NLE Nursing Leadership & Management — Nursing Management: Delegation, Staffing & QualityConcept Map

Concept

Delegation

Sub Concepts

• Five Rights of Delegation (Task, Circumstance, Person, Direction, Supervision)
• Delegable vs Non-delegable Tasks
• Accountability vs Responsibility Transfer
• Scope of Practice: RN, LPN, UAP
• Delegation to Unlicensed Assistive Personnel

Relationship To Central

Core operational skill for task distribution while maintaining accountability

Concept

Prioritization

Sub Concepts

• Maslow's Hierarchy of Needs (Physiologic, Safety, Love/Belonging, Esteem, Self-actualization)
• ABCs Framework (Airway, Breathing, Circulation)
• Acute vs Chronic Conditions
• Actual vs Potential Problems
• Unstable vs Stable Patients
• Three-Tier Triage Model (Emergent, Urgent, Non-urgent)

Relationship To Central

Framework for deciding order of patient care and task completion

Concept

Staffing and Scheduling

Sub Concepts

• Patient Classification Systems (Acuity Levels)
• Nursing Care Hours per Patient Day (NCH/PPD)
• Full-Time Equivalent (FTE)
• Staff Mix and Skill Mix
• Nurse-to-Patient Ratios
• Scheduling Approaches (Centralized, Decentralized, Self-Scheduling)
• Care Delivery Modalities (Functional, Team, Primary, Modular, Case Management)

Relationship To Central

Management function ensuring right number and mix of qualified personnel

Concept

Conflict Resolution

Sub Concepts

• Types of Conflict (Intrapersonal, Interpersonal, Intergroup)
• Thomas-Kilmann Modes (Competing, Accommodating, Avoiding, Compromising, Collaborating)
• Assertive Communication
• Win-Win Problem Solving
• Focus on Issue not Person

Relationship To Central

Strategy for managing inevitable team disagreements constructively

Concept

Change Management

Sub Concepts

• Lewin's Three-Stage Model (Unfreezing, Moving, Refreezing)
• Force-Field Analysis (Driving and Restraining Forces)
• Resistance to Change
• Change Implementation Strategies
• Communication and Education in Change

Relationship To Central

Leadership approach for implementing new practices and protocols

Concept

Quality Improvement

Sub Concepts

• Quality Assurance (QA) vs Continuous Quality Improvement (CQI/TQM)
• Donabedian Framework (Structure, Process, Outcome)
• PDSA/PDCA Cycle
• Standards and Nursing-Sensitive Indicators
• Root Cause Analysis (RCA) for Sentinel Events
• Failure Mode and Effects Analysis (FMEA)
• Benchmarking and Audits
• Just Culture and Patient Safety Culture

Relationship To Central

Systematic continuous effort to improve healthcare processes and outcomes

To

Five Rights Framework

From

Delegation

Strength

strong

Relationship

Five Rights are the operational checklist ensuring safe, legal delegation within scope of practice

To

Prioritization

From

Delegation

Strength

strong

Relationship

Delegation decisions must prioritize which tasks are delegable based on patient acuity and stability

To

Accountability

From

Delegation

Strength

strong

Relationship

Nurse delegates the task but retains accountability for outcome; core principle of professional responsibility

To

Maslow's Hierarchy

From

Prioritization

Strength

strong

Relationship

Maslow framework guides which physiologic and safety needs are addressed first in patient care

To

ABCs Framework

From

Prioritization

Strength

strong

Relationship

ABCs are the immediate application of Maslow in acute clinical situations; Airway, Breathing, Circulation supersede all other priorities

To

Triage Model

From

Prioritization

Strength

moderate

Relationship

Three-tier triage translates prioritization concepts into categories (emergent, urgent, non-urgent) for resource allocation

To

Patient Classification Systems

From

Staffing and Scheduling

Strength

strong

Relationship

Acuity classification determines nursing care hours needed, which directly informs staffing requirements

To

NCH per Patient Day

From

Staffing and Scheduling

Strength

strong

Relationship

NCH/PPD is calculated from patient acuity and census; core metric for determining nurse-to-patient ratios and FTE

To

Care Delivery Models

From

Staffing and Scheduling

Strength

strong

Relationship

Care delivery model (functional, team, primary, modular, case management) determines how staff is organized and how work is delegated

To

Skill Mix

From

Staffing and Scheduling

Strength

strong

Relationship

Ratio of RN to UAP affects both patient safety outcomes and cost; acuity determines optimal skill mix

To

Thomas-Kilmann Modes

From

Conflict Resolution

Strength

strong

Relationship

Five modes represent a spectrum of responses to conflict; choice depends on situation urgency, relationship, and goals

To

Assertive Communication

From

Conflict Resolution

Strength

moderate

Relationship

Assertive communication is the tool enabling collaborative, win-win conflict resolution; avoids aggression or passivity

To

Lewin's Three-Stage Model

From

Change Management

Strength

strong

Relationship

Lewin model (Unfreeze-Move-Refreeze) is the foundational framework for planning and executing organizational change

To

Force-Field Analysis

From

Change Management

Strength

moderate

Relationship

Force-field analysis is a tool within Lewin model to identify and strategically address forces for and against change

To

Resistance Management

From

Change Management

Strength

moderate

Relationship

Managing resistance is central to all three stages of change; addressed through education, communication, participation, and support

To

Donabedian Framework

From

Quality Improvement

Strength

strong

Relationship

Donabedian's Structure-Process-Outcome model guides systematic evaluation of quality across three dimensions

To

PDSA Cycle

From

Quality Improvement

Strength

strong

Relationship

PDSA is the iterative engine of CQI; continuously tests, measures, and refines improvements

To

Root Cause Analysis

From

Quality Improvement

Strength

moderate

Relationship

RCA is a retrospective quality tool triggered by sentinel events; identifies system failures for corrective action

To

FMEA

From

Quality Improvement

Strength

moderate

Relationship

FMEA is a prospective quality tool that identifies and mitigates risks before failures occur, complementing RCA

To

Just Culture

From

Quality Improvement

Strength

moderate

Relationship

Just culture environment enables staff to report errors and near-misses without fear, supporting systems-based improvement

To

Prioritization

From

Staffing and Scheduling

Strength

moderate

Relationship

Staffing decisions must account for prioritized patient needs; higher acuity units need richer RN ratios

To

Care Delivery Models

From

Delegation

Strength

moderate

Relationship

Care delivery model defines how delegation is structured within the unit (functional vs. team vs. primary)

To

Staffing and Scheduling

From

Quality Improvement

Strength

moderate

Relationship

Quality outcomes (such as fall rates, CAUTI, medication errors) are nursing-sensitive indicators influenced by staffing adequacy and skill mix

To

Change Management

From

Conflict Resolution

Strength

moderate

Relationship

Conflict often arises during change; collaborative conflict resolution supports successful implementation of new practices