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Orientation
Karla Arana, Paige Dinehart, Bethany Keenan, Rachel Lepore,
Kristen Youtsey
April 17th, 2019
1
Overview of Patient Care Delivery System
https://business.tucsonchamber.org/list/member/carondelet-st-joseph-s-hospital-140619
2
Microsystem Model: Leadership
● “Research has shown that the leader-manager must
assume a variety of leadership styles, depending on the
needs of the worker, the task to be performed, and the
situation and environment. This is known as situational or
contingency theory.”
● Resources available:
○ Charge Nurse
○ Nurse manager
○ House supervisor
○ Union representatives (in process of Unionizing)
4
Microsystem Model:
Patient Focus & Staff Focus
● Patient Focus: “...the registered nurse is expected to take appropriate
action regarding instances of illegal, unethical, and inappropriate
behavior that can endanger or jeopardize the best interests of the
health-care consumer or situation…”
5
Microsystem Model:
Interdependence of Care Team
● Interdisciplinary teams reduce “mortality and improved
quality of life for patients, a reduction in health-care
costs, and a more rewarding professional experience for
the healthcare worker”
● Rounding
○ Physician, Charge RN, Primary RN, Case manager,
pharmacy, RT, dietician
● Physicians on site
● No techs
● RNs do own monitoring
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in
nursing: Theory and application (9th ed. p. 466). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins.
6
Microsystem Model:
Use of Information and Healthcare Technology
● Educational requirements
● Performance appraisals- “how well employees
perform the duties of their job”
○ Reflective practice- evaluates oneself and “seeks
learning opportunities to promote continued
competence”
○ Yearly
● Comparisons to other units
10
Specific Aspect Targeted for Improvement and State
IN Principle & Describe IN Modality Applied (cont.)
12
Month 3: Month 5-10:
Determine the Month 4: Select and train
best approach Present plan to preceptors
to orient novice selected staff within core ICU
RNs on the unit nurses
Plan for
Month 1 and 2: Improvement:
Evaluate and
gather current Timeline Months 11 and
12: Implement
data regarding
on the unit
orientation of
novice RNs
13
References
American federation of State, County and Municipal Employees (2019). The cost of failure.
Retrieved from
https://www.afscme.org/news/publications/health-care/solving-the-nursing-shortage/the-
cost-of-failure
Crane, P. J. & Ward, S. F. (2016). Self-healing and self-care for nurses. AORN Journal,
104(5). doi: https://doi.org/10.1016/j.aorn.2016.09.007
Hofler, L. & Thomas, K. (2016). Transition of new graduate nurses to the workforce:
Challenges and solutions in the changing health care environment. North
Carolina Medical Journal, 77(2), 133-126. doi: 10.18043/ncm.77.2.133
Kozub, E., Hibanada, M., Harget, G., & Ecoff, L. (2015). Redesigning
Orientation in an Intensive Care Unit Using 2 Theoretical Models. AACN
Advanced Critical Care,26(3), 204-214. doi:10.1097/NCI.0000000000000088
14