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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?
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Exam 1
2 Takes nursng from clinical experience, knowledge of patho, and
intuition scientificevidence, 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 efficiency4 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
o Chain of command
- Hierarchy of authority and responsibility
- Line authority: CNE managerstaff nurse
- Staff authority: advisory relationship in which
recommendations andadvice 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
o Organizational structure
- Departmentalization to maintain chain of command, reinforce
authority,
and formal system for communication
- Bureaucracy: ideal, rational, most efficient form of
organization.
o 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
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Exam 1
open system: interacts both internally and with its
environment
closed system: self-contained and usually can be only found in
physical
science
o Input imported from environment
o Throughput is performed to produce a product
o Output- is then imported to the environment
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 Governanceo nursing practice is best determined by
nurses
o allows staff to control over major decisions about nursing
practice
o Heterarchy Structure
o Acknowledges the linkages among people and their
relationship
o 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
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Exam 1
o Goal: to improve functioning and productivity
o
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.
