NR 446 Edapt Week 1

Student Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

NR446 Collaborative – Week 1 Key Concepts

What is the difference in Leaders and Managers?

Leader

Leaders develop a compelling vision of what can be achieved and motivate others to work toward that goal. They focus on inspiring individuals to contribute to something greater than themselves. Leaders encourage teamwork, promote creativity, and concentrate on group processes because they believe collaboration produces greater results than individual efforts alone.

Manager

Managers primarily focus on setting measurable objectives, monitoring progress, and ensuring results are achieved. They are responsible for implementing plans efficiently and effectively, relying on processes, organization, and resource allocation. Managers typically emphasize operational control and outcome measurement.

Aspect	Leaders	Managers
Focus	Inspiring vision and shared goals	Setting and meeting objectives
Approach	People-centered, transformational	Process-centered, task-driven
Team Role	Motivator and facilitator	Organizer and coordinator
Outcome Goal	Long-term development	Short-term results

Leadership Role Variety (Display 2.3)

Leaders may assume multiple roles depending on the needs of their teams and organizations. These roles include counselor, teacher, critical thinker, advocate, visionary, director, decision-maker, communicator, evaluator, facilitator, risk-taker, mentor, energizer, priority setter, and coach. Each role requires a combination of interpersonal skills, problem-solving abilities, and strategic thinking.

Leadership Theories

Authoritarian

This approach involves leaders making decisions without input from team members. While this can be perceived as restrictive, it is effective in urgent situations requiring quick, decisive action, such as during medical emergencies.

Democratic

The democratic style promotes open communication and participation from staff members. Leaders encourage feedback, distribute responsibilities, and provide recognition. This method fosters team engagement and a sense of ownership over outcomes.

Laissez-Faire

In this style, leaders adopt a hands-off approach, offering minimal supervision. Decision-making is slow, change is rare, and improvements are typically reactive rather than proactive. This can lead to stagnation if team members lack self-motivation.

What is emotional intelligence (EI)?

Emotional intelligence is the capacity to recognize, understand, and manage one’s own emotions while also perceiving and influencing the emotions of others. In nursing, EI helps build rapport, resolve conflicts, improve communication, and strengthen teamwork.

Delegation

Five Rights of Delegation

Right	Definition	Example
Task	Assign tasks that match the scope of practice.	Asking a certified nursing assistant (CNA) to record stable patient vital signs.
Circumstances	Ensure patient condition and environment are appropriate for delegation.	Not delegating care of an unstable patient to unlicensed staff.
Person	Confirm delegate’s competence and legal scope.	Avoid assigning tracheostomy suctioning to a CNA.
Direction/Communication	Provide precise instructions verbally or in writing.	Instructing a CNA to measure Room 5 patient’s vital signs within 15 minutes and report results.
Supervision/Evaluation	Monitor performance and offer feedback.	Observing proper hand hygiene and correcting errors.

Delegating vs. Assigning

• Delegating: Transferring authority for a nursing activity to a qualified individual in a defined situation while retaining accountability. For example, RNs and LPNs may delegate to UAPs.
• Assigning: Allocating responsibility for a task to a licensed professional who is qualified to perform it. For example, RNs assign to RNs or LPNs, and LPNs assign to LPNs.
• Supervising: Directing, monitoring, and evaluating the performance of another healthcare team member.

Accountability

Accountability refers to the willingness to accept responsibility for one’s actions. Licensed nurses retain accountability for appropriate assignments and delegations, while the delegatee is responsible for completing the task correctly.

Seven Rights of Medication Administration

#	Right
1	Patient
2	Drug
3	Dose
4	Time
5	Route
6	Reason
7	Documentation
8	Right to Refuse

How do you manage a medication error?

When a medication error occurs, the nurse’s first priority is to assess the patient for any harm and provide immediate interventions to prevent further injury. Subsequent steps include notifying the provider, documenting the incident, and completing an incident report per facility policy.

What are the minimum requirements for any medication order?

A medication order must include:

1. Full patient name
2. Date and time of the order
3. Medication name
4. Dosage
5. Medication form
6. Route of administration
7. Time or frequency of administration
8. Prescriber’s signature

How do you transcribe a telephone or verbal order from a physician?

Verbal Order

• Used only in emergencies or when the provider cannot document orders.
• Must include date, time, “V.O.,” provider’s name, nurse’s signature, and title.

Telephone Order

• Used when the provider is not present.
• Document with date, time, “T.O.,” provider’s name, nurse’s signature, and title.
• Fax may be used to confirm orders in writing.

What is the State Nurse Practice Act?

The Nurse Practice Act outlines the legal scope of nursing in each state, detailing responsibilities, limitations, and protections for the public. While specifics vary by state, all must align with federal standards.

Who can suspend or revoke a nursing license?

