ATI Assessment Material PDF

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RN VATI LEADERSHIP ASSESSMENT REMEDIATION  Management of Care – (11)  Assignment, Delegation and Supervision – (1)  Managing Client Care: Time Management Strategies (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 1)  Organize care according to client care needs and priorities. Use time-saving strategies and avoid time wasters. Time management is a cyclic process  Be cognizant of assistance needed by other health care team members. Offer to help when unexpected crises occur. Assist other team members with provision of care when experiencing a period of down time  Take time for yourself. Schedule time for breaks and meals. Take physical and mental breaks from work and the unit  Case Management – (1)  Nasogastric Intubation and Enteral Feedings: Client Assessment Following a Total Appendectomy (Active Learning Template – System Disorder, RM FUND 9.0 Chp 54)  Following surgery, the patient is taken to the postanesthesia care unit (PACU) until the anesthesia wears off. During this time, the nursing staff checks temperature, heart rate, and breathing at frequent intervals. When the anesthesia wears off and vital signs stabilize, the patient is transferred to their hospital room.  Unruptured Appendix – With an unruptured appendix, the patient's recovery time is relatively quick. The morning after surgery, clear liquids are offered. Once those are tolerated, the diet progresses to solid food. Once the patient is eating and drinking, the intravenous is removed. Physical activity, such as getting out of bed, begins on the same day as surgery or the next morning. Most patients need medication to relieve the pain in and around the incision. The smaller incisions of a laparscopic procedure often cause less pain than the large incision made in open appendectomy. The nursing staff continues to monitor the patient for signs of infection and checks that the incision is healing. Patients with uncomplicated surgeries usually leave the hospital 1 or 2 days following surgery.  Once at home, the patient must check the incision site. It should be dry and the wound should be completely closed. If the incision drains blood or pus, or if the edges are pulling apart, the physician should be notified immediately. Fever and increasing pain at the incision site also should be reported to the physician.  Collaboration with Interdisciplinary Team – (1)  Dosage Calculation: Verifying Administration Rate (Active Learning Template – Basic Concept, RM FUND 9.0 Chp 48)  Volume (mL)/ Time (min) x Drop factor (gtt/mL) = X  Concepts of Management – (1)  Managing Client Care: Identifying Types of Care Delivery Systems (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 1)  Leadership and management are concepts that are integral to effective management and motivation of staff and clients. Management is the process of

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planning, organizing, directing, and coordinating the work within an organization. Leadership is the ability to inspire others to achieve a desired outcome. Effective managers usually possess good leadership skills. However, effective leaders are not always in a management position. Managers have formal positions of power and authority. Leaders might have only the informal power afforded them by their peers. One cannot be a leader without followers. A number of theories describe the characteristics of a leader. Behavioral theories describe leadership theories contrast two types of leaders. The emotionally intelligent leader displays sensitivity when interacting with others. Confidentiality/Information Security – (1)  Professional Responsibilities: Nursing Actions for a Breach of Confidentiality (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 3)  It is essential for nurses to be aware of the rights of clients in regard to privacy and confidentiality. Facility policies and procedures are established in order to ensure compliance with HIPAA regulations. It is essential that nurses know and adhere to the policies and procedures. HIPAA regulations also provide for penalties in the event of noncompliance with the regulations. Continuity of Care – (2)  Coordinating Client Care: Information to Include in SBAR Communication Tool (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 2)  Describe the situation – what is going on now (one sentence). Identify self, unit, patient, room number  Safe Medication Administration and Error Reduction: Use of Approved Abbreviations (Active Learning Template – Basic Concept, RM FUND 9.0 Chp 47)  Use the full name of medication. Smaller units (500 mcg) or a leading zero (0.5 mg). Without a trailing zero (1 mg, 100 g). Units. Metric units. Daily or intentded time of administration. Informed Consent – (1)  Professional Responsibilities: Informed Consent for a Minor (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 3)  Individuals authorized to grant consent for another person – parent of a minor. Legal guardian. Court-specified representative. Client’s health care surrogate (individual who has the client’s durable power of attorney for health care/health care proxy). Spouse or closet available relative (state laws vary) Legal Rights and Responsibilities – (1)  Professional Responsibilities: Responding to Possible Substance Use Disorder (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 3)  Impaired Coworkers - Impaired health care providers pose a significant risk to client safety. A nurse who suspects a coworker of using alcohol or other substances while working has a duty to report the coworker to appropriate management personnel as specified by institutional policy. At the time of the infraction, the report should be made to the immediate supervisor, such as the charge nurse, to ensure client safety. Health care facility policies should provide

