Fundamentals to nursing chap: 1, 2, 3, 4,9, 21, 23, 12, 13, 19, 20, 27, 33 Flashcards
historical background of nursing
16th century women convicted of crimes were recruited into nursing in lie of serving jail sentences.
19th century to the 20th century social reforms changes the roles of nurses and of women in general.
19th to 21st century both the work of Florence nightingale and the care provided for battle casualties during the civil war focused attention on the need for educated nurses in the united states.
definition of nursing
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. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
status of nursing as a profession and as a discipline
Well-defined body of specific and unique knowledge
Strong service orientation
Recognized authority by a professional group
Code of ethics
Professional organization that sets standards
Ongoing research
Autonomy (patients are able to make independent decisions)and self-regulation
aim of nursing as they interrelate to facilitate maximal health and quality of life for patient
to promote health
to prevent illness
to restore health
to facilitate coping with disability or death
how does nursing qualifies a a profession
nursing encompasses a passion for the increasing well-being of patients, a desire to provide specialized skills, and a desire to grow as a nurse.
levels of education preparation in nursing
LPN: license Practical nurse RN: Register nursing education BSN: BACCALAUREATE NURSING Masters (APRNs): Advanced practice nurses DNP: Doctor of nursing practice
discuss the effects on nursing practice of nursing organizations, standards of nursing practice, nurse practice acts, and nursing process.
nursing practice of nursing organizations will guide your nursing education as a student and how you practice after graduation.
standards of nursing practice: allows nurses to carry out professional roles, serving as protection for the nurses, the patient and the institution where health care is provided.
nurse practice acts: are laws established in each state in the united states to regulate the practice of nursing.
nursing process:
identify current trends in nursing
Nursing shortages will offer unique opportunities.
Job opportunities are expanding outside the hospital, and nurses will play a much bigger role in communities.
Technology will play a larger role in nursing practice.
Nurses will collaborate more with other health care providers.
discuss the importance of self care in relation to the demands of the nursing profession
Self-care reduces stress, replenishes a nurse’s capacity to provide compassion and empathy, and improves the quality of care
deaconesses
made the first organized visits to sick people and members of male religious order gave nursing care and buried the dead.
nightingales contributions include:
Identifying the personal needs of the patient and the role of the nurse in meeting those needs
Establishing standards for hospital management
Establishing a respected occupation for women
Establishing nursing education
Recognizing the two components of nursing: health and illness
Believing that nursing is separate and distinct from medicine
Recognizing that nutrition is important to health
Instituting occupational and recreational therapy for sick people
Stressing the need for continuing education for nurses
Maintaining accurate records, recognized as the beginnings of nursing research
health
is a state of optimal functioning or well being. As defined by the World Health Organization (WHO), a person’s health includes physical, social, and mental components, and is not merely the absence of disease or infirmity
nursing is recognize as a profession based on the following defining criteria:
Well-defined body of specific and unique knowledge
Strong service orientation
Recognized authority by a professional group
Code of ethics
Professional organization that sets standards
Ongoing research
Autonomy and self-regulation
licensure
legal authority to practice as a nursing professional
ICN: INTERNATIONAL NURSING ORGANIZATION
the ICN provides a way for national nursing organizations to work together.
American Nurses Association (ANA)
Its primary mission is to advance the profession of nursing to improve health for all. It is the premier organization representing the interests of the 3.6 million RNs in the United States
National League for nurses (1952; NLN)
The NLN conducts one of the largest professional testing services in the United States, including pre-entrance testing for potential students and achievement testing to measure student progress. It also serves as the primary source of research data about nursing education, conducting annual surveys of schools and new RNs
American Association of College of Nursing
The AACN is the national voice for baccalaureate and higher-degree nursing education programs. The organization’s goals focus on establishing quality educational standards, influencing the nursing profession to improve health care, and promoting public support of baccalaureate and graduate education, research, and nursing practice
National Student Nurses Association
Established in 1952 with the assistance of the ANA and the NLN, the NSNA is the national organization for students enrolled in nursing education programs
standards
allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is provided
Nurse practice acts are laws established in each state in the United States to regulate the practice of nursing
Protect the public by defining the legal scope of nursing practice, excluding untrained or unlicensed people from practicing nursing.
