419 prlims.pdf

PRELIMS CU1 LEADERSHIP STYLES (behavioral theory) AUTHORITARIAN Strong control over the work group use of coercion and command downward flow of communication (the leader is the only one who comman...

PRELIMS CU1 LEADERSHIP STYLES (behavioral theory) AUTHORITARIAN Strong control over the work group use of coercion and command downward flow of communication (the leader is the only one who commands (boss type) emphasis on the difference in status criticism is punitive DEMOCRATIC less control econ and ego rewards as motivators suggestion and guidance communication flows up and down (everyone communicates) “we” constructive criticism LAISSEZ-FAIRE permissive, with little to no control supports when requested by the group or individuals little to no direction upward and downward commu disperses decision making thruout the group “on the group” “kayo” PRELIMS 1  does not criticize LEADERSHIP STYLE (FEIDLER) TELLING (S1) leaders tell their people exactly what to do. SELLING (S2) leaders will provide info and direction, but there’s more communication w/ followers. leaders “sell” their message to get the team on board. PARTICIPATING (S3) focus more on the relationship and less direction. leader works with the team, and shares decision-making responsibilities. DELEGATING (S4) leader pass most of the responsibilities to the group. less involved in decisions. POWER the ability to impose the will of one person or group to bring certain behaviors in other person or groups. Reward Power ability to reward others for complying. Coercive Power based on fear of punishment if one fails to conform Legitimate Power based on Identification with a leader to influence and the staff member an organization to accept that influence. Referent Power PRELIMS 2  identification with a leader and what that leader symbolizes. Leader is admired and exerts influence bec the followers desire to be like the leader. Expert Power gained thru knowledge, skills, information, experience and competence expertise gains people respect and compliance. Information power from knowledge, access to info, and sharing of info Connection Power from formal and informal coalitions and interpersonal relations and links to prestigious and influential people w/in and outside of the org. ROLE OF A MANAGER INTERPERSONAL symbol of the organization, liaison between the organization and the outside contacts. INFORMATIONAL Monitors, Disseminates info represents the subordinates to superiors and vice versa DECISIONAL troubleshooter, conflict negotiator SKILLS OF A MANAGER TECHNICAL skills performs activity in correct manner w/ the right technique HUMAN attitude PRELIMS 3  deals with people and gets along with them CONCEPTUAL knowledge sees individual matters as they relate to the total picture. dev. creative and efficient ways to respond to identified probs using relevant facts. CU2 Patient Classifications / PCS a system grouping patients based on acuity of illness and complexity of nursing activities necessary to care for the patients. an objective approach to determine staffing needs (proper mix and number) based on patient care needs workload management, or patient acuity tools Levels of Care Self-care / Minimal Care - include patients who are recovering and normally requires only diagnostic studies, minimal therapy, less frequent observations, and daily care for minor conditions and are awaiting elective surgery. Moderate care Include moderately ill or under the recovery stage from a serious illness or operation. They require nursing supervision or assistance that is related to ambulating and caring for their own hygiene. Intensive care Patient needs close attention and complete care all through the shift. The nurses initiate, supervise and perform most of the patient's activities. Critical care patients are acutely ill and high level of nurse dependency is required because of the unstable condition of the patient. Frequent evaluation, PRELIMS 4  observation, monitoring and adjustment of therapy is also required. Patients in these levels include those in critical conditions or in life and death situations. Modalities of Care Case Method or Total Patient Care nurses assume total responsibility during their time on duty for meeting all the needs of assigned patients. patients may be assigned as cases FUNCTIONAL NURSING Personnel were assigned to complete certain tasks rather than care for specific patients may lead to fragmented care and the possibility of overlooking patient priority needs and may result in low job satisfaction. TEAM NURSING Ancillary personnel collaborate in providing care to a group of patients under the direction of a professional nurse. The nurse-leader determines the condition and needs of all the patients assigned to the team and plans for individual care. Duties vary based on the patient’s needs and the workload and may include assisting team members, giving direct personal care to patients, and coordinating patient activities. MODULAR NURSING Uses a mini-team (two or three members with at least one member being an RN), with members of the modular nursing team sometimes being called care pairs. Patient care units are typically divided into modules or districts, and assignments are based on the geographical location of patients. PRIMARY NURSING Relationship-based nursing ;uses some of the concepts of total patient care as the RN also provides bedside care. PRELIMS 5  The primary nurse assumes 24-hour responsibility for planning the care of one or more patients from admission or the start of treatment to discharge or the treatment’s end. During work hours, the primary nurse provides total direct care for that patient. When the primary nurse is not on duty, associate nurses, who follow the care plan established by the primary nurse, provide care. CASE MANAGEMENT collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes”. (Case Management Society of America (CMSA, 2008-2016) as nurses address each patient individually, identifying the most cost-effective providers, treatments, and care setting possible. In addition, the case manager helps patients access community resources, helps patients learn about their medication regimen and treatment plan, and ensures that they have recommended tests and procedures. CONTEMPORARY MODELS OF ORGANIZING PATIENT CARE Professional Nursing Practice Model identified as a core feature of Magnet hospitals (Neisner & Raymond), 2002) Nurses have greater autonomy and control over practice, and there are higher rates of patient satisfaction, lower rates of nurse burnout, and safer work environments. Differentiated Nursing Practice Model Care in this model is differentiated based on the level of education, competence, and clinical expertise of RNs w/ associate degree function as technical nurses and provide the majority of bedside care- baccalaureate-prepared nurse function in collaborating and facilitating patient care from admission through