ATI RN LEADERSHIP PROCTORED FOCUS
REVIEW
Chapter 1, Managing client care:
• Prioritizing client care o Systemic before local o Acute before chronic o Actual
problems before potential ones o Listen carefully to clients and do not assume o
Recognize and response to trends vs transit findings
o Recognize indications of medical emergencies and complications vs expected
findings
o Apply clinical knowledge to procedural standars to determine the priority action
• Client care assignments o Assigning is performed in a downward or lateral manner with
regard to members of the healthcare team
o Client factors are:
Condition of client and level of care needed
Specific care needs such as cardiac monitoring or ventilation mechanical
Special precaution needs such as isolation or fall precautions or seizures,
procedures requiring time commitments
o Health care team factors:
Knowledge and skill levels of the team members
Supervision that is necessary
Nurse to client ratio
Experience with similar clients
Familiarity of staff member with unit o Additional factors;
If receiving an unsafe assignment the nurse should bring the unsafe
assignment to the attention of the scheduling charge nurse and negotiate
new assignment, if the issue is not resolve, take the concern up the chain
of command
Nurse should file a written protest to the assignment such as an
assignment despite objection (ADO) or document of practice situation
(DOPS) with the appropriate administratior
If not follow proper failure to accept the assignment following proper
channels could be considered client abandonment.
o Delegations to an assistive personnel
ADLS
Bathing, dressing, toileting, ambulating, feeding if pt has no problems
with swallowing
Positioning
Routine task, bed making
Specimen colletion
REVIEW
Chapter 1, Managing client care:
• Prioritizing client care o Systemic before local o Acute before chronic o Actual
problems before potential ones o Listen carefully to clients and do not assume o
Recognize and response to trends vs transit findings
o Recognize indications of medical emergencies and complications vs expected
findings
o Apply clinical knowledge to procedural standars to determine the priority action
• Client care assignments o Assigning is performed in a downward or lateral manner with
regard to members of the healthcare team
o Client factors are:
Condition of client and level of care needed
Specific care needs such as cardiac monitoring or ventilation mechanical
Special precaution needs such as isolation or fall precautions or seizures,
procedures requiring time commitments
o Health care team factors:
Knowledge and skill levels of the team members
Supervision that is necessary
Nurse to client ratio
Experience with similar clients
Familiarity of staff member with unit o Additional factors;
If receiving an unsafe assignment the nurse should bring the unsafe
assignment to the attention of the scheduling charge nurse and negotiate
new assignment, if the issue is not resolve, take the concern up the chain
of command
Nurse should file a written protest to the assignment such as an
assignment despite objection (ADO) or document of practice situation
(DOPS) with the appropriate administratior
If not follow proper failure to accept the assignment following proper
channels could be considered client abandonment.
o Delegations to an assistive personnel
ADLS
Bathing, dressing, toileting, ambulating, feeding if pt has no problems
with swallowing
Positioning
Routine task, bed making
Specimen colletion
