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N 108 Nursing Transition > Chapter Four > Flashcards

Chapter Four Flashcards

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1
Q

What does the NCSBN state about Evidence Based Practice?

A

The NCSBN, states that EBP is the “integration of the best research with clinical expertise and patient values.”
The use of current best evidence in making decisions about patient care
A problem solving approach to clinical practice and administrative issues that integrates:
A systematic search for and critical appraisal of the most relevant evidence to answer a burning clinical question
One’s own clinical expertise
Patient preferences and values

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2
Q

What is the definition of evidence based practice?

A

Application of current and best evidence, clinical expertise, and patient values integrated in the deliverance of safe and quality patient centered care.

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3
Q

Evidence-Based Nursing

LEVEL A

A

LEVEL A:
Randomized control trials
Systematic reviewormeta-analysis
Clinical practice guidelines

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4
Q

Evidence-Based Nursing

LEVEL B

A 
Level B 
Well-designed control trials without randomization
Clinical cohort study
Case-controlled study
Uncontrolled study
Epidemiological study
Qualitative study/quantitative study
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5
Q

Evidence-Based Nursing

LEVEL C

A

Level C
Consensus viewpoint and expert opinion
Meta-synthesis

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6
Q

The Purpose of Evidence Based Practice

A

To take research out of the sphere of academia and into real-world settings.
Understand why something works and how itappliesto a patient’s situation.
Quality improvement data and expert opinion

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7
Q

The process of Evidence-based research (EBR)

A

What is the research question?
Patient population being examined & interventions considered
Accessing the research literature
accessing of the research literature, and the tools for critical analysis of the reports
The sample
The sample is critically evaluated using stringent standards [e.g. the Consolidated Standards of Randomized Trials (CONSORT)
The data
The data from separate reports are pooled, analyzed for acceptability
The last step
summarizes the process and the findings.

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8
Q

Nursing Research Goals

The registered nurse shall

A

Recognize the value of research
Utilize resources
Participating in committees/unit based activities to improve quality safety / cost effective care
Collaboration
Patient/family satisfaction as a key determinant of quality

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9
Q

Roy Adaptation Model Sister Callista Roy

A

Developed 1970’s, influenced by system, stress theory and adaptation theory
Based on the assumption that an individual adapts behavior to cope with stimuli from environmental stressors
Environmental stressors disrupt the individual’s state of equilibrium and illness results
The focus of this model:
Physiological needs
Self concept
Role function and interdependent relations

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10
Q

Watson Model of Caring

A

Assists the patients to balance the impersonal, scientific and technological aspects of nursing care with the personal elements of care.
The theory is based on three assumptions:
Caring is a universal social behavior
Care for the self is necessary before care for others
Care and love are the cornerstones of humanness.
The nursing role in Watson’s theory is to emphasize the humanistic dimension of nursing that can only be practiced interpersonally.

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11
Q

Nursing Theories & Models

A

Nursing theory = the science of nursing
The possibility to organize the relationship among the concepts to describe, explain, predict and control practice
Nursing theory is the deliverance of nursing care. It offers conceptual bases / framework for nursing practice

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12
Q

What is Quality Improvement? (QI)

A

Identification of areas that may be a source of patient errors and actions taken to improve structure, process, and outcomes.

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13
Q

Quality Improvement

A

Measures the quality of health care by observing its structure, processes, and outcomes
Structure: Assess the accessibility, availability, and quality of resources
Process: The delivery of health care services
Outcomes: The final result of health care which are influenced by environmental and behavioral factors; mortality, patient satisfaction, and improved health status.

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14
Q

Quality Improvement Registered Nurses Role

A

QSEN competencies: how the novice nurse develops the knowledge & skills needed to participate in QI
Participate in QI initiatives
Engage in changes to improve the quality of healthcare
Implement new structure processes for better outcomes
Occurrence reporting of incident-events
Identify, report, and participate in the review of sentinel events

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15
Q

Quality and Safety Education for Nurses

QSEN

A

The overall goal for the Quality and Safety Education for Nurses (QSEN) project is to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work.

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16
Q

Potential sources of criminal law; Violations that may impact nurses ability to practice

A 
Negligence 
Malpractice 
Assault 
Battery
Breach of Confidentiality 
Right to Privacy 
Fraud 
Defamation of character 
EX: Slander and Libel 
Patient abandonment
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17
Q

CQI

A

Continuous Quality Improvement

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18
Q

TQM

A

Total Quality Management

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19
Q

The Institute of Medicine (IOM)

A

The Institute of Medicine (IOM) is affiliated with the National Academies of Science and serves as a nonprofit organization devoted to providing leadership on health care.

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20
Q

What is evidence based practice in Nursing?

A

A problem-solving approach to clinical practice that incorporates the best evidence from:
well-designed studies
patient values and preferences
clinician’s expertise in making decisions about a patient’s care
Findings are graded by the evidence or quality of research generated from a study or report.
Evidence-based information ranges from Level A (the strongest) to Level C (the weakest).