discharge advanced practice nurses’ function within the broad healthcare system and provide care across all settings throughout wellness and death. PRELIMS 6  recognizes that all nurses, regardless of education, are needed to provide high- quality, comprehensive care to all patients in all settings. Clinical Nurse Leader Model developed with the goal to improve the quality of patient care across the continuum and as a way to engage highly skilled clinicians in outcome based practice and quality improvement. The nurse in this role is the leader in the healthcare delivery system and is not in an administrative or managerial role. The CNL is a provider and coordinator of care and fosters inter professional and intra professional communication. Synergy Model For Patient Care needs of patients and families influence and drive the competencies of nurses and that synergy occurs when the needs and characteristics of the patient, clinical unit, or system are matched with the nurse’s competencies was originally developed for critical care units, but found use in a variety of clinical settings. It includes: Eight patient characteristics (resiliency, vulnerability, stability, complexity, resource availability, participation in care, participation in decision making, and predictability, Eight nursing characteristics or competencies derived from patient’s needs (clinical judgment, advocacy and moral agency, caring practices, collaboration, systems thinking, response to diversity, facilitation to learning, and clinical inquiry Transforming Care At The Bedside TCAB model of care transformational leadership, safe and reliable care, vitality and teamwork, patient-centered care, and value-added care processes. Patient- And Family-Centered Care Model PRELIMS 7  places an emphasis on collaborating and planning care with patients (and their families) of all ages, at all levels of care, and in all healthcare settings (Conway, 2006). CU3 NNCCS Serve as a guide for the development of the following: 1. Basic Nursing Education Program in the Philippines through the CHED 2. Competency-Based test framework as the basis for the development of course syllabi and test questions for “entry level” nursing practitioner in the PNLE. 3. Standards of the Philippine Professional Nursing Practice in various settingsin the Philippines 4. National Career Progression Program for nursing practice in the Philippines 5. Related evaluation tools in various practice settings in the Philippines PATIENT SAFETY STANDARDS Aims to prevent harm to patients, their families and friends, health care professionals, contractual service workers, volunteers, and the many other individuals whose activities bring them into an environment. making appropriate care available KEY ELEMENTS OF PT SAFETY Leadership - Leadership and political commitment are essential at the health facility level where patient safety becomes an integral component of quality care PRELIMS 8  Institutional Development Approaches to institutionalize patient safety and quality in the health facilities will have to consider the following: - financial and human resources facility and equipment management; - strengthen management responsibility, authority and competency; formulate standards of what is expected from health providers communicates; provide training; enforce the standards that comes with the policies and give the patients a voice through a feedback system or a patient satisfaction survey Reporting System The National Patient Safety Committee shall develop and institutionalize a pro-active reporting and learning system that requires its leadership to encourage reporting of events Performance feedback and benchmarking mechanism communicate leadership responses to the reports shall be established to demonstrate commitment to patient safety and ensure continuous improvement Disclosure of Reported Serious Events The reporting system ensures confidentiality of individual cases. - The events can be made available to the public through -(a)disclosure of results of investigation, - (b)summary reports or annual reports that summarize events and actions taken PRELIMS 9  Professional Development Training and supervision of the healthcare staff to improve their decision and clinical judgments - Instill standard norms of behavior of courtesy, promptness and efficiency among the healthcare workers and improve the quality of service given to patients. Patient Centered care and Empowerment of Consumers Patients must be at all centers of patient safety initiatives and must be partners in all aspects of the process. Importance of Safety in Health Care 1. Improve patient satisfaction and clinical outcomes. 2. Ensure accuracy of patient’s identification. 3. Enhance the effectiveness of communication among healthcare personnel. 4. Improve the safety of using medications. 5. Reduce the risk of healthcare associated infection 6. Reduce the risk of harm resulting from injuries. 7. Improve staff productivity and retention rate. 8. Increase awareness of occupational health and environmental control like ergonomically- designed workplace. 9. Workers must be trained on prevention practices and be educated about the benefits of adopting good practices and work methods. 10. A strong ergonomics integration prevents injuries and increases productivity Nursing Actions to Improve Patient Safety Knowledge and implementation about healthcare policies and procedures. Open communication and teamwork among all other healthcare providers. Review the medication rights before giving the medications. Engage in creating and updating reporting system to avoid a blaming culture PRELIMS 10  Involve in research and evidence-based activities for better decision making Be updated on all life-saving certification like CPR, BLS, ACLS, PALS, NALS and other Nursing Specialty Certification Programs. Engage in hospital committees to make the healthcare system safe, effective and patient-centered. Be responsible in reporting all errors and near misses not only for the patient to prevent sentinel and adverse events to happen again. Ensure better lighting and less clutter in the work areas SENTINEL, NEAR MISS SENTINEL A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm. Sentinel events are debilitating to both patients and health care providers involved in the event. NEAR MISS Near‐miss errors are errors that occur to a patient. However, the patient is never harmed because of fortuitous or appropriate intervention. Although damage has not occurred yet, such errors are highly likely to cause damage. Near‐miss errors are also referred to as potential adverse events (Capucho, 2011). CU4 CODE OF ETHICS RELATED ETHICAL PRINCIPLES DOCUMENTATION/ PT’S RECORD CONSENT CONTRACT AND WILL PRELIMS 11  CRIMINAL AND CIVIL CASE DOCTRINE CU5 MODELS OF COMMUNICATION MEMOS AND MEETING MINUTES EXTERNAL AND INTERNAL CUSTOMER SATISFACTION CHANGE OF SHIFT REPORTS NURSING ROUNDS PT TRANSFER PRELIMS 12