HomesteadSchools.com - Leadership and Management in Nursing

By
Anita W. Finkelman MSN, RN

Course Outline

Welcome to the first edition of Anita Finkelman’s Leadership and Management in Nursing! The first of its kind, this ground-breaking book combines print and interactive resources that will provide nursing readers with the most effective learning experiences. This book consists of chapters that emphasize interactive learning by interweaving Internet-based activities throughout to encourage further research and critical thinking. This book affords readers the most up-to-date leadership and management content to ensure that nurses are prepared in today’s healthcare environment.

Features that promote reader success by using the best of print and online media:

Test Your Understanding introduces students to the chapter’s content and supplies instant feedback
Current Issues invite readers to become actively involved in thinking about nursing leadership and management
Modules within chapters enhance reader understanding by focusing on content
The Summary and Applications section wraps up each chapter’s material
In the News are current news items relevant to chapter content with sections on Taking It Over and Thinking It Through, and Thinking About the Future
Work Together provide team-based exercises
Case Study Applications promote critical thinking skills

About the Authors

Anita W. Finkelman MSN, RN
is Senior Vice President for Nursing Operations at Orbis Education Services, Inc. and Adjunct Faculty, University of Oklahoma Health Sciences Center, College of Nursing. She served as Director of Undergraduate Curriculum and Associate professor/Clinical Nursing at the University of Cincinnati from Yale University and post-masters graduate work in health care policy and administration from George Washington University. Additional work in the area of health policy was completed as a fellow of the Health Policy Institute, George Mason University. Ms. Finkelman’s 35 years of nursing experience includes clinical, educational, and administrative positions. She has authored many books and journal articles and lectured on administration, health policy, continuing education, and psychiatric-mental health nursing, both nationally and internationally. She is a consultant to publishers and health care organizations and to a variety of educational institutions related to online course development. Other Prentice Hall publications include Managed Care: A Nursing Perspective (2001) and case studies in Critical Thinking in Nursing: A Case Studies Across the Continuum (C. Green, Ed., 1999).

Learning Objectives

After completing this course you’ll be able to:

