Professional Caring & Ethical Practice 20% Flashcards
Nonmaleficence
Obligation to do no harm.
Beneficence
Obligation to do good.
Fidelity
-Obligation to abide by agreements and responsibilities. -Honoring a commitment -Ie. agreeing to work a shift and showing up
Obligation to tell the truth
Veracity
Allowing a person to die without taking lifesaving measures.
Euthanasia (Passive versus Active)
Modifiable risk factors
- Smoking, diet, activity level
- Can be modified immediately versus long-term goals
Considering interdependent elements in a situation.
Systems Thinking
Transmissions -HIV
HIV: blood, semen, vaginal secretions, and breast milk – weak chlorine bleach
Organ Donation
- Advocate for patient’s wishes
- Coordinators speak with NOK
- Family refusal = 35% loss of potential donation
Essential Oils
- Lavender
- Chamomile
- Peppermint
- Frankincense
Lavender: antidepressant, anti-inflammatory, antibacterial effects
Chamomile: antiallergy, sedative effects
Peppermint: improves digestion, antiseptic, decongestant effects
Frankincense: increase ability to relax
Stevens Star Model
- Discovery research
- Evidence summary
- Translation to guidelines
- Practice integration
- Discovery research: original research is discovery of knowledge
- Evidence summary: systematic review of the research related to a specific clinical question
- Translation to guidelines: clinical practice guideline
- Practice integration: pilot test / implementation of evidence
Evidence-based practice
Activities encourage staff and leaders to ask “why” and utilize the literature to provide the evidence as to best practices.
TeamSTEPPS
- Strategy that provides framework for expressing concern regarding patient safety via the two challenge rule and by “CUS”ing
- “CUS”ing: express concern, clearly state that you are uncomfortable, and state that this is a safety issue
Types of Communication versus Communication strategies
Type of communication:
- Open communication
- Closed-loop communication
- Conflict resolution
Strategies:
-TeamSTEPPS
Clinical Practice Guidelines
- Translation of the best scientific evidence to recommendations for practice
- Primary purpose: use evidence summaries for translation of best evidence to best practices for consistency in the provision of EBP
- Useful in the elimination of significant variations in practice
Systematic Reviews
- Summary of evidence
- Compilation of similar studies to address a specific clinical question
- Specific criteria for inclusion and exclusion are identified before the initiation of the literature search for studies on the specific clinical question
- Advantage is that an expert already has appraised the studies critically for the strength of the evidence and made recommendation based on evidence
- Forms:
–Meta-analysis: quantitative studies using specific statistical methods to determine true magnitude of the effect
–Meta-synthesis: qualitative studies
Patient Education
- What does patient already know?
- Teach the “need to know” information
- “Nice to know” information can wait for outpatient teaching.
- Health maintenance taught under ideal circumstances
Care of HIV Patients
- avoid hot foods and drinks (increase discomfort)
Implied Consent
- Refers to patient’s presumed agreement for testing and treatment when patient is unable to grant informed consent and the immediate family is unavailable
- Should only be used in emergencies
Kotter Change Model
- Establishing a sense of urgency.
- Forming a powerful guiding coalition
- Creating a vision
- Planning for and creating short-term wins
Most important method of Infection Prevention
Hand Hygiene
Cultural Diversity
Haitians: respond positively to touch and direct eye contact
Jewish: dietary restrictions
Muslim: Death-privacy, body bathed by family, deceased person’s head turned to the right
Critical Care Pain Observation Tool (CPOT)
Facial Expression
0 - Relaxed, neutral
1 - Tense
2 - Grimacing
Body Movements
0 - Absence of movements/Normal position
1 - Protection
2 - Restlessness / Agitation
Compliance with Ventilator / Vocalization
0 - Tolerating vent / Normal tone
1 - Coughing / Sighing, moaning
2 - Fighting vent / Crying out, sobbing
Muscle Tension
0 - Relaxed
1 - Tense, rigid
2 - Very tense or rigid
Total ___ / 8
Validated Adult Pain Assessment Tools
- Wong-Baker FACES scale
- Critical-Care Pain Observation Tool
- Behavioral pain scale
Conflict Resolution **Facilitating collaboration**
Facilitating collaboration: using a mediator to assist two parties in developing common goals
Smoothing of conflict: attempt to reduce the emotional stress of the conflict but the conflict is not resolved
Encouraging compromise: each group would give up something that it wants
Democratic approach: majority rules
