N110 Week 4 Flashcards
_____ and human motivation can explain major nursing concepts.
Systems
Systems theory
a set of interrelated parts, in which each part is necessary to the whole
Component parts to a system include:
Input Throughput Output Evaluation Feedback
Systems model applied to Nursing Practice
Consists of:
person, environment, and health
- Nursing views “persons” as unique ____ systems.
- ____is defined as each individual man, woman, or child ( mind, body, spirit)
- Each individual person functions as an open system with numerous _______
- Open system: Promotes _____ of matter, energy, and information with other systems and the environment (all living systems)
- open
- Person
- subsystems
- exchange
Homeostasis
Dynamic balance within and between systems - internal stability
What is each level of Maslow’s human needs hierarchy (5)?
Level 1:physiological survival Level 2: Safety and security needs Level 3: Needs for love and belonging Level 4: Self-esteem needs Level 5: Self-actualization
Maslow’s human needs hierarchy.
Level 1:
- Those needs that ensure physiological survival. Oxygen, rest, activity, shelter, and sexual expression Ex: homeless person
Maslow’s human needs hierarchy.
Level 2:
Level 2: Safety and security needs
Include physical and psychological needs/ fairly predictable environment which is relatively free of chaos or fear Ex: infants moved into foster care with frequent changes
Maslow’s human needs hierarchy.
Level 3:
Level 3: Needs for love and belonging
Social and intimate relationships Ex: belonging in a group/assoc/team/ friends
Maslow’s human needs hierarchy.
Level 4:
Level 4: Self-esteem needs
Need for self-worth, self-respect, and self-reliance
Ex: feeling of self-worth/valued
Maslow’s human needs hierarchy.
Level 5:
Level 5: Self-actualization
Realization of one’s maximum or optimal potential
All elements of an individuals environment affect health. Elements include:
all circumstances, influences, and conditions that surround and affect individuals, families and groups
________ the most direct influence on a person, includes nuclear and extended families.
Family systems
________ consists of attitudes, beliefs, and behaviors of social and ethnic groups that are perpetuated through generations.
Cultural systems
________ groups of families, neighborhoods, schools, churches, professional associations, civic groups and recreational groups, poverty
Social systems
_______ larger systems in which people live
Community, national, and world systems
Health is a dynamic continuum:
Parsons (1959): Health is
“the state of optimum capacity of an individual for the effective performance of roles and tasks.”
According to World Health Organization (WHO, 1947): Health is
“a state of complete physical mental, and social well-being and not merely the absence of disease or infirmity”
Health is a ______ vs. an absolute state.
Health _____ from day to day.
Illness is not an ______ state; it also can vary from day to day.
continuum
varies
absolute
What is:
-A National Healthy Initiative
Disease prevention & health promotion
-Consists of goals and focus areas
-Access to quality health services to increase quality and years of healthy life and eliminate health disparities
Healthy People 2000, 2010, 2020
Health behaviors include:
Those choices and habitual actions that promote or diminish health, such as Eating habits, frequency of exercise, use of tobacco products and alcohol, sexual practices, adequacy of rest and sleep
What are the three components of the Health beliefs model (Rosenstock, 1966, 1990)?
- Evaluation of one’s vulnerability to, and seriousness of, a condition
- Individuals/groups perception of how effective the health behavior might be
- The presence of a trigger event that precipitates the health maintenance behavior
An Open system integrates person, environment and health. _____ nursing care nourishes the whole person: body, mind, spirit.
Holistic
Nursing care functions as an open system that:
interacts with, influences and
is influenced by forces that are internal and external to a patient.
Holistic health
a focus on the interrelationship of all the parts that make up a whole person.
\_\_\_\_\_\_\_ Health practices include: Nutritional habits Type and amount of exercise Types and amounts of rest How persons cope with stress Quality of interpersonal relationships Expression of spirituality Other lifestyle factors
Holistic
Role of Nursing is to help….
patient achieve the highest level of health
Nursing focuses on optimally assisting people to:
Manage health
Avoid or minimize disease and disability (prevention).
Restore wellness or
Achieve a peaceful death
The nurse’s ability to facilitate health for the patient involves:
- Collaboration with patients and families
- Provision of care regardless of individual differences
- Support for the value, dignity, and uniqueness of each person
- Consideration and inclusion of patients’ cultural and belief systems
Categories of Health Care Services Include:
Health promotion and maintenance
Illness prevention
Diagnosis and treatment
Rehabilitation and long-term care
assist patients to remain healthy, prevent disease and injuries, detect diseases early, and promote healthier lifestyles
Ex: church group holding “health fair” to discuss importance of BP screening, mammograms, annual check-ups
Health promotion and maintenance
Assist patients in reducing the impact of risk factors identified through family history and genetic predispositions
Risk factors are already present
Ex.: anticipatory guidance for grief counseling, encourage dermatology visits if hx melanoma
Illness prevention
Traditional goal of medicine; assess symptoms, conduct diagnostic tests, generate formal diagnosis, plan and implement treatment regimens. Ex: CT scan, X-ray, biopsy, medications
Diagnosis and treatment
Help restore the patient to the fullest possible level of function and independence following injury or illness
Ex: diabetic teaching
Rehabilitation and long-term care
Public agencies are supported by______ (federal or city govt.). While Private Agencies are supported by _________.
taxes
endowments and donations.
