Exam 2 Flashcards
What does ISBAR stand for?
Introduction
Situation
Background
Assessment
Recommendation
What does ISBARR stand for?
Introduction
Situation
Background
Assessment
Recommendation
Read back / Repeat
What should you always end report with?
“Do you have any questions for me?”
Name the basic assumptions of communication theory (4)
(1) We only know about ourselves through communication
(2) Feedback is the only way we can verify that our perceptions are valid
(3) Faulty communication can have bad results
(4) It is impossible NOT to communicate
The linear model of communication includes what key components?
Sender - Message - Receiver
Channel
Noise
Name the 4 modes of communication
Verbal, nonverbal, written, electronic
Name the 4 types of communication
Aggressive, Passive, Passive-Aggressive, Assertive
The unique reality of each individual based on life experiences
Perception
Name the 3 stages of the Perception Process
(1) Selection
(2) Organization
(3) Interpretation
What is selective perception?
The personal filtering of what we see and hear so as to suit our needs
In Stage 1 of the Perception Process, people are bombarded by _____ and must _____
stimuli, select what they want to focus on
In stage 2 of the Perception Process, how do individuals organize stimuli?
Based on their personality, knowledge, and past experiences
In the interpretation stage of the Perception Process (stage 3), what happens?
Individuals assign meaning to stimuli based on their unique reality
Professional, interpersonal alliance in which the nurse and client join together for a defined period to achieve health-related treatment goals
Therapeutic relationship
What is the goal of a therapeutic relationship?
Promotion of a person’s health and well-being
Name at least 3 therapeutic communication skills
Perseverance
Creativity
Sense of wonder
Integrity
Self-confidence
Humility
Empathy
Critical Thinking
Effective listening is when…
the message is received and understood as intended
Name at least 3 non-therapeutic communication traits
Getting too personal
Changing the subject
False reassurance
Sympathy, pity
Asking WHY
Defensiveness
Arguing
Name the 4 phases of Therapeutic Relationships
(1) Preinteraction phase
(2) Orientation phase
(3) Working phase
(4) Termination phase
_______ phase occurs before meeting the patient
preinteraction
The ______ phase is when the nurse and patient meet and get to know each other
Orientation
What is the purpose of the working phase in therapeutic relationships?
For the nurse and patient to work together to solve problems and accomplish goals
Name 4 things to do during the termination phase of a therapeutic relationship
(1) provide separation
(2) ensure smooth transition
(3) review goals / progress
(4) acknowledge, thank
Name at least 3 strategies for communicating with individuals with visual impairment
(1) Check for use of glasses / contacts
(2) Identify yourself when entering
(3) Speak in a normal tone of voice
(4) Ensure adequate lighting
(5) Do not rely on gestures
Name at least 3 strategies for communicating with individuals with hearing impairment
(1) Check for hearing aids / glasses
(2) Reduce environmental noise
(3) Face patient with mouth visible
(4) Get patient’s attention before speaking
(5) Speak at a normal volume - do not shout
(6) Rephrase rather than repeat if misunderstood
Name at least 3 strategies for communicating with older adults
(1) Create space
(2) Slow down
(3) Be present
(4) Listen actively
Name at least 3 strategies for communicating with people with cognitive impairment
(1) Simplify message
(2) Accept patient’s message
(3) Allow extra time
(4) Break tasks into simple steps
(5) Use a calming approach
(6) Take a break, try again later
(7) Use pictures
Name 3 methods for digital communication
Telephone, text, video
For symptoms of little concern, patient prefer ______ communication
telephone
For symptoms of CONCERN, patients prefer _____ communication
in-person
If someone is using “you” statements, is controlling, and interruptive, what is their communication style?
Aggressive
Honest and clear communication is ____ communication style.
Assertive
Someone who avoids conflict, is anxious, and hesitates to stand up for themselves has what communication style?
Passive
acting out in anger in indirect ways to show distaste / unhappiness is what communication style?
Passive-aggressive
The 5 levels of communication are what?