1.	Discuss the implications of change in the health care delivery system on nurse leadership.
2.	Describe key modern leadership theories.
3.	Compare and contrast leaders and managers.
4.	Discuss the importance of nurse leadership and its relationship to modern leadership theories.
5.	Explain the role of the clinical nurse as a leader and why it is important.
6.	Discuss critical nursing issues related to reengineering, redesigning, re-regulating, rightsizing, and restructuring.
7.	Discuss why the concept of change is important in the health care environment and to nursing leadership and management.
8.	Discuss external trends and factors that impact nursing practice and health care organizations.
9.	Define two key change theories.
10.	Describe eight key steps in the change process.
11.	Discuss resistance to change and how it can be handled.
12.	Identify strategies to improve responses to change.
13.	Apply the decision-making process.
14.	Describe the keys to successful planning.
15.	Distinguish between strategic and project planning.
16.	Describe key aspects related to collaboration.
17.	Identify barriers to achieving effective collaboration.
18.	Discuss the skills that are needed to improve collaboration.
19.	Discuss the impact collaboration has on nursing staff and interdisciplinary interactions.
20.	Describe key aspects related to coordination.
21.	Identify barriers to achieving effective coordination.
22.	Discuss the skills that are needed to improve coordination.
23.	Discuss the impact coordination has on nursing staff and interdisciplinary interactions.
24.	Describe key aspects related to conflict.
25.	Identify methods to prevent conflict.
26.	Discuss how individuals respond to conflict.
27.	Discuss the skills that are needed to respond to conflict.
28.	Explain conflict management and strategies that might be used.
29.	Discuss the impact conflict has on nursing staff and interdisciplinary interactions.
30.	Describe the critical elements of communication.
31.	Distinguish between the four lines of communication.
32.	Describe the communication process.
33.	Identify several examples for each of the communication component systems.
34.	Describe what might be included in an assessment of a work group’s communication.
35.	Identify three barriers to communication and how to resolve them.
36.	Describe four communication methods, including the most effective use of the method.
37.	Identify two strategies for resolving communication problems.
38.	Assess your own communication style.
39.	Describe the key organizational theories.
40.	Distinguish between structure and process.
41.	Identify the key differences between for-profit and not-for-profit health care organizations.
42.	Identify the key health care providers and their services.
43.	Explain the purpose of nursing care models.
44.	Compare and contrast the different nursing care models discussed in this chapter.
45.	Describe the key advantages of shared governance for nursing staff.
46.	Describe what would be included in an organization analysis.
47.	Describe the development of U.S. hospitals and the role they play in the health care delivery system.
48.	Identify the key methods for classifying hospitals.
49.	Define the key departments found in most hospitals.
50.	Discuss the use of committees by describing the work done by a policy and procedure committee as an example of committees.
51.	Describe major changes that are occurring in hospitals and their impact on nursing.
52.	Describe the Magnet Recognition Program, its history, its process, and the impact it has had on nursing.
53.	Discuss why each of the forces of magnetism would be important to new graduates as well as to any nurse considering a job change.
54.	Discuss the importance of teams in the health care delivery system.
55.	Describe the different types of teams.
56.	Describe team leader characteristics and how these relate to the team leader’s tasks and responsibilities.
57.	Explain the important considerations related to team building.
58.	Compare and contrast a nursing team and an interdisciplinary team.
59.	Identify the stages of team development.
60.	Explain motivation and its relationship to teamwork.
61.	Identify three strategies that might be used to improve motivation.
62.	Define delegation.
63.	Discuss the benefits of using delegation.
64.	Identify key legal issues related to delegation.
65.	Compare and contrast responsibility, authority, and accountability as they apply to delegation.
66.	Apply the delegation process in clinical situations when unlicensed assistive personnel are used.
67.	Discuss how to monitor and improve delegation.
68.	Define clinical pathway.
69.	Identify the purpose of clinical pathways.
70.	Describe the pathway development process.
71.	Identify liability and ethical issues related to the use of clinical pathways.
72.	Illustrate how clinical pathways might be implemented in a clinical setting, and both the positive and negative consequences.
73.	Explain why variance analysis is an important component of clinical pathways.
74.	Discuss the importance of practice guidelines.
75.	Compare and contrast the use of practice guidelines and disease management in managed care.
