Author Question: A small critical care unit forms a team of nurses to implement bedside rounds at shift change. ... (Read 44 times)

big1devin · **on:** Jul 8, 2018

A small critical care unit forms a team of nurses to implement bedside rounds at shift change.

The nurses have researched the efficacy of bedside rounds and have determined that this evi-dence-based practice will lead to improved communication of patient status. Which type of change does this demonstrate? a. First-order change
b. Second-order change
c. Emergent change
d. Organizational change

Question 2

The chief nursing officer has asked the staff development coordinator to facilitate the develop-ment of a clinical competency program for the facility.

While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. Which behavior by the staff development coor-dinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program.
b. Inform the nurses that this program is a requirement for JCAHO accreditation.
c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
d. Facilitate a meeting so nurses can articu-late their values and concerns about a competency program.

guyanai · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

A
First-order change occurs in a stable system and is characterized by rational stepwise processes. It is useful for smaller scale changes at a unit-based level. Adaptation and adjustment occurs when nursing uses a new evidence-based protocol and puts it into practice.

Answer to Question 2

D
The manager role involves guiding others through a set of derived practices that are evi-dence-based and known to satisfy preestablished outcomes such as participation in a competency program. This involves engagement of staff through sharing of concerns and ideas. A close analysis of the IOM report and the summary of the PPACA suggests that no health reform can unfold without active nursing engagement. Each document emphasizes that nurses must lead, manage, and behave as active collaborators with other members of the health team and with those being served.