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The "Fun" class > Nursing Intro - Exam 4? > Flashcards

Nursing Intro - Exam 4? Flashcards

1
Q

what does evidence- based care do?

A
  • improves quality, safety, and pt outcomes
  • increases nurse satisfaction
  • reduces costs
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2
Q

sources of evidence

A
  • textbooks
  • articles from nursing and health care literature
  • quality Improvement and risk management data
  • standards of care
  • infection control data
  • benchmarking, retrospective, or concurrent chart reviews
  • clinicians’ expertise
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3
Q

what are the steps of evidence based practice?

A
  1. cultivate a spirit of inquiry
  2. ask a clinical question in PICOT format
  3. search for the most relevant evidence
  4. critically appraise the evidence you gather
  5. integrate all evidence with your clinical expertise and pt preferences and values
  6. evaluate the outcomes of practice decisions or changes using evidence
  7. share the outcomes with others
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4
Q

what do you need to do when asking a clinical question?

A

develop a PICOT question

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5
Q

what does PICOT stand for?

A 
P = pt population of interest
I = intervention of interest
C = comparison of interest
O = outcome
T = time
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6
Q

which letters in PICOT may not be appropriate in every question?

A

I, C, and T

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7
Q

who are some experts you can ask for help?

A
  • nursing faculty
  • advances practice nurses
  • staff educators
  • risk managers
  • librarians
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8
Q

what can a medical librarian help you with?

A
  • identify the databases that are available to you

- identify key words that will provide the best answer to your PICOT question

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9
Q

after critiquing all articles for a PICOT question …

A
  • synthesize or combine the findings

- consider the scientific rigor of the evidence and whether it has application in practice

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10
Q

after critiquing the evidence, you will be able to answer the following questions

A
  • do the articles offer evidence to explain or answer my PICOT question?
  • do the articles show support for the reliability and validity of the evidence?
  • can i use evidence in practice?
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11
Q

what are the elements of an article?

A
  • abstract (brief summary)
  • introduction (contains more info about the purpose of the article)
  • literature review or background
  • manuscript narrative
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12
Q

what is integrating evidence?

A

teaching, assessment or documentation tools, clinical practice guidelines, policies and procedures

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13
Q

when applying evidence, consider …

A

setting, staff support, scope of practice, and resources

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14
Q

a ___ may be conducted when evidence is not strong enough to apply in practice

A

pilot study

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15
Q

when evaluating the EBP change determine …

A
  • was the change effective?
  • are modifications needed?
  • should the change be discontinued?
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16
Q

after implementing an EBP change, it is important to communicate the results with …

A
  • clinical staff on the unit
  • nursing practice council or the research council
  • clinicians
  • professional conferences and meeting
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17
Q

nursing research

A
  • a way to identify new knowledge, improve professional education and practice, and use resources effectively
  • many professional and specialty nursing organizations support the conduct of research for advancing nursing science.
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18
Q

quantitative

A
  • experimental research
  • nonexperimental research
  • surveys- frequency, distribution, and interrelation of variables among subjects in the study
  • evaluation research- determines how well a program, practice, procedure, or policy is working
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19
Q

qualitative

A
  • ethnography
  • phenomentology
  • grounded theory
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20
Q

what is the research process?

A

assessment - identify area of interest or clinical problem
diagnosis - develop research questions/ hypotheses
planning - determine how study will be conducted
implementation - conduct the study
evaluation - analyze results of the study use the findings

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21
Q

what is the institutional review board?

A

scientists and laypersons who review all studies conducted at the institution

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22
Q

what is the human research terminology?

A
  • informed consent means
  • participants receive full and complete information
  • they can understand the information
  • risks & Benefits
  • they have free choice to participate or withdraw
  • they understand how their confidentiality will be kept
  • confidentiality
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23
Q

what is caring?

A

a universal phenomenon that influences the way we think, feel, and behave

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24
Q

pt value the affective dimension of nursing care

A
  • connecting with patients and their families-develop rapport!
  • being present with a reassuring presence
  • all patients are unique
  • respecting values, beliefs, and health care choices
  • keeping a close and attentive eye on the situation
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25
Q

what is the ethic of care?

