Kahoot: Unit IV PDF

**Kahoot: Unit IV** 1. A payment methodology that rewards quality of care through payment incentives? a. **Value-based purchasing** i. Implemented by CMS to hold hospitals accountable for quality based care thorough performance measures ii. In VBP, provider...

**Kahoot: Unit IV** 1. A payment methodology that rewards quality of care through payment incentives? a. **Value-based purchasing** i. Implemented by CMS to hold hospitals accountable for quality based care thorough performance measures ii. In VBP, providers are held accountable for the quality and cost of the health-care services they provide by a system of rewards and consequences, conditional upon achieving prespecified performance measure iii. Incentives are structured to discourage inappropriate, unnecessary, and costly care 2. Propensity (tendency) of insured patients to use more medical services than necessary b/c their insurance covers so much of the? b. **Moral hazard** 3. T/F: in order to calculate NCH/PPD, divide \# of nursing hours worked by the pt census, Pg. 261 c. **True** d. **NCH/PPD = Nursing hours worked in 24 hours / patient census** e. EX: If you have 160 RN hours & 80 CNA hours (add together = 240) & divide by census at midnight (28) = 8.57 4. T/F: The largest of the budget expenditures is the **workforce or personnel** budget b/c healthcare is labor-intensive, pg. 260 f. **True** 5. Providers receive a fixed monthly payment regardless of services used by that pt during the month? g. **Capitation** 6. Predetermined level of excellence that serves as a guide for practice? h. **Standard** 7. McGregor's Theory X assumptions? i. **Avoid work, dislike work, need direction** j. **McGregor Theory X** managers believe employees are: Lazy, need direct supervision, need constant direction, & they are indifferent to organizational needs, require threats to be motivated, bad. "No one's gonna do what they need to do" k. **McGregor Theory Y** managers believe employees \["Y" for "yes"\]: iv. Enjoy their work, are self-motivated, willing to work hard to meet personal & organizational goals 8. The best way for managers to motivate staff? l. **Immediate praise** 9. T/F: Stretching is energizing people to enjoy the beauty of pushing themselves beyond what they think they can do? m. **True** n. **Saul Gellerman's Theory of "Stretching":** Suggests that individuals should be periodically "stretched" to do tasks more difficult than they are used to doing v. The challenge of "stretching" is to energize people to enjoy the beauty of pushing themselves beyond what they think they can do 10. Comes from within the person, driving him/her to be productive? o. **Intrinsic motivation** p. Internal drive to do or be something; may be influenced by others 11. In order to prevent burn out, is it a priority to follow? q. **Self-care** 12. A performance appraisal evaluates? r. **Actual performance** s. Performance appraisals are used to determine how well employees are performing their job. **Appraisals measure actual behavior** 13. T/F: If employees believe the appraisal is based on their job description, will they see it is relevant? t. **True** 14. T/F: Managers should keep ongoing anecdotal notes throughout the evaluation period? u. **True** v. **Anecdotal notes:** a brief, informal record of observation or incident 15. T/F: Halo effect occurs when the appraiser lets 1 or 2 positives affect the entire employee evaluation? w. **True** x. **Halo effect:** occurs when the appraiser lets one or two positive aspects of the assessment or behavior of the employee unduly influence all other aspects of the employee's performance 16. T/F: The Horns effect occurs when the appraiser allows some negative aspects of the employee's performance to influence the entire evaluation, leading to an inaccurate assessment of overall job performance y. **True** z. **Horns effect:** occurs when the appraiser allows some negative aspects of the employee's performance to influence the assessment to such as extent that other levels of job performance are not accurately recorded 17. Evaluation includes an assessment by all individuals within the sphere of influence of the individual? a. **360 evaluation** b. Includes an assessment by all individuals within the sphere of influence of the individual being appraised 18. If a manager suspects an employee is chemically influenced and presents a potential patient safety hazard: 1st action is? c. **Employee must be immediately removed from patient care environment** 19. T/F: The 2nd step in progressive discipline is informal reprimand or verbal admonishment? d. **False** e. **Steps of progressive discipline:** vi. Informal reprimand or verbal admonishment (warning) vii. Formal reprimand or written admonishment (warning) viii. Suspension from work ix. Involuntary termination or dismissal 20. T/F: The last step in progressive discipline is suspension from work? f. **False** 21. To reach goals, managers must? g. **Enforce rules** 22. T/F: Not discipling an employee who should be disciplined jeopardizes an organization's morale? h. **True** 23. T/F: 5 rights of delegation are right circumstance, right task, right direction, right supervision, right person i. **True** 24. Decision making is a complex, cognitive process often defined as choosing a particular course of action? j. **True** 25. People respond to the fact that they are studying, behaving in a manner that they feel will warrant attention? k. **Hawthorne effect** l. Mayo's Hawthorne Effect basically said that human beings under investigation will perform better bc they're being watched m. Hawthorne effect indicates that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. 