Funda prelims Flashcards
Learning to deliver care with compassion, caring and respect for patient dignity and individuality
Art
Based on body of knowledge and evidence-based practices that are continually changing
Science
The patient is the center of the nursing practice - individuals, families or communities
Nursing as a profession
True or False:
Nursing is simply a collection of specific skills and a nurse is simply a person trained to perform specific tasks
False:
Nursing is not simply a collection of specific skills and a nurse is not simply a person trained
to perform specific tasks
According to who:
Nursing incorporates the art and science of caring and focuses on the protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence
Ana 2021
According to who:
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people
ICN 2021
Scope of Nursing - a person shall be deemed to be practicing nursing within the meaning of ___ when he/she singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in any health care setting. It includes, but not limited to, nursing care during conception, labor, delivery, infancy,
childhood, adulthood and old age. As member independent practitioners, nurses are
primarily responsible for the promotion of health and prevention of illness. As
members of the health team, nurses shall collaborate with other health care providers for
the curative, preventive, and rehabilitative aspects of cares, restoration of health,
alleviation of suffering, and when recovery is not possible, towards a peaceful death.
RA no 9172, 2002 Article 6: Nursing practice and PRC Board Resolution no.425, 2003
What are the 5 duties of the nurse?
- Provide nursing care through the utilization of the nursing process
- Establish linkages with community resources and coordination with health term
- Provide health education
- Teach, guide and supervise students in nursing education programs, undertake consultation services, engage in activities that require the utilization of knowledge and decision-making skills
- Undertake nursing and health human resource development training and research to include development of advance nursing practice
What is the 2 scopes of nursing?
- Observe the code of ethics and uphold standards of practice
- Continual learning through continuing professional education provided by accredited professional organization
What is the beginning nurse’s roles on client care?
- Practices in accordance with legal principles and the code of
ethics in making personal and professional judgment - Utilizes the nursing process in the interdisciplinary care of
clients that empowers the clients and promotes safe quality
care - Maintains complete, accurate and up-to-date recording and
reporting system - Establishes collaborative relationship with colleagues and other
members of the team to enhance nursing and other health care
services - Promotes professional and personal growth and development
What is the beginning nurse’s role on management and leadership?
- Demonstrates management and leadership skills to
provide safe and quality care - Demonstrates accountability for safe nursing practice
- Demonstrates management and leadership skills to
deliver health programs and services effectively to
specific client groups in the community setting - Manages a community/village based health
facility/component of a health program or a nursing
service - Demonstrates ability to lead and supervise nursing
support staff - Utilizes appropriate mechanism for networking, linkage
building and referrals
What is the beginning nurse’s role on research?
- Engages in nursing or health related
research with or under the
supervision of an experienced
researcher - Evaluate research study/ report
utilizing guidelines in the conduct of
written research critique - Applies the research process in
improving patient care in partnership
with a quality improvement/ quality
assurance/ nursing audit team
Statement of philosophical ideals of right and wrong that define the principles the nurse will use to provide care to clients
Code of ethics
What are the professional responsibilities and roles of a nurse?
- Autonomy and accountability
- Caregiver
- Patient advocate
- Educator
- Communicator
- Manager
What are the trends in the nursing profession?
- Importance of nurses’ self-care
- Health care reform and costs
- Demographic changes
- Evidence-based practice
- Quality and safety education for nurses
- Emerging information technologies
- Genomics
- Health policy
What are the 8 professional nursing organization in the Philippines?