A

relationship between pt and nurse and the attitude of each toward the other

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26
Q

caring in nursing practice

A
  • as you deal with health and illness in your practice, you grow in your ability to care and develop caring behaviors.
  • caring is one of those human behaviors that we can give and receive.
  • recognize the importance of self-care.
  • use caring behaviors to reach out to your colleagues and care for them as well.
  • behaviors include being present, providing a caring touch, and listening.
  • calms anxiety and fear in stressful situations
  • caring is a product of culture, values, experiences, and relationships with others.
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27
Q

how can you provide presence?

A
  • being with the pt
  • body language
  • listening
  • eye contact
  • tone of voice
  • positive and encouraging attitude
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28
Q

touch

A
  • provides comfort
  • creates a connection
  • be aware of your pt’s cultural practices
  • contact touch
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29
Q

listening

A
  • creates trust
  • opens lines of communication
  • creates a mutual relationship
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30
Q

what is Benners theory?

A

caring is highly connected involving each nurse- pt encounter

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31
Q

what is Watson’s Transpersonal Caring theory?

A
  • caring is central focus of nursing
  • places caring before curing
  • 10 carative factors (pg 81)
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32
Q

what is Swanson’s Theory of Caring

A
  • includes 5 caring processes

- defines caring as a nurturing way of relating to an individual

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33
Q

knowing the pt

A
  • one of swansons 5 caring processes
  • develops over time
  • the core process of clinical decision making
  • aspects of knowing include
  • responses to therapy, routines, habits
  • coping resources
  • physical capabilities and endurance
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34
Q

relieving symptoms and suffering

A
  • performing caring nursing actions that give a patient comfort, dignity, respect, and peace
  • providing necessary comfort and support measures to the family or significant others
  • creating a physical patient care environment that soothes and heals the mind, body, and spirit
  • comforting through a listening, nonjudgmental, caring presence
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35
Q

autonomy

A

commitment to include pt’s in decisions; freedom from external control

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36
Q

beneficence

A

taking positive actions to help others

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37
Q

nonmaleficence

A

avoidance of harm or hurt

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38
Q

justice

A

being fair

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39
Q

fidelity

A

agreement to keep promises

40
Q

what is the code of nursing ethics?

A
  • a set of guiding principles that all members of a profession accept
  • helps professional groups settle questions about practice or behavior
  • includes advocacy, responsibility, accountability, and confidentiality
41
Q

social networking

A
  • presents ethical challenges for nurses
  • risk to pt privacy is great
  • friendship with a pt can cloud your ability to remain objective
42
Q

advocacy

A

refers to the support of a particular cause

43
Q

responsibility

A

refers to a willingness to respect one’s professional obligations

44
Q

accountability

A

refers to ability to answer for one’s actions

45
Q

confidentiality

A

HIPAA

46
Q

value

A
  • a value is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior
  • as a nurse, you agree to provide care to your pt’s solely on the basis of their need for your services
47
Q

values clarification

A
  • ethical dilemmas almost always occur in the presence of conflicting values
  • to resolve ethical dilemmas, one needs to be distinguished among values, facts, and opinions
48
Q

deontology

A

defines actions as right or wrong

49
Q

utilitarianism

A

proposes that the value of something is determined by its usefulness; main emphasis is on the outcome or consequence of an action

50
Q

feminist ethics

A

focuses on the inequality between people

51
Q

ethics of care

A

emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives

52
Q

casuistry

A

case- based reasoning; focuses on an “intimate understanding of particular situations”

53
Q

nursing point of view

A
  • nurses generally engage with patients over longer periods of time than other disciplines.- patients may feel more comfortable revealing information to nurses.
54
Q

processing an ethical dilemma

A

Step 1: Ask if this is an ethical dilemma.
Step 2: Gather all relevant information.
Step 3: Clarify values.
Step 4: Verbalize the problem.
Step 5: Identify possible courses of action.
Step 6: Negotiate the outcome.
Step 7: Evaluate the action.

55
Q

institutional resources

A
  • ethics committees are usually multidisciplinary and serve several purposes: education, policy recommendation, and case consultation.
  • any person involved in an ethical dilemma, including nurses, physicians, health care providers, patients, and family members, can request access to an ethics committee.
  • moral distress can occur when ethical problems are not processed well
56
Q

quality of life

A

central to discussions about end of life care, cancer therapy, physician assisted suicide, and DNR

57
Q

disabilities

A

antidiscrimination laws enhance the economic security of people with physical, mental, or emotional challenges

58
Q

care at the end of life

A

interventions unlikely to produce benefit for the pt

59
Q

health care reform

A

facilitated access to care for millions of uninsured Americas

60
Q

nurses must keep current with nurse practice act & changing laws

A

nurse practice acts - describe and define the legal boundaries of nursing practice within each state

