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NCLEX Review of Priority and Delegation Management of Care

 Concept of Management and Leadership


A way of behaving that influences others to respond, not because they have but because they want to/leader helps others to identifies focus on the personal development of the member of the group.

 Essential component of leadership

  • Knowledge
  • Self-awareness
  • Communication
  • Energy
  • Goals
  • Action

Nursing intervention

All nurses need leadership skills to manage other nurses, unlicensed personnel, and their is essential to the nursing role to identified and implement effective leadership practices.


A problem-oriented process with a focus on the activities needs to achieve a goal. Management involved personal interaction, but the focus is on the group process, the most effective manager are also effective leaders.

 An essential component of managers

  • Planning/organizations
  • Directions
  • Monitoring
  • Recognition and rewards
  • Management styles
  • Autocratic
  • Laissez-faire
  • Democratic

Nursing intervention

All nurses need to learn management skills and identified their leadership style. Additionally, the nurses need to know the difference between being an autocratic and democratic leader who uses an interdisciplinary approach that encouraged open communication, collaboration and promotes individual autonomy and accountability.

  • Power

Power is the ability to take action and having the strength to accomplish goals, power can be both coherent and acquired. Everyone has power in a different way and to a different degree.

 Types of power

  • Legitimate
  • Referent
  • Rewards
  • Expert
  • Information
  • Coercive
  • Informal

Nursing intervention

The nurse needs to understand that the power to influence others can originate from a variety of sources, as a nurse, the component to influences is aimed at accomplished goals for example used of appreciates delegation.

To the provided quality of care.


A team is a group of individual working together toward a common goal. Member of the team engaged in varying roles, supporting the achievement of these goals, each team member contribution is valued and important to the success of the team as a whole, think collaboration, coordination and communication. The group dynamic is the unlying process, that the group engaged in during their work as a team, some of these facilitate, and some hinder the process of the group.

 Team Roles

  • Task role
  • Initiating
  • Seeking information’s
  • Giving information
  • Clarifying
  • Coordinating
  • Summarizing
  • Group maintenance role
  • Supporting
  • Mediating
  • Gatekeeping
  • Following
  • Tension reducing
  • Standard-setting within group

 Nursing Intervention

The nurse understands the importance of group dynamics and teamwork in the health care environment. The strongest bond in nursing is a shared common purpose or goal (for example, providing client care) also the nurse encourages positive group dynamic that assists in effective clinical decision making and in addressing conflict.


Communications involved sending, receiving and interpreting both verbal and non-verbal information.

  • Between at least two people
  • Component of communication
  • A basic element of communication
  • Assertive communication

 Nursing Intervention

Effective communication required commitment, effort, focus and cooperation, especially when dealing with complete clinical issues with diverse background and perspective. It is essential to understand and use effective communication and successful coordinate care.


Conflict arises when the heir is two opposing views, feeling, expectations, and many other can occur within the individual, between individual, or between-group or organizations, conflicts can be managed.

  • Sources of conflicts
  • Conflict resolution
  • Avoidance
  • Accommodation
  • Compromises
  • Competition
  • Collaboration
  • Process of negotiation
  • Sexual harassment

 Nursing intervention

The practical nurse role is to identify the source of conflicts, understand the issues that have develops, and work toward conflicts resolution with the other is essential to address the person with whom you have conflict first before going to his or her superior (use the chain of command). Remember the strategy of the most important conflict involves the collaboration that results in a win solution for everyone.

Continuity of Care

Continuity of care focuses on the experiences of the client move through the health care system. Moving the client through this experience, require cooperation, integration, and facilitation of all the event along with the continuum nursing roles.

Factors impacting the continuity of care.

 Quality Improvement

A planning process to evaluate the delivery of care and to develop ways to address any problem or difficulty.

 Continuous versus total quality improvement

  • Types of quality indications
  • Structure
  • Process
  • Outcome
  • Data collection
  • Variances /incidence/occurrence reports


An incident or variance is an event that occurs outside the usual expected “normal’ activities or events of the client stay, organization process or unit functioning.