Create a state board of nursing or regulatory body having the authority to make and enforce rules and regulations concerning the nursing profession.
Define important terms and activities in nursing, including legal requirements and titles for RNs and LPNs.
Establish criteria for the education and licensure of nurses.
reciprocity
allows a nurse to apply for and be endorsed as an RN by another state
nursing process
the nursing process are assessing, diagnosing, planning, implementing, and evaluating
The nursing process allows nurses to use critical thinking and clinical reasoning when providing care that is individualized and holistic, and to define those areas of care that are within the domain of nursing
A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency department (ED). The nurse anticipates preparing the patient for ordered diagnostic tests. What aspect of nursing does this nurse’s knowledge of the diagnostic procedures reflect?
the science of nursing
Nurses today complete a nursing education program, and practice nursing that identifies the personal needs of the patient and the role of the nurse in meeting those needs. Which nursing pioneer is MOST instrumental in this birth of modern nursing?
Florence Nightingale
The role of nurses in today’s society was influenced by the nurse’s role in early civilization. Which statement best portrays this earlier role?
The nurse was the mother who cared for her family during sickness by using herbal remedies.
Nurses today work in a wide variety of health care settings. What trend occurred during World War II that had a tremendous effect on this development in the nursing profession?
there was a shortage of nurses and increased emphasis on education
A nurse practicing in a primary care center uses the ANA’s Nursing’s Social Policy Statement as a guideline for practice. Which purposes of nursing are outlined in this document? Select all that apply
A definition of the scope of nursing practice
The establishment of a knowledge base for nursing practice
A description of nursing’s social responsibility
A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which examples of nursing interventions reflect this goal? Select all that apply
A nurse counsels adolescents in a drug rehabilitation program
A nurse performs range-of-motion exercises for a patient on bedrest
A nurse shows a diabetic patient how to inject insulin
A nurse instructor outlines the criteria establishing nursing as a profession. What teaching point correctly describes this criteria? Select all that apply.
nursing is a recognize authority by a professional group
nursing has a code of ethics
nursing is influenced by ongoing research
A nurse is practicing as a nurse-midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level?
MSN
Nursing in the United States is regulated by the state nurse practice act. What is a common element of each state’s nurse practice act?
Defining the legal scope of nursing practice
according to the national advisory council on nurses education and practice, what is a current health care trend contributing to 21st century challenges to nursing practice?
older and more acute ill patients
Explain the sources of nursing knowledge and historical influences on nursing knowledge.
nursing knowledge is an awareness of reality acquired through learning or investigation. traditional knowledge. authoritative knowledge. scientific knowledge.
Florence Nightingales influence: nursing knowledge and practice by demonstrating efficient and knowledgeable nursing care.
system theory
adaptation theory
developmental theory
Explain the significance of the four concepts common to all nursing theories.
Discuss the evolution of nursing research
quantitative research methods
qualitative research methods
Describe evidence-based practice in nursing, including the rationale for its use
Outline the steps in implementing evidence-based practice.
Read and understand, on a beginning level, a published research article.
Use a framework to evaluate the salience of a research study
applied research
basic research
concept
like ideas, are abstract impressions organized into symbols of reality. Concepts describe objects, properties, and events and relationships among them
conceptual framework or model
A group of concepts that follows an understandable pattern
data
deductive reasoning
in which one examines a general idea and then considers specific actions or ideas
evidence-based practice (EBP)
Evidence-based practice guidelines
inductive reasoning
in which the reverse process is used—one builds from specific ideas or actions to conclusions about general ideas.
informed consent
nursing research
nursing theory
is developed to describe nursing. Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices
qualitative research
quality improvement (QI)
quantitative research
research
systematic review
theory
is composed of a group of concepts that describe a pattern of reality.
