Deck 13: Decentralization and Shared Governance

Question 1

One obstacle in the implementation of a shared governance model is that nurses have:

A) empowered participation in committee meetings.
B) limited time to work on projects.
C) the same basic educational foundation.
D) traditionally worked in decentralized structures.

Answer 1

limited time to work on projects.

Question 2

Research about shared governance suggests that it is:

A) enhancing the role of the nurse's aide within the organization.
B) improving organizational and patient outcomes.
C) not a cost-effective program when examining all areas of care.
D) too much additional work for the already overwhelmed RN.

Answer 2

improving organizational and patient outcomes.

Question 3

The local hospital has a new specialty unit for women and children. The nursing staff has created a family advisory council to assist in reviewing educational materials used at discharge. This shared governance structure is an example of:

A) interprofessional education.
B) whole-system integration.
C) engagement.
D) collaboration.

Answer 3

whole-system integration.

Question 4

The nurse manager should use which of the following behaviors when implementing a shared governance structure?

A) Autocratic decision making of the manager
B) Coaching the staff to be successful
C) Harboring the vision within the team
D) Reimbursing the staff for overtime

Question 5

In Magnet organizations, shared governance needs to be manifested through what mechanisms for nurses' decision making?

A) Unit practice councils
B) Democratic leaders
C) Authoritarian leaders
D) System-wide practice councils

Question 6

Participative leadership was first introduced in the late 1970s. It was adapted by health care organizations to form the basis of shared governance and has evolved to define the roles of nurses and resolve issues related to:

A) patient care.
B) nursing liability
C) nursing salaries.
D) nursing turnover.

Question 7

Which of the following leadership styles is best suited for implementation of a shared governance structure?

A) Authoritarian
B) Autocratic
C) Participative
D) Laissez-faire

Question 8

A nurse works in the critical care unit (CCU). She enjoys being on the unit charge nurse team, the recruitment and retention team, and the peer evaluation team. The recruitment and retention team is responsible for hiring new employees into the CCU. The five-member team, consisting of three registered nurses (RNs), a unit clerk, and a nurse's aide, conduct the interviewing process with key questions that were developed by the team. This is an example of:

A) centralized power.
B) shared governance.
C) span of control.
D) vertical authority.

Question 9

An employee satisfaction survey is conducted annually and shows that nurses in a particular unit are committed to their jobs and feel that they make positive contributions. These nurses are:

A) engaged.
B) disengaged.
C) unproductive.
D) at retirement age.

Question 10

In organizations that practice shared governance, staff, managers, and leaders are responsible for:

A) technology.
B) budgeting.
C) education.
D) innovation.

Question 11

In organizations that practice shared governance, the responsibility for unit outcomes rests with the:

A) nursing team.
B) nurse manager.
C) individual nurse.
D) chief nursing officer (CNO).

Question 12

Nurses' involvement in shared governance is an important component of:

A) practice models.
B) Magnet recognition.
C) increased reimbursement.
D) physician satisfaction.

Question 13

The purpose of an organization's philosophy is to:

A) influence the goals and objectives of an organization.
B) display how the parts of an organization are connected.
C) be an instrument that gives voice to the organization s mission.
D) serve as the institutional framework that shapes the direction of knowledge and skill acquisition.

Question 14

Which of the following statements best describes an organizational chart?

A) All job positions are displayed clearly in a two-dimensional drawing.
B) All outside organizations with relationships to the hospital are depicted.
C) Informal and formal structures within the organization are outlined.
D) It shows organizational positions and relationships in a visual representation.

Question 15

Institutions organize and structure themselves by defining departmental function and authority to achieve a more coordinated effort. In institutions where the executive leader retains more decision-making authority, the operation takes on a more _____ philosophy.

A) centralized
B) decentralized
C) autocratic
D) democratic

Question 16

The __________ of an organization is the formulation of ideas, plans, or dreams that help shape the future and ability to persuade colleagues and associates to share those dreams.

A) mission
B) core values
C) vision
D) organizational chart

Question 17

Traditionally, nurses have worked in strong, hierarchical institutions with centralized decision making and clear authority structures, rigid approval mechanisms, and extensive policies and procedures that have resulted in barriers to creating a shared governance system. One such barriers is:

A) lack of role clarity.
B) lack of time management.
C) poor time management skills.
D) that development takes a long time.

Question 18

Shared governance is a vehicle for engaging organizations and creating the necessary forums and intersections that assure the decisions and actions remain dynamic and as close to the point of service as possible. Shared governance promotes:

A) dependence.
B) non-punitive culture.
C) collaboration
D) executive decision making.

Question 19

Decentralization occurs when:

A) equipment is being purchased from approved vendors.
B) hiring decisions are made at the executive level.
C) power is distributed to those closest to the work of caregiving.
D) supplies are distributed from one central supply area in the hospital.

Question 20

Shared governance is a model of organizational structure in which staff nurses are:

A) employed to establish mutual goals with clients.
B) empowered through autonomy and accountability.
C) engaged in problem-solving strategies and techniques.
D) equipped with evaluative thinking methodologies.

Question 21

In an organization that has a decentralized organizational philosophy, decision-making authority rests in levels closer to the point of service rather than in the executive levels. Benefits of a decentralized organizational philosophy include: (Select all that apply.)

A) encouraging more input.
B) supporting greater innovation.
C) facilitating faster response times.
D) permitting a narrower span of control.
E) allowing for more levels of management.

Question 22

The instruments that give voice to the organization's philosophy include which of the following? (Select all that apply.)

A) Goals
B) Focus
C) Vision
D) Mission
E) Core values

Question 23

At its start, shared governance requires the education and support of organizational executives, managers, and point-of-care staff. Organizational benefits include: (Select all that apply.)

A) accountability of the nurse.
B) reduction in liability claims.
C) reduction in workers' compensation claims.
D) improved financial outcomes.
E) more expert involvement at the point of care.

Question 24

The primary purpose of unit practice committees in a health care organization is to improve: (Select all that apply.)

A) practice.
B) processes.
C) outcomes.
D) reimbursement.
E) urnover.

Question 25

Shared governance has far-reaching implications for today's health care environment. Patients benefit due to: (Select all that apply.)

A) quicker responses at the point of service.
B) more committed health care professionals.
C) a more stringent model of health care service.
D) better decisions being made by upper management.
E) nurses being more assured, confident patient advocates.

Question 26

In organizations that practice shared governance, the nurse manager's role is to: (Select all that apply.)

A) hire new employees.
B) mentor the nursing staff.
C) train new nurses in patient care.
D) support the decisions of the nursing team.
E) enable the staff to become effective leaders.

Question 27

Organizational benefits of a culture of shared governance include: (Select all that apply.)

A) improved financial outcomes.
B) interdependence among staff nurses.
C) increased commitment of staff to the organization.
D) more senior leadership involvement at the point of service.
E) a more efficient model for point-of-service decision making.