chapter 1 Overview of Professional Nursing Concepts for Medical-Surgical Nursing Flashcards
Medical-surgical nursing
specialty practice area in which nurses promote, restore, or maintain optimal health for patients from 18 to older than 100 years of age
family
refers to the patient’s relatives and significant others in the patient’s life whom the patient identifies and values as important.
settings for med sure
acute care agencies, skilled nursing facilities, ambulatory care clinics, and the patient’s home, which could be either a single residence or group setting such as an assisted living facility.
The role of the nurse
care coordinator and transition manager, caregiver, patient educator, leader, and patient and family advocate
KSAs
knowledge, skills, attitudes, and abilities
The Institute of Medicine
highly respected U.S. organization that monitors health care and recommends health policy
Health Professions Education: A Bridge to Quality
identified five broad core competencies for health care professionals to ensure patient safety and quality care
Patient-Centered Care
“the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for [the] patient’s preferences, values, and needs”
family-centered care
emphasize the importance of including the patient’s support system as part of interprofessional collaboration.
Attributes of Patient-Centered Care
- Respect for patients’ values, preferences, and expressed needs
- Coordination and integration of care
- Information, communication, and education
- Physical comfort
- Emotional support and alleviation of fear and anxiety
- Involvement of family and friends
- Transition and continuity
- Access to care
Canadian nursing practice
includes culture from a safety perspective
integrative care model
increasing use of these therapies by consumers to maintain health and help manage chronic health issues
reflects nursing theories of caring, compassion, and holism to respect the diverse preferences and needs of patients and their families.
Care coordination
is the deliberate organization of and communication about patient care activities between two or more members of the health care team (including the patient) to facilitate appropriate and continuous health care to meet that patient’s needs
case management
process is to provide quality and cost-effective services and resources to achieve positive patient outcomes. In collaboration with the nurse, the CM coordinates inpatient and community-based care before discharge from a hospital or other facility.
Transition management
involves safe and seamless movement of patients among health care settings, health care providers, and the community for ongoing care to meet patient needs.
Medication reconciliation
is a formal evaluative process in which the patient’s actual current medications are compared to his or her prescribed medications at time of admission, transfer, or discharge to identify and resolve discrepancies.
This comparison addresses duplications, omissions, and interactions and the need to continue current medications.
Medication discrepancies
can cause negative patient outcomes, including rehospitalizations for medical complications.
Safety
is the ability to keep the patient and staff free from harm and minimize errors in care.
The scope of safety
can be described as unsafe, possibly causing harm or even death, or safe to prevent harm or negative outcomes.
Patient harm and errors generally occur as a result of
- Lack of clear or adequate communication among patient, family, and members of the interprofessional health care team
- Lack of attentiveness and patient monitoring
- Lack of clinical judgment
- Inadequate measures to prevent health complications
- Errors in medication administration
- Errors in interpreting authorized provider prescriptions
- Lack of professional accountability and patient advocacy
- Inability to carry out interventions in an appropriate and timely manner
- Lack of mandatory reporting
Best safety practices
reduce error and harm through established protocols, memory checklists, and systems such as bar-code medication administration
work-arounds
Working around safety systems is not acceptable and can increase the risk of error to patients and/or staff.
Nursing Safety Priority: Critical Rescue
emphasizes the need for action for potential or actual life-threatening problems.
Nursing Safety Priority: Action Alert
boxes focus on the need for action but not necessarily for life-threatening situations.
Nursing Safety Priority: Drug Alert
boxes specify actions needed to ensure safety related to drug administration, monitoring, or related patient and family education.
The Joint Commission (TJC) National Patient Safety Goals (NPSGs)
These goals require health care organizations to focus on specific priority safety practices, many of which involve establishing nursing and health system approaches to safe care.
culture of safety
provides a blame-free approach to improving care in high-risk, error-prone health care organizations using interprofessional collaboration.
adverse events
variations in the standard of care
sentinel event
is a severe variation in the standard of care that is caused by human or system error and results in an avoidable patient death or major harm.
To provide patient- and family-centered care, the nurse:
“functions effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care”
interprofessional health care team
includes the patient, family, nurses, unlicensed assistive personnel and other health professionals and their assistants needed to provide appropriate and safe, evidence-based care.
Teamwork four general competencies include:
- Values/Ethics for Interprofessional Practice
- Role-Responsibilities
- Interprofessional Communication
- Teams and Teamwork:
