Podcast
Questions and Answers
What is the primary reason change is considered essential in healthcare settings?
What is the primary reason change is considered essential in healthcare settings?
- To ensure compliance with evolving regulatory standards.
- To foster innovation and prevent stagnation in patient care. (correct)
- To minimize the need for specialized training among staff.
- To reduce operational costs and maximize profits.
Which statement best describes the role of a change agent in an organization?
Which statement best describes the role of a change agent in an organization?
- A person with expertise in the change process who facilitates understanding and implementation. (correct)
- An individual who primarily enforces new policies without needing to explain them.
- Someone who resists alterations to maintain existing systems and traditions.
- A manager who delegates the change process to external consultants.
In an organization undergoing a significant change, what should a leader expect regarding employee reactions?
In an organization undergoing a significant change, what should a leader expect regarding employee reactions?
- Primarily neutral reactions as employees adapt quickly to new circumstances.
- Universally positive responses as change leads to improvement.
- A mix of positive and negative reactions as a natural part of the change process. (correct)
- Overall acceptance, provided the changes are communicated clearly.
An LVN is part of a team implementing a new electronic health record system. What role can the LVN effectively fulfill during this change?
An LVN is part of a team implementing a new electronic health record system. What role can the LVN effectively fulfill during this change?
An organization implements a new policy requiring all staff to use a new patient identification protocol. Which approach would best address inevitable negative reactions to this change?
An organization implements a new policy requiring all staff to use a new patient identification protocol. Which approach would best address inevitable negative reactions to this change?
In Lewin's Change Theory, what is the primary goal of the 'Unfreezing' phase?
In Lewin's Change Theory, what is the primary goal of the 'Unfreezing' phase?
Which of the following best describes 'Change by Drift'?
Which of the following best describes 'Change by Drift'?
An LVN is asked to implement a new patient documentation system. According to the principles of planned change, what initial step should the change agent prioritize?
An LVN is asked to implement a new patient documentation system. According to the principles of planned change, what initial step should the change agent prioritize?
Which of the following actions exemplifies the 'Refreezing' stage of Lewin's Change Theory?
Which of the following actions exemplifies the 'Refreezing' stage of Lewin's Change Theory?
How do 'driving forces' influence behavior in the context of Kurt Lewin's Change Theory?
How do 'driving forces' influence behavior in the context of Kurt Lewin's Change Theory?
In the context of Evidence-Based Practice (EBP), what is the role of patient preferences and values?
In the context of Evidence-Based Practice (EBP), what is the role of patient preferences and values?
What is the purpose of restraining forces in the unfreezing stage of Kurt Lewin's change model?
What is the purpose of restraining forces in the unfreezing stage of Kurt Lewin's change model?
When implementing changes at the bedside, what key action should an LVN take to facilitate the 'Moving' phase of Lewin's Change Theory?
When implementing changes at the bedside, what key action should an LVN take to facilitate the 'Moving' phase of Lewin's Change Theory?
A nurse leader is addressing a conflict that arose due to perceived inequities in workload distribution. Which initial action best demonstrates effective conflict management?
A nurse leader is addressing a conflict that arose due to perceived inequities in workload distribution. Which initial action best demonstrates effective conflict management?
A patient with a history of falls is insistent on ambulating without assistance, despite the nursing staff's concerns. How should the nurse best uphold the ethical principle of autonomy while ensuring patient safety?
A patient with a history of falls is insistent on ambulating without assistance, despite the nursing staff's concerns. How should the nurse best uphold the ethical principle of autonomy while ensuring patient safety?
A new graduate nurse is consistently delegating tasks to a more experienced LPN, even when the tasks are within the new graduate's scope of practice. What is the most appropriate initial intervention by the nurse manager?
A new graduate nurse is consistently delegating tasks to a more experienced LPN, even when the tasks are within the new graduate's scope of practice. What is the most appropriate initial intervention by the nurse manager?
During a severe weather event, a hospital experiences a surge in patient admissions while simultaneously facing a shortage of essential medical supplies. Applying the ethical theory of utilitarianism, which action would be most justifiable?
During a severe weather event, a hospital experiences a surge in patient admissions while simultaneously facing a shortage of essential medical supplies. Applying the ethical theory of utilitarianism, which action would be most justifiable?
