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chapter 4 Flashcards

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1
Q

Scopes and Standards of Practice

A

Describe a competent level of nursing care
The levels of care are demonstrated through the nursing process
The nursing process is the foundation of clinical decision making and includes all significant actions taken by nurses in providing care to clients
Within these are the nursing responsibilities for diversity, safety, education, health promotion, treatment, self care, and planning for the continuity of care

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2
Q

Standards of Care

A

Standards of care are important if a legal dispute arises over whether a nurse practiced appropriately in a particular case
Nursing standards of care pertain to professional nursing activities that are demonstrated by the nurse through the nursing process
These involve assessment, diagnosis, outcome identification, planning implementation, and evaluation.
The nursing process is the foundation of clinical decision making and encompasses all significant action taken by nurses in providing care to all consumers

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3
Q
  1. assessment
A

The nurse collects comprehensive data pertinent to the patient’s health or situation

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4
Q

assessment-measurement criteria

A

Collects data in a systematic and ongoing process
Data collection involves the patient, significant others, and health care providers, as appropriate
Prioritizes data collection activities based on the patient’s immediate condition or needs
Collects and documents pertinent data using appropriate assessment techniques

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5
Q
  1. Nursing Diagnosis
A

The nurse analyzes the assessment data to determine the diagnoses or health issues

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6
Q

nursing diagnosis-measurement criteria

A

Derives nursing diagnoses from the assessment data
Validates the diagnoses with patient, significant others, and health care providers, when possible
Documents diagnoses in a manner that facilitates the determination of expected outcomes and plan of care

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7
Q
  1. Outcomes Identification
A

The nurse identifies expected outcomes for a plan individualized to the patient or the situation

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8
Q

outcomes id-measurement criteria

A

Derives outcomes from the nursing diagnosis
Formulates outcomes mutually with the patient and other health care providers, when possible
Outcomes are culturally appropriate and realistic in relation to the patient’s present and potential capabilities
Defines expected outcomes in terms of the patient, patient values, ethical considerations, environment, or situation with such considerations as associated risks, benefits, costs, current scientific evidence, and clinical expertise when formulating expected outcomes
Outcomes are attainable in relation to resources available to the person
Outcomes include a time estimate for attainment for expected outcome
Outcomes provide direction for continuity of care
Modifies expected outcomes based on changes in the status of the patient or evaluation of the situation
Documents outcomes as measureable goals

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9
Q
  1. planning
A

The nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes

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10
Q

planning-measurement criteria

A

Measurement Criteria
The plan is individualized to the patient and patient’s condition or needs
Plan is developed with the patient, significant others, and health care providers, when appropriate
Includes strategies within the plan that address each of the identified diagnosis or issues, which may include strategies for promotion and restoration of health and prevention of illness, injury , and disease
Provides for continuity within the plan
Incorporates an implementation pathway or timeline within the plan
Utilizes the plan to provide direction to other members of the health care team
Defines the plan to reflect current status, rules, and regulations and standards
Integrates current trends and research affecting care in the planning process
Considers the economic impact of the plan
Uses standardized language or recognized terminology to document the plan

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11
Q
  1. implementation
A

The nurse implements the identified plan of care

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12
Q

implementation-measurement criteria

A

Interventions are consistent with the established plan of care
Implements interventions in a safe and appropriate manner, documents interventions
Utilizes evidence based interventions and treatments specific to the diagnosis or problem
Collaborates with nurse colleagues to implement the plan
Utilizes community resources and systems to implement the plan

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13
Q

5a. coordination of care

A

The registered nurse coordinates care

delivery

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14
Q

5B. Health teaching and health promotion

A

nothing

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15
Q

5C. Consultation

A

The advanced practice registered nurse and the nursing role specialist provide consultation to influence the identified plan, enhance the abilities of others and effect change

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16
Q

5D. Prescriptive Authority and Treatment

A

The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with the state and federal laws and regulations

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17
Q
  1. Evaluation
A

The nurse evaluates progress towards attainment of outcomes

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18
Q

evaluation-measurement criteria

A

Evaluation is systematic, ongoing and criterion based
Involves the patient, significant others, and the health care providers in the evaluation process, when appropriate
Uses ongoing assessment data to revise diagnoses, outcomes and plan of care as needed
Documents revisions in diagnoses, outcomes, and the plan of care
Evaluates the effectiveness of interventions in relation to outcomes
Documents the patient’s response to interventions

