370 Index Good Samaritan laws, 83 Health Insurance Portability and Accountability Act (HIPAA), 81–82 overview, 84t Patient Self-Determination Act (PSDA), 82 Safe Medical Devices Act (SMDA), 83 Feedback, 121, 121f, 125f Fidelity, 68 Fishbone diagrams, 165–166, 167f Five factors for becoming a skilled communicator, 289t Five rights of delegation, 259 right circumstances, 260 right direction or communication, 260 right person, 260 right supervision or evaluation, 261 right task, 259 Fixed expenses, 336 Fixed hours, 339f Flow charts, 167, 168f FMEA (Failure Modes and Effects Analysis), 162 Followership, 54–57 Forming, 318 For-profit organizations, 175 Foreseeability of harm, 87 Full-time equivalent (FTE), 241, 330t, 337–338, 338t for nonproductive time, 337–338, 338t Functional nursing, 231–232 Future directions, 363–364 Futures thinking, 181 G Gender, communication and, 124 General systems theory, 190–191 Generational differences communication and, 124 managing, 218–220 Good Samaritan laws, 83 Government health care, 29 Grapevine communication, 127 Growth strategies, professional, 355–359 H Handover, 134 Harassment, sexual, 285 Harm or injury, 87 Health-care access, 30–31 Health-care environment and policy, 27–42 Affordable Care Act (ACA), 37–38 current status of health care in the United States, 30–37, 30f health policy, 40–42 Medicare and Medicaid, 38–40, 39t overview, 27–28, 42 systems within health-care environment, 28–30 Health-care organizations, 174–193 for-profit versus not-for-profit organizations, 175–176 levels of service, 176 organizational structure and culture, and strategic planning, 177–182, 179f organizational theories, 188–192 overview, 175, 192 regulation and accreditation, 182–187 types of, 176, 176f Health insurance, lack of, 36–37 Health Insurance Portability and Accountability Act (HIPAA), 81–82, 203 Health literacy, 9 Health policy, 40–42 Health professional shortage areas (HPSAs), 36, 36f Healthy nurse, definition of, 360 Healthy work environment, building, 272–275 High-reliability organizations safety and, 23 HIPAA (Health Insurance Portability and Accountability Act), 81–82, 203 Histograms, 165, 166f Human dignity, 65 Human errors and factors in safety, 21–22 Human factors engineering, 21 I IHI (Institute for Healthcare Improvement), 152–154 Model of Improvement, 161 Implementation support model, 208 Incivility, 97–98, 282, 283f Incremental budgeting, 340 Indirect care hours, 339f Indirect expenses, 336 Informatics, 19–20. See also Information technology definition of, 19 department of, 204, 204t documentation, 20 information management, 19–20 nursing informatics, definition of, 196 project implementation. See Project implementation, informatics understanding nursing informatics, 196–201 Information technology (IT), 195–209. See also Informatics coding, 204–205 data, 199, 204–205 database, 199 data mining, 199 data security, 205 data set, 204 decision support systems, 200 informatics department, 204, 204t information security, 96 interfaces, 199–200 legislative and regulatory impacts upon, 202–204 network, 199 overview, 196, 209 patient safety and, 201 project implementation. See Project implementation, informatics rules and alerts, 200 standardized languages, 200–201 systems used in health care, 205–207 understanding nursing informatics, 196–201 Informed consent, 97 Injury or harm, 87 Innovation, 295 Innovators, 305, 306f, 306t 3021_Index_367-378 17/01/17 5:25 PM Page 370