A nurse discovers that a colleague is diverting narcotics for personal use. According to the nurse practice act and ethical guidelines, what is the nurse’s primary responsibility?
A nurse discovers that a colleague is diverting narcotics for personal use. According to the nurse practice act and ethical guidelines, what is the nurse’s primary responsibility?
A nurse manager is tasked with creating a staffing schedule that balances patient needs with budgetary constraints. Which strategy best incorporates the principles of ethical nurse staffing?
A nurse manager is tasked with creating a staffing schedule that balances patient needs with budgetary constraints. Which strategy best incorporates the principles of ethical nurse staffing?
A patient is scheduled for a surgical procedure but expresses uncertainty about the potential risks and benefits. Which action best demonstrates the nurse's role in upholding the principle of informed consent?
A patient is scheduled for a surgical procedure but expresses uncertainty about the potential risks and benefits. Which action best demonstrates the nurse's role in upholding the principle of informed consent?
A hospital implements a new electronic health record system. Several nurses express frustration due to increased workload and technical difficulties. How should the nurse manager address this organizational change to minimize conflict and promote staff morale?
A hospital implements a new electronic health record system. Several nurses express frustration due to increased workload and technical difficulties. How should the nurse manager address this organizational change to minimize conflict and promote staff morale?
A nurse witnesses a colleague making a disparaging remark about a patient's ethnicity. What action should the nurse take to promote justice and address this ethical issue?
A nurse witnesses a colleague making a disparaging remark about a patient's ethnicity. What action should the nurse take to promote justice and address this ethical issue?
A patient is readmitted to the hospital shortly after discharge with the same complications. Upon review, it's discovered that the patient did not receive adequate discharge teaching. Which legal concept does this scenario primarily implicate?
A patient is readmitted to the hospital shortly after discharge with the same complications. Upon review, it's discovered that the patient did not receive adequate discharge teaching. Which legal concept does this scenario primarily implicate?
A nurse administers a medication to a patient based on a verbal order from a physician, but the order was unclear and results in an adverse reaction. Which of the following statements is most accurate regarding the nurse's legal responsibility?
A nurse administers a medication to a patient based on a verbal order from a physician, but the order was unclear and results in an adverse reaction. Which of the following statements is most accurate regarding the nurse's legal responsibility?
During a home visit, a nurse observes unsanitary living conditions and suspects that a child is being neglected. What is the nurse's ethical and legal obligation in this situation?
During a home visit, a nurse observes unsanitary living conditions and suspects that a child is being neglected. What is the nurse's ethical and legal obligation in this situation?
A state Board of Nursing (BON) is responsible for which of the following actions?
A state Board of Nursing (BON) is responsible for which of the following actions?
A nurse provides emergency care at the scene of a car accident. Which law protects the nurse from liability as long as the care was provided in good faith and within their scope of practice?
A nurse provides emergency care at the scene of a car accident. Which law protects the nurse from liability as long as the care was provided in good faith and within their scope of practice?
An LVN, unsure about performing a new procedure after an organizational change, is encouraged to:
An LVN, unsure about performing a new procedure after an organizational change, is encouraged to:
A nurse is prioritizing care using the CURE framework. Which patient situation would be classified as 'Urgent'?
A nurse is prioritizing care using the CURE framework. Which patient situation would be classified as 'Urgent'?
A newly licensed nurse is struggling to manage their patient assignments during a busy shift. What strategy BEST exemplifies cognitive stacking to improve efficiency?
A newly licensed nurse is struggling to manage their patient assignments during a busy shift. What strategy BEST exemplifies cognitive stacking to improve efficiency?
What is the MOST important initial action a nurse should take when encountering a patient exhibiting signs of clinical deterioration?
What is the MOST important initial action a nurse should take when encountering a patient exhibiting signs of clinical deterioration?
A nurse is caring for a patient who is experiencing severe pain. According to prioritization frameworks, which level of priority does this represent?
A nurse is caring for a patient who is experiencing severe pain. According to prioritization frameworks, which level of priority does this represent?
A nurse precepting a student is explaining the importance of using evidence-based practice. Which action BEST demonstrates the application of this principle?
A nurse precepting a student is explaining the importance of using evidence-based practice. Which action BEST demonstrates the application of this principle?
