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 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:
- Discuss the implications of change in the health care delivery system on nurse leadership.
- Describe key modern leadership theories.
- Compare and contrast leaders and managers.
- Discuss the importance of nurse leadership and its relationship to modern leadership theories.
- Explain the role of the clinical nurse as a leader and why it is important.
- Discuss critical nursing issues related to reengineering, redesigning, re-regulating, rightsizing, and restructuring.
- Discuss why the concept of change is important in the health care environment and to nursing leadership and management.
- Discuss external trends and factors that impact nursing practice and health care organizations.
- Define two key change theories.
- Describe eight key steps in the change process.
- Discuss resistance to change and how it can be handled.
- Identify strategies to improve responses to change.
- Apply the decision-making process.
- Describe the keys to successful planning.
- Distinguish between strategic and project planning.
- Describe key aspects related to collaboration.
- Identify barriers to achieving effective collaboration.
- Discuss the skills that are needed to improve collaboration.
- Discuss the impact collaboration has on nursing staff and interdisciplinary interactions.
- Describe key aspects related to coordination.
- Identify barriers to achieving effective coordination.
- Discuss the skills that are needed to improve coordination.
- Discuss the impact coordination has on nursing staff and interdisciplinary interactions.
- Describe key aspects related to conflict.
- Identify methods to prevent conflict.
- Discuss how individuals respond to conflict.
- Discuss the skills that are needed to respond to conflict.
- Explain conflict management and strategies that might be used.
- Discuss the impact conflict has on nursing staff and interdisciplinary interactions.
- Describe the critical elements of communication.
- Distinguish between the four lines of communication.
- Describe the communication process.
- Identify several examples for each of the communication component systems.
- Describe what might be included in an assessment of a work group’s communication.
- Identify three barriers to communication and how to resolve them.
- Describe four communication methods, including the most effective use of the method.
- Identify two strategies for resolving communication problems.
- Assess your own communication style.
- Describe the key organizational theories.
- Distinguish between structure and process.
- Identify the key differences between for-profit and not-for-profit health care organizations.
- Identify the key health care providers and their services.
- Explain the purpose of nursing care models.
- Compare and contrast the different nursing care models discussed in this chapter.
- Describe the key advantages of shared governance for nursing staff.
- Describe what would be included in an organization analysis.
- Describe the development of U.S. hospitals and the role they play in the health care delivery system.
- Identify the key methods for classifying hospitals.
- Define the key departments found in most hospitals.
- Discuss the use of committees by describing the work done by a policy and procedure committee as an example of committees.
- Describe major changes that are occurring in hospitals and their impact on nursing.
- Describe the Magnet Recognition Program, its history, its process, and the impact it has had on nursing.
- Discuss why each of the forces of magnetism would be important to new graduates as well as to any nurse considering a job change.
- Discuss the importance of teams in the health care delivery system.
- Describe the different types of teams.
- Describe team leader characteristics and how these relate to the team leader’s tasks and responsibilities.
- Explain the important considerations related to team building.
- Compare and contrast a nursing team and an interdisciplinary team.
- Identify the stages of team development.
- Explain motivation and its relationship to teamwork.
- Identify three strategies that might be used to improve motivation.
- Define delegation.
- Discuss the benefits of using delegation.
- Identify key legal issues related to delegation.
- Compare and contrast responsibility, authority, and accountability as they apply to delegation.
- Apply the delegation process in clinical situations when unlicensed assistive personnel are used.
- Discuss how to monitor and improve delegation.
- Define clinical pathway.
- Identify the purpose of clinical pathways.
- Describe the pathway development process.
- Identify liability and ethical issues related to the use of clinical pathways.
- Illustrate how clinical pathways might be implemented in a clinical setting, and both the positive and negative consequences.
- Explain why variance analysis is an important component of clinical pathways.
- Discuss the importance of practice guidelines.
- Compare and contrast the use of practice guidelines and disease management in managed care.
- Explain the difference between disease management and demand management.
- Explain why standards of care, utilization review, benchmarking, and evidence-based practice are considered tools to increase collaborative care.
- Discuss the reasons for including health promotion and disease and illness prevention in this context.
- Explain why nurses should be involved in health care policy.
- Identify the difference between private and public policy.
- Describe the policy-making process.
- Discuss how nurses can be involved in the policy-making process.
- Identify how federal and state laws can affect health care.
- Discuss malpractice and how it relates to nursing practice.
- Describe ethical decision making.
- Discuss the impact of health care fraud on the health care system.
- Identify how nurses can become involved in reducing health care fraud and cope with ethical dilemmas presented by fraud.
- Define consumer.
- Describe the history of health care consumerism.
- Explain the relationship between public policy and the health care consumer.
- Compare and contrast the consumer implications of The Pew Report and Healthy People 2010.
- Discuss how health care information is available to the health care consumer.
- Discuss the relationship between patient education and health care consumerism.
- Describe how consumers are involved in evaluating the quality of care.
- Discuss the nurse’s role as patient advocate in the health care environment.
- Describe how the human resources department assists the health care organization and employees.
- Describe staff recruitment.
- Explain how a position description is developed.
- Describe the employment process.
- Identify critical guidelines that a nurse should consider when applying for a position.
- Explain why it is important for nursing staff to be involved in recruitment and how they might do this.
- Discuss the importance of retention.
- Discuss the purpose of performance appraisal.
- Describe the performance appraisal process.
- Identify strategies that can be used to prevent or decrease stress and passive-aggressive behavior in the work setting.
- Discuss reasons for the nursing shortage.
- Describe the critical elements of a career plan.
- Develop a resume.
- Discuss how networking, coaching, and mentoring might be beneficial to a new nurse.
- Discuss the implications of lifelong learning.
- Collect time data and analyze how time is used.
- Identify time management improvement strategies.
- Distinguish between the macrolevel and micro-level view of health care financial issues.
- Discuss critical issues related to national health care expenditures.
- Describe the role of the third-party payer.
- Explain how health care insurance is paid for and by whom.
- Identify the importance of the diagnosis-related groups.
- Discuss the importance of the various government benefit programs.
- Define two examples of managed care models.
- Discuss how managed care has changed since it began.
- Define the service strategies used by managed care to control costs and quality.
- Define the reimbursement strategies used by managed care to control costs and quality.
- Discuss the impact of reimbursement on health care delivery.
- Define key financial management terms.
- Describe the budgetary process and its importance to nursing.
- Define productivity.
- Identify strategies that nurses can use to participate in cost containment in their practice.
- Discuss the importance of information and clinical technology to nursing.
- Describe the critical issues related to privacy and confidentiality.
- Define telehealth.
- Identify the implications of telehealth to nursing practice, education, administration, and research.
- Describe how telehealth can be used for patient education.
- Critique critical issues related to defining quality.
- Define structure, process, and outcomes as they relate to quality.
- Identify two factors that support an increased interest in quality care.
- Summarize the recent activity of the Institute of Medicine and its importance to health care.
- Describe the accreditation offered by the Joint Commission Accreditation of Healthcare Organizations.
- Describe two methods used to measure and ensure quality, safe care.
- Describe a quality report card and its relevance.
- Discuss nurse and physician reaction to the quality of managed care organizations and their effect on health care.
- Define organizational culture.
- Describe how a dissonance culture can affect an organization and patient care.
- Discuss the importance of culture to the organization.
- Compare and contrast staff culture and patient culture.
- Identify the advantages to having a multicultural staff.
- Discuss the implication of a multicultural patient population for the staff and organization.
- Describe a healing organization.
- Explain why safety is an important aspect of organizational culture.
- Identify two strategies that may be used to improve an organization’s culture.
Course Contents
Section I Leadership and Planning
- 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
- 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
- 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
- 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
- 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
- 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 /intensivists
- 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
- 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
-
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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