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2 Chapter 1 | Leadership and Management Principles
KEY TERMS
authoritarian leadership style, p. 10 learning organizations, p. 16
chaos theory, p. 32 management, p. 21
commitment, p. 15 negligence, p. 26
complexity theory, p. 16 nurse manager, p. 5
contingency theory, p. 31 nursing management, p. 22
controlling, p. 26 organizing, p. 24
coordinating, p. 26 planning, p. 23
democratic leadership style, p. 10 quantum leadership, p. 16
directing, p. 25 servant leadership, p. 16
empowerment, p. 5 Situational Leadership theories, p. 12
Fiedler’s contingency theory, p. 12 strategic planning, p. 23
followership, p. 5 systems theory, p. 30
interactive planning, p. 24 tactical planning, p. 23
laissez-faire leadership style, p. 10 transactional leader, p. 14
leadership, p. 4 transformational leader, p. 14
leadership styles, p. 5
NURSING CURRICULUM STANDARDS
QSEN
Patient-Centered Care
o Clinical Leadership, pp. 16-17
Teamwork and Collaboration
o Process Part 4: Communication, p. 6
o Leadership Styles: Democratic, p. 10
o Servant Leadership, p. 16
o Effective Leadership, pp. 17-18
o Followership, pp. 18-19
o Leadership and Management Implications, pp. 19-20
o Practices That Ensure That the Whole Organization Feels Responsible and Accountable,
pp. 22-23
Evidence-Based Practice
o Leadership and Care Management Differentiated, pp. 1-3
o Research Note, p. 32
Quality Improvement
o Leadership Skills, p. 4
o Transactional and Transformational Leadership, pp. 14-16
o Controlling, p. 26
o Research Note, p. 32
o Current Issues and Trends, p. 35
Safety
o Clinical Leadership, pp. 16-17
o Leadership and Management Implications, pp. 19-20
o Research Note, p. 32
o Leadership and Management Implications, pp. 34-35
CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. R. (2013).
Concepts for nursing practice. St. Louis: Elsevier.
THEME: Attributes/Roles of Nurse
Concept: Professionalism
o Exemplar: Ethics
Characteristics of Leadership, pp. 7-8
Leadership and Management Implications, pp. 34-35
Concept: Leadership
o Exemplar: Clinical Agency—Operational Level
Leadership and Care Management Differentiated, pp. 1-3
The Leadership Role, p. 3
Leadership Overview, pp. 3-4
Leadership and Management Roles, p. 5
Background on Leadership, p. 5
Leadership: Five Interwoven Aspects, p. 5
Leadership Theories, pp. 7-11
Attitudinal Leadership Theories, pp. 11-14
Transactional and Transformational Leadership, pp. 14-16
Contemporary Leadership, p. 16
Clinical Leadership, pp. 16-17
Effective Leadership, pp. 17-18
Leadership and Management Implications, pp. 19-20
Management Overview, p. 21
Background: The Management Process, pp. 22-26
Management in Nursing Practice, pp. 26-27
Management in Organizations, pp. 27-34
Leadership and Management Implications, pp. 34-35
THEME: Care Competencies
Concept: Collaboration
o Exemplar: Nurse–Nurse Collaboration
Leadership and Care Management Differentiated, pp. 1-3
The Leadership Role, p. 3
Leadership Overview, pp. 3-4
Leadership and Management Roles, p. 5
Background on Leadership, p. 5
Leadership: Five Interwoven Aspects, p. 5
Leadership Theories, pp. 7-11
Attitudinal Leadership Theories, pp. 11-14
Transactional and Transformational Leadership, pp. 14-16
Contemporary Leadership, p. 16
Clinical Leadership, pp. 16-17
Effective Leadership, pp. 17-18
Leadership and Management Implications, pp. 19-20
Management Overview, p. 21
Management in Nursing Practice, pp. 26-27
Leadership and Management Implications, pp. 34-35
Concept: Safety
o Exemplar: Systems Level
Clinical Leadership, pp. 16-17
Leadership and Management Implications, pp. 19-20
Research Note, p. 32
Leadership and Management Implications, pp. 34-35
Concept: Evidence
o Exemplar: Qualitative Research Studies
Research Note, p. 32
Concept: Health Care Quality
o Exemplar: Quality Plans and Philosophies
Leadership Skills, p. 4
Transactional and Transformational Leadership, p. 14
Controlling, p. 26
Research Note, p. 32
Current Issues and Trends, p. 35
BSN Essentials
Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety
o Leadership and Care Management Differentiated, pp. 1-3
o The Leadership Role, p. 3
o Leadership Overview, pp. 3-4
o Leadership and Management Roles, p. 5
o Background on Leadership, p. 5
o Leadership: Five Interwoven Aspects, pp. 5-7
o Leadership Theories, pp. 7-11
o Attitudinal Leadership Theories, pp. 11-14
o Transactional and Transformational Leadership, pp. 14-16
o Contemporary Leadership, p. 16
o Clinical Leadership, pp. 16-17
o Effective Leadership, pp. 17-18
o Leadership and Management Implications, pp. 19-20 and 34-35
o Current Issues and Trends, pp. 20-21
o Controlling, p. 26
o Research Note, p. 32
o Current Issues and Trends, p. 35
Essential III: Scholarship for Evidence-Based Practice
o Leadership and Care Management Differentiated, pp. 1-3
o Research Note, p. 32
Essential V: Health Care Policy, Finance, and Regulatory Environments
o Current Issues and Trends, pp. 20-21, 35
Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health
Outcomes
o Process Part 4: Communication, p. 6
o Leadership Styles: Democratic, p. 10
o Servant Leadership, p. 16
o Effective Leadership, pp. 17-18
o Followership, pp. 18-19
IC Image Collection
Figure 1-1. Components of a leadership moment.
Figure 1-2. Continuum of leader behavior.
Figure 1-3. Expanded Situational Leadership® model.
Figure 1-4. Transactional and transformational leadership.
Figure 1-5. Systems view of management.
Figure 1-6. Four steps of the management process.
Figure 1-7. Linkage of clinical and management domains.
Figure 1-8. Mintzberg's 10 managerial roles.
Figure 1-9. Mintzberg's Model of Managerial Work.
TEACHING STRATEGIES
ATTITUDINAL LEADERSHIP Discuss how concern for task Activity: After discussing the theories, have
THEORIES, p. 11 and relationship influences students journal (during or outside of class) about
Situational Theories, attitudinal leadership theories. which theory fits their own perspective, why, and
p. 11 Review Fiedler’s as well as how they see themselves using that theory in
Hersey and Blanchard’s models, practice.
and explain how situational
models differ from attitudinal
models.
TRANSACTIONAL AND Define and distinguish Discussion Topic: Is a transactional or
TRANSFORMATIONAL transactional versus transformational leadership style most effective?
LEADERSHIP, p. 14 transformational leadership.
CONTEMPORARY Explain that health care Small Group Activity: Have groups of students act
LEADERSHIP: demands that nurses maintain out different leadership styles for a particular
Interactional and the expertise and information scenario that you describe. Then have a group
Relationship-Based, necessary to take action to solve discussion about what actions revealed each style.
p. 16 problems; they need leadership Discussion Topic: What are the major leadership
Quantum Leadership, that is interactional, relational, styles? Which style is optimal to use in which
p. 16 and transformational at all situation?
Servant Leadership, p. 16 levels. Define and contrast Discussion Topic: What practices are common to
quantum versus servant most exceptional leadership achievements?
leadership.
CLINICAL LEADERSHIP, Define clinical leadership and Activity: Provide names of nurse leaders in your
p. 16 discuss how the IOM’s goals community and describe their professional
relate to it. contributions.
EFFECTIVE LEADERSHIP, Describe characteristics of Online Activity: Have students visit
p. 17 effective leadership. Review http://www.nwlink.com/~donclark/leader/survlea
Table 1-1 on Tornabeni’s advice. d.html to access a Leadership Self-Assessment
Emphasize that leadership Activity. Ask students how leaders can use this
effectiveness is based on the assessment to identify strengths and areas of
ability to adapt in a complex and improvement.
chaotic environment. Discussion Topic: What are characteristics of an
effective leader? Give an example of an effective
leader you know, and explain why and how s(he)
is effective.
FOLLOWERSHIP, p. 18 Specify the linkage between Discussion Topic: Define the characteristics of
Types of Followers, p. 18 followership and leadership. followership and leadership and then have
Discuss types of followers. students describe how they are connected.
LEADERSHIP AND Discuss how the size of the Discussion Topic: How does nurses’ variety of
MANAGEMENT profession and the complexity educational backgrounds affect nursing’s need for
IMPLICATIONS, p. 19 of nursing tasks require leadership?
leadership.
CURRENT ISSUES AND Review demographic data and Discussion Topic: Ask students, “What current
TRENDS, p. 20 trends that affect nursing. issues in leadership concern you?”
MANAGEMENT The recruitment, deployment, Discussion Topic: Ask students if all managers are
OVERVIEW, p. 21 development, motivation, and leaders.
leveraging of nurses as scarce Discussion Topic: Have students provide
resources and prime assets are examples of management practices that they
critical management issues for have seen in clinical situations.
nursing and health care.