Index 371 Institute for Healthcare Improvement (IHI), 152–154 Model of Improvement, 161 Institute for Patient- and Family-Centered Care (IPFCC), 238 Insurance Health Insurance Portability and Accountability Act (HIPAA), 81–82, 203 lack of, 36–37 professional and liability insurance, 93 Integrity, 65 Interdisciplinary, definition of, 11 Intergroup conflict, 309 International Council of Nurses Code of Ethics for Nurses, 71–72 Interpersonal conflict, 308–309 Interprofessional, definition of, 11 Interprofessional communication, 128–133 interprofessional team rounding, 129 SBAR, 130–133, 131t TeamSTEPPS, 129–130 Interprofessional teams, 314 Interviewing, 214–215, 215t, 351–352 Intrapersonal conflict, 308 Intraprofessional communication, 133–136 nurse-to-nurse transitions in care, 134–136 Intraprofessional teams, 314 Intuitive thinking, 106–107 IPFCC (Institute for Patient- and Family-Centered Care), 238 IT (information technology). See Information technology (IT) J Joint Commission, The (TJC), 154–155 Justice, 67 K Kotter’s eight-stage process of creating major change (1996), 299–300 L Laggards, 305, 306f, 306t Laissez-faire leaders, 47t Late majority, 305, 306f, 306t Lateral communication, 127 Lateral violence, 283 Leadership characteristics, 51–54 historical development of theories, 46–47 situational and contingency theories, 47 styles, 47, 47t trait theories, 46–47 Lean Model, 160–161 Learning organizational theory, 192, 302 Legal aspects of nursing practice, 77–93. See also Ethical and legal aspects Legislative and regulatory impacts upon information technology, 202–204 Levels of evidence, 14, 15f Lewin’s Force-Field Model (1951), 296–297 Liability, 90–92 Licensed practical nurses (LPNs) nurses prohibited from delegating certain aspects of nursing process to, 255 scope of practice, 245 specific nursing activities of, 258–259, 258t Licensed vocational nurses (LVNs) nurses prohibited from delegating certain aspects of nursing process to, 255 scope of practice, 245 specific nursing activities of, 258–259, 258t Licensure and regulation of nursing practice, 79–81, 182, 203 Lippitt’s Phases of Change Model (1958), 297–298 Living will, 94 LPNs (licensed practical nurses). See Licensed practical nurses (LPNs) LVNs (licensed vocational nurses). See Licensed vocational nurses (LVNs) M Magnet Recognition Program, 183–187, 184t–185t Maintenance, 208 Malpractice, 85–92 elements of, 86–87 expert witnesses, 90 liability, 90–92 major categories, 88–90 Management of conflict, 309–310 evidence-based, 16–17 information management, 19–20 nursing case management, 232–233 self-management, 8–9 theories. See Nursing leadership and management, theories of Mass trauma or natural disasters, 285 Meaningful Use program, 203 Medicaid, 38–40 Medical errors, 144–148, 145t, 147t definition of, 144 incidents and policy outcomes, 145t Medicare, 38–39, 39t Mental self-care, 361 Mentors, 57–58, 354–355 Mindful communication, 262 Mining, data, 199 Mission statement, 179 Morals, 63–64 moral courage, 74 moral distress, 74–75 moral integrity, 63 moral obligation, 63–64 moral uncertainty, 73 Moving stage, 297 Multidisciplinary, definition of, 11 N National Council of State Boards of Nursing (NCSBN), 80–81 National Database of Nursing Quality Indicators (NDNQI) staffing benchmarks, 247–249 National or universal health care, 29 3021_Index_367-378 17/01/17 5:25 PM Page 371