Which scenario exemplifies an interpersonal conflict between a nurse and a healthcare provider (HCP) that could negatively impact patient care?
Which scenario exemplifies an interpersonal conflict between a nurse and a healthcare provider (HCP) that could negatively impact patient care?
A nurse is prioritizing tasks at the beginning of a shift. Which activity should be considered a 'Routine' priority?
A nurse is prioritizing tasks at the beginning of a shift. Which activity should be considered a 'Routine' priority?
A post-operative patient requires assistance with hygiene and mobility. According to priority setting frameworks, this need falls under which level of priority?
A post-operative patient requires assistance with hygiene and mobility. According to priority setting frameworks, this need falls under which level of priority?
How can conflict, when managed effectively, contribute positively to a nursing team's performance?
How can conflict, when managed effectively, contribute positively to a nursing team's performance?
A hospital implements a new policy regarding medication administration. According to the 'Basic Considerations' for decision-making, this decision is primarily based on:
A hospital implements a new policy regarding medication administration. According to the 'Basic Considerations' for decision-making, this decision is primarily based on:
What is the MOST significant contribution of change in healthcare?
What is the MOST significant contribution of change in healthcare?
What is a KEY characteristic of an effective change agent?
What is a KEY characteristic of an effective change agent?
How should a healthcare leader primarily interpret negative reactions to a proposed change?
How should a healthcare leader primarily interpret negative reactions to a proposed change?
In what capacity can an LVN serve during an organizational change?
In what capacity can an LVN serve during an organizational change?
An organization is undergoing a major technological change. What approach would BEST help staff adjust to the new system and minimize resistance?
An organization is undergoing a major technological change. What approach would BEST help staff adjust to the new system and minimize resistance?
Following Kurt Lewin's Change Theory, what is the immediate next step after successfully creating buy-in and understanding of a proposed change among staff?
Following Kurt Lewin's Change Theory, what is the immediate next step after successfully creating buy-in and understanding of a proposed change among staff?
Which action represents the most effective way for an LVN to contribute to 'unfreezing' during a period of organizational change?
Which action represents the most effective way for an LVN to contribute to 'unfreezing' during a period of organizational change?
A hospital is transitioning to a new patient care model. Which strategy would most effectively support the 'moving' phase of Lewin's change theory?
A hospital is transitioning to a new patient care model. Which strategy would most effectively support the 'moving' phase of Lewin's change theory?
How could a new graduate nurse leverage their understanding of driving and restraining forces when starting their first job?
How could a new graduate nurse leverage their understanding of driving and restraining forces when starting their first job?
Which of the following scenarios involves an application of Evidence-Based Practice (EBP) in nursing?
Which of the following scenarios involves an application of Evidence-Based Practice (EBP) in nursing?
In a healthcare setting, how can an LVN best promote the 'refreezing' stage after implementing a new patient charting system?
In a healthcare setting, how can an LVN best promote the 'refreezing' stage after implementing a new patient charting system?
A clinic is considering implementing a new diabetes management program. Which initial step would align with the principles of planned change?
A clinic is considering implementing a new diabetes management program. Which initial step would align with the principles of planned change?
What is the most significant difference between 'planned change' and 'change by drift' in a healthcare organization?
What is the most significant difference between 'planned change' and 'change by drift' in a healthcare organization?
A nurse is caring for a patient who is experiencing an acute episode of anxiety alongside a chronic diagnosis of hypertension. How would you categorize the patient using the CURE framework?
A nurse is caring for a patient who is experiencing an acute episode of anxiety alongside a chronic diagnosis of hypertension. How would you categorize the patient using the CURE framework?
A newly admitted patient has several needs, among which are administering regularly scheduled oral medications, completing an admission assessment, and providing education on a new medication. Using general priority-setting principles, which should the nurse address FIRST?
A newly admitted patient has several needs, among which are administering regularly scheduled oral medications, completing an admission assessment, and providing education on a new medication. Using general priority-setting principles, which should the nurse address FIRST?
When prioritizing interventions using Watson's framework of caring, what action should a nurse prioritize with a patient in severe pain?
When prioritizing interventions using Watson's framework of caring, what action should a nurse prioritize with a patient in severe pain?
A nurse is delegating tasks to other staff members. Which task should be completed first?
A nurse is delegating tasks to other staff members. Which task should be completed first?
