Chapter One: Overview of Professional Nursing Flashcards
Nursing “KSAs”
- knowledge
- skills
- ability
- attitude- a good one!
What is the general job overview of a med-surge nurse
promote, restore, or maintain optimal health for patients over 18
what are the 6 major roles of a med-surge nurse
- Care coordinator
- transition manager
- caregiver
- Pt. educator
- leader
- advocate for the pt. and family
10 QSEN concepts needed for competent care
- patient centered care
- collaborate w. interdisciplinary HC team
- evidence based practice
- quality improvement
- informatics
- safety
- clinical judgement
- ethics
- HC orgsnizations
- HC disparities
explain what is meant by “patient centered care”
the patient is the source of control and a full partner in the care plan
the nurse must be ________ in order to provide patient-centered care to diverse patients and their families
culturally competent
what are the attributes of pt. centered care?
- respect for values, preferences, and expressed needs
- coordination and integration of care
- information, communication, and education
- physical comfort
- emotional support and alleviation of fear/anxiety
- involvement of fam and friends
- transition and continuity
- access to care
what does family-centered care emphasize according to The Joint Commission
it emphasizes the importance of including the patient’s support system as a part of interprofessional care
special considerations and populations when providing pt. centered care
- cultural and spiritual considerations
- gender health considerations
- considerations for older adults
- veterans health considerations
what is an integrative care model
integrating complementary and alternative medicine (CAM) into patient care plans
examples of CAM (integrative care)
-pet therapy, massage therapy, acupuncture, biofeedback, exercise routine, nutritional supplements
this nursing role is the organization of patient care activities between 2 or more members of the HC team to facilitate appropriate and continuous HC to meet patients needs
care coordination
one of the most important members of the HC team who assists with care coordination is the __________ AKA _______
case manager
discharge planner
________ provides quality and cost effective services and resources to achieve pt. outcomes
case management
the case manager coordinates ______ and _____ before the patient is discharges
inpatient and community-based care
what is the purpose of case management?
to prevent readmission
this nursing role prevents adverse events and hospital readmission by safely moving patients among HC settings, health providers, and the community
transition management
6 recommendations by the joint commission for effective care coordination and transition management
- understandable discharge info for pt. and fam
- explanation of self-care activities
- ongoing or emergency care info
- list of community and outpatient resources and referrals
- knowledge of pt. language, culture, and health lit.
- medication reconciliation
this nursing role involves evaluating actual current medications and comparing them to pt’s prescribed medications @ the time of their admission, transfer, or discharge to identify and resolve discrepancies
medication reconciliation
what is the purpose of medication reconciliation
prevent duplications, omissions, and interactions
what is the DMAIC methodology of medication reconciliation
the nurse must : Define Measure Analyze Improve Control
patient medications
define the QSEN competency “safety”
the ability to keep the pt. and staff free from harm and minimize errors in care
what is meant by “unsafe”
possibly causing harm or death
what is meant by “safe”
preventing harm or negative outcomes
pt. harm and error most often occur as the result of these 9 things:
- lack of communication
- lack of attentiveness/ pt care
- lack of clinical judgement
- inadequate measures to prevent health complications
- med. administration errors
- error in interpreting provider prescriptions
- lack of professional accountability/ pt advocacy
- inability to carry out interventions in timely manner
- lack of mandatory reporting
what is interprofessional collaboration
interprofessional collaboration involves the pt, their family, nurses, UAP, and other health care professionals
what is the purpose of interprofessional collaboration
to provide safe evidence based practice
Interprofessional Education Collaboration (IPEC) Competencies
- Values/ethics for interprofessional practice
- role responsibility
- interprofessional communication
- teams and teamwork
2 forms of proper communication
- SBAR
2. STEPPS
what does STEPPS stand for
Strategies and Tools to Enhance Performance and Patient Safety
what are “Cus” words used in the STEPPS model?
“concerned”
“uncomfortable”
“safe”
what are “Check Backs” in STEPPS
restating what the other person says to verify all team members understand
what are “Call outs” in the STEPPS model?
shout out important information so all team members hear @ once
what is the “two challenge rule” in the STEPPS model?
state the concern twice as needed- if the concern is ignored twice then follow chain of command to get it addressed
_______ is the process of transferring a select nursing task to a competent person of authority
delegation
who is ALWAYS held accountable for the task that was delegated?
the nurse
describe the importance of supervision as it pertains to delegation
the nurse should guide, direct, evaluate, and follow up on the task he/she delegates
what are the 5 rights of delegation?
- Right Task- its within UAP scope of competence
- Right Circumstance- setting and resources are appropriate
- Right person- UAP capable of performing task
- Right communication- expectations are stated
- Right Supervision- nurse follows up
what is evidence based practice
integration of the best current evidence and practices to make decisions about patient care- takes into consideration what the patient prefers and values
what is the best source of evidence?
research, specifically: systematic reviews and meta-analysis
__________is a process in which nurses and the interprofessional healthcare team use indicators (data) to monitor care outcomes and develop solutions to improve care
Quality Improvement
what is PDSA quality improvement
1 .Plan- identify/analyze problem
- Do- develop & test evidence based solution
- Study- analyze effectiveness of solution
- Act- implement improved solution
what is FOCUS_PDCA quality improvement
Find a process to improve Organize a team Clarify the current process Understand variations in current process Select the process to improve
Plan the improvement
Do the improvement
Check for results
Act to hold the gain
what is the DMAIC quality improvement model
Define issue/problem
Measure key aspects of current process for issue
Analyze collected data
Improve current process-> implement EVP intervention
Control future state of intervention to ensure
_______ is the access to and use of information and electronic technology to communicate, manage knowledge, prevent error, and support decision making
informatics
______ is the process used to make decisions based on interpretation of the patient needs and problems
clinical judgement
what influences sound clinical judgement?
-how well the nurse knows the patients typical response pattern and the situational context of the nursing care unit
the worst result of poor clinical judgement is _____
failure to rescue
what is failure to rescue
the inability of the nurse and other team members to save a patient’s life in a timely manner when issues occur
what are the attributes of clinical judgement skills?
Think ADPIE
- Assessment: noticing a new issue
- Diagnosis/analysis: interpreting the new issue
- Planning/implementation: responding to new issue
- Evaluation: reflecting on the response
what is the role of the Rapid Response Team
save lives and decrease the risk for harm by providing care before a medical emergency occurs by intervening rapidly when needed for patients who are beginning to clinically decline
what is applied professional nursing ethics?
using clinical judgement to decide what is right and wrong to make clinical decisions
ANA code of Ethics
- Autonomy- pt is in charge of themselves
- Beneficence- promote + actions- do good
- Nonmaleficence-preventing harm
- Fidelity- keeping promises to pt
- Veracity- honest and tell truth
- Social Justice- equality and fairness
_____ are purposely designed & structured systems in which HC is provided by nurses and members of interprofessional teams
Health care organizations
_______are differences in pt. access to or availability of appropriate HC services
healthcare disparities
causes of HC disparities
- poor communication
- lack of access to HC
- health literacy (lack thereof)
- Healthcare provider biases and discrimination