Energetic, emotional, auditory, verbal, and physical
Give 3 examples of communication barriers
language, culture, cognitive impairment
Describe at least 3 benefits of an interprofessional team
(1) Improved access / coordination
(2) Greater efficiency of client referral
(3) Increased quality
(4) Decrease in complications
Name at least 3 barriers to collaboration among clinicians
(1) Hierarchy of professions
(2) Lack of knowledge of the team
(3) Poor communication
(4) Lack of trust
(5) Lack of cultural competency
(6) Inability to resolve conflicts
(7) Structural factors (i.e., time)
Method to settle disagreements peacefully and respectfully, through compromise and accommodation
Conflict management / negotiation
We want to share goals and avoid competition with the other party during what?
Conflict management / negotiation
Name the 4 approaches for managing conflict
(1) Accommodation
(2) Compromise
(3) Avoidance and Competition
(4) Collaboration
Maintaining peace and harmony by smoothing over differences
Accommodation
can lead to creativity and new ideas by solving the issue objectively and evaluating all views
Collaboration
temporary solution and recognizes the importance of resolving the relationships
Compromise
____ and ____ are short-term solutions to conflict
Avoidance and competition
A policy adopted by many organizations to describe null, or an absolute, no tolerance for incivility, bullying, harassment, or other acts of intimidation or violence in the workplace.
Zero-tolerance policy
Cognitive rehearsal is…
a mental rehearsal of adverse / anxiety-producing situations
What are the goals of cognitive rehearsal?
Decrease anxiety and improve self-efficacy
What is emotional intelligence?
The ability to face, understand, and feel emotions, and act accordingly
Where does patient teaching fall in the nursing process?
Starts: Assessment phase
Impactful: Implement phase
Name at least 3 best practices when using a language interpreter
(1) Speak directly to the pt
(2) Use short sentences
(3) Speak clearly
(4) Use living room language
(5) Pause often
(6) Use teach-back when necessary
Name at least 3 important considerations when teaching elderly clients (verbal, written, tech)
(1) reduce background noise
(2) assure pt is comfortable
(3) make sure pt has aids
(4) dark font on light background!
(5) present 1 topic at a time
3 main goals for patient education
(1) Equip individuals to achieve optimal health
(2) Equip pts to be informed to be decision-makers
(3) Improve safety
(4) Reduce costs
(5) Contribute to improved health-related quality of life
Name at least 3 factors that affect a patient’s readiness to learn
(1) Maslow’s Hierarchy of needs
(2) Communication skills / abilities
(3) Psychosocial factors
Name at least 3 possible nursing diagnoses r/t patient education
(1) Risk diagnosis
(2) Problem-focused diagnosis
(3) Health promotion diagnosis
(4) Knowledge deficit
(5) Sedentary lifestyle
Name at least 3 education delivery methods
(1) Verbal 1:1 discussion
(2) Group instruction
(3) Preparatory instruction
(4) Demonstrations
(5) Analogies
(6) Simulation
What are the two main ways to tell if learning has occurred?
Demonstrate
Teach-back
The 5 stages of transtheoretical model of change are what?
(1) Precontemplation
(2) Contemplation
(3) Preparation
(4) Action
(5) Maintenance
Describe at least 5 ways for patients to become more involved in their treatment
(1) Speak up w/ questions or concerns
(2) Pay attention to the care you get
(3) Educate yourself
(4) Ask a trusted family/friend
(5) Know about your meds
Name the 5 categories of SDOH
(1) Education access and quality
(2) Health care access and quality
(3) Neighborhood and built environment
(4) Social and community context
(5) Economic stability
Helping individuals maintain or enhance their present health
Health promotion
Protects people from actual or potential threats to health
Disease / Illness Prevention
Education on a healthy diet is an example of what?
Health promotion
Working to better manage hypertension and educating on the risks to high blood pressure is an example of what?
Disease / Illness prevention
Nonmodifiable risk factors
Risk factors that cannot be changed.
What are the 3 common modifiable risk factors responsible for the majority of chronic diseases?
(1) unhealthy and excessive diet
(2) lack of physical exercise
(3) use of tobacco products
The act of intervening before negative health effects occur.
Primary Prevention
Secondary Prevention
To reduce the impact of disease or injury, and limit disability.