Following a change in hospital policy, several nurses voice resistance and struggle to adapt. What is the most effective strategy to address this resistance and facilitate smoother adoption?
Following a change in hospital policy, several nurses voice resistance and struggle to adapt. What is the most effective strategy to address this resistance and facilitate smoother adoption?
What is the primary risk of relying on 'change by drift' in healthcare management?
What is the primary risk of relying on 'change by drift' in healthcare management?
A nurse is caring for a patient with chest pain. What should the nurse do first?
A nurse is caring for a patient with chest pain. What should the nurse do first?
Which scenario best describes a situation of incivility between nurses?
Which scenario best describes a situation of incivility between nurses?
A team is tasked with implementing a new electronic health record system. Several team members have conflicting ideas on how to approach the rollout. What would be an appropriate tool or method to facilitate this?
A team is tasked with implementing a new electronic health record system. Several team members have conflicting ideas on how to approach the rollout. What would be an appropriate tool or method to facilitate this?
After implementing a new policy, a nurse manager wants to ensure the policy is being followed. What is the best evaluation method?
After implementing a new policy, a nurse manager wants to ensure the policy is being followed. What is the best evaluation method?
What is the primary risk associated with role ambiguity in a healthcare setting?
What is the primary risk associated with role ambiguity in a healthcare setting?
Which factor least affects nurse staffing levels in a healthcare facility?
Which factor least affects nurse staffing levels in a healthcare facility?
What is the most effective initial strategy for a nurse leader to address conflicts arising from limited resources?
What is the most effective initial strategy for a nurse leader to address conflicts arising from limited resources?
When managing conflict, what is the most important element for a nurse to consider to promote positive change?
When managing conflict, what is the most important element for a nurse to consider to promote positive change?
An elderly patient with cognitive impairment is about to be discharged. The patient states, 'I don't want to go home.' According to ethical principles, which principle is most applicable in advocating for the patient?
An elderly patient with cognitive impairment is about to be discharged. The patient states, 'I don't want to go home.' According to ethical principles, which principle is most applicable in advocating for the patient?
A new graduate nurse is considering whether to report a medication error they observed. Which ethical principle should primarily guide their decision?
A new graduate nurse is considering whether to report a medication error they observed. Which ethical principle should primarily guide their decision?
In a situation where a healthcare organization must decide how to allocate a limited supply of ventilators during a pandemic, which ethical theory would prioritize giving the ventilators to those patients most likely to survive?
In a situation where a healthcare organization must decide how to allocate a limited supply of ventilators during a pandemic, which ethical theory would prioritize giving the ventilators to those patients most likely to survive?
How does the State Board of Nursing (BON) primarily ensure safe and competent nursing practice?
How does the State Board of Nursing (BON) primarily ensure safe and competent nursing practice?
Which situation constitutes a violation of civil law?
Which situation constitutes a violation of civil law?
A nurse is asked to testify in a malpractice case. What legal standard will the court use to evaluate the nurse's actions in the situation?
A nurse is asked to testify in a malpractice case. What legal standard will the court use to evaluate the nurse's actions in the situation?
A patient refuses a life-saving blood transfusion due to religious beliefs. What is the nurse's primary legal and ethical responsibility?
A patient refuses a life-saving blood transfusion due to religious beliefs. What is the nurse's primary legal and ethical responsibility?
A nurse posts on social media about a difficult patient, without naming the patient directly, but includes details about their medical condition. What legal concept does this action violate?
A nurse posts on social media about a difficult patient, without naming the patient directly, but includes details about their medical condition. What legal concept does this action violate?
What is the nurse’s first action if they realize a medication order is incorrect?
What is the nurse’s first action if they realize a medication order is incorrect?
A nurse manager overhears a healthcare provider (HCP) complaining about the previous night shift nurse. What’s the most appropriate action by the nurse manager?
A nurse manager overhears a healthcare provider (HCP) complaining about the previous night shift nurse. What’s the most appropriate action by the nurse manager?
Which of these individuals should rely least on their intuition when faced with an ethical issue when providing patient care?
Which of these individuals should rely least on their intuition when faced with an ethical issue when providing patient care?
Flashcards
Change
Change
Altering the flow of events in any situation.
Importance of change
Importance of change
Healthcare advances when we are open to new ideas.