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21
Q

Evidence Based Practice Level B

A 
Level B 
Well-designed control trials without randomization
Clinical cohort study
Case-controlled study
Uncontrolled study
Epidemiological study
Qualitative study/quantitative study
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22
Q

Evidence Based Practice Level C

A

Level C
Consensus viewpoint and expert opinion
Meta-synthesis

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23
Q

Purpose ofEBP

A

To take research out of the sphere of academia and into real-world settings.
Understand why something works and how itappliesto a patient’s situation.
Quality improvement data and expert opinion

24
Q

The process of Evidence-based research (EBR)

A

What is the research question?
Patient population being examined & interventions considered
Accessing the research literature
accessing of the research literature, and the tools for critical analysis of the reports
The sample
The sample is critically evaluated using stringent standards [e.g. the Consolidated Standards of Randomized Trials (CONSORT)
The data
The data from separate reports are pooled, analyzed for acceptability
The last step
summarizes the process and the findings.

25
Q

Nursing Research Goals

A

The registered nurse shall:
Recognize the value of research
Utilize resources
Participating in committees/unit based activities to improve quality safety / cost effective care
Collaboration
Patient/family satisfaction as a key determinant of quality

26
Q

Watson Model of Caring

A

Assists the patients to balance the impersonal, scientific and technological aspects of nursing care with the personal elements of care.
The theory is based on three assumptions:
Caring is a universal social behavior
Care for the self is necessary before care for others
Care and love are the cornerstones of humanness.
The nursing role in Watson’s theory is to emphasize the humanistic dimension of nursing that can only be practiced interpersonally.

27
Q

What is Quality Improvement? (QI)

A

Identification of areas that may be a source of patient errors and actions taken to improve structure, process, and outcomes.

28
Q

Quality Improvement

A

Measures the quality of health care by observing its structure, processes, and outcomes
Structure: Assess the accessibility, availability, and quality of resources
Process: The delivery of health care services
Outcomes: The final result of health care which are influenced by environmental and behavioral factors; mortality, patient satisfaction, and improved health status.

29
Q

Registered Nurses Role in Quality Improvement

A

QSEN competencies: how the novice nurse develops the knowledge & skills needed to participate in QI
Participate in QI initiatives
Engage in changes to improve the quality of healthcare
Implement new structure processes for better outcomes
Occurrence reporting of incident-events
Identify, report, and participate in the review of sentinel events

30
Q

Ways nurses can maintain and expand their level of competencies to meet professional criteria and future role responsibilities include all of the following except:

A

A. expanding knowledge and skills
B. accepting increasing role stress
C. making a commitment to education
D becoming more assertive and autonomous

31
Q

Which nursing action would contribute to the cost of care for a patient?

A

A. Delaying discharge from an inpatient care unit for 1 hour until the patient’s transportation becomes available.
B. Encouraging a postoperative patient to turn cough and deep breathe every 2 hours.
C. Opening a dressing change kit to obtain a sterile gauze.
D. Encouraging an elderly patient to obtain an annual flu vaccine.

32
Q

Why is it essential for nurses to participate in the activities of nursing organizations? These organizations:

A

provide nurses with a professional identity through membership in a professional association
influence policies affecting nursing, nursing practice, and the health of the community
grant nurses access to professional networks
expose nurses to professional growth opportunities.

33
Q

The purposes of the American Nurses Association are to:

A

A. lobby Congress and regulatory agencies on health care issues affecting nurses and the public
B. foster high standards of nursing practice and project a positive image of nursing
C. promote the economic and general welfare of nurses in the workplace
D. all of the above

34
Q

Which patient would benefit most from a nurse advocate?

A

A. A patient who has previously undergone a procedure that is about to be performed for a second time.
B. A patient who has been educated on treatment options and chooses alternative treatments.
C. A cancer patient who makes an informed decision not to participate in chemotherapy treatment.
D. A geriatric patient with no family members who is uncertain about a decision of whether to have a gastrostomy tube inserted.

35
Q

Which statement reflects the concept of clinical competency for the RN?

A

A. Demonstrating clinical skills & problem solving while implementing policies & procedures.
B. Providing patient-centered care to meet identified needs.
C. Applying the nursing process for a variety of patients in clinical setting.
D. Researching evidence-based findings for application to patient care.

36
Q

Which organization is responsible for ensuring that schools maintain quality across nursing education programs?

A

A. The Joint Commission
B. American Nurses Association
C. National League for Nursing Accrediting Commission
D. National Council of State Boards of Nursing

37
Q

What is the purpose of the American Nurses Association (ANA) Standards of Professional Nursing Practice?

A

A. To provide guidelines for nursing education
B. To establish requirements for nursing licensure
C. To improve the practice of nursing
D. To promote unity within the nursing profession

38
Q

A healthcare provider has discussed potential treatment options for a patient in a coma with the patient’s family. One of the family members asks the RN, “What would you do if it was your loved one?” What is the most appropriate response the RN can make in this situation?

