Mod 2 Flashcards
What are the key concepts related to Reasonable and Prudent Care
The standard of care which a reasonable and prudent nephrology nurse would give under the same or similar circumstances
Actions a reasonable and prudent nephrology nurse would do, as well as actions the nurse would avoid doing
The skills and knowledge expected of a nephrology nurse is key to the specialty of nephrology nursing
Who established the Standards of Care for Nephrology Nursing and for what purpose?
American Nephrology Nurses Association (ANNA) establish the standards of care and scope of practice for Nephrology Nursing
Standards of Care can serve as a basis for many areas including policy and procedures, protocols, educational offerings, regulatory systems and more
What are three considerations when delegating nursing care activities?
Must be within the nurse’s scope of practice
Must be delegable by State Bored of Nursing
Personnel must be adequately trained to preform activity
What role does Davitia’s P and P play?
Provides evidenced based guidance
Meets CMS Conditions for Coverage
Complies with state and federal laws
What are the risks of performing activities your way?
Not providing safe evidence based care can lead to Civil Liability
What are the four reasons we document in the medical record
Proof that care was rendered
Provides data continuity
Communication tool
Permanent legal record
List six occurrences when to document
Change from baseline assessment
Change in patient’s condition
Procedure preformed or treatment provided
Medication given and patient reactions
Patient teaching
Care plan review and interventions
What does SMART communication stand for?
S simple keep message clear and simple
M meaningful thank about what and why you are sending the message
A actual just report the facts
R read make sure you are sending the message you intend
T teach others about SMART communication
What are possible consequences of not using SMART communication
Exposes you and DaVita to liability
Repetitional injury
Jeopardizes the recipient
Potentially career threatening
How to document late entries
If unable to chart immediately after rendering a service or at the time of an observation the teammate is to make the appropriate entry as soon as possible
How to document late entries electronic
If documenting within the EMR the notation will automatically contain your electronic signature, date and time
How to document late entries paper chart
The late entry must be signed by the person making the late entry
The late entry must be timed and dated at the time it is entered
How do you document charting errors
When documenting on paper, draw a single line through the entry, date/ signature/ teammate credentials, chart the correct information. If documenting in an electronic health record system, follow facility procedure for that system
What is the difference between data collection and assessment and who is responsible for which
Assessment-Nurse
Data collection PCT
Assessment-Nurse
Determining depth of edema
Heart rate, rhythm, quality of heart sounds
Respiration rate, rhythm, effort being put into breathing, identifying unusual lung sounds
Data collection PCT
Noting presence of edema
Counting the patient heart rate
Respiration rate, recognizing unusual breath sounds
Machine parameters, safety checks
What is the role of the licensed nurse prior to treatment initiation
Assess abnormal findings from data collection, determine appropriate interventions (based on physician orders) and contact physician if needed
When is pretreatment assessment by the licensed required
For a CKD hemodialysis patient: based in state law ( may be before treatment initiation or within an hour of treatment initiation) or if data collection has abnormal findings
For patients with AKI pretreatment assessment is always required
What is the role of the PCT prior to treatment initiation
Complete data collection and PCT must notify the RN if there are any abnormal findings prior to initiation of treatment
What are the appropriate times for documentation
Pretreatment safety checks
Prior to treatment initiation
Pretreatment patient data collection
Completed pretreatment/ assessment: prior to treatment initiation if required by state law or within first hour of dialysis treatment
What are the appropriate times for documentation/ observations during treatment
Document assessment pretreatment, continuous during treatment, as they occur
What are the appropriate times for documentation post treatment data collection/ assessment
Must be done after treatment is complete - some of the things needed post treatment
Documentation of clearance is dialyzer after rinse back
Blood pressure
Heart rate
Temperature
Respiratory rate
Weight
What is the preferred location for taking a blood pressure
Upper, non-vascular arm
What BP reading error can be caused by an incorrect cuff size?
Cuff to small reading may be higher than actual BP
Cuff too large reading may be lower than actual BP
What is the normal pretreatment blood pressure
Systolic equal to or less than 180 or equal to or greater than 90
Diastolic less than 100
