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Learning plan 1 ha ppt


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Learning plan 1 ha ppt

  1. 1. Health Alterations Learning Plan 1Introduction to Clinical Nursing Management
  2. 2. Objectives• Explain the contribution of nursing to quality patient care• Design a plan to obtain professional goals• Identify factors impacting role transition from student to practicing graduate nurse• Explain the impact of selected legal and ethical issues on nursing practice
  3. 3. Quality Patient Care • Nursing’s role in patient outcomes (Sasichay-Akkadechanunt et al., 2003)
  4. 4. Professional Nursing• Caring• Compassion• Spirituality• Community outreach• Providing comfort• Crisis intervention• Going the extra distance (Hudacek, 2008)
  5. 5. COMPETENCY 11Develop a plan for making the transition from student to practicing nurse
  6. 6. Your Plan
  7. 7. Sources of Law Legislation AdministrativeConstitution Common Law (Statutes) Law Nurse Practice Acts
  8. 8. Legal/Ethical• “The nurse • “The registered promotes, advocates nurse systematically for, and strives to enhances the quality protect the health, and effectiveness of safety, and rights of nursing practice.” the patient.” (ANA, 2004, p. 33) (ANA, 2001, p. 12)
  9. 9. Nurse Practice ActCredentialingStandards of Care
  10. 10. Agreement by a client to accept a course of treatment after being informedof:1. Benefits and risks of treatment2. Alternatives to the treatment3. Prognosis if treatment is declinedINFORMED CONSENT
  11. 11. Implied Exceptions • MinorsExpress • Unconscious or unresponsive • Mentally ill Informed Consent
  12. 12. Voluntary Authentic CompetentNurse’s Signature
  13. 13. The transfer of responsibility for the performance of an activity from oneperson to another while retaining responsibility for the outcome. (ANA,1997)DELEGATION
  14. 14. The Big “D”
  15. 15. NeglectAbuse Mandated Reporter
  16. 16. Americans with Disabilities Act (ADA) Clear, Clear, strong, Ensure that thecomprehensive consistent, federal national enforceable government mandate to standards plays a central eliminate addressing role in enforcing discrimination discrimination standardsagainst people against people establishedwith disabilities with disabilities under the act
  17. 17. Alcohol Impaired NurseMental DrugsIllness
  18. 18. Sexual Harassment• EEOC, 1987 • Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature • When submission is considered a condition of an individual’s employment • When submission or rejection is used as a basis for employment decisions • “intimidating, hostile, or offensive working environment”
  19. 19. Advance Directives OrganDonation Death and Autopsy Related Issues Certification DNR or DNI of Death
  20. 20. Legal Protections for Nurses•Good Samaritan•Liability Insurance (respondeat superior)•Carrying out MD orders•Nursing Process•Documentation•Incident Report
  22. 22. Objectives• Identify different leadership styles• Explain qualities and behaviors that contribute to effective leadership• Provide positive and negative feedback in a constructive manner• Identify conflict resolution strategies• Discuss the importance of effective communication
  23. 23. Manager Leader – Have an assigned position within – Often do not have delegated the formal organization authority but obtain power – Have a legitimate source of through other means such as power due to the delegated influence authority that accompanies their position – Have a wider variety of roles – Assigned functions, duties and than do managers responsibilities – May not be part of the formal – Emphasize control, decision organization making, decision analysis and – Focus on group process, results information gathering, – Manipulate people, the feedback and empowering environment, money, time and others other resources to achieve organizational goals – Emphasize interpersonal relationships – Greater formal responsibility and accountability for rationality and – Direct willing followers control than leaders – Have goals that may or may – Direct willing and unwilling not reflect those of the subordinates organization
  24. 24. Leadership Styles
  25. 25. What Makes a Good Leader?
  26. 26. Communication
  27. 27. SBAR •Situation •Background •Assessment •Recommendations
  28. 28. Objectives• Define management concepts• Explain the qualities and behaviors that contribute to effective management• Prioritize patient care needs• Describe conflict resolution techniques• Describe the role of the nurse in quality management
  29. 29. Management Concepts Boss Everyone Else Centralized
  30. 30. Management Concepts Input InputInput Input Boss Decentralized
  31. 31. Management Concepts Nursing Units Accounting OrganizationHuman Resources Public Relations Matrix
  32. 32. Effective Management
  33. 33. Student as Manager
  34. 34. Student as Team Member
  35. 35. Feedback
  36. 36. Student as Team Leader
  37. 37. Team Leading Responsibilities• Know all patient condition and needs• Assist team members and provide direct care• Coordinate patient care with employee strengths• React to changes in patient and unit needs• Delegate as appropriate, remain accountable
  38. 38. Manage care for a group of patientsaccording to the Nurse Practice Act COMPETENCY 13
  39. 39. Functional Nursing• Tasks, not patients, assigned• Assigned by qualifications• Efficient• Not holistic• Communication problems and fragmented care
  40. 40. Team Nursing• RN coordinates patient care• Ancillary staff collaborate• Democratic leadership• RN spends less time with patients• Lack of continuity of care and RN assessment
  41. 41. Total Patient Care Nursing• Original mode of care• RN assumes total care• Similar to private duty• Widely used• High autonomy and responsibility• Florence Nightingale
  42. 42. Primary Nursing• 1970’s, depends on a total RN staff• RN assumes caseload• Associates cover when RN is not present• May cost more• High level of nursing ability, experience, accountability
  43. 43. Case Management• Coordinator• Services to patients and families• Streamlines cost• Collaborative• Clinicians oversee specific groups• Critical pathways• Less direct patient care
  44. 44. Flood300 adults, minor injuries, thermoregulation needs 3 RNs, 6 LPNs, 30 CNAs, 30 Volunteers RN 1:100, LPN 1:50, CNAs and Volunteer 1:10
  45. 45. Time Management
  46. 46. Steps to Take inTime ManagementMaslow’s Hierarchy of Needs
  47. 47. The Big “P” First Order Second Order Third Order Fourth Order
  48. 48. How to PrioritizeWhat do I have to do? How can I save time?• Report • Gather supplies• Assessments • Location• Medications • Estimate needed time• Treatment • Document ASAP• Document ASAP • Leave on time• Rest breaks • Prioritize interruptions
  49. 49. Don’t Do Do Later Do Now Things you can safely Things that can wait delegate to LPN or CNA Patient care that a little while must be done by an RNBath, nail care, daily weight Phone messages Assessments Airway Breathing Cardiac Changes
  50. 50. Setting Priorities First-order Second-order Third-order Fourth-orderImmediate threat to Actual problem for Relatively urgent Actual or potentialphysiological or which patient or potential or actual problem for whichpsychological safety family has requested problem that patient patient or family attention or family does not may need future recognize helpAirway, breathing, Nausea, pain, bath; Monitoring for post- Home carecardiac; anxiety need to urinate operativeattack; suicide; fall complications;risk anticipated teaching needs
  51. 51. Change of Shift Report
  52. 52. Quality Management (TQI, TQM, QA, Six Sigma, etc) • Mission • Values • Philosophy • Professional standards • Care guidelines • Outcomes
  53. 53. • “Our Pediatric Intensive Care QI Plan Unit will show 100% Components compliance regarding dailyResponsibility checks of the crash cart”.Scope of Service • If the crash cart was checked 96% of the time, a QualityQuality Indicators Improvement plan will beThresholds instituted.Data Collection • A time frame for re- evaluation will be setEvaluation • The problem will be resolved/not resolved • The results will be communicated
  54. 54. Questions?