Source of knowledge
tradition
authoritative knowledge
scientific knowledge
nursing theory
is developed to describe nursing. differentiates nursing rom other disciplines and activities in that it serves the purposes of describing , explaining , predicting and controlling desired outcomes of nursing.
interdisciplinary base for nursing theories
general systems theory: ludwig von bertalanffy. this theory describes how to break whole things into parts and then to learn how the parts work together in sysems.
adaptation theory: Human adaptation occurs on three levels: the internal (self), the social (others), and the physical (biochemical reaction).
developmental theory: Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death
four concepts common in Nursing theories
(1) the person (patient), (2) the environment, (3) health, and (4) nursing.
nursing theory in clinical practice
provide autonomy (independence and self governance) in the practice of nursing in many ways.
nursing research
nursing research broadly defined, encompasses research to improve the care of people in the clinical setting as well as the broader study of people and the nursing profession, including studies of education, policy development, ethics and nursing history. nursing research is fundamental to the recognition of nursing as a profession.
the evolution of nursing research
During the 1950s and 1960s, nursing research was increasingly recognized as important. Early studies provided the basis for the development of nursing practice standards and the most effective educational preparation for registered nurses.
what are the goals of nursing research?
Build the scientific foundation for clinical practice
Prevent disease and disability
Manage and eliminate symptoms caused by illness
Enhance end-of-life and palliative care
symptom science
promoting personalized health strategies
wellness
promoting health and preventing illness
self management
improving quality of life for people with chronic conditions
end of life and palliative care
the science of compassion
method of conducting nursing research
conducted by quantitative and qualitative methodology
quantitative research method
involves the concepts of basis and applied research (variable, dependent variable, independent variable, hypothesis, data, instruments).
basic research pure or laboratory research is designed to generate and refine theory and the findings are often not directly useful in practice.
applied research directly influenced or improve clinical practice.
qualitative research
is the idea that reality is based on perceptions, which differ for each person and change over time. The research design follows many of the same steps as quantitative research, but differs in that the researcher primarily analyzes words or narratives rather than numbers
quantitative research process
- state the research problem
- define the purpose of the study.
- review related literature
- formulate hypotheses and variables
- select the research design
- select the population and sample
- collect the data
- analyze the data
- communicate findings and conclusions.
qualitative research methods
phenomenology
grounded theory
ethnography
historical
phenomenology
the purpose of phenomenology is to describe experiences as they are lived by the subjects being studied.
grounded theory
is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene.
ethnography
research is used to examine issues of a culture that are of interest to nursing.
historical research
examines events of the past to increase understanding of the nursing profession today
protection of the rights of human subjects
nurses play an important role in ensuring that patient interests are not sacrificed to research interests.
informed consent
the patients right to consent knowledgeably to participate in a study without coercion or to refuse to participate without jeopardizing the care that he or she will receive, the right to confidentiality and the right to protected from harm.
evidence based practice
problem solving approach to making clinical decision using the best evidence available
steps of EBP
Cultivate a spirit of inquiry.
Ask the burning clinical question in Population/Patient/Problem, Intervention, Comparison, Outcome, and Time (PICOT) format.
Search for and collect the most relevant best evidence.
Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, and synthesis).
Integrate the best evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change.
Evaluate outcomes of the practice decision or change based on evidence.
Disseminate the outcomes of the EBP decision or change.`
steps in implementing EBP
step one: ask a question about a clinical area if interest or an intervention.
step two: collect the most relevant and best evidence.
step three: critically appraise the evidence
step four: integrate the evidence with clinical expertise, patient preferences, and values in making a decision to change.
step five: evaluate the practice decisions or change
quadriplegia
paralysis from the neck down, including the trunk, legs and arms
health belief model
the nurse integrates knowledge that a client’s beliefs and actions are related and influenced by his personal expectations in relation to health and illness.
health
Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
The nurse is explaining primary and secondary care to the client. Which nursing activity reflects secondary care as provided by the nurse?
ordering a mammography
The nurse is caring for a client admitted for the third time in 90 days with a diagnosis of heart failure. What nursing activities on a tertiary level will the nurse educate the client regarding to prevent readmission?
importance of adhering to a low sodium diet
A group of students is reviewing the various levels of illness prevention. The students demonstrate understanding when they identify which of the following as a goal of tertiary prevention of illness?
minimizing complications
When caring for a client who has just been diagnosed with a chronic illness, the nurse understands the importance of promoting health by highlighting which concept?
Focus on what is possible.
The nurse is preparing to talk to a local community group regarding chronic illness. The nurse informs the group that both external and internal factors influence a person’s health. When discussing the fact that the male client has a higher chance of developing lung cancer due to his gender, which dimension is the nurse referring to?
