CHAPTER 1 Flashcards
VALUE OF CERTIFICATION
- to patient and family - caring for them have demonstrated experience and knowledge (licensure)
exam) - to employers - nurse is committed to the discipline
- to nurses - with sense of professional pride achievement, and confidence
ORGANIZATIONS
- AAC (American Association of Critical Care Nurses)
- ANCC (American Nurses Credentiality Center)
- AANN (American Association of Nurse Practitioners)
- BCEN (Board of Certification for Emergency Nursing)
STANDARDS OF CARE FOR ACUTE AND CRITICAL CARE NURSING
A, D, O, P, I, E
Assessment
Diagnosis
Outcome identification
Planning
Implementation
Evaluation
STANDARD OF PROFESSIONAL PRACTICE
- Quality of care
- Individual practice evaluation - evaluates practices of staff
- Education - bachelor’s degree
- Collegiality - colleague or relationship
- Ethics
- Collaboration - with different departments
- Research - up-to-date
- Resource utilizations - respiratory therapist
CRITICAL CARE NURSING ROLES
- Staff nurse
- Nurse- Educator
- Nurse- Manager
- Case Manager
- Case Nurse Specialist
- Nurse Practitioner
- Nurse Researcher
no specialization; bedside nurses
Staff nurse
health teachings
Nurse-Educator
delegate, supervise, evaluate
Nurse- manager
work with the multi-disciplinary health care team to measure the effectiveness of case management plan and to monitor outcomes
Case manager
advanced degree or expertise and is considered to be an expert in specialized are of practice
Case nurse specialist
advance education and graduate of NP program acute care (hospital) primary care (clinic, hospice care) - they will diagnose or give prescription
Nurse practitioner
with advance or doctoral degree investigates nursing problems to improve nursing care to refine and expand
Nurse researcher
8 Critical Care Competencies
- Advocacy
- Clinical judgement
- Caring practice
- Collaboration
- Cultural diversity
- Education
- Clinical inquiry
- Systems thinking
working on others behalf or refer
Advocacy
decision making and critical thinking
Clinical judgement
activities that created compassionate, supportive, and therapeutic
Caring practice
intradisciplinary (within unit)
and interdisciplinary (outside unit)
Collaboration
Sensitivity to recognize differences
Cultural diversity
create practices changes through
research utilization and experiential learning
Clinical inquiry
allow the nurse to manage whatever environmental and system resources exist for the patient and family and staff
Systems thinking
Critical care multidisciplinary team
- Patient-care technician
- Physical therapist
- Occupational therapist
- Speech pathologist
- Wound, ostomy, and continence nurse (CNS)
- Dietician
- Pastoral caregiver
- Social services worker
- involves equipment
- provide direct and indirect health care to patients by ensuring the cleanliness of their rooms, assisting with medical treatments and basic daily needs, monitoring their health, and performing basic nursing procedures.
Patient- care technician
important part of preventive care, rehabilitation, and treatment for patients with chronic conditions, illnesses, or injuries
Physical therapist
evaluate and treat people who have injuries, illnesses, or disabilities. They help clients meet goals to develop, recover, improve, and maintain skills needed for daily living and working.
Occupational therapist
to prevent, assess, diagnose, and treat speech, language, social communication, cognitive communication, and swallowing disorders in children and adults.
Speech pathologist
provide highly-skilled acute and rehabilitative care to people with complex wounds, fecal or urinary ostomies, and incontinence.
Wound, ostomy, and continence nurse (CNS)
qualified to translate scientific information about nutrition and food into practical dietary advice
Dietician
refers to emotional, social and spiritual support
Pastoral caregiver
practice-based profession that promotes social change, development, cohesion and the empowerment of people and communities
Social services worker
EFFECTIVE CRITICAL CARE TEAM COMMUNICATION
(SBAR COMMUNITY TOOL)
- S- Situation - Introduce yourself, pt. details, location and purpose of call
- B- Background - Admission details, history, meds allergies, labs, current treatments
- A- Assessment - Subjective and objective
- R- Recommendation - Recommended response
COMMUNITY IDENTIFIES NEEDS OF FAMILY MEMBERS IN CRISIS
- Need to feel satisfied with the care given
- Need for caregivers who show an interest in how the family is doing
- Need to receive information about the pt. at least once a day, and assurance that someone will call the family with any changes
- Need for honest Information about the patient’s condition, including information about the patient’s progress
- Need to have understandable explanation of why things are being done
- Need to see the pt. frequently and be near the pt.
- Meet physical and emotional needs
NURSING INTERVENTIONS FOR FAMILY IN CRISIS
- Hope and confidence in the family’s ability to deal with situation
- Try to perceive feelings that the crisis evolves in the family
- Demonstrate concern about the pt. and family as well as the willingness to help
- Speak openly to patient and family about the critical illness.
How?
- Discuss all issues
- Avoid generalization
- Be honest
- Avoid false reassurance
- Ensure family receive information - Involve family in decision-making
- Advocate for the adjustments of visiting hours
- Palliative
- DNR
- Coma - Locate the space near the unit where the family can be alone and have privacy
- Recognize patient and family’s spirituality and may suggest assistance of pastoral caregiver or spiritual adviser if there is a need
Ethico-legal of critical care
- Autonomy
- Beneficence
- Non-maleficence
- Veracity
- Fidelity
- Justice
- Negligence
It is the concept that each person has the right to make independent choices and decisions.
It is reflected in guidelines and laws regarding patient rights and self determination.
Autonomy
It is the duty of any health care provider to actively do good for patients.
Beneficence
upholds measures to avoid causing harm, minimize har, and correct harmful situations for patients in any form
Non-maleficence
being completely truthful with clients, families, and coworkers.
Veracity
implies the quality or state of being loyal or faithful and exhibiting faithfulness to commitments, beliefs, or causes.
Fidelity
there is an equitable distribution of social benefits and burdens in society.
Justice
failing to act as a reasonably prudent person would under the circumstances
Negligence
must be voluntary by a competent adult and understood condition and possible treatment
Inform consent
Use of restrain (Physical)
- Least restrictive or safest environment
- Should only be use in clinically situation
- Pt. must always evaluate
- Must be documented in medical record
- Pt. should be monitored
- Pt. and SO should receive education
