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EVIDENCE BASED PRACTICE > EBP > Flashcards

EBP Flashcards

1
Q

What are the 4 themes in the NMC code

A

Prioritise people, practise effectively, preserve safety and promote professionalism and trust

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2
Q

What is nursing?

A

A profession/ calling
intrinsic
Service to others
Requires specialist skills and knowledge FLORENCE NIGHTINGALE

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3
Q

Explain the regulation for nurses

A

NMC- protect the public
Maintain a register
Giving a protected title to nurses
Establishing how fitness to practise would function and be in action
Made it an offence for someone to falsely represent themselveslvez as being on the register

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4
Q

Public perception of nurses

A

:) all angels and do no wrong

:( not caring, scandals- mid Staffordshire report- poor care, poor attitude, poor communication, incompetence

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5
Q

What do patients want from their care?

A

Be treated well
Have high quality care
Nurses that keep them safe physically and mentally
Treated with compassion, respect and empathy
Treated as a person not a case

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6
Q

What is the purpose of the NMC?

A

Protect the public
Uphold fitness to practice
Sole funding Is by registration fees

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7
Q

What is the baseline of the NMC

A

The standard of below which professional practice must not fall below (education, training, conduct and performance)

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8
Q

What is the focused role of the NMC?

A

Define standards
Mentor adherence to standards
Act when standards are not being met

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9
Q

Where does confidentially arise from?

A

autonomy

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10
Q

What is confidentiality?

A

Implied promise healthcare professionals won’t go and spill their info.

The right that the persons medical info etc is kept secret (Apart from the healthcare team however they will only need to know what they need to know)

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11
Q

Why is trustworthy so important?

A

Without trust the relationship between the healthcare professional and the patient would break down and if the patient does not share necessary info then the healthcare professional cannot do their job

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12
Q

What is consequentialism?

A

Theory that suggests that actions should be determined by the consequences- the healthcare should be guided to bring out the greater good for the greatest amount of people.
Consequence could be wrong for the patient even if it is the right treatment!

Eg if the professional divulges confidential info then the patient may not seek healthcare again

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13
Q

What is the Caldicott Review?

A

Ensures that information that can identify an individual is protected and that information can only be used when it is appropriate to do so.

Eg must have a justified purpose
Must be necessary to give information to another healthcare professional
Access should be a strict need to know basis
Comply with law

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14
Q

When can you share information with others?

A

When a patient gives consent for info about their care and treatment to be shared with family members
THEY MUST BE COMPETENT, know what is going to be disclosed, reasons for disclosure, consequences, whom, and how much info will be given

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15
Q

When can you share info with others?

A

When a court law requires it

Public interest must be balanced with the private interest in maintaining confidentiality

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16
Q

What is safeguarding?

A

Protecting vulnerable people from harm

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17
Q

What happens if there is a safeguarding issue?

A

NMC must act if you think a patient is in danger, go higher and report it to safeguarding

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18
Q

What is paternalism?

A

Paternalism is when you interfere with someones autonomy, with the intent of preventing harm or promoting good.
Doctors will sometimes withhold info from their patient

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19
Q

What is candour?

A

Being open, honest, transparent.

If harmed by healthcare the professionals must inform patient and must offer a remedy

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20
Q

Describe being open

A

Allowing concerns and complaints to be raised without fear

Making sure that questions are answered

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21
Q

Describe being transparent

A

Sharing info with staff, the regulators and the public about the performance

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22
Q

Who should apologise

A

The person that made that mistake

Lead clinician even if it isn’t their fault

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23
Q

Describe the professional duty of candour process

A

1) Tell patient when something has gone wrong
2) Apologise to patient and family
3) Offer an appropriate remedy
4) Explain fully to the patient- STM and LTM effects

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24
Q

Does saying sorry mean you accept legal liability?

A

NO- right thing to do and shows regret

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25
Q

What are the 3 things a patient expects in an apology?