- Ang Nars, Inc
- Association of Deans of Philippine Colleges of Nursing (ADPCN)
- Association of Diabetes Nurse Educators of the Philippines, Inc (ADNEP)
- Association of Nursing Service Administrators of the Philippines (ANSAP)
- Association of Private Duty Nurse Practitioners Philippines (APDNP)
- Critical Care Nurses Association of the Philippines, Inc (CCNAPI)
- Gerontology Nurses Association Association of the Philippines (GNAP)
- Military Nurses Association of the Philippines (MNAP)
- Mother and Child Nurses Association of the Philippines (MCNAP)
- National League Philippine Government Nurses (NLPGN)
- Occupational Health Nurses Association of the Philippines (OHNAP)
- Operating Room Nurses Association of the Philippines (ORNAP)
- Philippine Hospital Infection Control Nurses Association (PHICNA)
- Philippine Nurses Association of the Philippines (PNA)
- Philippine Nursing Informatics Association (PNIA)
- Philippine Nursing Research Society (PNRS)
- Philippine Oncology Nurses Association (PONA)
- Philippine Society of Emergency Care Nurses (PSECN)
- Renal nurses Association of the Philippines (RENAP)
- Society of Cardiovascular Nurse Practitioners of the Philippines (SCVNPP)
- The organization of people, institutions, and resources to deliver health care services to meet the health needs of a target population, whether a single-provider practice or a large health care system
- totality of all policies, facilities, equipment, products, human resources and services which address the health needs, problems and concerns of the people
- in the us, it is termed as integrated health care delivery which were developed with a focus on improving health care quality and decreasing overall health care costs
- in the philippines, it is termed service delivery network which were redefined to suit universal health care or kalusang pangkalahatan
Health Care Delivery System
Identify the disease prevention based on its definition:
Health promotion and illness prevention
- based on the notion of maintaining optimum level of wellness
Primary Prevention
Identify the disease prevention based on its definition:
Diagnosis and Treatment
-requiring emergency, intensive and around the clock acute care
Secondary Prevention
Identify the disease prevention based on its definition:
Rehabilitation, Health Restoration and Palliative Care
- helps individuals move to their previous level of health
Tertiary Prevention
Identify the disease prevention based on its activities:
Adequate and proper nutrition, weight control and exercise, stress reduction, smoking cessation campaigns, environmental programs
Primary Prevention
Identify the disease prevention based on its definition:
Early detection and screening, diagnostic and treatment facilities, outpatient surgical units
Secondary Prevention
Identify the disease prevention based on its definition:
End of life care, rehabilitation services
Tertiary prevention
Healthcare system whose goals are to provide cost-effective, quality care that focuses on decreased costs and improve outcomes to group of clients
Managed care
Involves multidisciplinary teams that assume collaborative responsibility for care for groups of clients. Uses critical pathways to track client’s progress
Care management
System which utilizes the best possible use of nursing personnel based on education preparation and skill sets
Differentiated practice
One nurse is assigned to and responsible for the comprehensive care of a group of clients during a shift
Case Method
Focuses on jobs to be completed, based on production and efficiency model
Functional Method
Delivery of nursing care to individual clients by a group of providers led by a professional nurse
Team Nursing
One nurse is responsible for overseeing the total care of a number of hospitalized client 24 hours a day 7 days a week
Primary Nursing
Is a problem-solving approach to clinical practice that combines the deliberate and systematic use of best evidence in combination with a clinician’s expertise, patient preferences and values and available health care resources in making decisions about patient care
Evidence Based Practice (EBP)
What are the steps for evidence-based practice?
- Cultivate a spirit of inquiry within an EBP culture and environment
- Ask a clinical question in PICOT format
- Search for the most relevant and best evidence
- Critically appraise the evidence you gather
- Integrate the best evidence with you clinical expertise and patient preferences and values to make the best clinical decision
- Evaluate the outcomes of practice changes based on evidence
- Communicate the outcomes of EBP decision or changes
What is PICOT format of a research question?
Population, Intervention, Comparison, Outcome, Time frame
PICOT:
What specific patient population is of interest?
Population
PICOT:
What intervention or policy is being studied
Intervention
PICOT:
What is the main alternative?
Comparison
PICOT:
What should be measured?
Outcome
PICOT:
What is the appropriate time period to assess outcomes?
