CH 1 Flashcards
Nursing care combines
Art and science
Nursing care
Provide specified care according to standards of practice and follows a code of ethics
[from novice to expert]
Novice
Beginning nursing student or any nurse entering a situation in which there is no previous level of experience the learner learns via a specific set of rules or procedures, which are usually stepwise and linear.
[from novice to expert]
Advanced beginner
-some experience in field
-nurse is able to identify meaningful aspects or principles of nursing care.
[from novice to expert]
Competent
A nurse who has been in the same clinical position for 2 to 3 years.
This nurse is a competent practitioner who is able to anticipate nursing care and establish long range goals.
In this phase the nurse has usually had experience with all types of psychomotor skills required by the specific group of patients.
[from novice to expert]
Proficient
-A nurse with 2 to 3 years of experience in the same clinical position.
-nurse perceives a patient’s clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation.
-This nurse focuses on managing care as opposed to managing and performing skills.
[from novice to expert]
Expert
-nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem.
-nurse is able to zero in on the problem and focus on multiple dimensions of the situation.
-nurse is skilled at identifying patient-centered problems and problems related to the healthcare system or perhaps the needs of the novice nurse.
What is ANA?
What is it concerned with?
American Nurses Association
The legal aspects of nursing
What is the ANA definition of nursing?
Nursing incorporates the art and science of caring and focuses on the protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassion. Nursing is the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations and recognition of the connection of all humanity.
What is the ICN definition of nursing?
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in sharing health policy and inpatient and health systems management, and education are also key nursing roles.
What is the nursing process?
Assessment, diagnosis, outcomes identification and planning, implementation and evaluation
What are nurses responsibilities in terms of autonomy and accountability?
-The initiation of independent nursing interventions without medical orders.
-Collaboration with other healthcare providers to develop the best treatment plan for patient.
-Accountability: professionally and legally responsible for type and quality of nursing care provided, including dependent, independent, and interdependent nursing actions.
What is a nurses role as a caregiver?
-Help patients maintain and regain health, manage disease and symptoms and attain a maximum level of function and independence through the healing process.
-Restore patient’s emotional, spiritual, and social well-being. Set outcomes and assist them in meeting said outcomes
What is a nurse’s role as a patient advocate?
To protect patients human and legal rights. Suggesting alternatives to care, securing your patients healthcare rights, and facilitating personal and cultural preferences.
What is the role of an advanced practice registered nurse (APRN)?
-Independently functioning nurse with a masters or doctorate degree in nursing -advanced education and pathophysiology, pharmacology, and physical assessment; and certification and expertise in a special area of practice.
What is a clinical nurse specialist (CNS)?
-An APRN who has graduate preparation in nursing
-is an expert clinician in a specialized area of practice.
-Clinical nurse specialists provide diagnosis, treatment, and ongoing management of patients in all healthcare settings.
What is a nurse practitioner (NP)?
-Provide primary, acute, and specialty health care to patients of all ages and in all types of healthcare settings.
-This care includes assessment, diagnosis, planning, and treatment; monitoring ongoing health status; evaluation of therapy; and health education.
What is a certified nurse-midwife (CNM)?
-Scope of practice encompasses a full range of primary health care services for women from adolescence beyond menopause.
-The nurse midwife conducts physical examinations; prescribes medication‘s, including controlled substances and contraceptive methods
-admits, manages, and discharges patients; orders and interprets laboratory and diagnostic tests; and orders the use of medical devices.
What is a certified nurse-anesthetist (CRNA)?
-Advanced education from accredited nurse anesthesia program.
-Practice autonomously and collaboratively.
-Before applying for anesthesia program, must have a one-year critical care or emergency experience.
What is a nurse educator?
-Responsible for competently educating future nurses
-A nurse educator that educates patients in agency such as personal behaviors that promote healing
– usually a specialized field (ex. certified diabetic nurse educator [CDE])
What is a nurse administrator?
-Responsible for management of nursing staff and healthcare agency.
-Functions of administrators include budgeting, staffing, strategic planning of programs and services, employee evaluation, and employee development.
What is a nurse researcher?
-Conducts evidence base practice, performance improvement, and research to improve nursing care and further define and expand the scope of nursing practice
-often works in academic setting, hospital, or independent professional or community service agency.
What is a core responsibility of a RN in regards to evidence-based practice?
-To make sound clinical judgments.
-identify the patient’s health problems, and know what actions to take.
-uses clinical judgment and critical thinking
-does not rely solely on information gained during education, always searches for the best scientific evidence to apply to recurrent patient health care problems.
Who is Florence Nightingale?
What is her role in nursing history?
-Establish the first nursing philosophy based on the knowledge of “how to put the body in such a state to be free of disease or to recover from disease“.
