Government and third-party payers announce reduction of ...

[mikaylakyoung]

Government and third-party payers announce reduction of compensation for the delivery of patient services. Hospital STV has a flat organizational structure.
 
  After the funding announcements, senior officials at the hospital meet and make decisions regarding cost containment of new revenue streams. This action is consistent with:
 
  a. The practice of leaving financial decisions with senior officials who understand the total context of funding.
  b. A tendency to concentrate decision making during economic downturns at the top administrative level.
  c. A need to make expedient decisions that are likely to be poorly received by staff.
  d. Ensuring that decisions with regard to cost are made equitably across all departments.

Question 2

Nurses on the dialysis unit notice that changes in labeling of fluids have meant several alarming near misses in terms of wrong administration of fluids.
 
  They take this concern to the unit manager. As an advocate of nurse autonomy, the most appropriate response in this situation would be to:
 
  a. Ensure that the nurses are aware of the reasons for the change and how the decision was made about the new labels.
  b. Discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention.
  c. Suggest that the staff wait until they have become more familiar with the labels before taking further action.
  d. Tell the staff that you will notify the pharmacy about these concerns and leave it up to the pharmacy to decide what should be done.

[joanwhite]

Answer to Question 1

ANS: B
During times of economic downturn, decisions tend to become very centralized to avoid risk. History demonstrates that increasing the breadth of input during these times is more effective than narrowing it.

Answer to Question 2

ANS: B
Participation in decision making regarding one's practice is an appropriate expectation for professional nurses, provides for greater autonomy and authority over practice decisions, contributes to supporting the professional nurse, and is a major component of job satisfaction (Kramer et al., 2008; Pittman, 2007). Autonomy is encouraged through supportive management and through unit-level support of changes without the need for complex, multilevel approval of changes that can be made locally.

[mikaylakyoung]

TYSM

[nathang24]

Excellent