  • Purposes
  • Document standards
  • Nursing interventions

Variance or incident reports are not intended to point blame, just document the facts and figures. The purpose is to identified situation or systems issues the at contributes to the occurrences and engagement strategies to prevent reoccurrences or to correct the situations.

  • Resources management
  • Healthcare delivery
  • Retrospective versus prospective payment
  • Health maintenance organization
  • Nurses’ roles in resources management

Nursing Interventions

The nurse must also be aware of economic issues in healthcare, remember the more information available to the nurse, the better the decision and input into long-range planning for the institution.

 Consultation and referral


To ask for help to solve a problem or meeting a need of an individual or a group. This help is then applied and monitored by the nurse. Often it is a request for information from someone with special knowledge, including peers.


A request for assistance from someone with special knowledge or skills to help with the management of the client problems. Most often, it is a request for intervention from another professional who needs skills and knowledge.

  • The interventions become that specialist responsibility, but the nurse continues to be responsible for the monitoring of the client response and progress.
  • Common nursing consultation and referrals situations
  • Appropriate use of consultation and referral situation
  • Appropriate use of consultation and referral

 Nursing intervention

The process of consultation and referral are integral for effective utilization of services along the continuum. The nurse supports the client and families with appropriate consultation and referral to contact in the community.






Delegation: The act of asking another to do some aspect of care, assignment, or work that needs to be accomplished. Delegation can be horizontal to peers, upwardly vertical to management or downwardly vertical to the subordinate.

 Supervision: Monitoring the progress towards completion of delegated tasks. The amount of management or specifically the supervision required depends on the abilities of the person being delegated, the direction of the delegation, and the location of the ultimate responsibility for outcomes.



  • Tasks
  • Person
  • Communication
  • Feedback

 Nursing Interventions

A nurse needs to understand legal responsibilities when managing and delegating nursing care to a wide variety of health care workers. The nurse must delegate activities thoughtfully, taking into account individual job descriptions, knowledge base and demonstrated skills.

  • Roles and Responsibilities of Levels of Staff
    • Nursing Assistant (NA)

(i). May also be called as an unlicensed assistant (NA)

(ii). Training is often on the job

(iii). Nursing assistants may complete a certification program (CNA)

(iv). Function under the direction of the licensed practical or registered professional nurse

(v). Skills

  • Basic hygiene care and grooming
  • Communication
  • Assistance with ADLs such as elimination, nutrition and mobility
  • Emphasis is on maintaining a safe environment and recognizing situations to report to their immediate superior
    • Licensed Practical Nurse (LPN)

(i). May also be called a licensed vocational nurse (LVN)

(ii). Education is approximately 12 to 18 months in a formal program.

(iii). LPN’s must complete and pass the NCLEX-PN exam for licensure

(iv). Function under the direction of the registered professional nurse or primary care provider

(v). Skills (all the same as NA with additional skills of):

  • Meeting the health needs of the clients
  • Caring for clients whose condition is considered to be stable
    • Registered Professional Nurse (RN)

(i). Maybe diploma, associate degree baccalaureate degree (or higher)

(ii). Education rages from 2 to 4 (or more) years

(iii). RN’s must complete and pass the NCLEX-RN exam for licensure

(iv). Function under the direction of the primary care provider

(v). Skills: All of the skills of the NA and LPN with additional skills as outlined in the nurse practice act for each state. In general, the RN acts as a client advocate and provide care to the client advocate and provide care to the client by use of the nursing process

  • Advance practice nurse

(i). Maybe non-degree or master’s degree (or higher)

(ii). Education ranges from 18 months to 4 (or more) years (in addition to the basic RN) program

(iii). Must complete and pass a certification exam (in addition to the NCLEX-RN exam) applicable to the specialty and practice (for example adult nurse practitioner, a diabetic educator)

(iii). Functions vary according to the state practice act which may be either autonomously or under the direct or indirect supervision of a physician

(iv). Skills: Vary according to the state practice, may include the ability to prescribe, diagnose and treat

  • Primary Care Provider

(i). Maybe a physician, physician’s assistant or nurse practitioner

(ii). In general, only an attending physician has to admit privileges to an institution, although another care provider in the practice may direct the care given to the client.



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