372 Index National Quality Forum (NQF), 151–152 Natural disasters or mass trauma, 285 Near miss, 146 Necessary care activities, 334 Negligence and malpractice, 85–92 Network, 199 NHPPD (nursing hours per patient day), 242–243, 330t, 338, 339f Noise, 125–126, 125f Nonmaleficence, 66–67, 67t Nonphysical workplace violence, 282 Nonproductive hours, elements of, 339f Nonproductive time, 242 Non–value-added care activities, 334 Nonverbal communication, 122–123 Normative-reeducative strategy, 305 Norming, 318 Not-for-profit organizations, 176 Nurse extender model, 234 Nurse fatigue, 278–280 Nurse practice acts (NPAs), 80 Nurse practitioner (NP) certifications, 357 Nurses’ Bill of Rights, 272–273 Nurse shortage, 240–241 Nurse-to-nurse transitions in care, 134–136 Nurse-to-nurse violence, 282–284 Nurse-to-patient violence, 284 Nursing: Scope and Standards of Practice, 79 Nursing and Midwifery Council (United Kingdom), 71 Nursing care hours, elements of, 339f Nursing case management, 232–233 Nursing Council of Hong Kong, 71 Nursing Council of New Zealand, 71 Nursing hours per patient day (NHPPD), 242–243, 330t, 338, 339f Nursing informatics. See Informatics Nursing leadership and management, theories of, 45–58 contemporary theories of leadership, 47–50 emerging theories of leadership, 50–51 followership, 54–56 historical development of leadership, 46–47 leadership characteristics, 51–54 mentorship, 57–58 overview, 45–46, 58 professional competence in nursing leadership, 51 Nursing research, 15 Nursing-sensitive quality indicators, 151, 248 Nursing’s Social Policy Statement: The Essence of the Profession, 78 O Online health information, 206–207 Operating budget, 336–337 Optimal healing environment, 10 Organizational communication, 127–128 Organizational conflict, 309 Organizational theories, 188–192 classical, 189–190 contemporary organizational theories, 190–192 Organizational violence, 284–285. See also Violence, workplace Orienting new staff, 216–217 Outcome indicators, 151 Outcomes of care, 18 Overdelegation, 266–267 P Pareto charts, 167–169, 169f Partnership in Practice (PIP) model, 234 Partnership models, 233–234 Partnership to Improve Patient Care (PIPC) model, 234 Paternalism, 67 Patient acuity, 243 Patient- and family-centered care model, 238–239 Patient care, organizing, 229–251 care delivery models, 230–239. See also Care delivery models overview, 230, 251 staffing. See Staffing Patient classification system (PCS), 246 Patient-focused care, 233 Patient handling and mobility, 276–278 Patient portals, 206 Patient safety. See Safety Patient Self-Determination Act (PSDA), 82 Patient-to-nurse violence, 284 PCS (patient classification system), 246 PDSA (plan-do-study-act) cycle, 161, 162f Peer review, 223 Performance, 318, 341 appraisal, 221–223 Personal health record (PHR), 198 Personal space, communication and, 125 Personnel budget, 337–339, 338t, 339f Philippine Nurses Association, 71 Philosophy, 179 PHR (personal health record), 198 Physical self-care, 361 PIPC (Partnership to Improve Patient Care) model, 234 PIP (Partnership in Practice) model, 234 Plan-do-study-act (PDSA) cycle, 161, 162f Planned change, 295 Plausible future, 363 Position description, 214 Possible future, 363 Power-coercive strategy, 305 Preceptors and mentors, 354–355 Preferable future, 363 Primary care, 176 Primary nursing, 232 Principles of ethics, 65–69, 65t. See also Ethical and legal aspects autonomy, 65–66 beneficence, 66, 67t confidentiality, 68–69 fidelity, 68 justice, 67 nonmaleficence, 66–67, 67t privacy, 68 veracity, 68 Principlism, 70 Prioritization, 257 3021_Index_367-378 17/01/17 5:25 PM Page 372
