ATI LEADERSHIP PROCTORED FOCUS REVIEW

Managing Client Care: Appropriate Delegation to an Assistive Personnel (Active Learning

Template - Basic Concept, RN QSEN - Teamwork and Collaboration, RM Leadership 7.0
Chapter. 1)

 ADLs, bathing, grooming, dressing, toileting, ambulating, feedings (WITHOUT

DIFFICULTY SWALLOWING) intake and output, vital signs
 Nurses can only delegate tasks appropriate for the skill and education level of the
healthcare team member who is receiving the assignment
 Is the process of transferring the authority and responsibility to another team member of
complete a task, while retaining the accountability

Coordinating Client Care: Supporting the Family of a Client Who Has Alzheimer’s Disease (RM
Leadership 7.0 Chapter. 2, Active Learning Template - Basic Concept, RN QSEN - Patient-
centered Care)

 Educate family/caregivers about illness, methods of care, and adaptation of the home
environment
 Provides caregivers a temporary rest from caregiving while the person with Alzheimer’s
continues to receive care in a safe environment
 Review the resources available to the family as the client health declines. Include long
term care options

Managing Client Care: Identifying Conflict Resolution Strategies (RN QSEN - Teamwork and
Collaboration, Active Learning Template - Basic Concept, RM Leadership 7.0 Chapter. 1)

 Intrapersonal conflict- occurs within the person can involve internal struggle related to
contradictory values or wants
 Intergroup conflict- occurs between two or more group of individuals, departments or
organizations
 Stages of conflict:
o latent conflict- the actual conflict has not yet developed however factors are
present that have high likelihood of causing conflict
o perceived conflict: a party perfieves that a problem is present though an actual
conflict might not actually exist.
o Felt conflict- those involved begin to feel an emotional response to the conflict
o Manifest conflict- are aware of the conflict and action is taken
o Conflict aftermath- is the completion of the conflict process.
 Open communication among staff and between clients can help fray the need for
conflict
 Use I statements and focus on the problem, Escalating conflicts should be moved to a
private area
Managing Client Care: Implementing Scheduling Change (RN QSEN - Teamwork and
Collaboration, Active Learning Template - Basic Concept, RM Leadership 7.0 Chapter. 1)

 Bring unsafe assignment to the attention of the scheduling to charge nurse to negotiate a
new assignment
 Move up chain of command if nothing worked
 Failure to take care patient is patient abandonment

Coordinating Client Care: Referrals for Home Oxygen Therapy (RM Leadership 7.0 Chapter. 2,
RN QSEN - Teamwork and Collaboration, Active Learning Template - Basic Concept)

 The care can be provided in the acute setting or outside the facility
 Clients being discharged from health care facilities to their home can still require nursing
care
 Discharge referrals are based on client needs in relation to actual and potential problems
and can be facilitated with the assistance of social services, especially

Coordinating Client Care: Priority Client Care Following a Transfer (Active Learning Template -
Basic Concept, RM Leadership 7.0 Chapter. 2)
 confirm the facility receiving client has bed ready, communicate time transfer will occur
 complete documentation, give verbal transfer report in person or via phone
 make sure client is dressed appropriately, account for all client's valuables

Managing Client Care: Prioritizing Postoperative Client Needs (Active Learning Template -
Nursing Skill, RN QSEN - Patient-centered Care, RM Leadership 7.0 Chapter. 1)

 Recognizing that a postoperative client's report of pain could be due to pain in another
location rather than expected surgical pain
 Listen carefully to clients and don't assume.
 Recognizing a gradual deterioration in a client's level of consciousness and/or Glasgow
Coma Scale score

Professional Responsibilities: Evaluating the Need for Further Staff Education (RM Leadership
7.0 Chapter. 3, RN QSEN - Teamwork and Collaboration, Active Learning Template - Basic
Concept)

