under contract with NCSBN to administer NCLEX examination
recruitment
process of obtaining individuals for employment
remote state
any party state other hyman the home state
resume
summary of an individuals' past employment, education and honors
retention
preservation or maintenance of staff
speciality certification examination
credential specifying the candidate knowledge level within a specialty