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217 Cards in this Set

  • Front
  • Back

Nurse leader

the person who is expert in the area

nursing manager

looking at quality outcomes for pt.

Difference between status quo and what should be

What type of hospital would give you a voice

magnet, shared governence

shared governance

Decisions and responsibility is shared

Ex) magnet

If there is a hospital that is magnet status is JACO easier or harder

Easier, because they go above and beyond the requirements

There is a large organization that has a smaller group it is called


If you look at a root cause analysis you look at what kind of diagragm

fish bone

If in a magnet institution and you don't meet all the criteria, what do you do

Admit to it and go from there

What are Lewins three stages of change


Experiencing the change


What is unfreezing

Awareness of an opportunity, need or problem


What is experiencing the change

Incorporating of what is new or different into work and inter-personally process


What is refreezing

When participants accept change and use the new attitude or behavior


General hospital has best burn unit in country, the rural hospital is developing a rural burn unit in area and is looking at General hospital. What is that called?


Diffusion of innovations (Rogers)

innovations spread through society, occurring in stages; knowledge, persuasion, decision, implementation, and confirmation

Translating research into practice (TRIP)

Approaches that integrate the use of evidence into patient care

Your child is ill and going to be hospitalized for several months, what do you apply for


If you are on a committee to open a new hospital and have certificate of need pending, and you need to communicate with the legislature, what is the best way

face to face

working in a health department and patient commits suicide, what is that called

sentinel event

If you have an iv pump and you set it at 125 and it goes in at 1000 ml per hour what is that called

sentinel event

When 2 hospitals merge and the PICU from 1st hospital is put into 2nd hospital and were only given 1 days notice of change. There was merging of positions, If a person keeps blocking or making things difficult it is called

internal force

You are the team leader and you have 2 RNs, 4 CNA, and the CNA comes to you and says I can't get to this patient care, and this patient care and this patient care. Team leader responds "Oh deal with it, I don't have time for that" What is it called?


A clinical RN specialist is meeting one on one with staff nurses while they are working together to discuss data about the evidenced based practice. This is known as

Academic detailing

What is the basis for research utilization

Analysis of research done before putting it into practice

Why do you set career goals

To keep moving forward, goal to work toward

Why do you do a cover letter

To introduce yourself

What do you expect to be a benefit pckg

healthcare, sick days, vacation days

What will foster a successful interview process

Familiar with company, position, ask questions about it, proper language, dress professionally

If someone says you didn't do something right, what should your response be

Clarify communication

What does collective bargaining mean to nursing

It is more successful with patient safety

What is difference between traditional and nontraditional bargaining units

Traditional would be employees

Nontraditional: RN do it for the safety and quality of care especially when strain occurs between management and nurses

What is whistleblowing

Is when a employee voices concern about the quality of care would put them in a vulnerable position if the were (AT will employees), but due to legislation will be protected from repercussions

What is evidenced based practice

The integration of individual clinical expertise, built from practice with the best available clinical evidence from systematic research applied to practice

Evidenced based practice is using data and has same outcome every time

What is research utilization

Research utilization is the process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices

What is policy

A specifically designated statement to guide decisions and actions

What is politics

A process of human interaction within organizations

what is power

ability to influence others in an effort to achieve goals

What is political power

An authority held by a group within a society that allows for the administration of public resources and implement policies for society. Power may be acquired as a means of governmental direction or in opposition to a government group.