Time frame
Determine the levels of evidence:
Opinion of authorities and/or reports of expert committees
Level VII
Determine the levels of evidence:
Single descriptive or qualitative study
Level VI
Determine the levels of evidence:
Systematic reviews of descriptive and qualitative studies
Level V
Determine the levels of evidence:
Single, nonexperimental study (Case control, correlational, cohort studies)
Level IV
Determine the levels of evidence:
Controlled trial without randomization (Quasiexperimental study)
Level III
Determine the levels of evidence:
A well-designed RCT
Level II
Determine the levels of evidence:
Systematic review or meta-analysis of randomized controlled trials (RCTs) Evidence-based clinical on systematic reviews
Level I
Key communication strategy that produces a written account of pertinent patient data, clinical decisions and interventions and patient responses
Documentation
What are the purposes of the health care record?
- Facilitating interprofessional communication
- Legal record of care provided
- Justification for financial billing and reimbursement of care
- Audit, monitor and evaluate care provided for quality improvement
- Resource for education and research
What are the legal guidelines for documentation?
- Do not document retaliatory or critical comments
about a patient or care provided by another health
care professional. Quote all patient statements - Correct all records promptly.
- Record all facts
- Document discussions with providers that you
initiate. - Document only for yourself
- Avoid using generalized, empty phrases such as
status unchanged, had good day - Begin each entry with date and time and
end with your signature and credentials - Protect security of your password
- Do not erase or scratch out errors while
recording
10.Do not leave blank spaces or lines in a
written progress note
11.Record all written entries legibly using
black ink.
What are the different formats of nursing documentation?
Narrative, PIE, Focus charting, SOAP
Identify the nursing documentation formats:
A document stating what patient said
Narrative
PIE:
Example:
Lack of knowledge related to inexperience with disease condition
P: nursing Problem or diagnosis
PIE:
Example:
- Provided brochure on anticoagulation therapy for DVT. - - Explained rationale for bed rest and daily blood tests to check anticoagulation level
- Explained that heparin infusion will be stopped when PT/INR is at therapeutic level and that he can expect to take warfarin for about 6 months until clot resolves
I: Interventions that will be used to address the problem
PIE:
Example:
Patient states, “I’m worried about the blood clot, but I understand how it is being treated.” Able to teach back and verbalize that the heparin infusion will be stopped when PT/INR tests are “normal.” Also states that he expects to take warfarin for about 6 months until clot in leg dissolves
E: Nursing evaluation
What type of nursing documentation format has DAR?
Focus charting
What is DAR?
Data, Action or nursing intervention, Response of the patient
Focus charting:
Example:
Patient states, “My leg is so swollen. I’m worried about this blood clot. Do you know how they are going to treat it?”
Data
Focus charting:
Example:
Provided brochure on anticoagulation therapy for DVT. Explained rationale for bed rest and daily blood tests to check anticoagulation levels. Explained that heparin infusion will be stopped when PT/INR is at therapeutic level
Action of Nursing intervention
Focus Charting:
Example:
Able to teach back and verbalized that heparin infusion will be stopped when PT/INR reaches “normal level” and that he can expect to take warfarin for 6 months after discharge until clot is fully resolved
Response of the patient
What is SOAP?
Subjective, Objective, Assessment, Plan
Is that all standard for normal assessment finding or for routine care activities are met unless otherwise documented
Charting by Exception
Charting by Exception incorporates standards of care and use clearly, predefined statements for nursing documentation of WDL or WNL which both means what?
Within Define Limits, Within Normal Limits
Determine the hours of care and number of staff required for a given group of patients every shift or every 24 hours.
Is not part of the patient’s health record
Acuity Rating System
In an Acuity Rating system what does 1 and what does 5 mean?
1- independent in all but one or two aspects of care, almost ready for discharge
5- totally dependent in all aspects of care requiring intensive care
Is the use of information systems and other information technology to record, monitor, and deliver patient care, and to perform managerial and organizational functions in health care
Healthcare information technology (HIT)
Computer hardware and software dedicated to the collection, storage, processing, retrieval, and communication of patient care information in a healthcare agency
Health care information system
Is a large, computerized database management system that is used to access patient data needed to plan, implement, and evaluate care
Clinical information system
Contains rules and logic statements that link information required for clinical decisions to generate tailored recommendations for individual patients, the recommendations are presented to health care providers as alerts, warning, or other information for consideration
Clinical decision support systems