Reaction to change
Reaction to change
Negative reactions when change is implemented.
Change agent
Change agent
Someone skilled in the change process who can teach and implement.
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LVN as change agent
LVN as change agent
LVNs can lead and support implementing change.
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Planned Change
Planned Change
Change that is deliberate and well-organized, identifying forces for and against change.
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Change by Drift
Change by Drift
Change that is unplanned, arising from system imbalance, and may face resistance.
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Unfreezing (Lewin)
Unfreezing (Lewin)
First phase of change; preparing people for a new change, understanding what’s going on, may meet resistance.
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Moving (Lewin)
Moving (Lewin)
Second phase of change; people become ready to change and need support to address errors for learning.
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Refreezing (Lewin)
Refreezing (Lewin)
Third phase of change; stabilizing and integrating changes, making it part of regular work.
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Driving Forces
Driving Forces
Factors that motivate behavior towards a certain direction or decision to take place.
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Restraining Forces
Restraining Forces
Realities that restrain or discourage a behavior or decision to take place.
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Evidence-Based Practice
Evidence-Based Practice
Using current best evidence, clinical expertise, and patient preferences for optimal care.
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Facilitating Transitions
Facilitating Transitions
The process of relinquishing old roles, acquiring new skills, fostering spiritual growth, and establishing meaningful traditions.
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Setting Priorities
Setting Priorities
Priorities determined by evaluating urgency and importance, often guided by personal values and influenced by cultural, social, and philosophical factors.
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CURE Hierarchy
CURE Hierarchy
A prioritization framework categorizing needs as Critical, Urgent, Routine, or Extra, guiding immediate actions in patient care.
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First-Level Priorities
First-Level Priorities
Life-threatening conditions demanding immediate intervention (e.g., respiratory distress).
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Second-Level Priorities
Second-Level Priorities
Conditions that may become life-threatening if not addressed quickly (e.g., altered mental status).
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Third-Level Priorities
Third-Level Priorities
Activities that can wait until the client is stable, focusing on education, counseling, and non-acute needs (e.g., post-op hygiene).
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Cognitive Stacking
Cognitive Stacking
The dynamic cognitive process where nurses reorganize patient care and activities, adjusting to constant changes during a shift.
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Decision-Making Steps
Decision-Making Steps
Step-by-step approach used to resolve issues: identify the problem, desired outcome, solutions, evaluate, implement, and reassess.
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Conflict
Conflict
Disagreements arising from incivility, role ambiguity, environmental stress, nurse-to-patient ratios, and leadership styles; can foster collaboration if managed correctly.
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Intrapersonal Conflict
Intrapersonal Conflict
Conflict within oneself; acting in a way that contradicts personal values.
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Role Ambiguity
Role Ambiguity
Unclear role expectations leading to stress and errors.
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Nurse Staffing
Nurse Staffing
Staffing affected by census, acuity, and nurse shortages, which requires transparency.
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Limited Resources
Limited Resources
Insufficient resources impacting the ability to perform your role effectively.
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Ethics
Ethics
A branch of philosophy examining ideal human behavior.
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Ethical Dilemma
Ethical Dilemma
A conflict between two or more fundamental values.
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Autonomy
Autonomy
The right to choose one's own actions.
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Beneficence
Beneficence
To do what is good for the patient.
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Nonmaleficence
Nonmaleficence
To do no harm.
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Justice
Justice
Being just, impartial, and fair.
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Fidelity
Fidelity
Faithfulness to agreements made.
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Veracity
Veracity
Being truthful.
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Deontology
Deontology
Represents one's duty to others; do no harm.
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Utilitarianism
Utilitarianism
Greatest benefit for the greatest number of people.
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Standard of Care
Standard of Care
Level of care rendered by a comparable nurse in similar circumstances.
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Assault
Assault
Threat of unlawful touching of another.
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What is change?
What is change?
Altering events in a situation to improve it. Essential for progress.
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Change in healthcare
Change in healthcare
Healthcare improvement relies on new ideas and processes.
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LVNs as change agents?
LVNs as change agents?
Yes! They can support and implement changes effectively.
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Purpose of Planned Change
Purpose of Planned Change
Deliberate and organized change to reduce unexpected issues.
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Unfreezing
Unfreezing
Allowing those affected by change to understand the need to change.