What is career

progressive achievement throughout a persons professional life

What is certification

Designation of special knowledge beyond basic licensure

Continuing education

learning that builds on prior knowledge and experience with the goal of being a more competent professional

curriculum vitae

A listing of professional life activities


A right granted that gives the licensee permission to do something that he or she could not legally do absent such permisiion


A professional assemblage of materials that represent the work of the professional including evaluations, letters of recommendation, certificates of accomplishments, etc

professional association (organization)

An alliance of practitioners within a profession that provides opportunities for its member to meet leaders in the fields, hone leadership skills, policy formation specialized education and shape future


A summary of professional abilities and facts designed for specific opportunities

Friss career styles

Steady state


entrepreneurial and transient


What is a steady state

Constancy in position with increasing professional skill (example: staff nurse)

What is linear career style

Represent vertical movement in the organizational hierarchy

(example: Nursing service administrator)

Entrepreneurial and transient

appealing to nurses who wish to see the world or have a creative bent

(Private practice nurse, temp assignments)


Rational, independent responsibility for shaping career (in and out, up and down)

(Nurse who returns after raising a family)


inspire new thinking and new opportunities and steer you to various roles and clinical areas

Intrinsic reward examples

a level of competence enhancing professional autonomy and enhancing personal confidence

Extrinsic rewards

recognition from peers and employers, increased consumer confidence, increased salary

American Nurses Association

advances the nursing profession y fostering high standards of nursing practice

Advanced practice nursing

Based on knowledge and skills acquired through basic RN education and graduate educaion and experience that includes advanced nursing theory, physical assessment, psychosocial assessment and treatment of illness

Examples of Advanced practice nursing

Nurse practitioners, certified nurse midwives, ncertified registered nurse anesthetist, and clinical nurse specialist

Clinical nurse leader

masters degree prepared generalist who oversees the care coordination of a distinct group of pts in any setting. The CNL actively provides direct pt care in complex situations, evaluates pt. outcomes, & has decision making authority to change care plans when necessary. Puts EB into practice to ensure that pts. benefit from latest innovations in care delivery and is envisioned as a leader in the heath care delivery system

Doctor of nursing practice

expert in advanced nursing practice who has an earned clinically focused doctorate degree in nursing

Interprofessional team

Health care team composed of professionals from different disciplines including chaplains, nurses, dietitians, pharmacist, physical therapist, physicians, respiratory therapist, etc who cooperate, collaborate, communicate, and integrate care to ensure that care is continuous and reliable

Nursing roles

Traditional duties and responsibilites of the professional nurse, regardless of practcie area or setting, such as the roles of care provider, eduator, counselor, client advocate, change agent, leader, manager, and are guided by specifie professional standards of practice, carried out in a distinct practice area (flight nurse, forensic nurse)


looks at quality outcomes for pt and look at difference between what is and what should be


considered experts in that area

change agent

Analyzes status quo and finds problems, explores alternatives, possible outcomes and cost effective resources

Case managers

identify the best resources at the lowest cost to achieve the optimal health outcome for the client

Clinical nurse leader

Masters that oversees the care coordination of a distinct group of pts in any setting. Actively provides direct pt care in complex situations, may change care plans when necessary


Activities that enhance adaptation to a new environment


A collection of evidence demonstrating acquisition of skills, knowledge, and achievements related to a professional career

Professional objective

Occupational position for which one aims


Summary of a job applicant's previous work experience and education


Groups of individuals or organizations that join together temporarily around a common goal


The process by which we facilitate the participation of others in decision making and taking action so they are free to exercise power


process of using power


Conferring with others to bring about a settlement of differences


little or now interest in legislative politics as they relate to nursing and health care

buy in

recognition of the importance of activism within professional organization without active participation

self interest

involvement in professional organization to furthers ones own career

political sophistication

high level of professional organization activision

Leading the way

serving in elected or appointee positions in professional organization at the state and national levels

personal power

based on ones' reputation and credibility

Expert power

results from the knowledge and skills one possesses that are needed by others

position power

virtue of ones position within an organization or status within a group

perceived power

ones' reputation as a powerful person

information power

ones possession of selected information that is needed by others

connection power

gained by association with people who have links o powerful people


competent, experienced professionals who develop a relationship with a less experienced nurse for the purpose of providing advice, support, information, and feedback to encourage the development of that person

Goal setting

helps one to know if what was planned was actually accomplished


Factors, internal or external to the change situation, that interfere with movement toward a desirable outcome

change management

The overall processes and strategies used to moderate and manage the preparation for, effect of, responses to, and outcomes of any condition or circumstance that is new or different from what existed previously

