Professional Practice Flashcards
Name the First 6 Nursing Standards of Care/Professional Practice
- Assessment
- Diagnosis (actual or potential -> problems and issues related to cancer and other health concerns of the patient)
- Outcome identification - identify expected outcome, focus on health promotion & maintenance, symptom management, rehabilitation or a comfortable death
- Planning - > develop POC with interventions to attain expected outcomes
- Implementation -> implement PoC
5.a - Coordination of care
5.b - Health Teaching/Health Promotion - Evaluation, systematically and regularly evaluates progress toward expected outcomes
Name 7-12 Nursing Standards of Care/Professional Practice
- Ethics
- Culturally Congruent Cae
- Communication
- Collaboration
- Leadership
- Education
Name 13 -17 Nursing Standards of Care/Professional Practice
- Evidence Based Practice & Research
- Quality of Practice
- Professional practice evaluation
- Resource Utilization
- Environmental health
Name 6 ways to apply standards of practice and education
- Guide institution-specific PoC
- Frame/prioritize quality improvemtns
- Develop staff education activites/learnnig
- Develop staff performance eval. tools
- Determine research opportunities in oncology nursing
- Guide leadership development activities
Name 6x Institute of Medicine (IOM) 2013 components for quality care:
- Engaged patients
- Adequately trained, staffed, and coordinated workforce
- Evidenced-based care
- A learning healthcare information technology system for cancer
- Translational research, transforming evidence into clinical practice, quality measurement, and performance improvement
- Accessible and affordable health care
According to CMS (Centers for Medicare & Medicaid Services), good quality health care is adhering to this 5-step process ->
Name the steps.
According to CMS, good quality health care means:
1. doing the right thing
2. at the right time
3. in the right way
4. for the right person
5. and getting the best possible results
ONS (2022) defines quality care as fulfilling these 6 criteria. Name the criteria.
- safety
- efficacy
- timeliness
- patient-centered approach 5. coordinated by an interprofessional team
- integration of EBP to continuously improve care
Name 10 Key characteristics of Nursing Professional performance
- Collaboration
- Communication
- Education
- Environmental Health
- Ethics
- Evidence-based practice and research
- Leadership
- Professional practice evaluation/Self-awareness
- Quality of practice
- Resource utilization
ONS Professional performance and excellence in oncology nursing requires leadership, knowledge, and skills for lifelong learning and career development.
List five domains specified by the ONS Leadership Competency Project that are integral to achievement of Leadership Competencies:
5 domains identified as important based on ONS Leadership Competency Project:
- Personal mastery
- Vision
- Knowledge
- Interpersonal effectiveness
- Systems thinking
True or False:
Patient navigation models are applicable only to cancer care
False
Name the core function of Patient Navigation
Elimination of barriers to timely cadre across all segments of the healthcare continuum
True or False
Patient Navigation Research Program (PNRP) encompasses all cancer diagnoses
False
True or False
Patient Navigation Research Program (PNRP) is overseen by the Centers for Medicare and Medicaid Services
False
True or False
Patient Navigation Research Program (PNRP) is focused on populations experiencing cancer health disparities
True
Name 9 Principles of Patient Navigation
- Patient-centric
- Integrate a fagmented healthcare system for the individual patient.
- Elimination of barriers to timely care across all segments of the healthcare continuum.
- Require clear scope of practice that distinguishes the role and responsibilities of the navigator from that of all other providers.
- Should be cost-effective with training and skills necessary to navigate
- Who should navigate -> determined by the level of skills required at a given phase of navigation (ie. RN vs. lay).
- Defne the point at which navigation begins and the point at which navigation ends.
- Navigation can serve as the process that connects disconnected healthcare systems
- Patient navigation systems require coordination.
Name 3x Navigation Metrics
3x Navigation Metrics:
- Patient experience
- Clinical outcomes
- Business performance / Return on investment
Name 6 Key points to build a culture of quality and patient safety
Key points to build a culture of quality and patient safety
- Quality methodologies
- Tools to measure quality and safety
- Strategies to sustain quality
- Safety and quality monitoring
- Standards of care
- Creating a healthy work environment
What is SQUIRE?
Standards for QUality Improvement Reporting Excellence
Methodology for reporting Quality Improvement initiatives in effort to advance healthcare (quality, safety, effectiveness, patient-centeredness, timeliness, cost, efficiency, and equity of healthcare)
SQUIRE 2.0 Methods range from iterative changes using plan–do–study–act cycles in single settings to retrospective analyses of large-scale programmes to multisite randomised trials.