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19
Q

Nursing Standards: An Asset

A

To ensure quality of care, the nursing care needs standards
Standards are a degree of excellence
The aim of standard nursing care is to support and contribute to excellent practices
The role of the nurse is constantly changing to meet the growing needs of health services

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20
Q

Objectives of Nursing Standards of Care

A

Plan
Holistic approach
Appropriate nursing diagnosis
Realistic goals
Quality care rather than quantity of care
Economic use of time, materials, and energy

21
Q

Types of Standard Care

A

Structure: Things we use

Process: Things we do

Outcome: Results of what we do

22
Q

Characteristics of Standards of Care

A

Dynamic

Reflective of Change

Non Static

23
Q

Summary1

A

Standard: Nursing practice requires that a conceptual model for nursing be the basis for the independent part of that practice.
Elements: Nurses are required to have a clear idea of the distinct goal of nursing, the patient, the health needs of the society, the source of client difficulty, the focus, and the models of nursing interventions and the expected consequences of nursing activities

24
Q

Summary2

A

Standard: Nursing practice requires the effective use of the nursing process
Elements: Nurses are required to collect data in accordance with their conception of the goal of nursing, client, the source of client difficulty based on conceptual models for nursing

25
Q

Summary3

A

Standard: Nursing practice requires that the helping relationship be the nature of the client-nurse relationship
Elements: Nurses are required to increase the likelihood that the client will perceive the health service experiences as understandable, manageable, and meaningful at the onset. Nurses are required to ensure a successful termination of the helping relationship

26
Q

Summary4

A

Standard: Nursing practice requires nurses to fulfill professional responsibilities
Elements: Nurses are required to respect status and policies relevant to the profession and the practice setting. Nurses are required to comply with the Nursing Code of Ethics to their profession. Nurses are required to function as members of a health care team

27
Q

ANA Standards of Practice Conclusion

A

Nursing Standards of Care pertain to professional nursing activities that are demonstrated by the nurse through the nursing process.
The process involves assessment, diagnosis, outcome identification, planning, implementation, and evaluation
The nursing process is the foundation of clinical decision making and encompasses all significant nursing action taken by nurses in providing care to all consumers.

28
Q

Nursing Standards of Professional Performance

A

Nursing Standards of Professional Performance describes a competent level of nursing behavior in the professional role, including activities related to the quality of care, performance appraisal, education, collegiality, use of theory and ethnics, collaboration, research, and resource utilization.

29
Q

Nursing Standards of Professional Performance2

A

While Nursing Standards of Professional Performance describes the roles of all professional nurses, there are many other responsibilities that are hallmarks of professional nursing. Nurses need to be self directed and purposeful in seeking necessary knowledge and skills to enhance career goals.
Membership in professional organizations, certification in specialty, or advanced practice, and continuing education are desirable methods of enhancing nursing professionalism.
Accountability for one’s practice as a professional nurse rests with the individual nurse.

30
Q

Standards of Professional Performance3

A

The ANA Standards of Professional Performance describes a competent level of behavior in the professional role, including activities related to quality of care, performance appraisal, education, collegiality, ethics, collaboration, research, and resource utilization.
It serves as objective guidelines for nurses to be accountable for their actions, their patients, and their peers.
It provides a method to assure clients are receiving high quality care and assists the nurse in knowing exactly what is necessary to provide nursing care.

31
Q
  1. quality of practice
A

The Registered nurse systematically enhances the quality and effectiveness of nursing practice.