(planning, organizing, implementing, evaluating, seeking feedback)

change outcome

The end product of a change process

change process

The series of ongoing efforts applied to managing a change

change situations

The field comprising various factors and dynamics with which change is occuring

chaos theory

Theoretical construct defining the random appearing yet deterministic characteristics of complex organiztions

cybernetic theory

Regulation of systems by managing communication and feedback mechanisms


Factors, internal or external to the change situation, that promote movement toward a desired outcome

high compexity change

A complicated change situation characterized by the interactions of multiple variables of people, technology, and systems

informal change agent

Person without designated authority who advances the change among a group of people

learning organization

The designation of a type of organization in which continual learning as an expectation permeates all levels to promote adequate responses required by dynamic, accelerated change

low complexity change

An uncomplicated change situation characterized by the interactions of the limited influences of people, technology, and systems

negative feedback

Information indicating a correction is needed

nonlinear change

change occurring from self organizing patterns not human induced ones, in complex open system organizations

planned change (linear)

change expected and deliberately prepared beforehand by using systematic directional processes to develop and carry out activities to accomplish a desired outcome

(reorganizing storage of unit supplies)


Approaches designed to achieve specific purposes

What are the two approaches on change

linear and nonlinear

change agent in linear planned changes focus on

specific goals and incremental steps needed to attain those goals

change agents in nonlinear, complex changes

Serve as monitors of the environment, negotiators of influences on a change, and precise forecasters of possible scenarios and their anticipated outcomes

What is force field anoalysis

an analysis of change situation including early and ongoing assessment of barriers and facilitators

Havelock six phases of planned change idea

change can be planned, implemented and evaluated in 6 sequential steps

Useful for low-level, low-complexity change

Lippit, watson, and westley 7 phases of planned change

Useful for low-level, low-complexity change

Rogers innovation-decision process

Useful for individual change

Senges 5 disciplines of learning organizations

1. systems thinking

2. personal mastery

3. Mental models

4. Shared vision

5. Team learning

Example of chaos and learning organization theory

community hospital that has been sensitive to and has adapted to external and internal environmental influences, such as the need to make changes in reimbursement and accreditation policies

Hirschhorn three aspects to change

Political (working with pharmacy to effect a change in delivery of meds to pts)

,marketing (Determining what motivates others to change)

military (Paying attention to the change outcomes

6 behavioral responses to change


Early adopters

Early majority

Late majority




Thrive on change , may be disruptive to stability

Early adopters

respected by their peers and sought out for advice and information about changes

Early majority

prefer doing what has been done in the past but eventually will accept new ideas


prefer keeping traditions and openly express their resistance to new ideas


oppose change actively, even use sabotage

leadership rounding tool (Studor group)

-Establish and maintain a human rapport with staff

-Ask what is working well for staff as they perform their daily functions

-Ask what is not working well

-Ask if there is someone whom they would like to especially recognize as a contributor to outstanding patient care

-Answer any tough questions


manipulated involvement through an appointed or assigned role


appeals to the motivational needs of others and influences them to participate


use of power to force others to make a change

Diffusion theory (Rogers)

Describes how the innovation is communicated and spreads over time throughout members of a specific culture or group

The starfish and the spider (Brafman and Beckstrom)

2 leadership styles

Starfish: neural network of cells (decentralized due to no head or central command)(ie. AA)

Spider: 1 head and 8 legs (centralized organizatio)

We need both


Recognition that an employee is valued and respected for what the have to offer to the workplace, team, or group

Active listening

Focusing completely o the speaker and listening without judgment to the essence of the conversation


Feeling passionate about and dedicated to project or event


An "either/or" way of conceptualizing reality in terms of 2 opposing sides or parts

Effective communication

A process that leads to positive outcomes for senders and receivers in terms of clarity, usefulness, and efficiency


A number of individuals assembled together or having a unifying relationship


A phenomenon in which teamwork produces extraordinary results that could not have been achieved by any one individual


A number of people associated together in specific work or acctivities


live by rules and don't question authority


lived through cold war and influenced by assassinations of Kennedy, MLK, civil rights, womens rights

Gen X

latch key kids (both parents worked, divorce common, poor job stability)

Gen Y

Future, massive tech, terrorism and natural disasters, education is key to success

When the sender is feeling stressed they could act how

Atttibution of blame


Constrained, cool-headedness



Attribution of blame

Mostly "you" messages; like "you really blew it"


" I was wrong. I'm sorry. Its all my fault"

Constrained, cool-headedness

"Studdies ahve show that in 75% of cases, the pt is correct. I decided to use research data in comeing to a solution" No feelings


(changes the subject)


"For now, I feel concerned about the anger and hostility exhibed by Dr. X. I'm wondering what approach would de-esculate him"

(words, actions, feelings match)

Barriers to communication


Inadequate knowledge

poor planning

differences in perception

emotions and personality

Communication pitfalls

Giving advice

making others wrong

being defensive

judging the other person


giving false reassurance

asking why questions

blaming others

Keys to concept of team

conflict resolution

singleness of mission

willingness to cooperate


Tools and issues that support teams

In groups and out groups

power and control

Use, develop, and be appreciated for my skills and resources

Qualities of a team player











mission conscious



self improving


solution oriented


To create synergy consistently

Establish a clear purpose

use active listening

be compassionate

tell the truth

be flexible

commit to resolution

Druskat and wolff believe that 3 major componenet of smoothly functioning teams must be created

mutual trust among all members

Strong sense of team identity

Sense of team efficacy

Work group effectiveness improves when

team is functioning smoothly and emotions and feelings are being addressed on a routing basis






Agency for Healthcare Research and quality

The primary federal agency devoted to improving quality, safety, efficiency, and effectiveness of health care


A new deeming organization as of 2008 to accredit healthcare organizations

Direct competitor for JCAHO internationally

Institue for Healthcare Improvement

An independent organization devoted to improving pt. safety and health care globally

Transforming care at the bedside

Focuses on safety, reliability, care team vitality, patient-centeredness, increased value

Institute of Medicine

An organization that works outside of the federal government to provide independent, scientific advice

"to err is human" and "preventing medication errors"

Magnet Recognition Program

Only national designation built on evolving through research. Designed to acknowledge nursing excellence

National Quality Forum

A membership based organization that sets priorities and goals for performance improvement and endorses standards for measurement

"Never events"

The Joint Commision

An organization that accredits healthcare organizations and is deemed by the center for medicare and medicaid services as holding healthcare facilities to CMS standards

Not for profit but facility must pay lots of $ for approval

STAR approach to pt safety

Stop to concentrate on task

Think about task

Act to accomplish the task

Review how well the task was accomplished

at will employee

An individual who works without a contract


The main federal agengy protecting the health and safety agency protecting the health and safety of people in the US

Collective action

A mechanism for achieving professional practice through group decision making

collective bargaining

Mechanism for settling labor disputes y negotiation between the employer and representatives of the employees


It consists of values, beliefs, attitudes, practices, rituals, and traditions


A sharing of power and control with the expectation that people are responsible for them selves


Those with whom a leader iteracts


System by which an organization controls and directs formulation and administration of policy


An experienced person who helps a less experienced person navigate into expertise

role model

A person who enacts a role, typically in a positive way, so that others can follow the example

shared governance

A flat type of organizational structure with decision making decentralized


Element of a main culture that has formed its own culture that differs in some way


A person

who makes public a serious wrongdoing or danger concealed within an organization when internal actions have failed to correct or make public a situation

workplace advocacy

Refers to acting on or in behalf of another who is unable to act for himself or herself to effect change about workplace conditions

