Nursing Ethics and Healthcare Culture Quiz

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Questions and Answers

Which of the following is NOT a characteristic of a just culture?

  • Identifies and punishes individuals responsible for errors (correct)
  • Encourages reporting of errors without fear of punishment
  • Focuses on preventing future events
  • Promotes open communication and learning from mistakes

Which of the following is an example of a near miss event?

  • A patient falls out of bed while unattended, causing a minor fracture
  • A patient dies from a heart attack while in the hospital
  • A nurse notices a discrepancy in a patient's medication order before administering the medication (correct)
  • A nurse administers the wrong medication to a patient, resulting in a severe allergic reaction

What is a key characteristic of a High Reliability Organization (HRO)?

  • They have a strong focus on individual accountability for errors
  • They maintain a culture of continuous improvement and learning (correct)
  • They prioritize cost-effectiveness over patient safety
  • They rely heavily on reactive measures to address safety issues

Which of the following is NOT a barrier to error reporting?

<p>Belief that reporting errors will lead to positive change (D)</p> Signup and view all the answers

Which of the following best describes a 'workaround' in a healthcare setting?

<p>A nurse overrides a medication alert in the electronic medical record to administer a medication quickly (A)</p> Signup and view all the answers

Which ethical principle is most closely aligned with the concept of 'treating people equally and without prejudice, regardless of social or economic background'?

<p>Justice (A)</p> Signup and view all the answers

Which of the following situations is an example of the ethical principle of 'utility'?

<p>A nurse prioritizing care for a patient with a life-threatening condition over a patient with a minor injury. (D)</p> Signup and view all the answers

Which step in the ADPIE process involves considering the implications of each potential solution to an ethical dilemma?

<p>List and analyze all possible options for resolving the dilemma and review the implication of each option (D)</p> Signup and view all the answers

Which ethical principle is MOST directly violated when a nurse withholds information from a patient about their increasing blood pressure?

<p>Veracity (A)</p> Signup and view all the answers

Which of the following actions by a nurse leader is MOST likely to create an ethical workplace?

<p>Providing clear guidelines for ethical decision-making. (D)</p> Signup and view all the answers

Which of the following is NOT a responsibility of the RN when delegating a task?

<p>Conduct a comprehensive initial patient assessment (A)</p> Signup and view all the answers

Which of the following tasks can be delegated to a UAP?

<p>Assessing a patient's vital signs (D)</p> Signup and view all the answers

Which of the following is a responsibility of an LVN/LPN?

<p>Administering blood to a patient after receiving appropriate training (B)</p> Signup and view all the answers

Which of the 'Five Rights of Delegation' ensures the delegated task is appropriate for the patient's condition and the available resources?

<p>Right Circumstances (D)</p> Signup and view all the answers

Which principle of delegation ensures that the task is clearly defined and communicated to the delegate, including expectations and limits?

<p>Right Direction/Communication (A)</p> Signup and view all the answers

What is the primary focus of constructive discipline?

<p>Assisting employees in meeting organizational goals. (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic of destructive discipline?

<p>Employee reassured that punishment is due to actions, not their character. (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic of effective care coordination?

<p>Using threats and fear to control employee behavior. (B)</p> Signup and view all the answers

Which of the following is a core principle of Team STEPPS?

<p>Implementing clear communication strategies. (B)</p> Signup and view all the answers

What is the most effective form of discipline?

<p>Self-discipline, where rules are internalized and become part of the person’s personality. (B)</p> Signup and view all the answers

What is the primary role of the administration within the team structure?

<p>To provide support to the rest of the team (A)</p> Signup and view all the answers

Which of the following best describes situation monitoring?

<p>Actively scanning and assessing situational elements (C)</p> Signup and view all the answers

Cross monitoring is an error reduction strategy that primarily aims to:

<p>Monitor the actions of other team members for safety (D)</p> Signup and view all the answers

What does the 'E' in the STEP acronym represent in team monitoring?

<p>Environmental factors affecting patient care (D)</p> Signup and view all the answers

What is one of the critical job responsibilities of a team leader?

<p>To promote and facilitate good teamwork (D)</p> Signup and view all the answers

Which of the following decision-making tools is best suited for analyzing a project with numerous complex tasks and dependencies?

<p>PERT Chart (A)</p> Signup and view all the answers

What type of decision-making tool is often used in emergency situations, such as CPR or medication administration?

<p>Decision Tree (C)</p> Signup and view all the answers

Which of the following steps in the Six Step Decision Making Model addresses the nurse's legal responsibility for performing a specific activity?