A

A. “What do you think the patient would want done?”
B. “It sounds like your unsure which treatment options to choose.”
C. “I’ve seen patients live many years with the treatment.”
D. “Would you like the provider to explain the options to you again?”

39
Q

An RN notifies the health care provider after making an error in medication administration. There were no adverse patient outcomes as a result of the error. Can the RN be sued for the malpractice by the patient?

A

A. Yes. The RN did not follow hospital protocols.
B. Yes. The RN failed to follow-up action.
C. No. The patient was not harmed.
D. No. The RN notified the healthcare provider.

40
Q

An RN is assigned to assist a patient who was recently diagnosed with cancer, to help the patient & family deal with complex care issues & barriers related to the treatment plan. What is the term used for this type of nursing practice?

A

A. Nurse coder
B. Nurse navigator
C. Nurse entrepreneur
D. Patient safety officer

41
Q

Which leadership actions assist nurse managers in facing challenges such as sufficient staffing & ensuring that safe, quality patient care is provided? (Select all that apply.)

A

A. Establish common goals that can be achieved.
B. Use written warnings to ensure that work is accomplished.
C. Recognize positive patient outcomes and accomplishments by staff.
D. Reschedule staff meetings when busy with other responsibilities.
E. Volunteer to document minutes of meetings so all staff is informed.

42
Q

A graduate RN asks an UAP to report changes in a patient’s urine output. What aspect of this delegation indicates a violation to the rights of delegation and requires that the graduated RN follow up on the request?

A

A. The UAP does not have the proper qualifications to complete this particular task.
B. The instruction should have included a request for specific information on when & what the UAP should report.
C. This task can be completed independently by the UAP and does not need the graduate RN’s judgement.
D. The UAP has 5 years of experience but was assigned to the current unit 2 months prior.

43
Q

A team of RN’s on a medical nursing unit developed & implemented a new system to improve hand-off reports. One RN, who returned from an extended leave to find the new system already in place, refuses to use it. Which is the most likely reason for the RN’s resistance to change

A

A. Lack of involvement in the decision making process
B. Lack of research that supports the need for the change
C. Increase in the time required for documentation
D. Lack of familiarity with the new process

44
Q

An RN questions the nurse manager about why a traditional nursing practice is still being utilized on the unit and references a nursing journal article supporting a more effective practice that could be employed. Which feature of professional nursing, as highlighted by the ANA support of evidence based practice, is the RN demonstrating?

A

A. Applying wide accepted traditional nursing practice to patient care
B. Assuring safe, quality patient care using the best evidence available
C. Maintaining basic features of professional nursing knowledge
D. Distributing EBP findings to clinical nurses who lack research understanding

45
Q

What is the fastest growing segment in the business of the healthcare industry?

A

A. Home healthcare
B. Alternative medicine
C. Long term care
D. Community health centers

46
Q

What is the fastest growing segment in the business of the healthcare industry?

A

A. Home healthcare
B. Alternative medicine
C. Long term care
D. Community health centers

47
Q

Home healthcare provides a spectrum of care from birth to death except:

A

A. hospice care.
B. rehabilitative care.
C. respiratory services.
D. none of the above

48
Q

The “Patient Self Determination Act” is:

A

A. a legislative expression of the ability of a patient to determine whether he wants to refuse treatment.
B. a legislative expression of the ability of a patient to determine or select a healthcare provider even if that provider is not on the list of providers for insurance purposes.
C. a legislative expression of the ability of a patient to determine if self care or alternative treatment is appropriate.
D. none of the above

49
Q

Beneficence is the principle that stands for:

A

A. the right to be treated equally.
B. the obligation to be honest.
C. the obligation to be faithful to a commitment.
D. none of the above

50
Q

Veracity is the principle that stands for:

A

A. the obligation not to lie, misrepresent or deceive others.
B. the obligation to tell the truth.
C. both a and b
D. none of the above

51
Q

When a patient executes a living will, the patient is using the principle of:

A

A. justice.
B. beneficence.
C. autonomy.
D. confidentiality.

52
Q

A nurse learns best when she is told instructions out loud. What type of learning style is this?

A

A. Auditory learner
B. Visual learner
C. Reading-writing learner
D. Kinesthetic learner

53
Q

Continuing education is the same as continuing competence.

A

A. True

B. False

54
Q

Advanced practice nurses have limitations placed on them by the Nurse Practice Act of each state. Examples of these types of limitations include:

A

A. prescriptive abilities.
B. collaborative agreements.
C. drug classifications for prescriptive abilities.
D. all of the above

55
Q

Controlled discussion is a conflict management technique where:

A

A. each person makes one point at a time.
B. each person takes the other person’s point of view.
C. each person speaks to an empty chair as if the other person were in it.
D. a facilitator controls the substance of the discussion.

56
Q

You notice that a fellow nurse has been stealing medications from your facility. You decide to report the nurse. What is this called?

A

A. Internal whistle blowing

b. Personal whistle blowing
c. External whistle blowing
d. Corporate whistle blowing

N 108 Nursing Transition (4 decks)

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