4 main purposes of collective participation

To promote the practice of professional nursing

To establish and maintain standards of care

To allocate resources effectively and efficiently

To create satisfaction and support in the practice environment

6 critical considerations in shared governance

Defined by the person in the role

Defined by role, not job or task

Based on outcomes

Set in advance

Linked to results

Has observable processes

porter, Hawkins, and Parker basic principles of shared governance

partnerships, equity, accountability, and ownership

Gadow's manifestations of advocasy

Ensuring relevant information

Enabling the selection of information

Disclosing a personal view

Providing support for making and implementing decisions

Helping determine personal values


Best practices, processes, or systems identified by a quality improvement team to be compared with the practice, process, or system under review

Continuous quality improvement

A comprehensive program designed to continually improve the quality of care

Failure mode and effects analysis

A method to analyze reliability problems proactively to avoid negative outcomes

Near miss

A clinical situation that resulted in no injury but that highlights the need for action

Never event

Error in medical care that is clearly identifiable, preventable, and serious in its consequences for the patient and that indicates a real problem in the safety and credibility of a health care facility

Nursing-sensitive outcome

Patient outcomes that relate to the quality of nursing care provided

paitent care outcome

A measureable end result of patient care

performance improvement

The aplication of quality improvement principles on an ongoing basis

quality assurance

A process that focuses on the clinical aspects of a providers care often in response to an identified problem

Goal: To improve quality

Focus: Discovery and corretion of errors Major tasks: Inspection of nursing activities & chart audit

Quality team : QA personnel or department personnel

Outcomes: Set by QA team with input from staff c flFh

quality improvement

An ongoing process of innovation, prevention of error, and staff development used by an organization that has adopted a quality management philosophy

Goal: To improve quality

Focus: Prevention of errors

Major tasks: Review of nursing activites, innovation, staff development

Quality team: Multidiciplinary team

Outcomes: Set by QI team with input from staff & pts a#?Sewgith#?I{$

Quality management

A corporate culture emphasizing customer satisfaction, innovation, and employee involvement in quality improvement activities

Risk management

Integrated into a quality management program as a process of developing and implementing strategies that will minimize risks and mitigate the impact of adverse effects

Root-cause analysis

The process used to identify all possible causes of a sentinel event and all appropriate risk reduction strategies

Sentinel event

A serious, unexpected death or injury, such as suicide, infant abduction, or wrong site or wrong site surgery

Total quality management

A comprehensive program designed to achieve perfection in quality of care

Six Sigma 5 step methodology

Define opportunities

Measure performance

Analyze opportunity

Improve performance

Control performance

Pareto chart

Bar chart that identifies the major causes or components of a particular quality control problem


Effective method of summarizing a brainstorming session for a specific problem or outcome


Bar chart that shows the frequency of events


describe complex tasks

line graphs (trend chart)

present data by showing the connection among variables


North American Nursing Diagnosis Association






National Database of Nursing Quality Indicators

from the ANA that provides hospitals with unit level performance reports with comparisons with national averages and percentile rankings

Clinical guidelines

Statements of practice expectations developed by a group of healthcare practitioners to guide the clinical management of pts.

diffusion of innovation

Process by which ideas spread through a culture

evidence-based practice

The integration of individual clinical expertise, built from practice, with the best available clinical evidence from systematic research applied to practice


Statistically combines similar studies on a particular issue to determine if the findings are significant across settings


Anticipated or actual effects of program activities and outputs

practice based evidence

A research methodology that helps inform practice decisions by examining outcomes in the real world where patients may not be similar and the actual application of an intervention may have multiple variations

practice based research network

Originally formed to adress research issues in primary care. PBRN's are increasingly being used in large healthcare organizations having the capability of integrating system sacross multiple practice sites. The exist for primary care, community nursing centers, and school nursing

randomized controlled trial

Study in which patients are assigned by chance to one of the groups defined in the study


A systematic investigation to determine the truth or falsehood of a hypothesis

research utilization

Process of synthesizing, discriminating, and using research generated knowledge to make an impact or change in existing practices

translating research into practice (TRIP)

Approaches that integrate the use of evidence into patient care

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Flow chart

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Line graph

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