Nur 4112 class #3
description
Transcript of Nur 4112 class #3
ORGANIZATIONAL STRUCTURE/MAKING
DECISIONS
February 21, 2012
INTERRELATIONSHIP OF MISSION, VISION AND
PHILOSOPHY
Mission Statement: • Tells what the organization does• Defines the purpose and primary objectives• Internal- defines key measures of success for leadership
Vision Statement:• Explains why; where it is aiming• Descriptive state of future• External- Shapes customers understanding
Philosophy:• Values: How they will do that work- the talk they want to
walk
GROUP PROJECT
Search the web and define assigned organizations• Mission Statement• Vision Statement• Philosophy or Values Statement
Post on Wallwisher at:http://www.wallwisher.com/wall/Missionvisionvalues
ORGANIZATIONAL CULTURE
The reflection of the norms or
traditions of the organization as
exemplified through behaviors
that illustrate the values and
beliefs of the organization.
CHARACTERISTICS OF ORGANIZATIONAL
STRUCTURES
Complexity
Formalization
Centralization
TYPES OF ORGANIZATIONAL
STRUCTURES
Functional
Service Line
Matrix
Flat
Shared governance
FUNCTIONAL
SERVICE LINE
MATRIX
FLAT
SHARED GOVERNANCE
Promotes autonomy and accountability
Also referred to a professional practice models
Magnet hospitals
Varies hospital to hospital• Forums• Committees• Councils with authority- organizational
MAKING DECISIONS AND SOLVING PROBLEMS
CRITICAL THINKING
Critical thinking is the mental process of analyzing
or evaluating information• Reflects upon the meaning of statements,
examines available date and uses reason to make informed decisions
• Necessary to reflect and evaluate from a broader scope of view
• more complex than decision making but is needed in order to make good decisions
• Nurses us when making decisions, prioritizing and managing the care of clients.
BLOOM’S TAXONOMY
ATTITUDES OF CRITICAL THINKERS
Intellectual Humility
Intellectual Courage
Intellectual Empathy
Intellectual Integrity
Intellectual Perseverance
Faith in Reason
Intellectual Sense of Justice
INTELLECTUAL HUMILITY
Knowing what you don’t know
Knowing your own personal bias
or prejudices
INTELLECTUAL COURAGE
Involves the ability to withhold
judgments and conclusions until all
the facts are in.
Willing to be open to other ideas,
beliefs, and concepts
INTELLECTUAL EMPATHY
Being able to imagine yourself in
the role of another in order to better
understand comprehend and assist
the other person in dealing with
whatever it is they are face with
INTELLECTUAL INTEGRITY
Hold yourself to the same
standard that you hold
others.
INTELLECTUAL PERSEVERANCE
Involves taking the appropriate
steps and persevering through to
the conclusion because the end
results is worth the time and
trouble.
FAITH IN REASON
The belief that people owe
it to themselves and to their
profession to develop,
maintain and enhance critical
thinking abilities and skills.
INTELLECTUAL SENSE OF JUSTICE
The ability to fairly evaluate and
reach conclusions based on what is
known, not what you or someone
else only perceive to be true.
CRITICAL THINKING
Professional Judgment
Creativity
Decision Making
Problem Solving
PROFESSIONAL JUDGMENT
Skill
Training
Education
CREATIVITY
Conceptualizing new and
innovative approaches to a
problem or issue.
DECISION MAKING
Is a purposeful and goal-directed effort that
uses a systematic process to choose among
options
The process by which a course of action is
determined. The course of action may be in
response to a problem or an issue.
DECISION MODELS
Satisficing- good enough
Optimizing – best possible
DECISION-MAKING STYLES
Autocratic- decide and
announce
Democratic/participative- group
input
DECISION MAKING TOOLS
Decision Grids
SWOT
DECISION GRID
SWOT
Framework for situation analysis
Encompasses both internal and external
environment• Internal factor: Strengths &
Weaknesses• External factors: Opportunities and
Threats
CREATE A PLAN OF ACTION
What steps can you take to:• Capitalize on your strengths• Overcome or minimize you weaknesses• Take advantage of some new
opportunities• Respond to the threats
• Set goals and objectives, like with any other plan
SWOT TEMPLATESWOT Analysis Template
Internal Strengths Weaknesses
1.
