NR 446 Edapt Week 1

NR 446 Edapt Week 1

Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

Collaborative – Week 1 Key Concepts

Differences Between Leaders and Managers

Leaders are visionaries who articulate a compelling picture of what is achievable and inspire others to work towards realizing that vision. They empower individuals to engage in a larger purpose, often adopting distinct roles that enhance team dynamics. Leaders prioritize group processes, believing that cohesive teams can accomplish far more collectively than individuals can alone.

In contrast, Managers concentrate on establishing, measuring, and achieving organizational goals. They serve as implementers who ensure tasks are completed efficiently. Managers are process-oriented and rely on coordinating various resources—including personnel, time, and finances—to meet set objectives.

Varied Leadership Roles

Leadership encompasses various roles, as illustrated in Display 2.3 of the Leadership Text. These roles include:

• Counselor
• Teacher
• Critical thinker
• Buffer
• Advocate
• Visionary
• Director
• Decision maker
• Communicator
• Evaluator
• Facilitator
• Risk taker
• Mentor
• Energizer
• Priority setter
• Coach

Leadership Theories

Leadership theories vary significantly, with three prominent styles being Authoritarian, Democratic, and Laissez-Faire.

• Authoritarian leadership involves a leader making unilateral decisions without considering staff input, often employing negative reinforcement and punishment to enforce compliance. While this approach may seem rigid, it can be effective in emergencies requiring rapid decision-making.

• Democratic leadership fosters open communication and encourages staff participation in decision-making, promoting a sense of accountability and shared responsibility among team members.

• Laissez-Faire leadership is characterized by minimal direction or supervision from the leader, who adopts a hands-off approach. This style can lead to a lack of proactive changes and typically results in reactive quality improvements.

Understanding Emotional Intelligence (EI)

Emotional Intelligence (EI) is defined as the ability to recognize and understand one’s own emotions while engaging with others. This awareness can enhance interpersonal interactions and improve team dynamics.

Delegation in Nursing

The Five Rights of Delegation

Effective delegation is guided by five key rights, which include:

Delegating vs. Assigning

• Delegating involves transferring the authority to perform specific nursing activities to a competent individual while retaining accountability. Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) can delegate tasks to Unlicensed Assistive Personnel (UAP).

• Assigning designates responsibility for executing specific tasks to individuals qualified to perform them. RNs assign tasks to other RNs and LPNs, while LPNs assign to other LPNs.

Supervising and Accountability

Supervision entails directing, monitoring, and evaluating the performance of tasks by other healthcare team members.

Accountability refers to the obligation to accept responsibility for one’s actions. Licensed nurses remain accountable for appropriate assignments and delegation, while individuals to whom tasks are assigned are responsible for executing them correctly.

Seven Rights of Medication Administration

When administering medication, it is essential to adhere to the following rights:

1. Patient
2. Drug
3. Dose
4. Time
5. Route
6. Reason
7. Documentation
8. Right to refuse

Managing Medication Errors

In the event of a medication error, the nurse’s first priority is to assess the patient for any injuries and provide immediate care to prevent further harm.

Minimum Requirements for a Medication Order

For any medication order to be valid, it must include the following elements:

1. Full name of the patient
2. Date and time of the order
3. Name of the medication
4. Ordered dosage
5. Form of the medication
6. Route of administration
7. Time or frequency of administration
8. Signature of the ordering physician

Transcribing Orders

Verbal orders are acceptable only in emergencies or when a physician cannot write their own orders. The date and time must be documented, along with the physician’s name and the person transcribing it.

Telephone orders are used when the physician is not present for direct assessment but require immediate guidance for patient care. These orders should also be documented with the date, time, physician’s name, and the transcriber’s signature.

Understanding the State Nurse Practice Act

The Nurse Practice Act delineates the scope of nursing practice and may vary between states, yet all must comply with federal regulations. The Board of Nursing has the authority to suspend or revoke a nursing license if an individual violates this act.

