Exam 1

Chapter 1
1. What are the forces that are changing the health care system? The healthcare business o HC changed from service oriented to business oriented o It is now a competitive market o Costs are getting higher as well as the number or uninsured/underinsured o Every expenditure is under close monitor Health care networks o Emerged to cut across costs o Treat pts prior to hospital admission which is very costlyPRIMARY CARE o Deliver continuum of care Demand to reduce errors o Medical errors: -computerized systems -CMS no longer reimburses for hospital acquired infections/errors o Leapfrog Group- focus on pt safety practices and reward hospitals that demonstrate quality outcome measures

Cultural and generational differences Aging patients and nurses

2. How does quality improvement and benchmarking reduce medical errors? Quality Improvement o Addresses problems before they occur o Constant evaluation of how well consumers needs are met and then devising plans to perfect the process (pt satisfaction surveys) Benchmarking o Differs from QI in that it is a comparison with similar organizations rather than within units of the same organization o Results can help enhance areas of strength and address weaknesses

3. What is the impact of cultural and generational differences on the health care environment? Being culturally sensitive requires commitment, respect, and persistence Generational differences: o Traditionals: loyalty and respect authority o Baby boomers: professional and personal growth o Generation X: positive work environment, wrk to have worth, independence, fun, balance b/w work and personal life o Millenials: tech savvy, responsible, competent 4. How does evidence-based practice impact on nursing practice?

Exam 1

Takes nursng from clinical experience, knowledge of patho, and intuition scientific evidence, pt values and preferences, the clinical situation

5. What are the challenges that you will face as a professional registered nurse entering the profession? 2 The system in constantly changing 3 Administrators focus on cost and efficiency 4 Employees want adequate staffing, supplies, equipment, and time 5 Managers are in the middle and try to balance both 6 Nurses must be committed, innovative, flexible, involved, enthusiastic, good mental & physical health

Chapter 2 & 3
1. Define various organizational theories. Classical o Provides a formal chain of commend and system for communication o Focuses on structure of formal organization o Division and specialization of labor - Work is divided among staff - Increases efficiency and improves organizations product - Lends itself to proficiency and specialization - Economically beneficial Chain of command - Hierarchy of authority and responsibility

Line authority: CNE managerstaff nurse Staff authority: advisory relationship in which recommendations and advice are offered. ACNP and manager collaborate to improve efficiency and productivity of the managers unit but neither is responsible for the work of the other

Organizational structure - Departmentalization to maintain chain of command, reinforce authority, and formal system for communication - Bureaucracy: ideal, rational, most efficient form of organization.

Span of control - Addresses how many employees a manager can effectively supervise Humanistic o Focuses on social aspect of organizational design o States formal authority works only with willing participants o Systems o open and closed systems o

Exam 1 open system: interacts both internally and with its environment closed system: self-contained and usually can be only found in physical science Input imported from environment Throughput is performed to produce a product Output- is then imported to the environment

o o o o Contingency o Believe organizational performance can be enhanced by matching an organizations structure to its environment o Environment is made up of internal and external forces o Chaos o Organizations are living, self-organizing systems that are complex and self adaptative o Creativity and flexibility are necessary to adopt to change o Leaders role To build resilience To maintain balance To encourage creativity Complexity o Random events interfere with expectations o No linear cause to explain outcomes o System interacts and adapts to change o Managers must encourage the flow of info. In all directions,

2. What are relationship-oriented structures? o Shared Governance o nursing practice is best determined by nurses o allows staff to control over major decisions about nursing practice Heterarchy Structure o Acknowledges the linkages among people and their relationship Self-Organizing Structure o Flexible and able to respond to both internal and external change o Requirement: Self- reference _ Future

3. Define redesigning, restructuring, and reengineering. o Redesigning o Distibution of activities , role overlap , excess specialization and waste are examined o Goal: to design each job according to appropriate tasks and necessary qualifications & have all jobs fit together so that work gets done in most efficient and effective manner o Restructuring and Reengineering o Examine entire health organizations structure

Exam 1 o o Goal: to improve functioning and productivity

4. Why is strategic planning important for organizations? 5. How does the organizational environment and organizational culture affect success? 6. Define the traditional and integrated models of care. 7. What are the positive and negative factors of different systems?

Chapter 4
Why is every nurse a manager and can be a leader? What are the differences between leaders and managers? What are the four categories of leadership theories? What the four leadership styles? Select one of the contemporary theories on leadership that you would like to aspire to and state your rationale. What are the functions of nurse managers? Describe the five areas of competency for a manager as defined by AONE and how your nursing program has prepared you in these competencies. What makes a leader successful?

Chapter 5
Why are nurses change agents? How do different theorists explain change? How is change theory similar to the nursing process? Describe the three change strategies and evaluate their effectiveness. Why do individuals resist change? Describe the nurses role as a change agent.