61
Q

standards of care

A

the knowledge and skill ordinarily possessed and used by nurses including

  • legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care
  • best known comes from the American Nurses Association (ANA)
  • set by state and federal laws that govern where nurses work
  • joint Commission requires policies and procedures (P&Ps).
62
Q

advances directives

A
  • PSDA
  • living wills/durable power of attorney
  • health care proxies or durable power of attorney for health care
  • DNR
63
Q

Uniform Anatomical Gift Act

A

individual at least 18 years of age has the right to make an organ donation

64
Q

HIPAA

A
  • limits who is able to access a pt’s record

- provides confidentiality of a pt’s medical information

65
Q

HITECH

A

PHI is not inadvertently conveyed on social media

66
Q

restraints

A

there are now standards for reducing the use of all types of restraints in health care settings

67
Q

licensure

A

NCLEX; BON suspends or revokes a license if a nurse’s conduct violates the Nurse Practice Act

68
Q

good samaritan laws

A

limit liability and offer legal immunity for nurses who help at the scene of an accident

69
Q

public health laws

A

protect populations, advocate for the rights of people, regulate health care and health care financing, and ensure professional accountability for care provided

70
Q

the uniform determination of death act

A

the cardiopulmonary standard; the whole-brain standard

71
Q

autopsy

A

when a pt’s death is not subject to a medical examiners review, consent must be obtained

72
Q

death with dignity or physician assisted suicide

A

know your state’s laws to ensure your practice falls withing the laws requirements

73
Q

what are torts?

A
  • civil wrongful acts or omissions made against a person or property
  • intentional torts
74
Q

assault

A

intentional threat toward another person that places the person in reasonable fear that harmful, imminent, or unwelcome cotact

75
Q

battery

A

intentional offensive touching without consent

76
Q

false imprisonment

A

unjustified restraint of a person without a legal reason

77
Q

quasi- intentional torts

A

acts which intent is lacking but volitional action and direct causation occur
- invasion of privacy

78
Q

defamation of character

A

publication of false statements that result in damage to a persons reputation

79
Q

slander

A

when one speaks falsely about another

80
Q

libel

A

written defamation of character

81
Q

unintentional torts

A

includes negligence and malpractice

82
Q

negligence

A

conduct that falls below the generally accepted standard of care

83
Q

malpractice

A

often referred to as professional negligence. certain criteria are necessary to establish malpractice

84
Q

a consent form must be …

A

signed

85
Q

informed consent

A
  • agreement to allow care based on full disclosure of risks, benefits, alternatives, and consequences of refusal
  • must be obtained and witnessed when the patient is not under the influence of medication such as opioids
    the nurse’s signature as a witness to the consent means that the patient voluntarily gave consent, the patient’s signature is authentic, and the patient appears to be competent to give consent
  • parents usually sign consent for pediatric patients
  • patients with mental illnesses must also give consent; they retain the right to refuse treatment until a court has determined legally that they are incompetent
86
Q

nursing students

A
  • as a nursing student in a clinical setting, you are expected to perform as professional nurse would in providing safe patient care.
  • you are liable if your actions cause harm to patients, as is your instructor, hospital, and college/university.
  • you are expected to perform as a professional when rendering care.
  • you must separate your student nurse role from your work as a certified nursing assistant (CNA).
87
Q

malpractice insurance

A
  • a contract between nurse and the insurance company
  • provides a defense when a nurse is in a lawsuit involving negligence or malpractice
  • nurses covered by institutions insurance while working at their place of employment
88
Q

short staffing

A
  • legal problem occur if an inadequate number of nurses will provide care
  • CHAP
  • registered nurse safe staffing act
89
Q

floating

A
  • based on census load and pt acuities

- must inform the supervisor of any lack of experience in caring for the type of pts

90
Q

health care providers orders

A

nurses follow orders unless they believe an order is given in error or is harmful

91
Q

risk management and quality assurance

A

a system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs

92
Q

steps involved in risk management

A
  • identify possible risks
  • analyze risks
  • act to reduce risks
  • evaluate steps taken
93
Q

occurence reporting

A
  • serves as a database for further investigation
  • alerts risk management to a potential clean situation
  • separate from the medical record
94
Q

documentation

A

a nurses documentation is evidence of care

95
Q

TJC’s Universal Protocols

A

time out

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