Patient Centered Care: Exam 1 (found) Flashcards
Health Promotion: Primary Prevention
things we do to prevent disease & promote health
Health Promotion: Secondary Prevention
screening tests for disease
- Sensitivity: picks up a disease when disease is present (without too many false positives)
- Specificity: correctly identifies when disease is not present
Health Promotion: Tertiary Prevention
taking medicine/ disease management
Health Disparities
differences in the quality of care received by minorities and non-minorities who have equal access to care.
Based on conscious or unconscious thought process
ex. treating 2 patients with similar conditions differently based on types of insurance they have
Six Aims for Improvement of the Healthcare System (IOM):
- Safe: avoiding accidental injuries
- Effective: providing services based on scientific knowledge (evidence-based)
- Patient-Centered: providing care that is responsive to individual patient preferences, needs and values
- Timely: reducing waits and harmful delays
- Efficient: avoiding waste
- Equitable: care does not vary in quality because of personal characteristics
Attributes of Patient-Centered Care
Empathy: treating patients how you want to be treated
Communication: encouraging active communication between the healthcare team & patient
Holistic Care:
treating a patient based on complete physical, mental, and social well being, not merely absence of disease or infirmity
Steps of the Nursing Process
ADPIE
- Assessment: gathering patient care data through observation, interviews, and physical assessment
- Diagnosis: Analyze, validate, and cluster patient data to identify patient problems
- Planning: Prioritize the nursing diagnosis and identify short/long term goals that are realistic, measurable, and patient focused
- Implementation: Initiate specific nursing interventions and treatments designed to help the patient achieve established goals and outcomes
- Evaluation: Determine whether the patients goals are met, examine effectiveness, and decide whether the plan of care should be discontinued or revised
Assessment
Data collection:
Primary Data: patient interview
Secondary Data:
-Subjective Data: verbal communication, signs/symptoms told by patient
-Objective Data: signs observed/ measured/ tested
Nursing Diagnosis
Looks at patient problems, clusters to find a common problem
- Actual Nursing Diagnosis: a problem already exists, trying to prove the problem. Identified by signs/ symptoms
- Risk Nursing Diagnosis: a potential problem. Assessment findings suggest the patient is at risk
Actual Nursing Diagnosis
A problem already exists. Trying to prove the problem by identifying signs/ symptoms
3 parts: problem, etiology, symptoms
formula: PROBLEM related to PATHOPHYSIOLOGY as evidenced by SIGNS/ SYMPTOMS
Risk Nursing Diagnosis
a potential problem, identified by signs/ symptoms
2 parts: problem, risk factors
formula: PROBLEM due to RISK FACTORS
Planning
- prioritizes a patients various diagnosis
- create short & long term goals
- chooses outcome indicators & identifies interventions to address patient goals
Goals= things the patient will do to improve
Goals must be SMART
Specific Measurable Appropriate to patient Realistic Timeframe (have a timeframe specified)
Implementation
initiation of interventions to meet patient needs.
Clinical Pathways: multidisciplinary resources to guide patient care
Protocols: standard procedures
Standing Orders: to be carried out when certain criteria is met
Evaluation
Patients response to nursing interventions and goal or outcome attainment
- care plan evaluation
- continue or discontinue treatment
- revise/adapt treatment
Development
sequence of physical, psychosocial, and cognitive changes that take place over the human lifespan
- physical growth: measured in numerical changes
- differentiation: growth @ cellular level
- developmental tasks
- maturation
Order of Developmental Stages
Infant Toddler Preschool School Age Adolescent Young Adult Middle Adult Older Adult
Developmental Milestones
Specific skills most individuals achieve at a certain age
Used to identify developmental delay or regression
Principles of Intervention
#1 Early identification and early intervention are critical #2 Specific interventions are dependent on category, age & type of developmental delay #3 Management requires interdisciplinary collaboration
Sigmund Freud: Psychoanalytic/Psychosexual Development
Personality grows, develops, & changes during lifespan
ID: Unconscious, present @ birth, generates impulses that seed immediate satisfaction
EGO: view of self/ what one wants others to see
SUPEREGO: 3-5 yrs. delays immediate gratification for socially appropriate reasons, recognition of good and bad, moral guide/ conscience
*5 stages of psychosexual development
5 Stages of Psychosexual Development (Freud)
- Oral (0-1): Mouth/sucking
- Anal (Toddler): Self-control of bowels/ potty training
- Phallic (Preschool): self-centered, masturbation, identifies with parent of opposite sex
- Latency (School Age): focuses on industry, achievement & skills
- Genital (Puberty): seeks mutual pleasure with a partner, sexual urges
Oral Stage of Development
0-1 yr
focuses on mouth & need to suck
Anal Stage of Development
Toddler
learning self control of bowels
Phallic Stage of Development
Preschool
self-centered, masturbation, child identifies with parent of opposite sex
Latency Stage of Development
School Age
surprises sexual urges, focuses on achievement & skills
Genital Stage of Development
Puberty
sexual urges involving opposite sex, seeks mutual pleasure with partner
Defense Mechanisms for Coping
- Rationalization: excuse for behavior
- Repression: Forced forgetfulness
- Projection: onto another person
- Agression/Regression: going backward in developmental stages
Jean Piaget: Cognitive Theory of Development
4 stages of development related to learning to understand and relate logically to the world
cognitive milestones involving sensory & motor interactions with the world
Sensorimotor Stage of Cognitive Development
Piaget’s 1st stage:
0-2:
object permanence, cause & effect, time of day
Preoperational Stage of Cognitive Development
Piaget’s 2nd stage:
2-7:
pretend play, self-centered, language explosion
Concrete Operations Stage of Cognitive Development
Piaget’s 3rd stage:
7-11:
understands more than 1 piece of info, realistic understanding, present focused