26. The authoritarian leader? n. **Has a strong control, communicates downward, decisions don\'t involve others** o. **Authoritarian/autocratic**: Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Ex: found in the armed forces x. Strong control is maintained xi. Others motivated by coercion xii. Others are directed by commands xiii. Communication flows downward xiv. Decision making does not involve others xv. Emphasis the difference in status of "I" & "you" xvi. Criticism is punitive xvii. Acceptable in certain situations (like a code) 27. T/F: Multiple communication modes should be used for important messages if the manager wants them to be interpreted correctly? p. **True** 28. T/F: Nurses act as advocates by helping pts make informed decisions, acting as intermediary, or directly intervening for a pt? q. **True** 29. Decreasing the number of nursing care hours per pt day can? r. **Increase patient injuries/errors** **Kahoot: Comprehensive** 1. The right task, circumstance, person, direction/communication, and supervision are the? a. **5 rights of delegation** 2. T/F: Assigning a NAP (nursing assistant personnel) to administer a tube feeding to a comatose patient is an example of the right task? b. **False** c. Five Rights of Delegation: i. **Right task**: one is delegable for a specific patient ii. **Right circumstances:** appropriate patient setting, available resources, & other relevant factors considered iii. **Right person**: delegating the right task to the right person to be performed on the right person iv. **Right direction/communication:** clear, concise, description of the task, including its objective, limits, & expectations v. **Right supervision:** appropriate monitoring, evaluation, intervention, & feedback 3. To assure you are delegating to the right person, the RN must? d. **Know the competencies of the person** 4. T/F: "I want a PET scan for nausea b/c my insurance covers the procedure." This is an example of a moral hazard? e. **True** f. Moral hazard: Refers to the propensity of insured patients to use more medical services than necessary because their insurance covers so much of the cost 5. The new grad delegated to the LPN to administer tube feedings to an unstable client with a head injury. This is the? g. **Wrong person** 6. A new graduate should practice which skill in order to avoid burnout? h. **Self-care** 7. A manager who ascribes to which theory believes that staff are self-motivated and creative? i. **McGregor's Theory Y** 8. A manager makes sure the staff attend time-management courses in order to? j. **Maintain unit productivity standards** k. Good time-management results in an increase in productivity in healthcare organization; poor time management can result in decreased patient satisfaction 9. The approach the manager must take when understaffed is which of the following? l. **Maintain high quality patient care (patient care must not be jeopardized)** 10. T/F: A nurse is forced to provide care that is conflicting with his or her religious beliefs is an example of ethical dilemma? m. **True** n. **Ethical Dilemmas:** being forced to choose between two or more undesirable alternatives 11. A hospital has doubled tuition reimbursement for RNs. This hospital is said to believe in the value of? o. **Human capital** vi. Represents the capability of the individual vii. Ex: manager proposes the hospital board hire someone to teach management classes to managers, the organization offers tuition reimbursement 12. T/F: Professional negligence or malpractice are the same? p. **True** q. **Professional negligence (AKA malpractice):** Failure of a trained professional to act in a reasonable & prudent manner 13. T/F: HIPAA is violated when the nurse discusses care with the family before discussing it with the competent patient? r. **True** 14. T/F: Patients are more satisfied when the nurse can manage his or her time effectively? s. **True** 15. The best time for making priorities for the day is when? t. **Early, and again when situations change** viii. **Start the day/morning by planning** and update the plan as needed in order to improve productivity ix. It is important for the nurse manager to appropriately prioritize day-to-day planning to meet short-term and long-term unit goals x. The nurse/nurse manager must reprioritize what tasks will be accomplished based on new information received 16. The manager uses email, direct communication, memo, and staff meeting to communicate changes in order to? u. **Increase the likelihood of the message being received** v. Multiple communication methods should be used. 17. Critical pathways severe many purposes (SATA) w. **Facilitate expected outcomes** x. **Reduce lengths of stay** y. **Evaluate the cost-effectiveness of care** xi. **Critical pathways:** 1. Evidence-based interventions designed to shorten length of hospital stay 2. Strategy for assessing, implementing, & evaluating the cost effectiveness of patient care 3. Predetermined courses of progress that patients should make after admission for a specific diagnosis or after a specific surgery 4. They reflect standardized predictions of a patient\'s progress for a diagnosis **Study tips:** **Chapter 10** 1. Value Based Purchasing ✅ 2. Moral Hazard ✅ 3. 3 Types of unit budgets ✅ a. **Operating Budget:** the second largest expense for the hospital i. This budget covers the day-to-day expenses of running the unit, including salaries, supplies, and other operational costs. It ensures that the unit has the necessary resources to provide patient care. b. **Capital Budget:** large purchases like equipment ii. This budget is used for major expenditures such as purchasing new equipment, renovating facilities, or other significant investments that have a long-term impact on the unit. c. **Personnel Budget:** biggest expense for a hospital iii. This budget focuses specifically on staffing costs, including wages, benefits, and other related expenses. It helps manage the allocation of human resources effectively to meet patient care needs. 