A

What happened
What can be done to deal with harm caused
What will be done to prevent someone else being harmed

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26
Q

When should you say sorry?

A

In a way they can understand
At a time and place that suits them
Be considerate and respectful

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27
Q

What are notifiable incidents?

A

Any unexpected or unintended incident that causes moderate harm or worse

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28
Q

What is a near miss?

A

An adverse incident that had a potential to cause harm but didn’t

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29
Q

What is a regulator?

A

CQC- carry out regular inspections that determine whether or not standards are being met for safe, effective, compassionate and high quality care

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30
Q

What is nursing care?

A

The provision of care where a patient needs to be provided for- not just by a nurse

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31
Q

What are regulated activities

A 
Personal care
Accommodation 
Treatment of diseases
Surgical procedures
Maternity and midwifery services 
Nursing care
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32
Q

What are the 2 types of harm?

A

Moderate and severe

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33
Q

What is moderate harm?

A

Requires a moderate increase in treatment eg unplanned surgery, increase in care, prolonged time in hospital, transfer to another treatment

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34
Q

What is severe harm?

A

Permanent damage
Lessening of sensory, physiological, psychological functions
DEATH
Not part of natural course of patients treatment

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35
Q

What is whistleblowing?

A

When a worker passes on info concerning a wrong doing to supervisor/ tutor

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36
Q

Why don’t nurses raise concerns?

A

shunned, suspended, frightened, sacked, not action would be taken, loss of friendships

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37
Q

What is negligence?

A

Failure to take proper care over something
Defendant was owed a duty of care
The harm was caused by carelessness

38
Q

What is duty of care?

A

A moral or legal obligation to ensure safety of others

39
Q

What is the legal aspect of duty of care?

A

Off duty should only have duty of care if caused accident

40
Q

What is the professional aspect of duty of care?

A

Off duty always have duty of care IF COMPETENT

41
Q

What causes negligence?

A

If standard of care falls below the standard

42
Q

When negligence is taken to court, who are judged against?

A

Against what a reasonable professional would do in the same situation

43
Q

If I am a student nurse and was taken to court, who would I be judged against?

A

A newly qualified nurse

44
Q

What are the four main ethical principles?

A

Autonomy
Justice
Beneficence
Non-malificence

45
Q

Describe autonomy

A

Right to make own decision and take actions based on personal views

46
Q

Describe justice

A

Treat people equitably, distribute benefits and burdens fairly (Eg personalised treatment- people get the same right that they get the best treatment for them

47
Q

Describe beneficence

A

Do right thing for the patient

48
Q

Describe non-non-maleficince

A

Obligation not to inflict intentional harm

DO NO HARM

49
Q

What is fact?

A

A fact that can be proven with evidence

50
Q

What is opinion?

A

Personal, interpretations and cannot be verified with evidence

51
Q

What is evidence based practice?

A

Finding the best information to inform your decision-making

52
Q

What are the 3 things in EBP?

A

Clinical expertise, best research evidence, patient values and preference

53
Q

What does EBP require?

A

Requires that decisions about health care are based on the best available, current, valid and relevant evidence

54
Q

What happens when practice is not evidence based?

A

You will not be fit for practice

55
Q

What is the pyramid of evidence?

A

1) Animal/ Lab studies
2) Case Report/ Case
studies
NO DESIGN. NO HUMANS
3)Case control studies
4)Cohort studies
5) Randomised
PRIMARY STUDIES/ OBSERVATIONAL
6)Meta analysis
SECONDARY

56
Q

What are the 4 approaches for research?

A

Quantitive
Qualitative
Mixed methods
Review

57
Q

Describe qualitative data

A

Learn about people’s experience through discussions/ interviews
Gives insight and detailed descriptions

58
Q

What is nursing?

A

Both a science and an art

59
Q

Describe quantitive data

A

Uses a LARGE number of participants
explores C+E
Used to compare treatments
Is to support fact based decisions for groups NOT INDIVIDUALS

60
Q

What are both types of primary research?