Physical dimension
physical dimensions
The physical dimension includes genetic inheritance, age, developmental level, race, and biological sex. both external and internal strongly influence the persons health practice.
tertiary health promotion and illness prevention
begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning. include teaching, physical therapy, referrals to support group
interventions that reduce disparities and provide access to quality health care include:
Interventions include laboratory tests, low-cost medications, free patient education, and consultations as needed.
Other nursing interventions include teaching about a healthy diet, the importance of regular exercise, safety in industry and farms, using seat belts, and safer sex practices.
vulnerable populations
such as racial and ethnic minorities, those living in poverty, women, children, older adults, rural and inner-city residents, and people with disabilities and special health care needs
primary health promotions and illness prevention
Examples of primary-level activities are immunization clinics, family planning services, providing poison-control information, and accident-prevention education.
exacerbation
the symptoms of the disease reappear
illness behavior
stage 1: experiencing symptoms
stage 2: assuming the sick role
stage 3: assuming dependent role
stage 4: achieving recovery and rehabilitation
the human dimensions
the factors influencing a persons health, illness status, health beliefs and health practices relate to the persons human dimensions.
the human dimensions
physical dimension: genetic, age, developmental levels, race and biological sex. emotional dimension intellectual dimension environmental dimension sociocultural dimension spiritual dimension
the agent-environment model (develop by leavell and clark -1965)
views the interaction between an external environment as causes of disease in a person. explains how certain factors place some people at risk for an infectious disease. a model that is currently helpful in addressing the zika virus.
the health-illness continuum
continuum illustrates the ever-changing state of health as a person adapts to changes in internal and external environments to maintain a state of well-being
death-illness-normal health-good health-high level wellness
What have the models of health promotion and illness prevention been used for?
To help health care providers understand health-related behaviors.
secondary-level interventions
Administering medications
Providing wound care
Which model is most useful in examining the cause of disease in an individual, based upon external factors?
The Agent-Host-Environment Model
health promotion
is the behavior of a person who is motivated by a personal desire to increase well being and health potential.
risk factor
something that increases a persons chances for illness or injury
modifiable
things a person can change such as quitting smoking
nonmodifiable
things that cannot be changed such as a family history of cancer
Maslow’s physiologic needs?
Oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest
The hierarchy is based on the theory that something is a basic need if it has the following characteristics:
Its lack of fulfillment results in illness.
Its fulfillment helps prevent illness or signals health.
Meeting it restores health.
It takes priority over other desires and needs when unmet.
The person feels something is missing when the need is unmet.
The person feels satisfaction when the need is met.
safety and security needs
using proper hand hygiene and sterile techniques to prevent infection
using electrical equipment properly
administering medication knowledgeably
skillfully moving and ambulating patients
teaching parents about household chemically that are dangerous to children
self actualization (the highest level on the hierarchy)
includes the need for people to reach their full potential :
Acceptance of self and others as they are
Focus of interest on problems outside oneself
Ability to be objective
Feelings of happiness and affection for others
Respect for all people
Ability to discriminate between good and evil
Creativity as a guideline for solving problems and pursuing interests
family
a group of people who live together and depend on one another for physical, emotional and financial support.
the five major areas of family function are:
physical, economic, reproductive, affecting and coping and socialization.
Duvalls theory for family with older adults
task: adjust to retirement, adjust to loss of spouse, may move from family home.
risk factor: increase age with loss of physical function, chronic illness, depression, death of spouse.
nurse interventions: screening for chronic illness, home safety information, retirement information, pharmacology information.
What are 6 categories of characteristics that influence the health of a member of a community?
1) Education and rec programs
2. ) Production of services and goods
3. ) Protection, safety, aesthetic concerns
4. ) Transportation, communication
5. ) Healthcare resources
6. ) Prevailing values and beliefs
QSEN
QUALITY, SAFETY EDUCATION FOR NURSES
leaving AMA
Patient is legally free to leave if over 18. (IF under age parent decides to remove pt from mam, physician can refused if pt need ama)
choice carrier a risk for increased illness or complications.
patient must sign a release form.
patient is informed of risks prior to signing form.
patients signature must be witnessed.
form become part of medical record.
private insurance will evaluate covering cost of care if patient leaves AMA.