-improved the sanitary, nutritional, and basic conditions in battlefield hospitals
-the mortality rate at the barracks hospital in Scutari, turkey, was reduced from 42.7% to 2.2% in six months
What is Quality and Safety Education for Nurses (QSEN)?
(QSEN) project:
-preparing future nurses and advanced practice nurses to have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work.
In the USA who oversees the regulation of the scope of nursing practice?
-In the United States each State Board of Nursing oversees it’s Nurse Practice Act.
-The NPA regulates the scope of nursing practice for the state and protects public health, safety, and welfare.
-The definition of nursing practice published by the ANA is representative of the scope of nursing practice as defined in most states.
What us the EHR?
Electronic health record, method for documenting and managing patient healthcare information.
What is genomics?
Term that describes study of all genes in a person and interactions of these genes with one another and with that person‘s environment.
What is continuing education in nursing?
-Continuing education updates your knowledge about the latest research and practice developments
-helps you specialize in a particular area of practice, and teaches you new skills and techniques, all of which are crucial factors to improving patient care.
-Involves formal, organized educational programs offered by universities, hospitals, state nurse associations, professional nursing organizations, and educational and healthcare institutions.
What is in-service education?
-An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other healthcare professionals employed by the institution.
-Often in-service programs are focused on new technology such as how to correctly use the newest safety syringes.
-Many in-service programs are designed to fill required competencies of an organization.
-For example a hospital might offer an in-service program on safe principles for administering chemotherapy or a program on cultural sensitivity.
What does a profesional organization do?
-deals with issues of concern to those practicing in the profession.
-Some professional organizations focus on specific areas such as critical care, advance practice, maternal Child nursing, oncology, and nursing research.
-present educational programs and publish journals.
Thinking back on a recent clinical experience, which QSEN competencies in knowledge, skills, or attitudes did you use while providing care?
What impact do evidence based practice and emergent technologies have on high-quality patient centered care?
Help us provide competent care in line with the most up-to-date research and track patient care as effectively as possible?
[ANA standards of nursing]
Assessment
The registered nurse collects patient data and information relative to the healthcare consumers health or the situation
[ANA standards of nursing]
Diagnosis
The registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues
[ANA standards of nursing]
Outcomes identification
The registered nurse identifies expected outcomes for plan individualized to the healthcare consumer or the situation
[ANA standards of nursing]
Planning
The registered nurse develops a plan encompassing strategies to achieve expected outcomes
[ANA standards of nursing]
Implementation
The register nurse implements the identified plan
Coordination of care: the registered nurse coordinates care delivery.
Health teaching and Health promotion: the registered nurse employs strategies to teach and promote health and wellness.
[ANA standards of nursing]
Evaluation
The registered nurse evaluates progress toward attainment of goals and outcomes
[ANA standards of nursing]
Ethics
The registered nurse integrates ethics in all aspects of practice
[ANA standards of nursing]
Advocacy
The registered nurse demonstrates advocacy and all roles and settings
[ANA standards of nursing]
Respectful and equitable practice
The registered nurse practices with cultural humility and inclusiveness
[ANA standards of nursing]
Communication
The registered nurse communicates effectively in all areas of professional practice
[ANA standards of nursing]
Collaboration
The registered nurse collaborates with healthcare consumers and other key stakeholders
[ANA standards of nursing]
Leadership
The registered nurse leads within the professional practice setting and the profession
[ANA standards of nursing]
Education
The registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking
[ANA standards of nursing]
Scholarly Inquiry
The registered nurse integrate scholarship, evidence, and research findings into practice.
[ANA standards of nursing]
Quality of Practice
The registered nurse contributes to quality nursing practice
[ANA standards of nursing]
Professional Practice Evaluation
The register nurse evaluates one’s own and others’ nursing practice
[ANA standards of nursing]
Resource Stewardship
The registered nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and fiscally responsible and avoid waste.
[ANA standards of nursing]
Environmental Health
The registered nurse practices in a manner that advances environmental safety and health
[QSEN competency]
Patient centered care
-Recognize the patient as source of control and full partner in providing compassionate and coordinated care based on respect for patients preferences, values, and needs
-example involve family and friends in care, integrated understanding of patient, family, community preferences, values.
-Provide patient center care with sensitivity and respect for the diversity of the human experience.
[QSEN competency]
Teamwork and collaboration
Function effectively with a nursing in interprofessional team, fostering open communication, mutual respect, and share decision making to achieve high quality patient care
-ex. recognize the contributions of other individuals and groups helping patient/family achieve health goals. Discuss effective strategies for communicating and resolving conflict.
-Participate in designing systems to support effective teamwork
[QSEN competency]
Evidence-based practice
-Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal healthcare
-example demonstrate knowledge of basic scientific methods appreciate strengths and weaknesses of scientific bases for practice appreciate the importance of regularly reading relevant journals
[QSEN competency]
Quality improvement
-Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems.
