Chapter 1 Professional Nursing Practice Exam 1 Flashcards
Domain: As a nurse you?
(1) offer skilled care to those recuperating from illness or injury
(2) advocate for patients’ rights
(3) teach patients to manage their health
(4) support patients and their caregivers at critical times
(5) help them navigate the complex health care system.
The American Nurses Association (ANA) states that the authority for the practice of nursing is based on a contract with society that acknowledges?
professional rights and responsibilities, as well as mechanisms for public accountability
In 1980 the ANA defined nursing as
“the diagnosis and treatment of human responses to actual and potential health problems”
-In this context, your care of a person with a fractured hip would focus on the patient’s possible responses to impaired mobility, pain, and loss of independence.
An advanced practice registered nurse (APRN) is a nurse educated at the?
master’s or doctoral level, with advanced education in pathophysiology, pharmacology, and health assessment and expertise in a specialized area of practice.
APRNs include?
clinical nurse specialists, nurse practitioners, nurse midwives, and nurse anesthetists.
APRNs play a vital role in the health care delivery system. In addition to managing and delivering direct patient care, APRNs have roles in?
leadership, quality improvement, evidence-based practice, and informatics
The doctor of nursing practice (DNP) degree is a practice-focused terminal nursing degree. By raising the educational preparation for APRNs to the doctoral level, nursing is moving in the same direction as other health professions that offer practice doctorates (e.g., pharmacy [PharmD], physical therapy [DPT]). Nurses with a research-focused doctorate (PhD) typically serve as?
faculty in schools of nursing, policy analysts, and researchers. However, they are being increasingly used in health care settings as clinical experts, researchers, and health care system executives.
Healthy People 2020 Overarching Goals
- Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
- Achieve health equity, eliminate disparities, and improve the health of all groups.
- Create social and physical environments that promote good health for all.
- Promote quality of life, healthy development, and healthy behaviors across all life stages.
Key Messages for the Future of Nursing
- Nurses should practice to the full extent of their education and training.
- Nurses should achieve high education and training through an improved education system that promotes seamless academic progression.
- Nurses should be full partners with physicians and other health professionals in redesigning health care.
- Effective workforce planning and policy making require better data collection and information infrastructure.
Patient centered care: Recognize the patient and caregiver as full partners in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs
Knowledge, Skills, and Attitudes
• Provide care with sensitivity and respect, taking into consideration the patient’s perspectives, beliefs, and cultural background
• Assess level of comfort and treat appropriately
• Engage the patient in an active partnership that promotes health, well-being, and self-care management
• Facilitate patient’s informed consent for care
Occupational therapist (OT) May assist patient with?
fine motor coordination, performance of activities of daily living, cognitive-perceptual skills, sensory testing, and the construction or use of assistive or adaptive equipment
The Five Rights of Delegation
The registered nurse uses critical thinking and professional judgment to be sure that the delegation or assignment is:
- The right task
- Under the right circumstances
- To the right person
- With the right directions and communication
- Under the right supervision and evaluation
Right Task
Description
Questions to ask
- Description: One that can be delegated for a specific patient
- Questions to ask: Is it appropriate to delegate based on legal and agency factors? Has the person been trained and evaluated in performing the task? Is the person able and willing to do this specific task?
Right Circumstances
Description
Questions to ask
- Description: Appropriate patient setting, available resources, and considering relevant factors, including patient stability
- Questions to ask: What are the patient’s needs right now?nIs staffing such that the circumstances support delegation strategies?
Right Person
Description
Questions to ask
- Description: Right person is delegating the right task to the right person to be performed on right person
- Questions to ask: Is the prospective delegatee a willing and able employee?n Are the patient needs a “fit” with the delegatee?
Right Directions and Communication
Description
Questions to ask
-Description: Clear, concise description of task, including its objective, limits, and expectations
-Questions to ask: Have you clearly communicated the task? With directions, limits, and expected outcomes?
Does the delegatee know what and when to report? Does the delegatee understand what needs to be done?
Right Supervision and Evaluation
Description
Questions to ask
- Description: Appropriate monitoring, evaluation, intervention, and feedback
- Questions to ask: Do you know how and when you will interact about patient care with the delegatee? How often will you need to provide direct observation? Will you be able to give feedback to the staff member if needed?
National Patient Safety Goals
Goal 1: Identify patients correctly.
Advanced Practice Nurse
nurse with a master’s degree in nursing, advanced education in pharmacology and physical assessment, and expertise in a specialized area of practice; includes clinical nurse specialist, nurse practitioner, nurse midwife, and nurse anesthetist.