State Boards of Nursing have the legal authority to suspend, revoke, or impose disciplinary measures on a nurse’s license if violations of the Nurse Practice Act occur.

What interventions are limited in scope to the RN only?

• Conducting initial assessments and admission processes
• Patient education
• Reporting IV site phlebitis
• Blood transfusion administration
• Initiating IV fluids
• Performing Glasgow Coma Scale (GCS) assessments
• Initiating care plans
• Administering Rhogam injections

What interventions can both the RN and LPN share?

• Tracheostomy care
• IV site observation
• Dressing and wound changes
• Suctioning
• Inserting urinary catheters
• Rectal tube insertion
• Checking nasogastric tube patency
• Administering medications
• Collecting sterile specimens
• Reinforcing patient teaching
• Follow-up teaching

NR 446 Edapt Week 1

What interventions can safely be delegated to a UAP?

• Activities of daily living (ADLs)
• Transferring patients between bed, chair, or stretcher
• Ambulating patients
• Feeding
• Positioning
• Collecting non-sterile specimens
• Recording vital signs for stable patients
• Tracking intake and output
• Bathing

If you are acting charge nurse, what should be considered whenever you are assigning patients to rooms?

Consider patient condition, mental status, and the need for specialized equipment or room type (e.g., negative or positive pressure). Patients needing frequent observation should be assigned closer to the nurse’s station.

If you are acting charge nurse, what should you consider when assigning a float nurse an assignment on your floor?

The charge nurse should review the float nurse’s prior experience and specialty, ensuring patient ratios are safe. Assignments should match the nurse’s competence level to prevent unsafe care.

As a float nurse, what are your priorities when being assigned to a new floor?

• Learn the unit’s specialty and patient population
• Locate medication and supply rooms
• Understand patient ratios
• Identify crash cart location
• Know the charge nurse for the shift

Why was the SBAR created and what are its components?

SBAR (Situation, Background, Assessment, Recommendation) was developed to standardize urgent communication in healthcare.

• Situation: Identify yourself, the patient, and the current issue.
• Background: Provide relevant medical history and treatment details.
• Assessment: State your evaluation of the patient’s condition.
• Recommendation: Suggest next steps or interventions.

What are the best types of change of shift report?

Bedside reporting is considered best practice because it promotes transparency, patient involvement, and accuracy.

When does discharge planning begin?

Discharge planning begins at the time of admission to ensure a smooth transition and continuity of care.

What role does a case manager play in discharge planning?

Case managers coordinate resources, identify patient needs, arrange referrals, and develop strategies to support recovery both in and out of the hospital.

What is a critical pathway and how does it determine the care your patient receives in and out of the hospital?

A critical pathway is a standardized, evidence-based care plan for patients with a specific condition or surgical procedure. It outlines expected recovery milestones and helps coordinate multidisciplinary care.

Describe in detail the functions of each of these members of the interdisciplinary team:

Role	Function
RN	Licensed through diploma, associate, or bachelor’s programs to provide direct patient care, assessments, and care planning.
MD/DO	Physicians diagnose, treat, and manage patient conditions, often specializing in specific medical fields.
Speech Pathologist	Assists patients with speech, language, swallowing, and communication disorders.
Wound Care Nurse	Specializes in managing complex wounds, ostomies, and continence issues.
Dietitian	Assesses and plans patient nutrition needs.
OT	Helps patients regain independence in daily living activities.
PT	Restores mobility and function through physical rehabilitation.
Chaplain	Provides spiritual and emotional support.
Social Worker	Addresses social, financial, and housing needs affecting patient care.
Case Manager	Oversees care coordination, assessments, and discharge planning.

Delegation Worksheet

Task	RN	LPN	UAP
ADLs	✔	✔	✔
Transfer to chair/bed/stretcher	✔	✔	✔
Ambulating	✔	✔	✔
Tracheostomy care	✔	✔
Suctioning	✔	✔
Feeding	✔	✔	✔
Positioning	✔	✔	✔
Inserting urinary catheter	✔	✔
Checking NG tube patency	✔	✔
Medication administration	✔	✔
Sterile specimen collection	✔	✔
Vital signs (stable)	✔	✔	✔
Intake and output	✔	✔	✔
Reinforcing teaching	✔	✔	✔
Initial assessment	✔
Follow-up teaching	✔	✔
Observe IV site	✔	✔
Blood transfusion	✔
Initiate IV fluids	✔
Change dressing	✔	✔
GCS assessment	✔
Initiate care plan	✔
Measure urine output	✔	✔	✔
Administer second IVPB dose	✔	✔
Administer G-tube feedings	✔	✔
Administer Rhogam injections	✔

References

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA.

Cherry, B., & Jacob, S. R. (2022). Contemporary nursing: Issues, trends, & management (9th ed.). Elsevier.

NR 446 Edapt Week 1

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing (10th ed.). Wolters Kluwer.