Index 373 Privacy, 68 Private health care, 28–29 Probable future, 363 Problem solving, definition of, 112 Process indicators, 151 Productive hours, elements of, 339f Productivity, 330t, 333–334 monitoring, 250–251 Professional and liability insurance, 93 Professional nurse, becoming, 346–364 balancing personal and professional life, 360–362 career planning and development, 347–352 contributing to nursing profession, 359–360 future directions, 363–364 interviewing, 351–352 overview, 346–347, 364 preceptors and mentors, 354–355 professional growth strategies, 355–359 resume, 349–351, 350f, 352f transition to practice, 353–354 Professional nursing practice environment, hallmarks of, 348–349 Professional Nursing Practice Model, 234–235 Professional values for nurses, 64–65 Project implementation, informatics, 207–209 conversion strategy and conversion planning, 207–208 implementation support model, 208 maintenance, 208 system downtime, 208–209 Providers and services, lack of, 35–36, 35f–36f PSDA (Patient Self-Determination Act), 82 Public health care, 29 Q Quality, definition of, 17 Quality and safety education, 7–23 Quality and Safety Education for Nurses (QSEN) initiative, 3, 5–7 Quality improvement, 16–18 care process, 18 models, 160–163 outcomes of care, 18 principles of, 155–159, 158f structure or care environment, 18 teamwork and collaboration, 16 Quality improvement, tools for, 164–169 bar chart, 165, 165f fishbone diagram, 165–166, 167f flow chart, 167, 168f histogram, 165, 166f Pareto chart, 167–169, 169f run chart, 164–165, 164f Quality of care, 33–35 Quantum leadership, 48 R RCA (Root Cause Analysis), 162–163 Reactive thinking, 105–106 Recruiting, 213–214 Reflective thinking, 106 Refreezing stage, 297 Registered nurses (RNs) scope of practice, 243, 245 specific nursing activities of, 258–259, 258t Regulation and licensure of nursing practice, 79–81, 182, 203 Relational leadership theories, 48–50 connective leadership, 49–50 quantum leadership, 48 transactional leadership, 48–49 transformational leadership, 49 Relationship self-care, 361 Reliability science, 21–22 Research, nursing, 15 Respondeat superior, 90 Responsibility, 257 Resumes, 349–351, 350f, 352f Retaining nurses, 217–218 Revenues, 337 RNs (registered nurses) scope of practice, 243, 245 specific nursing activities of, 258–259, 258t Rogers’ innovation-decision process (1995), 298–299 Root Cause Analysis (RCA), 162–163 Rules for health-care delivery in the 21st century, 5–6 Run charts, 164–165, 164f S Safe Medical Devices Act (SMDA), 83 Safety, 20–23, 142–170, 275–290 culture of, 22–23, 148–150 current state of, 23 definition of, 20 high-reliability organizations, 23 human errors and factors, 21–22 informatics and, 201 medical errors, 144–148, 145t, 147t nurse fatigue, 278–280 overview, 143–144, 170 patient handling and mobility, 276–278 patient safety event, 144 patient safety initiatives, 150–155 Quality and Safety Education for Nurses (QSEN) initiative, 3, 5–7 standardized protocols and practice, 22 work environment, 275–290 workplace violence, 280–290. See also Violence, workplace SBAR tool, 130–133, 131t SDLC (system development life cycle), 197, 197t Secondary care, 176 Second victims, 147 Security, data, 205 Self-appraisal, 222 Self-awareness, 53 Self-care, 360–361 Self-management, 8–9 Sentinel event, 146 Sexual harassment, 285 Singapore Nurses Board, 71 Six Sigma Model, 161, 161t, 162f Skilled communicator, becoming, 289t 3021_Index_367-378 17/01/17 5:26 PM Page 373
374 Index Skill mix, 243 SMART (specific, measureable, appropriate, realistic, timed) technique, 222 SMDA (Safe Medical Devices Act), 83 Social justice, 65 Social networking, 96 Span of control, 177 Specialty certification, 357–358 Spiritual self-care, 361 Staffing, 239–251 Agency for Healthcare Research and Quality (AHRQ) nurse staffing model, 247, 248f American Association of Nurses Principles for Safe Staffing, 246–247 approaches, 245–249 appropriate, 239 average daily census (ADC), 242 effectiveness, monitoring, 251 full-time equivalent (FTE), 