ANCC NE-BC cheat sheet

Thomas-Kilmann conflict modes: competing (high assertiveness/low cooperativeness), collaborating (high/high), compromising (mid/mid), avoiding (low/low), accommodating (low assertiveness/high cooperativeness).

Possible two-way communication channels in a group = n(n − 1) ÷ 2, where n = number of members; a 5-person team has 10 channels, a 10-person team has 45.

SBAR handoff structure: Situation, Background, Assessment, Recommendation - used for shift reports, provider calls, and rapid-response escalation.

Tuckman group development sequence: forming → storming → norming → performing → adjourning; direction and structure needs are highest in forming/storming.

Goleman emotional intelligence domains: self-awareness, self-management, social awareness, relationship management.

Just culture decision rule: human error → console; at-risk behavior → coach and remove incentive; reckless behavior → sanction or discipline.

Principled negotiation (Fisher & Ury): separate the people from the problem, focus on interests not positions, invent options for mutual gain, insist on objective criteria.

Escalation tools for safety concerns: CUS (Concerned, Uncomfortable, Safety) and the two-challenge rule; DESC (Describe, Express, Specify, Consequences) for confrontation.

Interprofessional collaboration is measured through shared decision-making structures such as shared governance councils, multidisciplinary rounds, and documented care-pathway participation.

Transformational leadership = the 4 I's: idealized influence, inspirational motivation, intellectual stimulation, individualized consideration.

Situational leadership (Hersey-Blanchard) matches style to follower readiness: directing (low readiness), coaching, supporting, delegating (high readiness).

Five rights of delegation: right task, right circumstance, right person, right direction/communication, right supervision/evaluation.

Lewin change model: unfreezing → movement → refreezing; force-field analysis compares driving forces against restraining forces before implementing change.

Kotter 8 steps: urgency, guiding coalition, vision, communicate vision, remove barriers, short-term wins, build on change, anchor in culture.

Magnet model components (ANCC): transformational leadership, structural empowerment, exemplary professional practice, new knowledge/innovation/improvements, empirical quality outcomes.

Span of control = number of direct reports per manager; wide spans flatten cost and autonomy but reduce coaching time; narrow spans increase oversight and management overhead.

Simon's bounded rationality: managers often satisfice (choose the first acceptable option) rather than optimize; rational decision models assume complete information.

Eisenhower matrix prioritization: urgent + important = do now; important but not urgent = schedule; urgent but not important = delegate; neither = eliminate.

IOM/NAM six aims for improvement: safe, effective, patient-centered, timely, efficient, equitable.

Donabedian quality triad: structure (resources, staffing, equipment) → process (what is done) → outcome (results, including nursing-sensitive indicators).

ANA Code of Ethics contains 9 provisions; provision 3 addresses protection of patient rights and provision 4 addresses accountability for nursing judgment.

PICOT question = Population, Intervention, Comparison, Outcome, Time; Level I evidence is a systematic review or meta-analysis of randomized controlled trials.

Improvement methodologies: PDSA/PDCA (rapid-cycle small tests), Six Sigma DMAIC (reduce variation), Lean (remove waste), FMEA (prospective failure risk).

RCA is retrospective after a sentinel event; FMEA is prospective before a process change. Sentinel events trigger immediate investigation and disclosure.

NDNQI nursing-sensitive indicators: falls and fall injuries, pressure ulcers, CAUTI, CLABSI, ventilator-associated events, restraint prevalence, skill mix and RN turnover.

AACN healthy work environment standards: skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, authentic leadership.

QSEN pre-licensure competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, informatics.

Key regulations: EMTALA (stabilizing emergency care regardless of ability to pay), HIPAA (privacy/security), OSHA (workplace safety and bloodborne pathogens).

1.0 FTE = 40 hours/week = 2,080 paid hours/year; annual FTE = total paid hours ÷ 2,080.

Hours per patient day (HPPD) = total nursing hours worked ÷ total patient days; required FTE = (HPPD × average daily census × 365) ÷ 2,080.

Break-even volume = fixed costs ÷ (price per unit − variable cost per unit).

Variance = actual − budget; expense under budget = favorable, revenue under budget = unfavorable; variance % = variance ÷ budget.

Capital decisions compare ROI = (net gain ÷ investment cost) × 100, payback period (shorter is better), and net present value (positive NPV = accept).

Balanced scorecard (Kaplan & Norton) perspectives: financial, customer, internal process, learning and growth.

Prospective payment: Medicare pays a fixed DRG rate per discharge; readmissions, never events, and HACs may reduce or eliminate payment.

Benefits typically load 25–30% above base salary; contract/agency labor carries a premium that increases cost per patient day.

Productive hours are worked hours; nonproductive hours (vacation, sick, education, orientation) are budgeted separately and still count as paid FTE.