Case management
Collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals health needs through communication and available resources to promote quality and cost effective outcomes
clinical (critical) pathway
directs the entire health care team in the daily care goals for select health care problems. It includes a multidisciplinary care plan, goals and interventions specific for each day of hospitalization, and a documentation tool.
clinical reasoning
Problem-solving activity in which you use critical thinking to examine patient care issues.
collaborative problems
Actual or potential health problem that may occur from complications of disease, diagnostic studies, or the treatment regimen; the nurse works together with other members of the healthcare team toward its resolution.
concept map
Another way of recording a nursing care plan. Is a visual representation of client data and interventions that shows their relationships to one another
critical thinking
knowing how to learn, reason, think creatively, generate idea,s make decisions and solve problems.
delegation
Transferring authority and responsibility to another person to carry out specific activities.
electronic health record (EHR)
Info. includes patient demography, progress notes, problems, medications, vital signs, past medical history, immunizations, lab results, and radiology reports.
evidence based practice
A problem solving approach to making clinical decisions, using the best evidence available (considered “best” because it is collected from sources such as published research, national standards and guidelines, and reviews of targeted literature).
Healthy People
A nationwide health promotion and disease prevention plan designed to serve as a guide for improving the health of all people in the United States
nursing(as defined by the ANA in 1980)
Diagnosis and treatment of human responses to actual and potential health problems.
nursing informatics
the science of using computer information systems in the practice of nursing
nursing process
A decision making problem-solving process-to provide efficient and effective care to patients.
telehealth
use of communication technologies & electronic info to provide or support health care when pt separated by distance
unlicensed assistive personnel
Help nurses provide direct care to patients; titles include nurisng assistnants, orederlies, attendants, or technicians.
What are the influences on the professional nursing practice?
Expanding knowledge and technology, diverse populations including patients with chronic illness, and consumerism.
HMO (Health maintenance organization)
A prepaid health insurance plan in which patients receive health care from designated providers
PPO (Preferred provider organization)
A prepaid health insurance plan in which providers agree to deliver services for discount fees; patients can go to any provider, but using nonparticipating providers results in higher costs to the patient
HIPAA
The Health Insurance Portability and Accountability Act, a federal law protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed.
QSEN
QUALITY AND SAFETY EDUCATION FOR NURSES: the competencies of patient centered care, team work and callaboration, evidence based practice, quality improvement, safety, teamwork/collaboration.
IOM
Institute of Medicine of the National Academies; a nonprofit organization created to provide unbiased, evidence based and authoritative information and advice concerning health and science policy
Team nursing model
RN functions as a TEAM LEADER & COORDINATES a SMALL GROUP
Total patient care model
RN-aka case nursing- nurse is responsible for all care of patient, or group of patients.
Primary Nursing Model
Care delivery model. Primary nurse responsible for total patient care 24 hrs/day (or over a period of time).
Two main purposes of NANDA-I (North American Nursing Diagnosis Association International) are:
To develop a diagnostic classification system or taxonomy (nursing terminologies); and to identify and accept nursing diagnosis.
NOC ( Nursing outcome classifications)
A list of concepts, definitions and measures that describe patient outcomes described by nursing interventions.
NIC (Nursing intervention Classification)
interventions, which are grouped into 30 classes and seven domains: basic, physiological, behavioral, safety, family, health systems, and community
NANDA-NOC-NIC Linkages
Linkages can be used together to assist in determination of a nursing diagnosis, projection of a desired outcome, and selections of interventions to achieve desired outcome.
CPOE
Computerized Physician Order Entry. It eliminates errors caused by transcription of hand written or verbal orders.
CIS
clinical information system
TJC
The Joint Commission- accredits hospitals and other health care organizations sets the standards for patient care while in hospital.
PICOT or PICO
The five components of an evidence-based question: patient population of interest, intervention of interest, comparison of interest, outcome of interest, and time.
NPSG
National Patient Safety Goals
independent nursing action
Include interventions such as promotion and optimization of health, prevention of illness, and patient advocacy.
dependent nursing action
An action that requires a physician’s order before it can be legally carried out
How does EBP improve student knowledge, skills and behavior? (student handbook p. 15)
I helps us learn to ask questions, search for evidence, and apply critical appraisal techniques that influence and direct nursing practice.
Autonomous nursing
engaging in the practice of nursing independetly, without external supervision
collaborative nursing function
Demonstrated when the nurse monitors patients for complications of acute illness, administers IV fluids and medications per physician or nurse practitioner orders, and implements nursing interventions such as providing emotional support or teaching about specific procedures.
RCTs
Randomized controlled trials: draws conclusions about the effects of health care interventions