DEFINITIONS, p. 21 Define and describe Discussion Topic: Ask students what tasks are
management. common to both leadership and management.
BACKGROUND: THE Define nursing management and Large Group Activity: Quiz Show! Divide the class
MANAGEMENT describe the practices involved. into two groups. Have students decide within
PROCESS, p. 22 Define and review the four steps each group who will write out each key term and
Practices That Give of the management process its definition on an index card. At the next class
Executives the (Figure 1-6). Discuss the period, have students sit together as groups.
Knowledge They Need, balancing of competing needs: Collect the cards, and read the definitions
p. 22 the needs of the staff related to alternately to the two groups. When a group
Practices That Help growth, efficiency, motivation, correctly provides the key term for the definition
Executives Convert morale, and accomplishment you read, award a point to that group. Let the
Knowledge to Action, with the outcome of staff group members talk amongst themselves before
p. 22 satisfaction; and the needs of giving the answer. Choose in advance what prize
Practices That Ensure That the employer for productivity, the winning team will receive, such as no
the Whole Organization quality, and cost-effectiveness homework for a night or the losing team will write
Feels Responsible and with the outcome of out the definitions for the next quiz show.
Accountable, p. 22 productivity.
Planning, p. 23
Organizing, p. 24
Directing, p. 25
Controlling, p. 26
MANAGEMENT IN Discuss the roles of nurse as Discussion Topic: How does management in
NURSING PRACTICE, care provider and integrator. nursing practice differ from management in
p. 26 Explain that managers in nursing general?
Two Roles of the Nurse, perform functions that provide Activity: Invite an exceptional nurse manager as a
p. 26 an environment and climate to speaker for the class. Have the manager discuss
facilitate delivery of client his or her role.
services.
MANAGEMENT IN The manager's role is distinct Activity: Divide the class into three groups. Assign
ORGANIZATIONS, p. 27 and important for individual and Group 1 to the three interpersonal roles
The Nature of Managerial organizational outcomes (figurehead, leader, and liaison), Group 2 to the
Work, p. 27 because of its direct impact on three informational roles (monitor, disseminator,
Contemporary how and what gets done. and spokesperson), and Group 3 to the four
Management Theories, Discuss Mintzberg’s managerial decisional roles (entrepreneur, disturbance
p. 29 skills (Fig. 1-8) and Mintzberg’s handler, resource allocator, and negotiator). Have
model of managerial work (Fig. each group discuss each of the assigned roles, the
1-9). Review the contingency, purpose and function for each, and then role-play
systems, complexity, and chaos each assigned role for the entire class.
theories of management. Activity: Have each student choose one of the
contemporary management theories, describe it,
and explain its advantages and disadvantages in a
short paper.
Activity: Have students work in small groups to
present a video (posted on YouTube if desired)
explaining Mintzberg’s model or another
contemporary management theory.
LEADERSHIP AND Discuss the different duties of a Discussion Topic: Which of Curtin’s 10 ethical
MANAGEMENT nurse manager versus nurse values in the text is most important for nurse
IMPLICATIONS, p. 34 executive. Review challenges of managers?
balancing day-to-day operations Activity: Have students complete one of the case
with transformative studies below and then host a group discussion of
management and leadership. the answers and rationales to the questions.
CURRENT ISSUES AND Review issues and trends in Discussion Topic: Ask students, “What current
TRENDS, p. 35 access, cost, and quality. issues in management concern you?”
Lucille Brown is a nurse manager for a 26-bed critical care unit for a major teaching hospital in New
York. She is very relationship- and people-oriented. Nurse Brown encourages and facilitates group
discussion and group decision making. Teamwork is the focus for all projects on her unit, and she
provides needed resources to the team. Nurse Brown makes sure that everyone has a role on the unit
and input into decision making.
1. (a) What style of leadership does Nurse Brown seem to exhibit most of the time? (b) Where do you
predict this places her leadership style in terms of Tannenbaum and Schmidt’s behavioral style
continuum?
Answer: (a) Nurse Brown most often exhibits a “relationship behavior” leadership style. (b) This predicts
that her leadership will be more democratic than authoritarian.
Rationale: The way people influence others through actions taken and the perspectives of other people
is related to leadership efforts and constitutes leadership style. The two major leadership terms are task
behavior and relationship behavior, and a leader's leadership style is some combination of task and
relationship behavior. Tannenbaum and Schmidt (1973) suggested that a leader might select one of
many behavior styles arrayed along a continuum. The continuum ranges from democratic to
authoritarian (or subordinate-centered to leader-centered).