Nurse Practice Act Principles of Management Delegation

Card Set Information

Nurse Practice Act Principles of Management Delegation
2015-02-11 21:00:41
Nurse Practice Act Principles Management Delegation

Nurse Practice Act, Principles of Management, Delegation
Show Answers:

  1. Learning outcomes for Nurse Practice Act, Management, and Delegation
    Examine the significance of the nurse practice act to managing and delegating patient care (think about yourself, then pt, then personnel)

    Describe the ROLE of state boards of nursing

    Apply principles of time management while providing care

    Compare participative and authoritarian leadership styles to person being lead and the specific environment (PEDS/Community, etc)

    Differentiate the goals of delegation and when to delegate

    Discuss delegation to RNs, LPNs, and unlicensed assistive personnel
  2. Professionalism + Clinical Knowledge =
    Nurse Practice Act

    *Advocate (representative for the family)

    *Direct Pt Care Provider (provider of activities of patient care)

    *Care Coordinator (communicator of info; delegator of activities of patient care)

    *Leader (representative for health care team; representative for profession of nursing)

    *Teacher (instructor of information and skill to pt/families)
  3. Practice nursing as registered professional nurse means to practice nursing by performing for compensation any of the following:
    Assessing the health status throughout the life span 

    Establishing a nursing dx

    Establishing nursing goals to meet identified health needs

    Planning, Implementing, and Evaluating nursing care

    Providing for safe and effective nursing care rendered directly or indirectly through delegation

    Managing and supervising the practice of nursing

    Collaborating with other members of the health care team in the management of care

    Teaching the theory and practice of nursing

    Administering, Ordering, and Dispensing medications, dx studies, and medical treatments authorized by protocol, when such acts are authorized by other general laws and such acts are in conformity with those laws

    Administering meds/treatments as prescribed by physician practicing medicine in accordance with Article 2, Chap 34 

    Performing any other nursing act in the care and counsel of the ill, injured, or infirm, and in the promotion and maintenance of health with individuals, groups, or both throughout the life span
  4. What is the point of having a nurse practice act?
    Protect, promote, and preserve the public health, safert and welfare through legislation

    Control registered professional nursing education and practice

    Ensure that any person practicing, offering to practice or using the title registered professional nurse shall be licensed
  5. Overseer of registered professional nursing (maintains membership in the national council of state boards of nursing NCLEX exam)
    State Board of Nursing
  6. Roles of State Board of Nursing:
    Sole professional nursing licensing board

    Enforce qualifications and license qualified applicants

    Develop and set standards

    Approve/Disapprove education programs

    Regulate advanced practices

    Implement disciplinary process

    Provide education and practice consultation

    Determine fees
  7. Process to accomplish organizational goals; Art of getting things done through people

    Directing, Coordinating, and Influencing the operation of an organization to obtain desired result and enhance the total organization performance
  8. Management is the process of:
    *reaching organizational goals by working with and through people and other organizational resources

    *planning, organizing, leading and controlling the work of organization members 

    *using all available organizational resources to reach stated organizational goals.
  9. Key Elements of Nursing Management:
    High-quality health services (require skilled management) 

    Higher Quality Patient Care

    • Reduced Patient Complaints
    • (there is a direct coorelation between high-quality management and leadership and outcomes)

    Management Framework (could provide consistent approach to management development for all health professionals)

    Management skills (considered priority for staff development)

    Leaders (rise out of need to improve situations)

