distribution of work within each person's scope/licensure

practicing without a license; exceeding scope

ongoing monitoring, guidance, and evaluation of care provided

based on court decisions

based on court decisions

the obligation to answer for one's actions and the outcomes of delegated/assigned tasks

laws written by legislatures

RN is accountable for ensuring patients are assigned to staff with the proper scope

offenses against society

RN is accountable for confirming the delegatee is competent and that the task is appropriate

disputes between people

RN must follow up and evaluate that the task was completed correctly and safely

judge made law and precedents

failure to act as a reasonable person would

stable patients, predictable outcomes, tasks within scope, wound care, catheter insertion, and reinforcing teaching

professional negligence by a licensed provider

non-invasive, routine, repetitive tasks (ADLs, vitals, I/O, hygiene, ambulation, feeding

protect nurses who help outside work unless grossly negligent

nursing process, teaching, clinical judgement, or unstable patients

protects government-employed nurses from certain lawsuits

4 P's of prioritization

threatening harm

why is the patient receiving care (safety, survival, essential treatment first)

touching without consent

what is the current clinical (ABCs, stable vs. unstable, changes in status)

spoken false words about someone's reputation

what is the best plan of care based on data and priorities

written false statements that harm reputation

what is my part, and what can be delegated/assigned appropriately

overall term for written future care wishes

AP can ambulate a stable patient

specific treatment preferences when terminal or unconscious

don't delegate feeding to an AP if patient has an aspiration risk

person appointed to make decisions

old or chronic disease

old or chronic disease

poor

withdrawing from conflict

LPN gives IM injection, not AP

giving in to maintain harmony

take vitals q4h and report if BP <100 systolic

authoritative or assertive dominance

check that vitals were recorded and abnormal findings reported

defines scope of practice, regulates licensure, disciplinary action, and delegation rules

provides model rules and develops NCLEX

RN physically present; overseeing new grad inserting a catheter

RN available via phone/electronically; LPN reports patient changes by phone

RN oversees care overall, not every task; routine daily delegation to LPN/AP

the knowledge, skills, abilities, and judgement necessary to perform safely and effectively

RN provides all care for patients; used in ICU and hospice

staff is divided by specific tasks; long-term care and mass casualty

RN leads a team to care for a group of patients; used in med-surg when balancing a skill mix

variation of team nursing but with geographic assignment; used in units with physical separation

1 RN is primarily responsible for a patient's care plan across shifts; chronic care, oncology, home health

inspires and influences others

task and role-focused and maintains stability

uses interpersonal skills, communication, and motivation

uses authority, planning, and resource allocation

independent, self-contained; little interaction with environment

interacts with external environment; adapts and exchanges informaiton/resources

charge nurse assigns staff to patients

nurse manager gives preferred shifts for good performance

threat of discipline if policies are not followed

wound care nurse seen as authority due to knowledge

well-respected nurse inspires others to follow

staff member has access to needed data

leaders are born with qualities (ex. confidence or integrity)

recognizing and cultivating natural leadership traits in charge nurses

focus on organization, hierarchy, and efficiency

nurse manager organizes schedule to maximize staffing

systems are unpredictable; small changes have big effects such as a single sick call disrupting the entire staff plan

organization works as interrelated parts such as the pharmacy being short staffed which affects nursing workflow

identify problem and create awareness; staff realizes infection rates are rising

implement new process; introduce new central line care protocol

solidify new practice; audit compliance or recognize staff adherence

makes quick decisions; best in crises (code blue)

collaborative decision-making; best when input is valuable

hands-off, staff self-direct; best with experienced, motivated teams

inspires and motivates toward vision; best for unit change or quality improvement

based on rewards/punishments; best for structured tasks

chooses among options; which staffing model to use

identifies underlying issues and develops solutions; why staff turnover is high

a deliberate plan of action chosen to address an issue

the process of influencing who makes policies and how

writes and passes laws

affordable care act, HIPPA, EMTALA, medicare/medicaid, and OSHA

implements and enforces

nurse practice act, mandatory reporting laws, state immunization requirements, and state medicaid rules

interprets laws and resolves disputes

grassroots includes writing letters, calling representatives, signing petitions, voting, etc

grassroots includes writing letters, calling representatives, signing petitions, voting, etc

healthcare providers are paid for each individual service that is performed

providers are paid based on patient outcomes, quality of care, and cost efficiency

violating nurse practice act and HIPPA violations

stealing meds, abuse, intentional harm

malpractice lawsuits, negligence

both parties give up something

an unexpected, serious adverse event causing death or severe harm

a preventable serious error that should never occur, such as wrong-site injury

a preventable serious error that should never occur, such as wrong-site injury

attacking the person instead of their argument

misrepresenting someone's argument to attack the weaker version

initial excitement, everything seems manageable

introducing irrelevant info to distract from the issue

making a broad conclusion from too little evidence

frustration with reality, conflict, and workload

assuming A caused B just because A happened before B

accepting responsibilities, gaining confidence