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Moving stage support
Moving stage support
Supporting individuals through the change process, as they adapt.
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Refreezing implementation
Refreezing implementation
Formalizing changes into policies and regularly evaluating their effectiveness.
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Driving Forces defintion
Driving Forces defintion
Factors that encourage movement toward a new behavior or decision.
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Evidence-Based Practice definition
Evidence-Based Practice definition
The use of research, data, and patient input to guide clinical decisions.
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Evidence-Based Practice includes
Evidence-Based Practice includes
Integrating patient values and preferences with best evidence for optimal health care.
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Evidence-Based Practice sources
Evidence-Based Practice sources
Using surveys, statistics, research, and written records to decide plan of action .
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Reliable Websites
Reliable Websites
Websites that are peer-reviewed and updated regularly by governmental or professional organizations.
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Types of Priorities
Types of Priorities
Daily tasks to complete, efficient decisions, and personal values to help guide.
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Setting Priorities (In Nursing)
Setting Priorities (In Nursing)
Use Maslow's Hierarchy of Needs, always prioritizing the most critical patient first, within Watson's caring framework.
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CURE Acronym
CURE Acronym
Critical, Urgent, Routine, Extra.
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CURE Definitions
CURE Definitions
Critical (life-threatening), urgent (potentially life-threatening), routine (stable), and extra (non-acute).
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Priorities of Care Levels
Priorities of Care Levels
First level (life-threatening), second level (potentially life-threatening), and third level (stable).
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Need for Priority Setting
Need for Priority Setting
Knowledge, evidence-based practice, and sharing expertise with colleagues.
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Basic Considerations
Basic Considerations
Medication administration based on laws, policies, and procedures; ER decisions based on patient condition.
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Conflict in Nursing
Conflict in Nursing
Inevitability of disagreements.
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Organizational Conflict
Organizational Conflict
Tension from incompatible personalities, ineffective leadership, demanding jobs, organizational changes, or societal factors.
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Resolving Conflict
Resolving Conflict
Proactive engagement of a nurse leader when conflict arises.
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Personal Values
Personal Values
Underlying principles guiding ethical behavior.
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Nurse Practice Act
Nurse Practice Act
Sets legal requirements for LVN practice in a state.
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State BON
State BON
Enforces rules in NPA, manages licensure and education.
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Statutory Law
Statutory Law
Laws enacted by a formal law-making body.
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Common Law
Common Law
Based on customs and usage; used to sway judges or juries.
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Criminal Law
Criminal Law
Affects public welfare; punished by imprisonment, fines, or loss of license.
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Civil Law
Civil Law
Laws between individuals/organizations; remedy usually involves payments.
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Duty to Seek Medical Care
Duty to Seek Medical Care
Nurse must ensure patient receives safe care; act as advocate.
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Good Samaritan Law
Good Samaritan Law
Protects nurses offering voluntary assistance in emergencies without expecting pay.
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Fraud
Fraud
Deliberate deception for personal gain.
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Planned Change
- Deliberate, identifying driving and restraining forces to unfreeze, move, and refreeze the system.
Change by Drift
- Imbalance leads to an unplanned scenario with unsure outcomes.
Kurt Lewin's Change Theory
- A three-phase model to understand and implement change effectively.
Unfreezing
- Understanding what is going on allows time for consideration and adaptation to change
Moving
- People are unfrozen and concerning the proposes change, they become ready to change
Refreezing
- The ability to stabilize and integrate after the change.
Evidence Based Practice
- Utilizing best evidence, clinical experience, and patient preferences to customize the approach to health care.
Priorities
- Setting meaningful priorities that align with personal values and the urgency of clinical needs.
CURE Hierarchy
- A way to categorize patient needs to take a more thorough approach
Need for Priority Setting
- Constant changes and the needs of the staff is always evolving
Conflict
- Handled correctly, it can promote collaboration and increase productivity
Types of Conflict
- Handling conflict in nursing profession, a nurse to patient level is triggered by not answering call lights, ignoring pain levels, not giving meds on time, abrasive communication
Role Ambiguity
- Clear expectations and keys and communication
Ethics
- Behaviors of the population
Legal Considerations
- Enforced in the NPA state
Law
- State BON dictates the HCP with legal duty to carry out the orders
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