241 mix, 242 National Database of Nursing Quality Indicators (NDNQI) staffing benchmarks, 247–249 nurse shortage, 240–241 patient acuity, 243 patient classification system (PCS), 246 for patient safety, 239–251 plan, developing and implementing, 249–250 productive time, 242 productivity, monitoring, 250–251 skill mix, 243 unit intensity, 243 workload and units of service, 242, 242t Staff meeting template, 324t Standardization, 149 Standardized languages, 200–201 Standardized protocols, 22 Standards for clinical practice, 22, 78–81 Nursing: Scope and Standards of Practice, 79 Nursing’s Social Policy Statement: The Essence of the Profession, 78 State and federal legislation, 81–84 disclosure statutes, 83–84 employment laws, 84, 84t Good Samaritan laws, 83 Health Insurance Portability and Accountability Act (HIPAA), 81–82 overview, 84t Patient Self-Determination Act (PSDA), 82 Safe Medical Devices Act (SMDA), 83 State boards of nursing, 81 State nurse practice acts (NPAs), 80 Storming, 318 Strategic planning, 179–182, 180t Structure, organizational, 177, 179f Structure indicators, 151 Superusers, 207 Supervision, 257 SWOT analysis, 111–112, 179–180, 180t Synergy creating, 319–320 definition of, 319 Synergy Model for Patient Care, 236, 236t–237t System development life cycle (SDLC), 197, 197t System downtime, 208–209 T Taiwan Nurses Association, 71 TCAB (Transforming Care at the Bedside), 236–238 Teams, 313–325 building, 317–320 collaboration and teamwork, 10–17, 314–316, 316f creating synergy, 319–320 effective, characteristics of, 320 leading and managing, 321–324, 324t overview, 313, 325 stages of development, 318–319 team nursing, 232 team rounding, 129 TeamSTEPPS, 129–130 Telehealth, 206 Tertiary care, 176 The Joint Commission (TJC), 183 accreditation, 183 Third-party violence, 284 360-degree feedback, 223 TJC (The Joint Commission), 154–155 Torts, 85, 86t Total patient care, 231 Transactional leadership, 48–49 Transformational leadership, 49 Transforming Care at the Bedside (TCAB), 236–238 U UAP (unlicensed assistive personnel). See Unlicensed assistive personnel (UAP) Uncompensated care, 32, 32f Underdelegation, 267 Underinsured, definition of, 30 Unfreezing stage, 297 Uninsured, definition of, 30 Unionization, 226 Unit intensity, 243 Units of service (UOS), 242, 242t Unity of command, 177 Universal or national health care, 29 Unlicensed assistive personnel (UAP) nurses prohibited from delegating certain aspects of nursing process to, 255 scope of practice, 245 specific nursing activities of, 258–259, 258t Unplanned change, 295 Unsafe or questionable practice, 98 UOS (units of service), 242, 242t Upward communication, 128 Utilitarianism, 69–70 V Value-added care activities, 334 Values, 64–65 clarification of, 64 core professional values for nurses, 64–65 3021_Index_367-378 17/01/17 5:26 PM Page 374
Index 375 Variable expenses, 336 Variance, 330t, 332 report, 333t Veracity, 68 Verbal and nonverbal communication, 121–123 Vertical violence, 283 Violence, workplace, 275, 280–290 AONE Guiding Principles: Mitigating Violence in the Workplace, 275 consequences, 286–287 continuum of incivility, 283f contributing and risk factors, 286 preventative strategies, 287–288, 289t types of, 282–285 Vision statement, 179 W Will, living, 94 Work environment. See Environment, work Workforce creating, 212–218 managing, 218–227 overview, 213, 226 Workload and units of service, 242, 242t Workplace safety, 275–290. See also Safety World Health Organization (WHO), 155 Z Zero-based budgeting, 341 3021_Index_367-378 17/01/17 5:26 PM Page 375
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