Scope of Nursing Interventions

Certain interventions are exclusive to RNs, such as:

• Initial assessments
• Patient education
• Reporting IV site phlebitis
• Blood transfusions
• Initiating IV fluids
• Performing Glasgow Coma Scale assessments
• Initiating care plans
• Administering Rhogam injections

Interventions that both RNs and LPNs can perform include:

• Trach care
• Observing IV sites
• Dressing changes
• Wound care
• Suctioning
• Inserting urinary catheters
• Checking NG tube patency
• Medication administration
• Collecting sterile specimens
• Reinforcing client teaching
• Follow-up teaching

Tasks Delegated to Unlicensed Assistive Personnel (UAP)

UAPs can be delegated tasks such as:

• Activities of daily living
• Transferring patients
• Ambulation
• Feeding
• Positioning
• Collecting non-sterile specimens
• Taking vital signs (for stable clients)
• Recording intake and output
• Bathing

Considerations as Charge Nurse

As a charge nurse, patient assignments should consider:

• Patient status, ensuring those needing frequent monitoring are closer to the nursing station.
• Mental status, particularly for confused or disoriented patients.
• Necessary equipment for room setup.
• Whether patients require a negative or positive pressure room.

When assigning a float nurse, the charge nurse should be aware of:

• The float nurse’s prior experience and specialty.
• The patient ratio that the float nurse can manage effectively.

Priorities as a Float Nurse

Upon being assigned to a new floor, a float nurse should prioritize:

• Familiarizing themselves with the unit’s specialty and patient types.
• Locating essential areas such as the medication room and supply room.
• Understanding patient ratios.
• Learning the unit’s operational procedures.
• Identifying the location of the crash cart.
• Knowing who the charge nurse is for the shift.

SBAR Communication

SBAR is a standardized communication tool designed for conveying critical and urgent information. It stands for Situation, Background, Assessment, and Recommendation.

• Situation: Introduce yourself and the patient, briefly stating the issue.
• Background: Provide context, including the patient’s diagnosis and treatment history.
• Assessment: Summarize the patient’s current condition and the perceived problem.
• Recommendation: Suggest new treatments or changes and provide recommendations for further action.

Effective Change of Shift Reports

The most effective type of change of shift report is a bedside report, allowing for direct patient engagement.

Discharge Planning

Discharge planning begins at the time of admission, ensuring a smooth transition from hospital to home.

Role of the Case Manager

A case manager plays a critical role in discharge planning by performing program referrals, addressing patient needs, and developing strategies for ongoing care.

Critical Pathways in Patient Care

Critical pathways are established protocols that outline the expected recovery trajectory for patients with similar conditions. They guide the care provided both in the hospital and post-discharge.

Interdisciplinary Team Functions

The interdisciplinary team consists of various professionals, each with distinct functions:

• Registered Nurse (RN): Responsible for direct patient care, assessments, and care coordination.
• Medical Doctor (MD): Provides medical diagnoses and treatment plans, often specializing in specific fields.
• Speech Pathologist: Assists patients with communication and swallowing disorders.
• Wound Care Nurse: Specializes in the assessment and treatment of complex wounds.
• Dietitian: Evaluates and manages patients’ nutritional needs.
• Occupational Therapist (OT): Aids patients in regaining independence in daily activities.
• Physical Therapist (PT): Focuses on improving physical functioning for patients with musculoskeletal issues.
• Chaplain: Addresses the spiritual and emotional needs of patients.
• Social Worker: Helps with issues related to access to care, housing, and social support.
• Case Manager: Coordinates care plans and ensures comprehensive service delivery.

Delegation Worksheet

Conclusion

Understanding the differences between leadership and management, alongside the principles of delegation and effective communication, is vital for ensuring quality patient care. Effective collaboration among healthcare team members enhances patient outcomes and fosters a supportive work environment.

References

American Nurses Association. (n.d.). Nursing: Scope and standards of practice. Retrieved from [insert URL].

Bishop, M. (2020). Leadership in nursing practice. Journal of Nursing Management, 28(5), 1050-1058. https://doi.org/10.1111/jonm.12838

NR 446 Edapt Week 1

Smith, L. (2019). Emotional intelligence and its impact on nursing leadership. Nursing Management, 50(8), 26-32. https://doi.org/10.1097/01.NUMA.0000553708.52239.02