32
Q

quality of practice-measurement criteria

A

Demonstrates quality by documenting the application of the nursing process in a responsible, accountable, and ethical manner
Uses quality improvement activities to initiate changes in nursing practice and health care delivery system
Uses creativity and innovation to improve nursing care delivery
Incorporates new knowledge to initiate changes in nursing practice if desired outcomes are not achieved
Participates in quality improvement activity

33
Q
  1. education
A

The nurse attains knowledge and competency

that reflects current nursing practice

34
Q

education-Measurement Criteria

A

Participates in ongoing educational activities related to clinical knowledge and professional issues
Demonstrates commitment to life long learning
Seeks experiences to maintain clinical skills
Seeks knowledge and skills appropriate to the practice setting
Maintains professional records that provide evidence of competency

35
Q
  1. professional practice evaluation
A

The nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations, and lifelong learning

36
Q

professional practice evaluation-measurement criteria

A

Engage in self evaluation on a regular basis
Seeks constructive feedback regarding one’s own practice
Takes action to achieve goals identified during the evaluation process
Participates in systematic peer review as appropriate
Practice reflects knowledge of current practice standards, laws, and regulations
Provides age appropriate care in culturally and ethnically sensitive manner

37
Q
  1. collegiality
A

The nurse interacts with and contributes to the professional development of peers and other health care providers as colleagues.

38
Q

collegiality-measurement criteria

A

Shares knowledge and skills with peers and colleagues
Provides peers with feedback regarding their practice
Interacts with peers and colleagues
To enhance one’s own professional nursing practice
Maintains compassionate and caring relationships with peers and colleagues
Contributes to an environment that is conducive to clinical education with nursing students, as appropriate
Contributes to a supportive and healthy work environment

39
Q
  1. collaboration
A

The nurse collaborates with patient, family, and others in the conduct of nursing practice

40
Q

collaboration-measurement criteria

A

Communicates with the patient, significant others, and health care providers regarding patient care and nursing’s role in the provision of care
Collaborates with the patient, family, and other health care providers in the formulation of overall goals, and plan of care in the decisions related to care and delivery of services
Partners with others to effect change and generate positive outcomes
Document referrals, including provisions for continuity of care, as needed

41
Q
  1. ethics
A

The nurse integrates ethical provision in all areas of practice

42
Q

ethics-measurement criteria

A

Practice guided by Code of Ethics for nurses with interpretive statement
Maintains therapeutic and professional patient-nurse relationship
Delivers care in the manner that preserves patient autonomy, dignity, and rights
Seeks available resources in formulating ethical decisions
Reports illegal, incompetent, or impaired practice
Maintains patient confidentiality within legal and regulatory parameters

43
Q
  1. research
A

The nurse integrates research findings in practice

44
Q

research-measurement criteria

A

Utilize best available evidence including research findings to guide practice decisions
Participates in research activities as appropriate to the nurse’s education and position
Identifies clinical problems suitable for nursing research
Participates in data collection, unit organization, or community research committees.
Shares research activities with others, critiques research for application to practice, and uses research findings in the development of policies, procedures, and practice guidelines for patient care.

45
Q
  1. resource utilization
A

The nurse considers factors related to safety, effectiveness, cost, and impact on practice in the planning and delivery of nursing services.

46
Q

resource utilization-measurement criteria

A

Evaluates factors related to safety, effectiveness, availability, and cost when practice options would result in the same expected patient outcome
Assists the patient and family in identifying and securing appropriate and available services to address health related needs
Assigns or delegates tasks as defined by the state nurse practice acts and according to the knowledge and skills of the designated care giver
Assigns or delegates tasks based on the needs and condition of the patient, the potential for harm, the stability of the patient’s condition, and complexity of the task and the predictability of the outcome
Assists the patient and family in becoming informed consumers about the costs, risks, and benefits of treatment and care

47
Q
  1. leadership
A

The nurse provides leadership in the professional practice setting and the profession

48
Q

leadership-measurement criteria

A

Engages in team work
Works to create and maintain a healthy work environment
Teach others to succeed through mentoring
Exhibits creativity and flexibility during changes
Directs coordination of care across settings and care givers
Serves in key roles in the work settings by participating on committees, councils, and administrative duties
Promotes advancement of the profession
Displays the ability to define a clear vision, the associated goals, and a plan to implement and measure progress
Demonstrates energy, excitement, and a passion for quality work
Willingly accepts mistakes by self and others, thereby creating a culture in which risk taking is not only safe, but expected

49
Q

nursing code of ethics

A

Nursing has a code of ethics that defines the principles by which nurses provide care to their clients.
Nurses must incorporate their own values into their practice.
The code of ethics for nurses with interpretive statements provides a guide for carrying out nursing responsibilities that provide quality nursing care and provides for the ethical obligations of the profession

nursing theory (3 decks)

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