guidelines for handling employees who have a substance use disorder. Many facilities provide peer assistance programs that facilitate the health care provider’s entry into a treatment program. Each state board of nursing has laws and regulations that govern the disposition of nurses who have been reported secondary to substance use. Depending on the individual case, the boards have the option to require the nurse to enter a treatment program, during which time the nurse’s license can be retained, suspended, or revoked. If a nurse is allowed to maintain licensure, there usually are work restrictions put in place, such as working in noncritical care areas and being restricted from administering controlled medications. Health care providers who are found guilty of misappropriation of controlled substances also can be charged with a criminal offense consistent with the infraction. Behaviors can be difficult to detect if the impaired nurse is experienced at masking the substance use disorder  Referrals – (2)  Coordinating Client Care: Interdisciplinary Team Collaboration Following a Stroke (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 2)  The nurse’s role regarding referrals - Begin discharge planning upon the client’s admission. Evaluate client/family competencies in relation to home care prior to discharge. Involve the client and family in care planning. Collaborate with other health care professionals to ensure all health care needs are met and necessary referrals are made. Complete referral forms to ensure proper reimbursement for prescribed services  Coordinating Client Care: Referral for Caregiver Relief (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 2)  Provide caregiver with temporary relief from tasks associated with care giving for chronically ill family members – Respite care  Safety and Infection Control – (6)  Emergency Response Plan – (1)  Maintaining a Safe Environment: Priority Action Responding to Fire (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 4)  Fire response follows the RACE sequence  R: Rescue and protect clients in close proximity to the fire by moving them to a safer location. Clients who are ambulatory may walk independently to a safe location.  A: Alarm: Activate the facility’s alarm system and then report the fire’s details and location  C: Confine the fire by closing doors and windows and turning off any sources of oxygen and any electrical devices. Ventilate clients who are on life support with a bag-valve mask.  E: Extinguish the fire if possible using the appropriate fire extinguisher.  Handling Hazardous and Infectious Materials – (1)  Infection Control: Cleaning Contaminated Equipment (Active Learning Template – Nursing Skill, RM FUND 9.0 Chp 11)

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Always wear gloves and protective equipment. Rinse first in running cold water. Hot water coagulates proteins, making them adhere. Wash the article in warm water with soap. Use a brush or abrasive to clean corners or hard-to-reach areas. Rinse well in warm water. Dry the article. It is considered clean at this point. Clean the equipment used in cleaning and the sink (still dirty unless a disinfectant is used). If indicated, follow facility policy for recommended disinfection or sterilization. Remove gloves and perform hand hygiene. Reporting of Incident/Event/Irregular Occurrence/Variance – (1)  Facility Protocols: Completing an Incident Report (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 5)  Client’s name and hospital number (or visitor’s name and address if visitor injury), along with the date, time, and location of the incident. Factual description of the incident and injuries incurred, avoiding assumptions as to the incident’s cause. Names of witnesses to the incident and client or witness comments regarding the incident. Corrective actions that were taken, including notification of the provider and referrals. Name and dose of any medication or identification number of any equipment involved in the incident. Safe Use of Equipment – (1)  Airway Management: Client Teaching About Home Oxygen Safety (Active Learning Template – Therapeutic Procedure, RM FUND 9.0 Chp 53)  Family members who smoke should do so outside. Nail polish and other flammable materials may cause a fire and should not be used. A “Oxygen in Use” sign should be placed near the front door. Cotton materials should be used instead of woolen and synthetic materials as they create static electricity. A readily available fire extinguisher should be placed in all homes, including the home of a client who is receiving oxygen. Standard Precautions/Transmission-Based Precautions/Surgical Asepsis – (1)  Bacterial, Viral, Fungal, and Parasitic Infections: Contact Precautions (Active Learning Template – System Disorder, RM FUND 9.0 Chp 56)  Implement contact precautions for Clostridium difficile, herpes simplex virus, impetigo, methicillin-resistant Staphyloccocus aureus (MRSA), vancomycinresistant Staphylococcus aureus (VRSA) Use of Restraints/Safety Devices – (1)  Maintaining a Safe Environment: Use of Limb Restraints (Active Learning Template – Basic Concept, RM Leadership 7.0 Chp 4) 

In general, seclusion and restraints should be prescribed for the shortest duration necessary and only if less restrictive measures have proved insufficient. They are for the physical protection of the client, or the protection of other clients or staff. Use of restraints is a difficult adjustment for the client and family. The client loses his freedom and can be embarrassed and experience low self-esteem and depression. The nurse can allay some of the concerns by explaining the purpose of the restraint and that the restraint is only temporary. Seclusion and/or restraints must never be used for convenience of the staff, punishment for the client, clients

who are extremely physically or mentally unstable, clients who cannot tolerate the decreased stimulation of a seclusion room. PRN prescriptions for restraints are not permitted. Restraints should never interfere with treatment, restrict movement as little as is necessary to ensure safety fit properly, be easily changed to decrease the chance of injury and to provide for the greatest level of dignity. When all other less restrictive means have been tried to prevent a client from harming self or others, the following must occur for seclusion or restraints to be used. The treatment must be prescribed by the provider based on a face-to-face assessment of the client. In an emergency situation in which there is immediate risk to the client or others, the nurse can place a client in restraints. The nurse must obtain a prescription from the provider as soon as possible in accordance with agency policy (usually within 1 hr). The prescription must specify the reason for the restraint, the type of restraint, the location of the restraint, how long the restraint can be used, and the type of behaviors demonstrated by the client that warrant use of the restraint. The provider must rewrite the prescription, specifying the type of restraint, every 24 hr or the frequency of time specified by facility policy....