Académique Documents
Professionnel Documents
Culture Documents
6, 9, 10
Chapter 6: Patient, Subordinate, and Professional Advocacy:
1. Advocacy:
Advocacy: helping others grow/ self-actualize;
-inform others of rights; protecting one believes for others and self
Leader: use risk taking, vision, self-confidence, ability to articulate needs, assertiveness
Manager: for all
-whistleblower- legislator/media/ influence health policy
-Nurses act as advocates by helping others make informed decision,
By acting as an intermediary in the environ,
Or directly intervening on behalf of others
empowerment.
Leadership Roles:
1. Create Climate-value advocacy + assoc risk taking
2. Seek fairness/justice for those unable
3. Strengthen Pt/ subordinate support systems- encourage autonomy/ decision making
4. Provide info to empower autonomy
5. Assertively advocate for others when needed
6. Participate in proff nursing organize/groups that advance nursing proff
7. Role Model proactive involvement in health-care policy
8. Speak up to advocate for health care practices for safety/ quality improve
9. Help create national/ legal binding Bill of Rights for pts
10. Social justice/ individual pt advocacy
11. Differentiate btwn control pts/ assisting choices--- domination/dependence vs.
freedom
Management Functions:
Advocate for:
1. pt/subordinate adequate info for making decisions
2. Prioritize pt- rights/ values
3. Consultation for pt, if inter/intrapersonal conflict
4. Promote workplace safety/health for all
5. Encourage subord express concerns/ impunity for whistleblowers
6. Demonstrate skills to deal w/ media/ legislators health care issues
jeopardizes all
Nursing Values Central to Advocacy:
Individuals have right to:
1. Right to autonomy deciding course of action/ health-care goals
2. Right to hold personal values/ make decisions
3. Right to Access of info- to make informed decisions
4. Nurses acts on behalf of those unable to
5. Empower pts/ subordinates to make decision for their own essence of advocacy
Patient Advocacy:
Disease/ Aging/ Physical/ Mental Disability can result in: dec independence, dec
freedom, dec ability to make choices alone advocacy ensures vulnerable protected
Important for pt-advocate to differentiate btwn:
Controlling pt choices (domin/dependence)
Assisting pt-choices (freedom)
Common Areas- Requiring Nurse-Pt Advocacy:
1. End- of life decisions
2. Techn advances
3. Reimbursement- health care
4. Access to health care
5. Provider-pt Conflicts- expectations/ outcomes
6. Withholding info
7, Insurance coverage: authorize/ denials/ delays
8. Pt privacy/ confidentiality
9. Med Errors
10. Pt grievances/ appeals
11. Cultural/ ethnic diversity senility
12. Respect/ dignity for pts
13. Incompetent HCP
14. Inadequate consent
15. Complex social probs: AIDS, teen preg, violence, poverty
16. Aging Pop
Patient Rights:
-Consumer Bill of Rights/ Responsibilities (Pt Bill of Rights): 1998; laying out
rights/responsibilities of pts and hcp
-Influence public policy by: active in national nursing organizations; directly lobby
legislator in person/by letter; collective influence to impact health care policy
-Nurses must exert their collective influence
-make concerns known to policy makers
-before: having a major impact on political/ legislative outcomes
-Political action Committees (PACs): of Congress of Industrial Organizations- attempt
to persuade legislators to vote certain way; lobbyist of PACs may be from: groups
interested in partic law or paid agents want bill passed/defeated
-Nurses need to be more active in PACS
-Nurse should lobby for: quality of care, access to care, safety, restructuring, direct
reimbursement for advanced practice nurses; funding for nurse education
-Short-term planning: specific task, less complex, annual/ quarter/ monthly/ weekly/
daily/ hourly
-not planning= stressful, increased errors,
-managers: need to find time to plan
Time Management: making optimal use if available time
-Good time management skills allow individual to spend time on things that matter
-optimize time manage: prioritize duties; manage/ control crises; reduce stress; balance
Ex: day-day: charge nurse staffing, pt care assign, coord lunch breaks,
EX: staff nurse: how handoff reports given/received, timing/ methods initial assess,
coord of meds, tx, procedures, docum
assess
Not all important things are urgent,
Not all urgent things are important
Some projects are not accomplished because they arent broken down into
manageable tasks
Reprioritizing: change when new info received ; if crisis-set aside original priorities for
Time Wasters:
1. Technology- internet, gaming, email, social media
2. socializing
3. Paperwork overload
4. Interruptions
- dont need to check email 100 x per day
How to prevent subordinates from taking manager time:
1. Dont make self overly accessible
2. Interrupt rambling
3. Be brief- stand up when done
4. Schedule long-winded individuals
Personal Time Management: self-knowledge/ aware; clearly id personal goals/
someones responsibility
Forecasting: making educated budget estimate by using historical data
Budget: financial plan includes expenses as well as income for period of time
16. Fee for service system (ffs): reimbursement sys after service delivered
17. For profit org (fpo): financial contributors have ownership interest; own stocks;
dividends on profits
18. Full-time equivalency (FTE): number of hours worked by ft employee for one
week. FTE 1.0=5 8 hour days = 40 hours per week
19. Health maintenance organization (HMO): prepaid org; healthcare providers
receive preset money on per person per month basis; managed care
20. Hours per patient day (hppd): hours of nursing care/ patient/day; various level
of nursing personnel
21. International Classification of Disease codes (icd): coding used to record
severity and treatment of dx, illness, injuries; determines reimbursement; revision
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22. Indirect Costs: example housekeeping. You know this.
23. Managed care: healthcare plans that contain costs of services, maintain qual
24. Medicaid: fed assisted, state administered; low income indiv; groups: elderly,
blind, disabled, families, pregnant women
25. Medicare: nationwide; title 18 of ssact, 65 and older; catastrophic chronic
illness: als, renal failure,
26. Noncontrollable costs: indirect expenses, ex: rent, lighting, wear and tear of
equip.
27. Not for-profit organization: financed by several sources, contributors have no
ownership interests; profits generated go back to hosp for expansion/capital
28. Operating Expenses: daily costs
29. Patient classification system: different criteria; classification of patients; acuity
30. Pay for performance programs (P4P): incentives pay to each cp to get top
clinical performance; for specific patient pop
31. Pay for Value programs: payment incentives to hcp for specific setting; increase
qual efficiency
32. Preferred provider organization (PPO): contracts to give service on fee for
service sys. Incentives for consumers to use select group of preferred hcp, pay
less for services. Insurance companies promise certain vol of patients/prompt
payment for fee discounts
33. Production hours: total amount: reg time, temp time, over time.
34. Prospective payment system: predetermined reimbursement for services
35. Revenue: source of income/reward for patient services
36. Staffing mix:
37. Third-party: usually ins co, govt agency pays patient bill
38. Turnover ratio: (employees leaving/#empl remaining)x100