Tertiary prevention
controlling the chronic effects of a health issue that has already occurred and on restoring the individual to optimal functioning
Quaternary Prevention
protecting clients from the excessive use of medical interventions that can cause more harm than good
Name 3 examples of nonmodifiable risk factors
(1) Age
(2) Race
(3) Biologic sex
(4) Genetics
Name 3 examples of modifiable risk factors
(1) Diet
(2) Exercise
(3) Alcohol and tobacco use
Health education is an example of _____ prevention
Primary
Immunizations are an example of what form of prevention?
Primary
Screening for infection is what form of prevention?
Secondary
What is the goal of tertiary prevention?
Improve abilities and quality of life
model of behavior health and behavior change is a model that maps out the stages of change in an individual
Prochaska’s Transtheoretical Model of Behavior Health and Change
What is the main goal of the Health Belief Model?
identify the motivations for someone to make changes.
What are two key components of the Health Belief Model?
Self-efficacy and action
Self-efficacy means
confidence that you can affect change
Cues to action are important in the Health Beliefs Model because they…?
provide information that triggers the action
Which model explores the individual characteristics and experiences that are involved in change?
Pender’s Health Promotion Model
______ model incorporates behavior-specific cognitions and effects to drive behavioral outcomes
Pender’s Health Promotion Model
Describe the difference between competing demands and preferences in Pender’s Health Promotion Model
Competing demands are things that individuals have little control over, while preferences are things that individuals can control.
Name the 5 stages of Benner’s Novice to Expert model
Novice
Advanced Beginner
Competent
Proficient
Expert
Name the 5 components of Kristen Swanson’s Theory of Caring
Maintaining Belief
Knowing
Being with
Doing for
Enabling
The purpose of the Healthy People program is to …?
improve the overall health of Americans.
Screening for Blood Pressure is an example of _____ prevention.
Secondary
Name 3 education domains
(1) Cognitive
(2) Psychomotor
(3) Affective
_____ is the thinking domain of education
Cognitive
The ____ domain of education claims that learning is based on _____
psychomotor; action
Describe affective domain of education
Learning is based on emotions and involves client’s feelings
Name - in order - Bloom’s Taxonomy from lowest to highest levels
Knowledge
Comprehension
Application
Analysis
Evaluation
Synthesis
Bloom’s Taxonomy - Knowledge
Recalling prior learned knowledge
Bloom’s taxonomy - Comprehension
Understanding and interpretation of information
Bloom’s taxonomy - Application
The ability to use data
Bloom’s Taxonomy - Analysis
The breakdown of information to understand its structure
Bloom’s taxonomy - Evaluation
Deciding the ideal of the ideas
Bloom’s taxonomy - Synthesis
Putting the elements together to create a new whole
Name at least 2 examples of factors that promote learning
Perceived benefit
Enhanced health literacy
Nonjudgmental support
Quiet, low-stim environment
Repetition
Name at least 2 factors that hinder / reduce learning
Fear, anxiety, and depression
Lack of motivation
Environmental distractions
Psychomotor deficits
Physical discomfort
Timing
What is the major difference between complementary and alternative approaches?
Complementary approaches are used with conventional medicine, while alternative approaches are treatment modalities that are used instead of conventional medicine
Integrative health is an approach that does what?
Uses conventional, complementary, and alternative medicine approaches
Define Holistic Nursing (ATI)
Nursing practices that consider the person, in their entirety, while focusing on the client-nurse relationship and promoting healing, rather than curing any diseases
Whole Medical Systems
Complete systems that include a defined philosophy and explanation of disease, diagnosis, and therapy
Name at least 3 examples of Whole Medical Systems
Ayurveda
Homeopathy
Japanese Kampo
Neuropathy
Traditional Chinese Medicine
What is Ayurveda?
an ancient Indian medical system that emphasizes the balance of mind, body, and spirit to prevent disease
The 5 basic elements of Ayurveda are what?
Fire
Water
Air
Earth
Sky / Space
Name at least 3 Mind and Body therapies that can be used.
Massage
Meditation
Mindfulness
Aromatherapy
Acupuncture
Chiropractic
Hypnotherapy
Name 5 therapies that nurses can specifically offer
(1) Deep breathing
(2) Meditation
(3) Guided imagery
(4) Aromatherapy
(5) Essential Oils
What are Never Events?