<p>Step 1 (D)</p> Signup and view all the answers

A nurse is considering administering a medication that is not specifically listed in the hospital's medication administration policy. Which step in the Six Step Decision Making Model should the nurse consider first?

<p>Step 2 (A)</p> Signup and view all the answers

Which of the following is NOT a factor considered in the Six Step Decision Making Model when determining the scope of practice for a registered nurse?

<p>Nurse's personal beliefs about the activity (A)</p> Signup and view all the answers

A nurse is asked to perform a procedure that they have never performed before. Which of the following actions should the nurse take first?

<p>Review relevant literature and seek guidance from a more experienced nurse (A)</p> Signup and view all the answers

A nurse is considering delegating a task to a licensed practical nurse (LPN). Which of the following factors should the nurse consider first?

<p>The LPN's competency to perform the task (B)</p> Signup and view all the answers

Which of the following scenarios is MOST likely to necessitate the use of a decision-making grid?

<p>Choosing between two different types of IV pumps for the hospital (D)</p> Signup and view all the answers

Flashcards

Work-Arounds

Actions taken that circumvent proper procedures in patient care to save time.

Near Miss

An event that could have caused harm but was caught before reaching the patient.

Sentinel Event

An unexpected event resulting in death or serious physical harm.

Just Culture

An approach to safety that focuses on learning rather than blaming individuals.

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High Reliability Organizations

Organizations that maintain high standards of safety and quality with minimal failures.

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Decision Making Grid

A system that rates devices or equipment to aid decisions.

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Decision Tree

A visual guide that outlines step-by-step decision rules.

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Program Evaluation and Review Technique (PERT)

A graphical method for analyzing project timelines and tasks.

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Gantt Chart

A simplified visual chart showing task completion order in a project.

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Six Step Decision Making Model

A structured process to ensure activities align with nursing standards.

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Nursing Practice Act (NPA)

Legal framework outlining the scope of nursing practice.

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Competency in Nursing

Possessing the necessary knowledge and skills for safe practice.

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Accountability in Care

Being responsible for the care provided and its outcomes.

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Utility

The principle of doing the greatest good for the greatest number.

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Justice

Fairness in treating people equally, regardless of background.

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Veracity

The commitment to truth and honesty in healthcare.

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Fidelity

Keeping promises and fulfilling commitments in nursing.

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ADPIE

A method for ethical problem solving: Assess, Diagnose, Plan, Implement, Evaluate.

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Goals of Care Coordination

Improved care, health outcomes, and cost reduction through collaboration.

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IOM's 6 Aims of Care

Safe, Timely, Effective, Efficient, Equitable, Patient-Centered healthcare standards.

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Team STEPPS

A teamwork system to improve collaboration and communication in healthcare.

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Constructive Discipline

Supportive discipline aimed at employee growth and organizational goals.

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Self-Discipline

Internalized rules that form part of a person’s character and guide behavior.

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Patient-Centered Care

Care practices focused on the individual patient's needs and preferences.

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Core Team

Team members working directly with patients on the floor.

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Situation Monitoring

Actively scanning and assessing situations to maintain team awareness.

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Cross Monitoring

Strategy where team members observe each other to catch mistakes.

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Team Coordination

Leadership activity ensuring team actions and resources are understood and shared.

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Responsibilities of RN in Delegation

The tasks an RN must complete when delegating to others, such as patient identification and supervision.

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UAP Delegation Limits

UAP can provide supportive care but must not perform total patient care or re-delegate tasks.

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LVN/LPN Responsibilities

LVN/LPN can do follow-up assessments, teach from care plans, and perform certain procedures after education.

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Five Rights of Delegation

A framework to ensure effective delegation: Right Task, Circumstances, Person, Direction, and Supervision.

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Right Task

The correct task that can be delegated for a specific patient while ensuring safety and predictability.