    Managers (take over the day-to-day functions required to sustain the improvement of patient outcomes)
  10. Management Key Element: provides consistent approach to management development for all health professionals
    Management Framework
  11. Management Key Element: Should be considered priority for staff development
    Management Skills
  12. Management Key Element: rise out of need to improve situation
  13. Management Key Element: Take over Day-to-Day functions required to sustain the improvement of patient outcomes
  14. Type of Leadership: Holds on to as much power and decision making process as possible
  15. Focus of Power in Authoritarian:
    The Manager
  16. Communication in authoritarian leadership
    Top-down; One-way
  17. Consultation in Authoritarian leadership:
    Minimal consultation
  18. Benefits of authoritarian leadership:
    Uses rewards/penalties
  19. Delegation in an authoritarian leadership:
    VERY LITTLE delegation
  20. Typical result from authoritarian leadership style:
    Unskilled subordinates and/or not trusted and the leader's ideas are not valued
  21. Type of leadership in which the leader decides what is best for employees
  22. Focus of power in Paternalistic leadership/ Results when used:
    Softer form of authoritarian leadership; which often results in better employee motivation and lower staff turnover
  23. Communication style of Paternalistic leadership
    A kin to parent/child relationship...the leader is seen as mother/father figure
  24. Delegation in paternalistic leadership style
    little delegation
  25. Consultation during paternalistic leadership
    Minimal, Explains the specific reason as to why they have taken certain actions
  26. Type of leadership in which the focus of power is more with the group as a whole- (MOST POPULAR STYLE of leadership)
  27. Focus of power within democratic leadership:
    Shared within the group
  28. Communication within democratic leadership style
    Employees have greater involvement in decision-making with potentially slow-down decision making
  29. Consultation/Delegation of Democratic leadership:
    Emphasis on delegation and consultation with the leader having the final say
  30. Benefits to a democratic leadership style
    Positive emotional connotations of acting democratically; potential trade-off between speed of decision-making and better motivation and morale
  31. Results from Democratic leadership style:
    Skilled, free-thinking and experienced subordinates
  32. "Leave Alone" type of leadership style
  33. Focus of Power in Laissez-Faire
    Conscious decision to delegate power (leader has little input in day-to-day decision making)
  34. Consultation in Laissez-fair leadership:
    Managers/employees have freedom to do what they think is best
  35. Delegation in laissez-faire leadership:
    Often criticized for resulting in poor role definition for managers
  36. Results of Laissez-Faire leadership:
    Staff are ready, willing, and motivated to take on responsibility; can be trusted to do their jobs
  37. ____ is NOT the same as abdication (handing over)
  38. ____ leaders direct and control all activities without meaningful participation by other members of the team
  39. ___ leaders encourage group members to participate, but retain the final say over the decision-making process
  40. ___ leaders give little or no guidance to group members
    Delagative or Laissez-Faire
  41. There is no ____ to leadership
    One Right Style
  42. The leadership style being used depends on ____
    The needs of the person you are leading and the needs of the environment
  43. Stable environment + Inexperienced subordinate
    Participative leadership
  44. Stable environment + capable subordinate =
  45. Stable environment + Expert Subordinate
  46. High growing or changing environment + Inexperienced Subordinate =
  47. High growing/changing environment + capable subordinate =
  48. High growing/Changing environment + expert subordinate =
  49. Environment in crisis + Inexperienced subordinate =
  50. Environment in Crisis + Capable Subordinate =
  51. Environmental Crisis + Expert subordinate =
  52. 6 leadership styles: (Goleman)
    Commanding- do what I tell you (crisis)

    Visionary- come with me (clear/new direction needed)

    Affiliative- people come first (motivate people)

    Democratic- what do you think (get input)

    • Pacesetting- do as I do, now (quick results)
    • Coaching- try this (help employee improve)
  53. Overall impact of commanding leadership
  54. Overall impact of visionary leadership
    Strongly positive
  55. Overall Impact of Affiliative leadership
  56. Overall impact of democratic leadership
  57. Overall impact of pacesetting leadership
  58. Overall impact of coaching leadership
  59. Time management tips:
    Plan day in advance!

    Focus on the most important activities first

    Don't let interruptions disrupt your day

    Keep yourself and workspace organized

    Learn to delegate tasks
  60. Ways to plan your day in advance:
    Planning makes tasks manageable

    List everything you must get done and make a note of how long it will take

    Rank the jobs in order of importance
  61. Key to delegation:
    Patient safety and personnel competency are key

    RN must complete thorough assessment of the total clinical situation

    The personnel receiving the delegated task may not reassign the task to someone else (only RN can delegate...not the tech)
  62. Circle of delegation
    • RN assesses
    • Delegate Task
    • Accountability for delegation is on RN
    • Practice Setting
    • Patient

    (Right task, right person, right directions/monitoring/communication, right supervision/evaluation, right circumstance)
  63. Example of delegation in "right circumstance"
    A tech/unlicensed personnel will not be able to take vital signs during a code
  64. To delegate to the right person:
    Make sure they have the knowledge base and skills to perform the duty

    Talk to personnel regarding their competency
  65. ____ is ultimately responsible for task completion after delegation (must evaluate the safety and efficacy of the assigned task)
  66. Goal of delegation safety:
    Give the right task under the right circumstance to the right person
  67. Steps to assessing and planning out day/delegation:
    Needs and condition of patients

    Level of clinical decision making/assessment needed

    Predictability of the patient's response to care

    Potential for adverse outcomes associated with tasks

    Cognitive and technical abilities needed to perform tasks

    Team member with scope of practice, skills, competencies and experience to perform the task

    Context of the situation and the environment (new admit or high acuity)

    Level of interaction/communication needed in care of the patient and with whom?
  68. Goal of communication in delegation:
    Give the right direction

    • -how is the task to be accomplished?
    • -when and what info should be reported?
    • -what is the process for seeking clarification about delegated care?
    • -what are the communication expectations in emergency situations?
  69. What needs to be assessed/implemented in supervision during delegation:
    Level of supervision/observation needed

    Frequency of monitoring/observing care

    Verification/documentation of completion of care

    Management of unexpected changes in a patient's condition
  70. Goal of observation/feedback during delegation:
    Assess the effectiveness of delegation

    • -was the delegation successful
    • -is there a better way to meet needs?
    • -is there need to adjust the plan of care?
    • -were there learning moments for staff/nurse?
    • -was appropriate feedback and follow-up care provided?
    • -was positive feedback given when appropriate?
  71. Patient Care and Medications: RN vs LPN
    • RN-
    • unlimited even though specialized training may be necessary for some areas (ie: chemotherapy); establish/contribute to patient care plans

    • LPN:
    • -limited under supervision of RN/physician;
    • -frequently oral meds and IM/Subcu injections only
    • -carry out patient care plans (monitor v/s, IVs, catheters, dressing changes, basic assessments)