Unambiguous adverse events that should never occur
Contaminated drugs, surgery on the wrong part of the body, and metal objects in the MRI are examples of what?
Never events
Name 3 types of adverse events
Preventable
Ameliorable
Adverse d/t negligence
Preventable adverse events
those that occur d/t error or failure to apply an accepted strategy for prevention
Ameliorable events are what?
Events that are not preventable but could have been less harmful
Adverse events d/t negligence
Occur d/t care that falls below the standards expected of clinicians in the community
What is the major difference between preventable and ameliorable events?
Ameliorable events are NOT preventable
Define near miss
An unsafe situation that is indistinguishable from a preventable adverse events, except the outcome does not happen.
Error
Broad term referring to any act of commission or omission that exposes the patients to a potentially hazardous situation
the original IHI triple aim includes what?
(1) Improved patient experience
(2) Better outcomes
(3) Lower costs
What does the Successive Layers of Defenses / Swiss Cheese model represent?
Safety and prevention measures
The conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions
Evidence-Based Practice
an approach to improving processes to meet existing knowledge and standards of care
QI
Research involves generating ____ to answer _____
new knowledge; unanswered questions
“Discovering the right thing to do”
Research
“Determining and implementing the right thing to do”
EBP
“Making the right thing easy to do”
QI
Name the 5 steps of the EBP process
(1) Ask a question
(2) Acquire the evidence
(3) Critically appraise the evidence
(4) Implement EBP
(5) Evaluate EBP
PICOT stands for what?
Patient / population, or disease
Intervention
Comparison
Outcome
Time
The pyramid of evidence goes from lowest to highest:
(1) Editorials / Expert Opinion (LOWEST)
(2) Case series, case reports
(3) Case-control studies
(4) Cohort studies
(5) Randomized controlled trials
(6) Meta-analysis and systematic reviews
Name at least 3 barriers to nurses using EBP regularly.
Insufficient time on the job
Inadequate EBP knowledge and skills
Lack of administrative support
Lack of an EBP mentor
Negative staff attitudes
Resistance to Change
What does CUS stand for?
(I am) Concerned
(I am) Uncomfortable
(I believe this is a) Safety issue
3 examples of herbals that can interfere with / prevent clotting are what?
Ginger
Gingko
Ginseng
____ lead to barriers to communication and fragmented care, which can negatively impact the processes created to provide safe, effective, seamless care of the clients within the organization.
Silos
What is the most common form of client education?
Individual
Communication failures in US hospitals and medical practices were responsible for ___% of all malpractice claims
30
Communication failures most commonly occur during ____ _____
shift change
The Joint Commission found ____% of serious medical errors were the result of miscommunication between caregivers during patient handovers
80
Describes what is currently happening to the client that needs to be addressed
Situation
Effective communication involves ____ from the sender and receiver
feedback
Who sets standards for patient and family education?
The Joint Commission
a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
Health
What percent of a person’s health is estimated to
be due to social determinants of health?
50%
every person has the opportunity to attain their full health potential
health equity
promotes a holistic approach to health promotion and disease prevention
Healthy People 2030
The two influencing variables for illness behavior are what?
Internal and externalI
Name at least 3 impacts of illness
(1) behavioral & emotional changes
(2) body image
(3) self-concept
(4) family roles
(5) family dynamics
helps people develop a greater understanding of their health and how to better manage their health risks
health education
helps individuals maintain or enhance their present health
health promotion
protects people from actual or potential threats to health
illness prevention
Any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident
Risk factor
Name two ways you can identify risk factors
(1) assessment
(2) health risk appraisal forms
In the US, at least ____% of hospitals connect with patients using some form of telehealth technology
76
Studies on the use of technology with patients showed that ___ and ___ are the key components.
Relationship building
Comfort using technology
Product intended to diagnose, treat, cure or prevent any disease
Drug
evidence-based recommendations to be used as guidelines in the medical management of disease processes and in the area of preventative care.
Clinical practice guidelines
tools used within a health care organization that help nurses manage the delivery of client care for a specific circumstance, category, or disorder.
Critical pathways
Evidence -based interventions that are typically implemented when caring for a client with a specific disorder
Standards of care