CHARACTERISTICS OF EFFECTIVE DOCUMENTATION
consistent, complete, accurate, concise, factual, organized and timely. legally prudent, confidential. document ASAP.
the nurse is obtaining consent from a subject newly recruited for a clinical drug trial that will last for 6 months . all subjects will be given gift certificates for participating. one subject says, “well I guess if the drug doesn’t work, ill just have to put up with the symptoms for 6 months.” what will the nurse tell the subject?
“participation may end at any time without penalty.”
right to autonomy
the right to self-determination. patients have the right to refuse to participate or to withdraw from a study at any time without penalty
the nurse is assisting with a clinical drug trial in which the side effect of two effective drugs are being compared. a patient who would benefit from either drug has elected to withdraw from the study, and the nurse assists with the paper work to facilitate this. this is an example of
autonomy
during a clinical drug trial for a new medication, researchers note a previously unknown serious adverse effect occurring in more than 50% of subject. which ethical principal is being exercised?
Beneficence
beneficence
the duty to protect subjects from harm. once a serious adverse effect is noted and it is determined that the benefits do not outweigh the risks of the study, researchers have an ethical obligation to stop the study.
in a 5 year experimental clinical trial to investigate a new cancer treatment, researchers in the second year note overwhelming improvement in almost all of the subjects in the treatment group. it is decided to stop the trial early and report the findings do to the overwhelmingly beneficial effects. this decision was made based on which ethical principle?
justice
principle of justice
requires that all people be treated fairly.
the nurse is enrolling subjects for a double-blind experimental study. one patient asks the nurse to explain the role of the experimental group. the nurse will explain that subjects in the experimental group in this type of study:
receive the experimental treatment being evaluated.
the nurse is obtaining signatures on consent forms for participation in a clinical drug trial. one patient says, “ i am not sure i want to do this, but i need the cash. “ the nurse will take which action?
report this statement to the lead investigator
which is the characteristic of preclinical in vivo testing?
a comparison of experimental and control data in animals
preclinical in vivo testing
is performed in animals or other living organisms. in vitro studies occur in test tube. safe therapeutic dose studies are part of clinical research. prior to clinical trials, an assessment is made of the disease and its seriousness.
many drugs marked in the 1980s may not be effective in a majority of the population. the nurse understands that this is because these drugs:
were not tested in women, minorities, or children.
the nurse is assisting with data collection in a study of drug effects in a small group of healthy subjects. the nurse assists with blood and urine collection to determine serum drug levels and the presence of metabolites in urine. which phase of drug development does this represent?
phase I
drug phase I
phase I drug trials are performed to assess safety and to identify the pharmacokinetics, such as metabolism and elimination, of drugs in healthy subjects.
the nurse is enrolling subjects for a clinical drug trial, in which subjects will be randomly assigned to either a treatment or a placebo group. the pills in both groups will be identical packaging with identical appearance. the group that receives the intervention is the:
experimental group
experimental group
the group that receives the drug being tested.
respect for persons is a core ethical principle of human subjects research. which of the following best describes this principle?
patients are independent and capable of making decisions in their own best interest
a clinical drug trial is concluding a study of pharmacokinetics and safety of a drug in healthy individuals. the nurse will assist enrollment of participants into the next phase of the study and will include which subjects?
subjects with the disease the drug will treat
after phase i studies
demonstrate drug safety and pharmacokinetics have been completed, the drug is tested on subjects who have the disease the drug will treat.
before marketing a new drug that has been approved for use based on clinical effectiveness and safety, the manufacturer wishes to study the potential new uses for the drug. this is an example of which phase of study?
phase iv
phase iv studies
are performed, in part, to examine potential new indications for approved drugs (effects associated with long term use).
which statement about the safety and efficacy of medication in children is accurate?
federal laws require that drugs for children be tested on children (FDA ,1997)
A nurse is preparing to administer a schedule II injectable drug and is drawing up half of the contents of a single-use vial. which nursing action is correct.
ask another nurse to observe and consign wasting the remaining drug from the vial.