76.	Explain the difference between disease management and demand management.
77.	Explain why standards of care, utilization review, benchmarking, and evidence-based practice are considered tools to increase collaborative care.
78.	Discuss the reasons for including health promotion and disease and illness prevention in this context.
79.	Explain why nurses should be involved in health care policy.
80.	Identify the difference between private and public policy.
81.	Describe the policy-making process.
82.	Discuss how nurses can be involved in the policy-making process.
83.	Identify how federal and state laws can affect health care.
84.	Discuss malpractice and how it relates to nursing practice.
85.	Describe ethical decision making.
86.	Discuss the impact of health care fraud on the health care system.
87.	Identify how nurses can become involved in reducing health care fraud and cope with ethical dilemmas presented by fraud.
88.	Define consumer.
89.	Describe the history of health care consumerism.
90.	Explain the relationship between public policy and the health care consumer.
91.	Compare and contrast the consumer implications of The Pew Report and Healthy People 2010.
92.	Discuss how health care information is available to the health care consumer.
93.	Discuss the relationship between patient education and health care consumerism.
94.	Describe how consumers are involved in evaluating the quality of care.
95.	Discuss the nurse’s role as patient advocate in the health care environment.
96.	Describe how the human resources department assists the health care organization and employees.
97.	Describe staff recruitment.
98.	Explain how a position description is developed.
99.	Describe the employment process.
100.	Identify critical guidelines that a nurse should consider when applying for a position.
101.	Explain why it is important for nursing staff to be involved in recruitment and how they might do this.
102.	Discuss the importance of retention.
103.	Discuss the purpose of performance appraisal.
104.	Describe the performance appraisal process.
105.	Identify strategies that can be used to prevent or decrease stress and passive-aggressive behavior in the work setting.
106.	Discuss reasons for the nursing shortage.
107.	Describe the critical elements of a career plan.
108.	Develop a resume.
109.	Discuss how networking, coaching, and mentoring might be beneficial to a new nurse.
110.	Discuss the implications of lifelong learning.
111.	Collect time data and analyze how time is used.
112.	Identify time management improvement strategies.
113.	Distinguish between the macrolevel and microlevel view of health care financial issues.
114.	Discuss critical issues related to national health care expenditures.
115.	Describe the role of the third-party payer.
116.	Explain how health care insurance is paid for and by whom.
117.	Identify the importance of the diagnosis-related groups.
118.	Discuss the importance of the various government benefit programs.
119.	Define two examples of managed care models.
120.	Discuss how managed care has changed since it began.
121.	Define the service strategies used by managed care to control costs and quality.
122.	Define the reimbursement strategies used by managed care to control costs and quality.
123.	Discuss the impact of reimbursement on health care delivery.
124.	Define key financial management terms.
125.	Describe the budgetary process and its importance to nursing.
126.	Define productivity.
127.	Identify strategies that nurses can use to participate in cost containment in their practice.
128.	Discuss the importance of information and clinical technology to nursing.
129.	Describe the critical issues related to privacy and confidentiality.
130.	Define telehealth.
131.	Identify the implications of telehealth to nursing practice, education, administration, and research.
132.	Describe how telehealth can be used for patient education.
133.	Critique critical issues related to defining quality.
134.	Define structure, process, and outcomes as they relate to quality.
135.	Identify two factors that support an increased interest in quality care.
136.	Summarize the recent activity of the Institute of Medicine and its importance to health care.
137.	Describe the accreditation offered by the Joint Commission Accreditation of Healthcare Organizations.
138.	Describe two methods used to measure and ensure quality, safe care.
139.	Describe a quality report card and its relevance.
140.	Discuss nurse and physician reaction to the quality of managed care organizations and their effect on health care.
141.	Define organizational culture.
142.	Describe how a dissonance culture can affect an organization and patient care.
143.	Discuss the importance of culture to the organization.
144.	Compare and contrast staff culture and patient culture.
145.	Identify the advantages to having a multicultural staff.
146.	Discuss the implication of a multicultural patient population for the staff and organization.
147.	Describe a healing organization.
148.	Explain why safety is an important aspect of organizational culture.
149.	Identify two strategies that may be used to improve an organization’s culture.

