Pharmacy reports that the medication records of a unit have begun ...

[Mr3Hunna]

Pharmacy reports that the medication records of a unit have begun to show frequent corrections.
 
  What other signs of diversion would the manager look for on the unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Chart review on effectiveness of pain control
  2. Increase in clients with conditions requiring pain medications
  3. Increase in use of doses of as-needed narcotics that results in wastage
  4. Chart review that reveals that clients require much more narcotic pain medication on one shift than on others
  5. Narcotic containers that look as if they have been altered

Question 2

The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate?
 
  1. Lateral communication
  2. Downward communication
  3. Diagonal communication
  4. Grapevine communication

[kusterl]

Answer to Question 1

1,3,4,5
Rationale 1: If many clients report their pain is not controlled, diversion may be occurring.
Rationale 2: An increase in clients requiring pain medications is likely census related.
Rationale 3: If the nurse has a choice of doses and is trying to divert medications, a smaller dose might be given resulting in a larger wastage that is then diverted.
Rationale 4: If one shift is giving much more pain medication that the other, it may be because someone is diverting drugs on that shift. It may also mean that inadequate pain control is being given on the other shift because someone is diverting drugs.
Rationale 5: Altering the container is a method of diversion.
Global Rationale:

Answer to Question 2

3
Rationale 1: Lateral communication involves discussion among individuals at the same hierarchical level (e.g., all nurse supervisors).
Rationale 2: Downward communication involves direction given by management to the staff.
Rationale 3: Diagonal communication involves dialogue among individuals at different hierarchical levels (e.g., staff nurses to chief executive officer of nursing).
Rationale 4: Grapevine communication is an informal channel among individuals at all hierarchical levels and has the potential to generate misinformation.
Global Rationale:

[Mr3Hunna]

Wow, this really help

[CAPTAINAMERICA]

TYSM