A

Know the facts- informed and technically competent

Need to change behaviour of patients

61
Q

What makes research good?

A 
Clear question
Sound theoretical basis 
Logical
Limits bias through recruitment 
Has implications
62
Q

What is the research hierarchy?

A

1) single case study- used when there is no evidence= small sample size
2) Descriptive studies- Provide several viewpoints, use theoretical framework from previous case studies
3) Generalisable conceptual studies- larger diverse sample, provide info that can be applied to all

63
Q

What come hand in hand with evidence when speaking to a patient

A

Trustworthiness- they have to trust the healthcare professional to listen to the advice/ evidence you’re giving

64
Q

What is your responsibility?

A

Professional responsibility to make evidence based decisions

65
Q

What is the alternative to whistle blowing?

A

Invited criticism
Culture that values feedback
Multiple channels of disclosure

66
Q

What is the research process?

A

1) Idea
2) Research question
3) Prioritising
4) Plan
5) Funding
6) Ethics approved
7) collect data
8) Analysing data
9) interpret data
10) tell people results
11) Change practice
12) re-evaluation

67
Q

What is ethnography?

A

Understanding a culture within that culture, in the point of view of that culture
participants observe
unstructured
Researching something from that cultures point of view

68
Q

What is the grounded theory?

A

Make own theory
Social processes
Shows solutions

69
Q

What is phenomenology?

A

Living in their world seeing it from their point of view
study of lived experience
researchers need to remove values/opinions

70
Q

What are the data collection methods for qualitative research?

A

Interview
Focus group
Observation

71
Q

Summarise qualitative data

A

Understand meaning
Coloured by judgements but this can be a benefit
gives insight and depth- peoples experience

72
Q

What is face validity?

A

does the procedure look like its effective and will measure what its supposed to measure

73
Q

What is construct validity?

A

degree of which a test measures what it claims to measure

74
Q

What is criterion validity?

A

extent to which a measure predicts an outcome for another measurement

75
Q

What is discriminate validity?

A

tests whether concepts/ measurements that are not supposed to be related are actually related

76
Q

What are the levels of measurement for quantitive data?

A

nominal- categories
ordinal- categories but have order within categories
interval- difference between 2 values is meaningful
ratio- same as interval but starts at 0

77
Q

What is stratified sampling?

A

group
random sample out of each group
random population
proportional

78
Q

What is special about random sampling?

A

everyone has the exact same chance of being picked

79
Q

What is purposive sampling?

A

Selective sampling- pick certain characteristics of population- stop when saturated

80
Q

What is test re-test reliability?

A

Give same tests to same respondents and should get the same results

81
Q

What is inter-rater reliability?

A

Degree of agreement among different raters

82
Q

What is the process of qualitative data analysis?

A

Familarise yourself with data
Generate codes
Review themes

83
Q

Describe the mid-staffordshire report

A

Neglect of patients- not washing, no water, dirty bed sheets
changes: tougher inspections, recruited more nurses, able to speak out if have concerns, more transparency over treatment, put patients in driving seat

84
Q

What is the ethical issues with informed consent?

A

Autonomy

85
Q

What is informed consent?

A

Making sure a patient is making a right decision by ensuring they have sound understanding

86
Q

How can you check if someone is giving informed consent?

A

Patient-teaching= check patient understanding by asking them to repeat what they understand
Asses for paternalism

87
Q

What is epidemiology?

A

studies that look at prevalent incidence or distribution of diseases

88
Q

What is prevalence?

A

Proportion of a population who have a specific characteristic in a given time period

89
Q

What is incidence?

A

measure of the number of new cases of a characteristic that develops in a population

90
Q

What are the key concepts of research for quantitive research?

A

1) recruitment- define population, big sample
2) Sampling-random, convenience etc representative of pop
3) Data collection- valid and reliable way of collecting data
4) Data analysis- summarise data using statistical tests

EVIDENCE BASED PRACTICE (1 decks)

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