Contrast Measurements to QI vs. Research in terms of:
- Knowledge
- Testing
- Data
- Duration
Knowledge:
R: Discovery
QI: Application for daily practice
Testing:
R: blinded, one-time, randomized, multicenter
QI: Multiple sequential small observable cycles of testing
Data:
R: Gather lots, analysis later
QI: Gather small bits, adjust, repeat testing cycle
Duration:
R: months-years
QI: incremental, accelerated change
ONS position: access to quality care
HC to all populations w/o discrimination & affordable
Oncology RNs provide essential services: at all points along care continuum
CNE programs & Practice guidelines for RNs to enable preparedness to meet patient needs
Diverse RNs similar to populations served
Holistic, culturally sensitive care, in-person or Telehealth -> enable understanding of ca & how ca treatments affect wellness
Advocacy efforts to reduced costs & enable access to treatments (insurance, oral agents, costs of care)
access to full choice of HC providers including APRNs with financial coverage
What METHODS (acronym) does the Joint Commission Center for Transforming Healthcare and its participating organizations use?
Are systematic approaches used?
List 6 GOALS
Robust Process Improvement® (RPI) methods and tools
YES: The use of improvement models applies a systematic approach to solving complex problems.
GOALS - Improve Organizational:
1. effectiveness
2. efficiency
3. customer satisfaction
4. compliance
5. culture
6. documentation
Name 5 Standards of Professional Performance (performance reviews based on)
I. Quality of Care
2. Practice Evaluation
3. Education
4. Collegiality
5. Ethical principles to guide decisions and advocacy
What are Quality and Safety Tools and Models?
List 6 examples
Tools to Measure Quality and Safety
1* Control charts
2* The Pareto chart
3* Cause and effect diagram
4* Scatter diagram
5* Physician Practice Patient Safety Assessment
6* Pathways for Patient Safety
What is Plan-Do-Study-Act (PDSA) module used for?
What is it often called?
What is the 3-step process preceding the PDSA?
PDSA model is an EBP model (backbone of the Lean Six Sigma strategy) for quality Improvement.
Often called the Model for Improvement (MFI)
3-step process:
AIM: Identify the QI goal
CHANGE IDEAS: Hypothesize actions that may help to achieve the goal
MEASURE: Determine what can be measured to validate improvement toward the goal
—- THEN -> PDSA
What is PICOT?
PICOT is the framework for nursing literature; is used to frame a Literature search Question. The PICOT question Includes:
P-population
I- Intervention of interest
C- Comparison intervention
O- Outcomes
T- Time (time till clinical outcome observed)
In the PDSA Cycle,
First step = P, explain.
P = PLAN
- Objective (goal)
- Outcome predictions
- Implementation plan (who, what, where, when, how)
- Measurement plan
In the PDSA Cycle,
Second step = D, explain.
D = ACT
- Carry out the plan
- Document problems and unexpected observations
- Begin data analysis
In the PDSA Cycle,
Third step = S, explain.
S = STUDY
- Complete data analysis
- Compare to predictions
- Summarize what was learned
In the PDSA Cycle,
Fourth step = A, explain.
A = ACT
- What changes are to be made next cycle?
2 Action based on prior results
What is QSEN?
Name 6 QSEN competencies
QSEN = Quality and Safety Education for Nurses
Name 6 QSEN competencies:
1. Patient-Centered Care
2. Teamwork and Collaboration
3. Evidence-based Practice (EBP)
4. Quality Improvement (QI)
5. Safety
6. Informatics
Name 3x Data Sources for EBP.
- Research based evidence (ie. clinical trials, observational, descriptive, or correlational studies)
- Theoretic evidence (prepositions based on empiric and non-empiric knowledge)
- ## Non-research evidence (ie chart review, QI analysis, international and/or local SoC, case reports, infection control data, etc)
List the 5x Levels of evidence hierarchy, which level is the highest quality?
5x Levels of evidence hierarchy
LEVEL 1: HIGHEST Quality of evidence: Randomized controlled trials; testing previously described diagnostics on MANY patients; systematic reviews of MANY level 1 studies (ie RCT) with multiple analysis
LEVEL 2: Prospective comparative studies; retrospective studies; development of diagnostics, limited reviews on level 1 studies with inconsistent results; systematic reviews of LIMITED level 1/ Level 2 studies with multiple analysis
LEVEL 3: Case control study (therapeutic / prognostic); retrospective comparative; analysis of nonconsecutive patients without consistently applied “gold standard”; systematic review of level 3 studies; reviews of LIMITED alternatives/costs/poor estimates
LEVEL 4: Case series; case control study (diagnostic); poor reference standard; analyses with no sensitivity analyses
LEVEL 5: Expert opinion
What term best describes: to give official authorization or approval of” and “to recognize as conforming with a standard.”
Accreditation
What term best describes: confrmation of certain characteristics of an object, person, or organization
Certification
What is the Joint Commission Enterprise?
A global driver of QI and patient safety in health care.
What is the Joint Commission Mission?
The mission of The Joint Commission is Consistently Excellent Health Care, to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.
What is the Joint Commission Vision?
Joint Commission Vision: all people always experience the safest, highest quality, best-value health care across all settings.
How does the Joint Commission achieve it’s Mission and Vision?
By setting quality standards, evaluating an organization’s performance, and providing an interactive educative experience that provides innovative solutions and resources to support continuous improvement.
Joint Commission Accreditation last for how many years
- Most Organizations
- Labs
- three years for most organizations
- two years for labs