1.
External Opportunities Threats
1.
1.
SWOT Analysis Summary
PROBLEM SOLVING
Includes a decision-making step, is
focused on trying to solve and
immediate problem, which can be
viewed as a gap between “what is” and
“what should be.”
PROBLEM SOLVING PROCESS
Define problem, issue, situation
Gather and analyze data
All possible solutions are identified
and evaluated
Select and Implement a solution
Evaluate results
CAUSE & EFFECT DIAGRAMS
Also called CEDAC, Fishbone diagram,
Ishikawa diagram
Identifies many possible causes
Can be used to structure a brainstorming
session
Sorts ideas into useful categories
FISHBONE TEMPLATE
PRIORITIZATION
Requires decisions be made regarding the
order in which• Clients are seen• Assessments are completed• Interventions are provided• Steps in client procedure are completed• Components of client care are completed
PRIORITIES BASED ON
Shift reports and other communications
with members of the healthcare team
Through careful review of documents
By continuously and accurately
collecting data
ATI PRIORITIZATION PRINCIPLES
Prioritize systemic before local (life before limb)
Prioritize acute before chronic
Prioritize actual problems before potential future problems
Listen carefully to clients and don’t assume
Recognize and respond to trends versus transient findings
Recognize signs of medical emergencies and complications versus
“expected client findings.”
Apply clinical knowledge to procedural standards to determine the
priority action
PRIORITY SETTING FRAMEWORKS
Maslow’s Hierarchy of Needs
Airway Breathing Circulation (ABC) Framework
Safety/Risk Reduction
Assessment First
Survival Potential
Least Restrictive
MASLOW’S HIERARCHY
ABC FRAMEWORK
An open airways is necessary for breathing, so it is highest
priority• Identify airway concern• Establish airway if indicated
Breathing is necessary for oxygenation of the blood to occur• Assess effectiveness of breathing• Intervene as appropriate (reposition, Narcan etc.)
Circulation is necessary for oxygenate blood to reach tissues
Disability_ Assess for current or evolving disability
SAFETY/RISK REDUCTION
Look first for a safety risk.
Next ask, “What’s the risk to the client?” and “How
significant is the risk compared to other posed
risks?”
Give priority to responding to whatever finding
poses the greatest (or most imminent) risk to the
client’s physical well-being
ASSESSMENT FIRST
Use the nursing process to
gather pertinent information prior
to making a decision regarding a
plan of action.
SURVIVAL POTENTIAL
Use this framework for situations in which health
resources are extremely limited (mass casualty,
disaster triage)
Give priority to clients who have a reasonable
chance of survival with prompt intervention. Clients
who have a limited likelihood of survival even with
intense intervention are assigned the lowest priority.
LEAST RESTRICTIVE
Select interventions that
maintain client safety while
posing the least amount of
restriction to the client.
TIME MANAGEMENT
Good time management• Facilitates grater productivity• Decreases work-related stress• Helps ensure the provision of quality and appropriately
prioritized client care• Enhances satisfaction with care provided
Poor time management• Impairs productivity• Leads to feelings of being overwhelmed and stressed• Increases omission of important tasks• Creates dissatisfaction with care provided
HOW TO ORGANIZE CARE
What must be done immediately?
What must be done by as specific time to ensure
client safety, quality care , and compliance with
facility policies and procedures?
What must be done by the end of the shift?
What can be delegated?
CYCLIC PROCESS
Time initially spent developing a plan will save time later and help to
avoid management by crisis
Set goals and plan care based on established priorities and thoughtful
utilization of resources
Complete one client care task before beginning the next, starting with the
highest priority task
Reprioritize remaining tasks based on continual reassessment of client
care needs
At the end of the day, perform a time analysis and determine if time was
use wisely.
TIME MANAGEMENT AND TEAMWORK
Be cognizant of assistance needed by other health
care team members
Offer to help when unexpected crises occur
Assist other team members with provision of care
when experiencing a period of “down time.”
TIME MANAGEMENT & SELF-CARE
Take time for oneself
Schedule time for breaks and meals
Take physical and mental breaks
from work/unit
CASE STUDIES
Critical Thinking