A patient is prescribed a medication and asks the nurse if the drug is available in a genetic form. the nurse understands that a genetic drug name is:
nonproprietary (the genetic name is the official, nonproprietary name for a drug.)
a patient receives a prescription on which the provider has noted that a genetic medication may be given. the patient asks the nurse what this means. what will the patient tell the patient about genetic drugs?
they tend to be less expensive than brand-name drugs.
the nurse reviews information about a drug and notes the initial “united states pharmacopeia (USP)” after the drugs official name. the nurse understands that this designation indicates the drug:
meets USP quality and safety standards.
USP designation is given to
drugs that have met high standards for therapeutic use, patient safety, quality, purity, strength, packaging safety, and dosage form by the united states pharmacopoeia national formulary.
the nurse is preparing to give a medication to a child. the medication is approved for use in children. the child’s parent asks whether the drug is safe for children. how will the nurse respond to the parent?
drugs approved for use in children are tested for both efficacy and safety in children in order to be marked for pediatric use
which laws govern all drug administration by nurses?
Nurse practice acts (each states nurse practice act identifies how nurses administer medications. the other acts govern how drugs are marked and tested)
a patient taking methadone as part of a heroin withdrawal program. the nurse understands that, in this instance, methadone is classified as which drug schedule?
methadone is category C II
The nurse is preparing to administer a combination drug containing acetaminophen and codeine. the nurse knows that this drug is classified as which drug schedule?
C-III (Codeine is normally a category ii, except when it is part of a combination product such as with acetaminophen, making it a category iii drug)
which are responsibilities of the FDA? (Select all that apply)
to ensure a drug has accurate labeling, drug is effective and to ensure a drug is tested for harmful effects.
adrenergic blocker is the same as
antagonist
who do you not give antagonist or adrenergic blockers to?
asthma client
beta blockers commonly seen in what clients?
hypertension
antagonist suffix
LOL
Agonist s/s
increase heart rate
fight or flight
vasoconstriction
increased blood sugar
before administering antagonist what do you check?
heart rate and blood pressure
cholinergic
salivate, lacrimation, urinate, defecate, decreased weight
whats the five rights of medication administration?
right patient right drug right dose right route right time
the RN must follow the original 5 rights of medication administration: i right patient?
must use two patient identifiers, never assume.
Rn must follow the original 5 rights of medication administration: ii. right drug?
components of a drug order. -date and time order was written -drug name -drug dose -route -frequency and duration -special instructions or hold parameters must exercise extreme caution when taking a verbal order or a telephone order-always read order back.
RN must follow the original 5 rights of medication administration: ii. Right dose?
unless health care provider orders a range of medication, you may never change the amount of medication you are giving- if you give to little or too much, you are changing the dose-practicing out of your scope of practice-illegal.
Rn must follow the original 5 rights of medication administration: iv. right time?
can give medication with 1 hour window of time.
1 hour before or 1 hour after.
what are time critical medications?
insulin
heparin
antibiotics
RN must follow the original 5 rights of medication administration: v. right route?
if ordered PO, cannot give it iv
never confuse oral medication in a syringe with an iv medication
certain medication-can call pharmacy to change route
whats the nurses rights when administering medication?
a. 6 rights
right to complete and clear order
right to have correct drug, route and dose
right to have access to inform
right to have policies to guide safe administration
right to administer medication safely, and to identify problems
right to stop, think, and be vigilant when administering medication
culture of safety potential cause for medication errors?
distraction memory lapses equipment failure inadequate monitoring lack of drug knowledge lack of standardization inadequate patient history increased number of drug available poor interdepartmental communication inadequate patient history increased number of drugs available poor interdepartmental communication transcription, dispensing, or delivery problems violation of rights of nursing medication administration
whats black box warning?
FDAs strongest labeling-warns health care providers of risk associated with specific medications
whats joint commision?
focuses on problems in health care-how to solve them
includes ambulatory health care, behavioral health care, critical care access, home care, hospitals, laboratory services, long term care, and office based surgery.
whats drug reconciliation
important for patient safety to identify the most accurate list of medication that the patient is taking at transitions in care, which include:
1-three transition points where medication errors occur
-hospital admission
-intra-hospital transfer
-discharge
comparing patients home medications to all medication patients has been taking
5 steps
list of current meds
list of meds to be prescribed
compare both med lists
make clinical decisions based on comparisons
communicate new list to patients, family and caregivers.