-Ex. use tool such as flow charts and diagrams to make process of care explicit
-appreciate how unwanted variation and outcomes affects care.
-Identify gaps between local and best practices
[QSEN competency]
Safety
-Minimize risk of harm to patients and providers through both a system effectiveness and individual performance
-ex. examine human factors and other basic safety design principles as well as commonly used unsafe practices such as work around and dangerous abbreviations.
-Value own role in preventing errors
[QSEN competency]
Informatics
-Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making
-ex. navigate an electronic health record
-protect confidentiality of protected health information in electronic health records
You are on the patient safety committee at your hospital. Your assignment is to identify two resources related to safety. One resource must relate to the individual nurse, and the second must relate to the practice and work environment.
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation, you have your classmates read the Nursing Code of Ethics for professional registered nurses. Your instructor asked the class why this document is important. Which statement best describes this code?
1. Improve self-healthcare
2. Protect the patient confidentiality
3. Ensure identical care to all patients
4. Defines the principles of right and wrong to provide patient care.
- When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that to find the principles who are used to provide care to your patience. It serves as a guide for carrying out nursing responsibilities to provide quality nursing care an ethical obligations of the profession
- A nurse is caring for patient with end stage lung disease. Patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the operation to the family and discusses the patients wishes with them. The nurse is acting as the patient’s:
- educator
- advocate
- caregiver
- communicator
- an advocate protects the patients human and legal right to make choices about his or her care. An advocate may also provide additional info to help a patient decide whether or not to except a treatment or find an interpreter to help family members communicate their concerns
The nurse spend time with a patient and family reviewing a dressing change procedure for the patient’s room. The patient spouse demonstrates how to change the dressing. The nurse is acting in which professional role?
1. Educator
2. Advocate
3. Caregiver
4. Communicator
- The nurses is demonstrating the role of educator and exhibits concepts and facts about health, describes the reason for routine care activities, demonstrates procedure such as home care activities, reinforces learning or patient behavior, and evaluate patient progress and learning through return demonstration.
Examination for RN licensure is the same in every state in the United States. This examination:
1. Guarantees safe nursing care for all patients
2. Insures standard nursing care for all patients
3. Provides the minimal standard of knowledge for an RN in practice
4. Guarantees standardize education across all pre-licensure program
- RN candidates must pass the NCLEX-RN to attain licensure. Regardless of educational preparation, exam for RN licensure is exactly the same in every state in the US
Contemporary nursing requires that the nurse have knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply)
1. Caregiver
2. Autonomy
3. Patient advocate
4. Health promotion
5. Genetic counselor
1, 2, 3, 4 each of these roles or skills and clues activities for the professional nurse. Each of these is used in direct care or are part of professionalism that guys nursing practice.
- Match the advanced practice nurse specialty with the statement about the role
- Clinical nurse specialist
- Nurse anesthetist
- Nurse practitioner
- Nurse midwife
A. Provides independent care, including pregnancy and gynecological services
B. Expert clinician in a specialized area practice such as adult diabetes care
C. Provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions
D. Plans and delivers anesthesia and pain management to patients across the lifespan
Clinical nurse specialist: expert clinician in a specialized area of practice that as adult diabetes care. The role statements describe the activities performed of the role of the advanced practice nurse specialty. Typically see hospitalized patients with a specific type of illness or health problem.
Nurse anesthetist: provides car services under the supervision of an anesthesiologist. The role state describe the activities performed in the role of the advance practice nurse specially. Care for patients during surgical experience and administer anesthesia during pregnancy.
Nurse practitioner: provides comprehensive care, usually in a primary care setting, directly managing the medical care patients were healthy or have chronic conditions. The role statements describe the activities performed on the role of the advanced practice nurse specialty. Care for patients who are healthy or have minor acute or stable chronic conditions.
Nurse midwife: provides independent care, including pregnancy and gynecological services. The role statements describe the activities performed in the role of the advanced practice nurse specialty
- Healthcare reform will bring changes and emphasis of care. Which of these models is expected from healthcare reform?
- Moving from an acute illness to a Health promotion, illness prevention model
- Moving from an illness prevention to a Health promotion model
- Moving from hospital-based to community-based care
- Moving from an acute illness to a disease management models
- Healthcare reform also affects how healthcare is delivered there is a greater emphasis on health promotion, disease prevention, and management of illness
The nurse manager meets with the registered nursing staff about an increase in urinary tract infections in patients with a Foley catheter. The staff work together to review the literature on catheter-associated urinary tract infections (CAUTIs), identifies at-risk patients, and establishes new catheter care practices. This is an example of which QSEN competency?
1. Patient-centered care
2. Safety
3.Team work and collaboration
4. Quality improvement
- This is an example of the competency of teamwork and collaboration. This competency focuses on the nurse functioning effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality pt care.