Course Contents


Section I Leadership and Planning
1.	Conceptual Base for Leadership and Management
		Change in the Health Care Delivery System: Implications for Nurse
		Leadership and Management Theories
			A historic perspective of leadership theories
			Modern or current leadership theories and styles
			A conclusion: Effective leadership
		Leaders and Managers: A Comparison
			Who is a nurse leader?
			Preparation and development of nurse managers
			Nurse manager competencies
			Leadership in community health
			The image of nursing
			Making a difference: Increasing nurse leaders
2.	Change and Decision Making
		The Five “Rs”: Change and Decision Making in Action Reengineering the health care organization
			Redesigning the workforce
			Re-regulating professional practice
			Rightsizing the workforce
			Restructuring nursing education
		The Concept of Change
			Examples of change theory
			The process of change
		A Decision: A Response to Change
			Decision styles
			Types of decisions
			The decision-making process
			Planning
3.	Keys to Working with Others: Collaboration, Coordination, and Conflict Resolution
		Collaboration
			Definitions
			Barriers to effective collaboration
			Nurse-physician relationships
			Skills to achieve effective collaboration
		Coordination
			Definitions
			Barriers to effective coordination
			Skills to achieve effective coordination
			Application of coordination
		Negotiation and Conflict Resolution
			Definitions
			Causes of conflict
			Stages of conflict
			Prevention conflict
			Conflict management: Issues and strategies
			Application of negotiation to conflict resolution
4.	Effective Staff Communication and Working Relationships
		Communication: What is It?
			Communication systems and lines of communication
			The communication process
			Communication component systems: verbal, nonverbal, and miscommunication
			Assessment of communication effectiveness
		Communication Methods
			Written communication
			Face-to-Face communication
			Storytelling
			Information technology and communication
			Resolving communication problems and improving communication
Section II Delivery Systems/ Nursing Models
5.	Organizational Structure for Effective Care Delivery
		Organizational Theories: Emphasis on Structure and Process
			Organizational theories
			Structure and process: Parts of organizational theory
		Health Care Organizations
			For-profit and not-for-profit delivery systems
			Marketing
			Health care providers
			Professional nursing practice within nursing care models
			Total patient care/case method
			Shared governance
			Organizational analysis
6.	Acute Care Organizations: An Example of a Health Care Organization
		Development of U.S. Hospitals
			Acute care organization and governance
			Classification of hospitals
			Typical departments found in an acute care
			Organizations and committees
		Framework for Effective Care
			Standards
			Policies and procedures
		Changes That Affect Health Care Delivery
			Emergency services
			Patient access to services
			Patient education
			Expansion into new areas and approaches
			Use of hospitalists /intensivits
			Advanced practice nurses, clinical nurse specialists, and nurse midwives
			Alternative/complementary therapies
			Financial issues and managed care: Impact on acute care
			Continuum of care and acute care
			Primary care providers
			Nurses and acute care hospital changes
			Staffing issues
		Magnet Nursing Services Recognition Program
		Research: The pathway to the magnet nursing services
		Recognition Program
			Magnet hospital framework
			Building magnetism
			The magnet recognition process
			Benefits of the program
7.		Teamwork and Motivation
		Teams in Today’s Health Care Environment
			Teams and teamwork
			Types of teams
			Team-based organizations
			The team leader
			Team building: Development of effective teams
		Effective Teams
			Stages of team development
			Motivation
			Building team power and spirit
			Barriers to team success
			Getting the job done
			The charge nurse and the team
8.	Delegation for the Staff Nurse
			Delegation: What Is It?
			Benefits of delegation
			Legal issues related to delegation
			Critical delegation issues: authority, responsibility, and accountability
			The delegation and unlicensed assistive personnel
			The delegation process and the NCSBN guidelines
		Effective Delegation
			Assessment of the delegation process
			Characteristics of effective delegation
			Barriers to effective delegation
			Supervision and assignment
9.	Tools to Manage and Evaluate Care
		Clinical Pathways
			Definition of clinical pathways
			Evolution of pathways
			Purpose of pathways
			Pathway development and implementation process
		Other Tools Used to Manage Care
			Practice guidelines
			Disease management
			Demand management
			Standards of care
			Utilization review/ management
			Benchmarking
			Evidence-based practice
			Health promotion and disease and illness prevention
Section III Legislation/Regulation/Policy
10.	Health Care Policy, Legal Issues, and Ethics in Health Care Delivery
		Health Care Policy
			Key health care policy issues
			The policy-making process
			The political process
			Health care policy and nursing
			Legislation: Impact on health care delivery
		Legal Issues and Nursing
			Basic legal terminology
			Patient privacy: The law expands
		Ethics: Impact on Decision Making, Planning, and Practice
			Ethical decision making
			Professional ethics
			Making complaints to the board of nursing
			Managed care organizations and ethics
			Health care rationing
			Health care fraud and abuse
			Organizational ethics
			Nurses coping with ethical dilemmas
11.	Consumers and Nurses
		The Consumer and Health Care
			Who is the consumer?
			Public policy and the health care consumer
			Examples of current consumer issues
			Patient satisfaction and quality
			The nurse as patient advocate
Section IV Recruitment/Retention
12.	Recruitment and Retention: Meeting Staffing Requirements
		Recruitment
			Human resources
			What is recruitment?
			The employment process
		Retention: What Is It Important
			Turnover: costs, reasons, prevention
			Staff role
			Orientation: Its role in retention and prevention of reality shock
			Losing staff
		Performance Appraisal
			Performance standards and position descriptions
			Competency-based performance appraisal
			Legal and regulatory issues
			Performance appraisal/evaluation process
			Problems with employees
		Staffing: The critical issue today
			Staffing basics
			The nursing shortage
			Strategies to resolve the problems: Some are successful and some are not
Section V Nursing/ Professional Culture
13.	Keys to Professional Success
		Career Development
			First job: Early issues
		Career plan: A Professional Growth Action Plan
			Getting guidance
			Licensure
			Certification
			Professional organizations: Developing a nursing career
			Seeking promotion
			Entrepreneur/intrapreneur
			Lifelong learning: Nursing professional development
			Professional issues
		Time Management to Get the Work Done
			Making the most of your time
			Time management implementation and barriers
			Meetings
Section VI Economic Value
14.	Health Care Financial Issues
		Health Care Financial Issues: The Macrolevel
			National health care expenditures
			Reimbursement for health care delivery services
			Government health benefit programs
			Managed care
			Reimbursement issues: Impact on nurses and nursing care
		Financial Issues: MicroLevel
			Financial component of hospitals and other types of health care Organizations
			Key financial management terminology
			The budgeting process: An overview
			Productivity
			Cost containment
Section VII Work Environment
15.	Technology and Health Care
		Importance of Information and Clinical Technology
			Critical factors
			Technical skills
			Information technology: Critical issues
		Technology: Implications on health care delivery
			Telehealth
			Implication for clinical practice
			Implications for nursing education
			Implications for nursing administration
			Implications for patient education
			Implications for nursing research
			Technology and managed care
16.	Health Care Quality Improvement and Safety
		The Changing View of Quality
			Increased interest in quality care
			Definition of quality
			Critical quality elements
			Critical health care safety issues
		Quality, Safe Care: Measurement and Improvement
			The accreditation process
			Methods used in establishing quality, safe care
			Evidence-based practice
			Quality report cards
			An example of professional perspectives on the quality of care
			The future direction: Nursing quality issues
Section VII Diversity
17.	Pulling It All Together: The Culture of the Organization
		Culture and Climate: Building Cultural Competency
			Definition of organizational culture and climate
			Consonant and dissonant cultures
			An effective, creative, and productive workplace
			Legal issues
			The staff and their culture
		Cultural Perceptions of Health and Illness: Need for a Caring, Healing Environment
			A diverse patient population
			What is the healing environment
			Safety: A component of organizational culture
			The physical environment as part of the healing environment
			Facilitating diversity and cultural diversity within health care organizations

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