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A nurse manager is planning to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated:
- A. The nurse devises a plan to switch to EHR.
- B. The nurse records the time spent on written records versus EHR.
- C. The nurse attains approval from management for new computers.
- D. The nurse analyzes all options for converting to EHR.
- E. The nurse installs new computers and provides an in-service for the staff.
- F. The nurse explores possible barriers to changing to EHR.
- G. The nurse follows up with the staff to check compliance with the new system.
Correct Answer: B,F,D,C,A,E,G
Rationale: Planned change involves the following steps: (1) recognize symptoms that indicate a change is needed and collect data, (2) identify a problem to be solved through change, (3) determine and analyze alternative solutions, (4) select a course of action from possible solutions, (5) plan for making the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change.
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A nursing student is actively working toward strengthening their leadership skills. What action will best assist the student to meet this goal?
- A. Being self-reliant in solving problems
- B. Being self-directed and asking for assistance when needed
- C. Using written communication instead of face-to-face communication
- D. Reporting nurses who do not follow policies to the nurse manager
Correct Answer: B
Rationale: Leader behavior includes being self-directed and knowing your limitations; demonstrating a commitment to excellence; having a clear vision and strategic focus that allow movement forward toward a creative solution; showing commitment to and passion for your work; and displaying problem-solving skills, trustworthiness and integrity, respectfulness, accessibility, empathy and caring, desire to be of service, and responsibility to enhance the personal growth of all staff.
A nurse erroneously administered two tablets of acetaminophen totaling 650 mg to their patient. When reporting this to the nurse manager, the nurse states, 'there are two tablets in a package labeled '325 mg, acetaminophen.' The prescription reads 'administer 325 mg of acetaminophen;' therefore, I administered what was in the package.' Based on a philosophy of just culture, what should happen next?
- A. The nurse should be found at fault for not clarifying the order.
- B. The package labeling should be reviewed with the pharmacy.
- C. The nurse should be disciplined.
- D. No follow-up is needed as the medication is over the counter.
Correct Answer: B
Rationale: A just culture is committed to accountability and safety. Nurses are encouraged to disclose clinical errors and potential error situations without the fear of punitive actions, allowing others to learn from this experience. Health care workers within the organization discuss concerns and challenges related to patient care, turning them into opportunities for improvement. Reviewing the package labeling with the pharmacy addresses the root cause of the error, which is unclear labeling, rather than solely blaming the nurse.
The nurses at an acute care hospital participate in a committee focused on achieving Magnet status. Which action do the nurses suggest to help achieve this goal?
- A. Centralizing the decision-making and scheduling process
- B. Promoting self-governance at the unit level
- C. Deterring professional autonomy to promote teamwork
- D. Promoting evidence-based practice over innovative nursing practice
Correct Answer: B
Rationale: Magnet hospitals use a decentralized decision-making process, self-governance at the unit level, and respect for and acknowledgment of professional autonomy. In Magnet hospitals, 14 characteristics, the Forces of Magnetism, have been recognized that identify quality patient care, excellent nursing care, and innovations in professional nursing practice.
After observing conflicts between nurses about scheduling, a nurse manager compliments the nurses for achieving the monthly goal of no patient falls. What strategy for conflict resolution did the manager display?
- A. Collaborating
- B. Competing
- C. Compromising
- D. Smoothing
Correct Answer: D
Rationale: The manager who avoids conflict by complimenting the parties and avoids disagreements is using smoothing to reduce the emotion of the conflict. The original conflict is rarely resolved with this technique. Collaborating is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. Competing results is a win for one party at the expense of the other group. Compromising occurs when both parties relinquish something of equal value.
Nursing students enrolled in a leadership and management course discuss the roles of the nurse manager during post conference. What roles should the students include in the discussion? Select all that apply.
- A. Developing and overseeing a unit budget for staff and patient care
- B. Hiring, evaluating, and promoting staff growth
- C. Performing patient care
- D. Developing treatment plans to improve care and patient outcomes
- E. Handling escalating situations between caregivers and patients
Correct Answer: A,B,E
Rationale: Responsibilities of the nurse manager include overseeing day-to-day operations, designing and managing a budget, supervising and providing training to team members, hiring and evaluating nursing staff, handling escalating situations between patients and health care providers, and collaborating to attain optimal patient outcomes. Nurse managers' roles do not typically include performing patient care or developing treatment plans.