Class #2 Flashcards
What is evidence?
Generally refers to information derived from clinical research
What is the purpose of Evidence Informed Practice? (EIP)
improve patient outcomes and to ensure that we are protecting ourselves as nurses
How long can it take for new evidence to be adopted into clinical practice and policy?
17 years or more
What are the 8 steps in the EIP process?
1) Reflection (What am I doing?)
2) Framing the Question
3) Searching for Literature
4) Critical Appraisal of Research Literature (Which literature is best/strongest?)
5) Syntheses of Findings from Divergent Literature
6) Adaption of Findings to practice (Can it applied/used in this situation?)
7) Implementation of Practice Change (Change management?)
8) Evaluation (Did it work? Impact on outcomes)
How to Frame a Clinical Question? (PICOT)
P = population/participants (who?)
I = Intervention (What?)
C = Comparison (Control?)
O = Outcomes
T = Time (if applicable)
What is the 6S pyramid? (Top to bottom)
1) Systems
2) Summaries
3) Synopses of Synthesis
4) Synthesis
5) Synopsis of studies
6) Studies
What happens when you move downward in the 6S pyramid?
Level of detail and specificity increases as you move downward
What happens when you move upwards in the 6S pyramid?
Applicability increases as you move upward
What is Carper’s 4 Ways of Knowing?
1) Empirical
2) Personal
3) Ethical
4) Esthetic
What is the goal of Carper’s 4 Ways of Knowing?
With the goal of providing appropriate, effective patient centred nursing care
What does “Empirical” mean in regard to Carper’s 4 ways of knowing?
Facts, scientific knowledge (ie., pathophysiology, the rational behind the skills, evidences)
What does “Personal” mean in regard to Carper’s 4 ways of knowing?
Knowledge of own self in a situation (ie., self reflection: what did you do well, what you could do better?) – Realizing that my interaction with my patients can affect their healing process
What does “Ethical” mean in regard to Carper’s 4 ways of knowing?
Morally correct in a situation (ie., CNA codes of ethics, what is right/just an ought to be done etc.,)
What does “Esthetic” mean in regard to Carper’s 4 ways of knowing?
Art of nursing, awareness of nursing in the moment of care (ie., empathy, caring, genuineness, respect, relational, being with the other, self-disclosure)
What does emancipatory ways of knowing emphasize?
Emphasizes action that arises from an awareness of social injustices embedded in a social and political system
What is Emancipatory ways of knowing also known as?
Social Justice
What is Emancipatory ways of knowing able to recognize?
Is the human ability to recognize social and political problems of injustice or inequity, to realize that things could be different, and to work toward change that creates social justice for all
Is hegemony often hidden?
Often hidden, taken as granted, taken as truth, and as the only possibility
What is hegemony?
Dominate to a point but does not get challenged or questioned (viewpoints that are taken as truth and attempts to question them)
The dominance of certain ideologies, beliefs, values, or worldviews over other possible viewpoints
What does emancipatory ways of knowing require?
Requires critical examination that aims to uncover why injustices seem to remain invisible
What does hegemony tend to recreate?
Tends to recreate itself or perpetuate itself. Can be very hard to change
Emancipatory knowing vs. hegemonic thinking/being
Emancipatory knowing works to “Free” us of hegemonic thinking/being
Who are the Grey Nuns?
They provided quality nursing care to all without consideration of race or social class to justify provision of care
Cared for patients in homes and in the convent.
Later, established hospitals in many places, some of which still operate today (though often under new names now).
Who was the founder of modern, professional nursing?
Florence Nightingale
How did Florence Nightingale change nursing?
Applied principles of cleanliness and comfort
Dramatically decreased mortality and morbidity rates with simple nursing care
How were nurses seen after the World War?
Began to be seen as a profession of specialization, skill, and bravery rather than simply a religious vocation
What are some challenges regarding gender and diversity in nursing?
1) Nursing still seen as women’s work
2) Women seen as sexual objects
3)Traditional societal values negate nurturing roles for men – seen as effeminate or homosexual
What was the first training school for nurses called?
St. Catherines Training School (1874)
Who is the “Mother of Nurses in Canada?”
Mary Agnes Snively
What did Mary Agnes Snively do for nursing?
- Superintendent at Toronto General Hospital School of Nursing
- Established proper living conditions for students, a curriculum, established criteria for clinical and educational time
- Formed Canadian National Association of Trained Nurses, which eventually became CNA (in 1924), recognizing that the nursing profession is unique
What is the Royal Commission on Health Services of 1964?
Called for better prepared faculty in schools
Quality and standards must be met in nursing education programs
Basic integrated model (theory and practice) became the program of choice
Target date of 2000 for all nurses to be prepared at baccalaureate level
What are some expanding roles for nurses in the 21st Century?
- Nursing Research
- Nursing Administration
- Nursing Policy
What are some new challenges with nursing trends in the 21st Centurty?
- Chronic disease
- Physical inactivity and obesity
- Where we live and how we work
- Aging population
- Slowed growth of RN workforce
- Stress and mental health disorders are increasing
- Widening economic gap: poverty
- Meeting the basic health needs Indigenous peoples
- Access to healthcare for immigrants and greater need for cultural safety
- Changing family structure
- Climate change
- Technological changes
- Nursing’s impact on politics and health policy; activism
Preparedness for pandemics and epidemics
