The core of leadership is awareness. The text by Don Miguel, The Four Agreements, presents a set of agreements to enhance p awareness. What is NOT one of the four agreements?

A. Nurse-patient ratios refer to the number of patients assigned to a nurse at any given time. While maintaining optimal nurse-patient ratios is crucial for patient care quality and nurse workload management, it is not directly related to the concept of intellectual capital.
B. Centralized staffing involves managing staffing needs and scheduling from a central point to ensure coordination and efficiency across departments. While centralized staffing can improve organizational efficiency and care coordination, it does not directly address the concept of increasing overall organizational improvement through intellectual capital.
C. According to the NIC Theory, intellectual capital is crucial for improving organizational performance. An increase in knowledge—whether at the individual, group, or organizational level—directly contributes to overall improvement. Enhanced knowledge and skills among nursing staff lead to better decision-making, innovation, and overall quality of care, thereby positively impacting organizational outcomes.
D. Adherence to budget-based staffing involves staffing levels and allocation based on budgetary constraints. While important for financial management and resource allocation, budget-based staffing does not directly relate to the concept of increasing organizational improvement through intellectual capital.

A. Discharge planning should start as soon as the client is admitted to the facility. Early planning helps anticipate and address the patient’s needs and ensures that all necessary arrangements for post- discharge care are made well in advance.
B. Starting discharge planning 48 hours before discharge is generally too late. Effective discharge planning requires more time to coordinate care, education, and resources. Beginning the process 48 hours before discharge may not allow enough time to address all aspects of the plan adequately, potentially leading to issues in the transition.
C. Waiting for insurance approval before starting discharge planning can lead to delays and may not be in the best interest of the patient. Discharge planning should be initiated based on the patient’s needs rather than insurance coverage. Waiting for approval can also disrupt the timeline for arranging follow- up care and services.
D. Waiting until the discharge order is written is too late for effective discharge planning. By the time the discharge order is written, many elements of the discharge plan should already be in place. Waiting until this point can lead to rushed arrangements and potentially inadequate preparation for the patient’s needs after leaving the facility.