4. Types of budget expenses ✅ d. **Fixed expenses** -- Do not vary with volume iv. Ex- Managers salary e. **Variable expenses** -- Vary with volume v. Ex- Salary of employees & cost of supplies f. **Controllable expenses** -- Can be controlled or varied by manager vi. Ex- The number of staff members or staff mix that are working g. **Non Controllable expense**s -- Can not be controlled or varied by the manager vii. Ex- Equipment depreciation, emergency overtime of staff, and the type of supplies needed on unit 5. Calculate NCH/PPD ✅ 6. Cost-effectiveness ✅ h. Cost-effective means producing good results for the amount of money spent i. Expensive items can be cost-effective and inexpensive items may not j. Cost-effectiveness then must take into account factors such as anticipated length of service, need for such a service, and availability of other alternatives 7. Managed Care pros and cons ✅ k. Broadly defined as a system that attempts to integrate efficiency of care, access, and cost of care l. **CMS is the largest purchaser of managed care in the country** m. Utilization review is a process used by insurance companies to assess the need for medical care and to assure that payment will be provided for the care n. Capitation, whereby providers receive a fixed monthly payment regardless of services used by that patient during the month o. Managed care examples: Medicaid and Medicare, Health Maintenance Organization (HMO), Point of Service (POS), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) p. **Cons**: Loss of existing physician--patient relationships, Limited choice of physicians for consumers, Lower level of continuity of care, Reduced physician autonomy, Longer wait times for care, Consumer confusion about the many rules to be, followed 8. Capitation ✅ 9. Prospective payments ✅ q. A hospital payment system with predetermined reimbursement ratio for services given r. The primary reason for the prospective payment system was the advent of Medicare & Medicaid followed by increasing healthcare costs 10. Level of excellence ✅ **Chapter 18** 11. McGregor's Theory X and Y ✅ 12. Importance of manager's role in motivating staff ✅ s. The attitude and energy level of managers directly affects the attitude and productivity of their employees 13. Strategies a manager uses to motivate ✅ t. Motivation increases when employees trust and respect their leader/manager u. Have clear expectations for workers v. Be fair and consistent with employees w. Encourage teamwork x. Know the uniqueness of each employee y. Stretch employees intermittently z. Reward desired behavior a. Allow employees as much control as possible 14. Intrinsic vs extrinsic motivation ✅ b. Intrinsic Motivation: internal drive to do or be something; may be influenced by others c. Extrinsic Motivation: motivation enhanced by the job environment or external rewards (**EX:** pizza party for high patient satisfaction) 15. Preventing burnout ✅ 16. Importance of manager's role in creating a motivational climate and motivating staff ✅ d. A motivational climate increases good morale 17. Staff recognition ✅ e. Recognition for a job well done is the most powerful motivational tool f. Positive reinforcement must be specific or relevant to a particular performance g. Positive reinforcement must occur as close to the event as possible h. Reinforcement of new behaviors should be continuous **Chapter 24** 18. Performance appraisal, standards, and interview ✅ 19. Managerial strategies for a fair performance appraisal ✅ i. Appraisal should be based on standard j. The appraisal tool must adequately & accurately assess job performance k. Employee should have input into development of the standard l. Employee must know the standard in advance m. Employee must know the source of data gathered for the appraisal n. Appraiser should be someone who has observed the employee's work o. Appraiser should be someone who the employee trusts & respects p. Employer support & clarity of expectations are critical to the employee perceiving the appraisal as fair 20. Self, peer, and 360 degree appraisals ✅ 21. Tactics to employ during the interview ✅ 22. Horn's, Halo and Central Tendency effect ✅ q. **Central tendency effect**: The manager who falls into the central tendency trap is hesitant to risk true assessment and therefore rates all employees as average. These appraiser behaviors lead employees to discount the entire assessment of their work. **Chapter 25** 23. Stages of progressive discipline and what occurs (can occur) in each stage ✅ 24. Understanding of organizational goals and rules in the organization ✅ 25. Drugs commonly abused by nurses ✅ r. The majority of disciplinary actions by licensing boards are related to misconduct resulting from chemical impairment, including the misappropriate of drugs for personal use & the sale of drugs & drug paraphernalia to support the nurse's addiction 26. Profile of an impaired nurse/reaction upon confrontation ✅ 27. Constructive versus destructive discipline ✅ s. **Constructive Discipline:** viii. Helps employee to grow, not as a punitive measure ix. Is carried out in a supportive, corrective manner x. Employee is reassured that punishment is given because of actions & not because of who he or she is as a person xi. Primary focus is to assist employees to be self-directed in meeting organizational goals t. **Destructive Discipline:** xii. Punitive (inflicting or intended as punishment) xiii. Use of threats & fear to control behavior xiv. Employee always alert to impending penalty or termination xv. Arbitrarily administered & either unfair in the application of rules or in the resulting punishment