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Study Notes

Key Terms in Leadership and Management

  • Management: Defined as planning, organizing, staffing, controlling complexity, and coordinating to achieve order, consistency, and predictability.
  • Leader: Obtaining power through influence, wide variety of roles, potentially separate from hierarchy and focuses on feedback, processes, information gathering, and empowerment.
  • Participative Management: Involves team members in decision-making processes, encouraging collaboration.
  • Hawthorne Effect: Demonstrates that worker productivity is increased when workers are given attention and feel valued, highlighting the impact of social and psychological factors on performance.
  • Theory X: Assumes employees are inherently lazy, need control, and are motivated primarily by money and security.
  • Theory Y: Assumes employees are motivated by factors beyond money and security; they seek responsibility, are self-motivated, and desire personal growth.
  • Trait Theories: Focuses on identifying the traits or characteristics of effective leaders.
  • Authoritarian Leader: Exercises significant control and makes decisions unilaterally, without much input from team members.
  • Democratic Leader: Involves team members actively in decision-making.
  • Laissez-faire Leader: A hands-off style, offering autonomy.
  • Situational Leadership: Leader's style adapts to the needs of their followers.
  • Contingency Leadership: Leadership effectiveness depends on the situation; different circumstances require different types of leadership.
  • Interactional Leadership: Leaders build strong relationships with their followers
  • Transactional Leadership: Focuses on exchange or transaction between leaders and followers, motivating through rewards and punishments.
  • Transformational Leadership: Inspires and motivates followers to achieve exceptional outcomes and promotes personal and organizational growth.
  • Servant Leadership: Enriches followers’ lives and builds better organizations while creating a just, caring environment.
  • Emotional Intelligence: Ability to understand, recognize, manage, and use emotions effectively in oneself and others.
  • Authentic Leadership: Style emphasizing genuineness, transparency, and adherence to one's values.
  • Reflective Thinking/Practice: Analyzing and evaluating one's actions, decisions, and experiences to improve future performance.
  • Maslow's Hierarchy of Needs: A hierarchical model of human needs to highlight the importance of satisfying needs from basic necessities to self-actualization.
  • Self-Actualization: The realization of one's full potential, often considered the highest need according to Maslow.
  • Motivation-Hygiene Theory: Suggests factors that increase/decrease job satisfaction.
  • Worker Empowerment: Allowing employees to make decisions and take actions to increase motivation and productivity.
  • Incentives and Rewards: Includes monetary/non-monetary incentives to increase motivation.
  • Manager vs Leader: Managers have assigned positions with specific responsibilities, focus on control, and direct willing and unwilling subordinates. Leaders obtain power through influence and direct willing followers.

Management Theories

  • Scientific Management: Emphasizes optimizing work, standardizing tasks to increase efficiency.
  • Bureaucratic Management: Emphasizes formal approach, clear hierarchies, and impersonal relationships.
  • Human Relations Management Theory: Highlights the importance of motivation, interpersonal relationships, and employee well-being in the workplace.
  • Motivational Theories: Examine what motivates employees, including Maslow's Hierarchy of Needs.
  • Two-Factor Theory (Motivator-Hygiene Theory): Different factors affect satisfaction versus dissatisfaction and include hygiene factors (related to the working environment) and motivator factors (related to the work itself).
  • X and Y Theories: Describing assumptions about employee motivation; Theory X suggests employees are lazy and need control, while Theory Y suggests employees are self-motivated and desire personal growth.

Quality Management and Safety

  • Six Aims for Healthcare: Ensures safe, timely, effective, equitable, and patient-centered care.
  • Quality Improvement: Uses data to monitor care processes and tests changes to continuously improve healthcare quality.
  • Quality Assurance: Systematic processes to ensure that healthcare services meet established standards.

Leadership and Management

  • Ethical Principles: Include respect for autonomy, beneficence, nonmaleficence, paternalism, justice, truthfulness, and preserving confidentiality.
  • Authentic Leadership: Genuine, transparent, and true to one's values.
  • Reflective Thinking: Continuously analyzing/evaluating actions and decisions to improve future performance.

Communication and Care Coordination in Healthcare

  • Communication Skills: Necessary to be an effective communicator in healthcare environments (including upward, lateral, and downward).
  • Barriers to communication: Examples and analysis of issues that hinder clear and effective communication.

Team STEPPS

  • Team Structure: Delineates elements for effective teams (size, membership, leadership).
  • Job Responsibilities: To empower members by clearly articulating goals and roles, facilitating communication and conflict resolution within groups.

Delegation

  • Five Rights of Delegation: Ensures safety and appropriate delegation of tasks. This includes considering task, circumstances, person, direction, and supervision.
  • Responsibilities of health team members: Clarify responsibilities and roles of each team member in the delegation process.

Ethical Considerations

  • Ethics of Practice: Issues addressing moral dilemmas.

Problem Solving and Decision Making

  • Decision-Making: Process of selecting a course of action from possible alternatives.
  • Critical Thinking: Questioning, examining, and analyzing assumptions to improve decisions.
  • Emotional intelligence: Understanding, controlling, and using one's own emotions in a positive manner. Also includes recognizing/using emotions in others.
  • Group Decision Making: Methods include nominal group technique and Delphi method; examining advantages/disadvantages of group decision-making.

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