- Focus on the health of all U.S. citizens; promote and conduct health and illness research, provide funding to train health care workers, assist communities in planning health care services; develop, staff and help fund health programs
- Establish standards of practice and safety for health care workers
- Nonprofit Ex: NIH, DHHS, CDC
Govt Agencies
- Oversee programs that affect the health of citizens within an individual state
- Usually do not provide direct patient care but support agencies that do
- Nonprofit EX: PA Dept of Health, state agencies for Medicaid/ Medicare/ WIC
State agencies (public)
-Serve one community, one county, or a few adjacent counties
-Services include immunizations, prenatal care, well-baby care, infectious disease clinics, tuberculosis clinics, and others
-Provide services to both paying and nonpaying citizens
Nonprofit. Ex: Phila public health dept …visiting RNs, prenatal clinics
Local agencies (public)
-Work to promote or restore health through private donations and government grants
-Usually nonprofit
Ex: American Red Cross/ Amer Heart Assoc/March of Dimes/ Amer Cancer Society
Voluntary agencies (private)
Use profits to pay personnel, improve services, advertise services, provide educational programs, or otherwise contribute to the mission of the agency. Monies are fed back into the agency
Not-for-profit agencies
- Include numerous home health care companies, hospital systems, specialty outpatient centers, heart hospitals, and rehabilitation centers
- These agencies distribute profits earned to partners or shareholders
For-profit agencies
- Care rendered at the point at which a patient first enters the health care system
- Care provided in physician’s office or clinic
- May include emergency care, health maintenance, chronic care, health promotion
Primary care services
- Involves the prevention of complications from disease
- Includes treatment of temporary dysfunctions requiring medical intervention or hospitalization
- Can be provided in a community hospital, ambulatory care center, surgical centers
Secondary care services
- Provided to acutely ill or injured patients with complex conditions
- Can be a hospital trauma center, burn center, or pediatric hospital
- Provides interdisciplinary approach to care……patient will be seen by a team of health care workers ( nutrition, social work, cardiology, internal medicine, etc.)
Tertiary care services
- Inpatient care that lies between hospital care and long-term care
- Goal-oriented, comprehensive inpatient care for patients who have acute illnesses, injuries, or exacerbations of a disease process
- Provides lower-cost health care than alternatives
Subacute care
- ______ The governing body, or Board of Trustees; community leaders and physicians who practice in the institution and provide business knowledge and expertise
- _______ Individual responsible for the overall operation on a daily basis; usually has a master’s degree in business or hospital administration
Board of Directors
Chief Executive Officer
- _______ Physicians who may be either employees of the organization or independent practitioners; must be granted privileges to see patients at the institution
- _______ Medical staffs are often organized by service, with Chief of Staff as head; work together with the Chief Executive Officer
Medical Staff
Medical Staff Governance
______Today are often members of the Board of Directors, as contributors to broad decision making for the organization
Chief Nursing Officer (or chief nurse executive, vice president for nursing or director of nursing)
- _____ Consists of all the registered nurses, licensed practical nurses/licensed vocational nurses, patient care technicians, and clerical assistants employed by the department of nursing
- _______Serves as a communication and decision-making vehicle. In some institutions, nurses are expected to govern themselves; responsibility for the professional practice of nursing in their institution
Nursing Staff
Nursing Staff Governance:
What are the two main means to ensure maintenance of quality standards?
Accreditation and Quality Improvement
Accreditation of health care agencies - occurs through one of two accrediting bodies approved by the Centers for Medicare and Medicaid Services (CMS). They are:
- The Joint Commission ( JCAHO): Nonprofit; serving as the nation’s predominant standard-setting and accrediting body in U.S. health care
- Healthcare Facilities Accreditation Program (HFAP)
An internal strategy for organizations to work toward improvement in patient outcomes
Focus on establishing procedures for ensuring high-quality patient care
Continuous quality improvement/total quality management
Defined as: Differences in the quality of health care provided to different populations
Health Care Disparities
Frequent health care disparities include:
- Ethnic or racial disparities
- Education level
- Gender
- Disability
- Age
- Sexual orientation
- Income
- Place of residence
Since the initial National Healthcare Disparities Report (NHDR), for minorities…
more things have gotten worse than gotten better
The nurse’s role includes (7)
- Provider of care
- Educator
- Counselor
- Manager
- Researcher
- Collaborator
- Patient Advocate
The nurse role “provider of care” includes:
- Provide direct, hands-on care in all health care agencies and settings
- Illness prevention
- Health promotion
- Health maintenance
______ Began in 1950s
- Organizing and distributing tasks among available staff
- Fragmented care/ task oriented
Functional nursing
________ Began in late 1950s
- Nursing teams composed of staff members with different skill levels assigned to defined groups of patients
- fragmented care/ lack of communication
Team nursing
_______1970s (increased acuity)
- An identified nurse for every patient during the patient’s hospital stay, for consistent comprehensive care….care of that patient from admission to D/C……
- Good continuity of care
Primary nursing
-Holistic approach to care
-Patient’s right to individualized care through multidisciplinary team of professionals.
-Patient’s needs have priority over institution’s needs.
Started 1970s and Used in most hospitals today
Patient-Centered Care
_______ accounts for 20% to 28% of the cost of hospitalization for most patient groups.
Nursing care
_____ Group of jointly funded federal-state programs for low-income, elderly, blind, and disabled individuals, established in 1965
People must meet eligibility requirements.
Medicaid
______A nationwide federal health insurance program established in 1965 for people ages 65 and over, regardless of income
Medicare
How can Nurses play a role in controlling health care costs?
First step is to become cost conscious
Nurses can promote cost savings by:
Providing excellent patient care
Being advocates for their patients’ financial needs regarding health care services
Nurses can help control health care costs by:
1. Question unnecessary or ______ laboratory studies and tests
Suggest generic drugs over name brands
2. _____ patients and families to monitor health conditions and detect problems early to avoid repeat hospitalizations
3._______ infections with basic hand-washing and avoidance of bed sores for patients
4. Prevent patient ____
5. Organize and streamline flow of patients for maximum ____
- repetitive
- Teach
- Prevent
- falls
- efficiency