 Nurse's involvement in the orientation, socialization, education, and training of fellow

health care workers to ensure the competence of all staff and to help them meet standards
set forth by the facility and accrediting bodies.
 The process of staff education is also referred to as staff development.
The quality of client care provided is directly related to the education and level of
competency of health care providers.
 The nurse leader has a responsibility in maintaining competent staff.
Nurse leaders work with a unique, diverse workforce. The nurse should respect and
recognize the health care team's diversity
Professional Responsibilities: Responding to Client's Concerns About Procedure (RM
Leadership 7.0 Chapter. 3, Active Learning Template - Basic Concept, RN QSEN - Patient-
centered Care)

 If the client refuses a treatment or procedure, the client is asked to sign a document
indicating that he understands the risk involved with refusing the treatment or procedure
and that he has chosen to refuse
 When a client decides to leave the facility without a prescription for discharge, the nurse
notifies the provider and discuss with the client the potential risk associated with leaving
the facility prior to discharge
 The nurse carefully document the information that was provided to the client and that
notifications of the provider occurred.

Professional Responsibilities: Priority Action to Take When Floating (RN QSEN - Teamwork
and Collaboration, Active Learning Template - Basic Concept, RM Leadership 7.0 Chapter. 3)

 Orient to the unit

 Inform Manager about capabilities
 Remain Positive, Care for patients
 Ask questions/guidance from charge nurse

Managing Client Care: Collecting Quality Indicator Data (Active Learning Template - Basic
Concept, RM Leadership 7.0 Chapter. 1)

 Begins with identification of standards and outcome indicators based on evidence

 Are goals that are set to determine at what level the outcome indicators should be met.
 Reflect how client care is provided and are established by policies and procedures
(clinical practice guidelines).

Coordinating Client Care: Priority Nursing Action for Discharge (RN QSEN - Teamwork and
Collaboration, RM Leadership 7.0 Chapter. 2, Active Learning Template - Basic Concept)

 Continuity of care is desired as clients move from one:

-Level of care to another, such as from the ICU to a medical unit
-Facility to another, such as from an acute care facility to a skilled facility
-Unit/department to another, such as from the PACU to the post-surgical unit
 Nurses are responsible for facilitating continuity of care and coordinating care through
documentation, reporting, and collaboration

 A formal, written plan of care enhances coordination of care between nurses,

interprofessional team members, and providers.

The Interprofessional Team: Recognizing Need for Referral to a Speech-Language Pathologist

(Active Learning Template - System Disorder, RM FUND 9.0 Ch 2, RN QSEN - Teamwork and
Collaboration)
  Evaluates and makes recommendations regarding the impact of disorders or injuries on
speech, language, and swallowing.
 Teaches techniques and exercises to improve function.
 A client is having difficulty swallowing a regular diet after trauma to head and neck.

Facility Protocols: Needle Stick Safety Procedures (Active Learning Template - Basic Concept,
RM Leadership 7.0 Chapter. 5, RN QSEN - Safety)

 Dependent on policy per hospital or employer

 Always fill out incident report
 Prophylactic testing/treatment

Facility Protocols: Appropriate Response to Tuberculosis (RN QSEN - Safety, Active Learning
Template - System Disorder, RM Leadership 7.0 Chapter. 5)

 N95 or HEPA respirator

 Negative airflow room
 Airborne precautions, Patient wears mask outside of room

Maintaining a Safe Environment: Isolation Guidelines (RM Leadership 7.0 Chapter. 4, Active
Learning Template - Basic Concept, RN QSEN - Safety)

 Seclusion is the placement of a client in a room that is private, isolated and safe
 Clients suspected of or known to have a communicable disease should be placed in the
appropriate form of isolation
 Facility policies and procedures should serve as a resource for proper implementation of
infection prevention and control

Medical and Surgical Asepsis: Principles of Surgical Asepsis (Active Learning Template -
Nursing Skill, RM FUND 9.0 Ch 10, RN QSEN - Safety)

 Conscientiousness, alertness, and honesty are essential qualities in maintaining surgical

asepsis
 A sterile object remains sterile only when touched by another sterile object
 A sterile object or field out of the range of vision or an object held below a person's waist
is considered contaminated