UNIT 4 HEALTHCARE TRENDS & NURSING ISSUES Flashcards
What is telemedicene?
Use of audio, video & other telecommunications and electronic information processing technologies to monitor the health status of a patient from a distance
What are the benefits of telemedicine?
- Support long-distance clinical health care
- Promotes patient and professional health-related education
- Support public health and health administration
- Reduce healthcare costs
-patient counseling
-case management- Supervision/preceptorship
What might be some disadvantages/things to be aware of with telemedicine?
- HIPPA, Confidentiality and informed consent
- May require additional licensure
- ANA scope of standards of nursing practice
- Future
-reimbursement
-legal issues
-health care ressources
What are different types of practice areas in telemedicine?
- Teletriage
- Teletrauma
- Telestroke/Telecaridology
- Telemental health
- Telehomecare
- Forensic Telenursing
True or false social media is a good platform for telemedicine?
false
What are the different types of healthcare payment models?
- Public insurance
- Private insurance
- Private pay
- Diagnosis-related groups (DRGs)
- Pay for performance
What are different accreditation a hospital can receive?
- Centers for Medicare and medicated (CMS)– which is evaluated by the Joint commission (JCAHO).
- Magnet designation
- Other- Trauma/NICU/Stroke
- Nursing education program accreditation
What is beneficence?
Ensuring that the patient’s best interest is considered regardless of the nurses personal opinion.
What is autonomy?
Autonomy in nursing grants nurses the power to determine components of a patients care without having to consult doctors to make decisions
What is justice?
Fairness or an equal distribution of benefits. Justice in nursing relates to impartiality regarding a patients age, ethnicity, economic status, religion, or sexual orientation
What is nonmaleficence?
The avoidance or minimization of harm
What is veracity?
Requires that healthcare providers be honest in their interactions with patients?
What is confidentiality?
Protecting patient privacy
What situations could cause an ethical delimma?
- Informed consent
- DNR
- Pain control
- Withdrawal of fluids and nutrition
- Genetic testing/reproductive therapies
- Inability to afford tx
- Organ/tissue donation
What legal documents aid in the ethical decision making process?
- Advance directives
- Living wills
- Patient care partnership/patient bill of rights
- Power of attorney
-Medical
-Legal
Interprofessional care teams help make ethical decision by?
Address issues beyond a strictly medical focus
Ethics committees help make ethical decisions by?
- Create policies to assist with decision making
- Education
- Review
- Policy Development
What structures are there within ethical decision making?
- Autonomy
- Patient benefit model
- Social justice model
Nurses have an obligation to report…
- Communicable diseases
- Criminal activity such as child/elder abuse/domestic violence
- Animial bites (including bed bugs)
- Gunshot/stab wounds
- Assaults/homicides/suicides
- HIPPA
What is the goal of incident reports?
- Avoiding a similar event at any stage in the future
- Improve patient care
In incident reports it should include what?
- Facts only/objective tone, specific details and descriptions
- Witness statements if you did not witness but were involved in care
True or false: Never report that an incident report was filed within your documentation of a patients chart?
True
When should you notify a physican?
- Change in patient condition
- Chain of command
What conduct requires mandatory reporting?
- Violates rule and contributed to the death or serious injury of a patient
- Suspects nurse’s practice is impaired by chemical dependancy or drug or alcohol abuse
- Abuse, exploitation, fraud, violation of professional boundries
- Lacks knowledge, skill, judgment, or conscientiousness and pose a risk of har.
What is TPAPN?
Set up for nurses who struggle with alcohol and drug abuse
True or false: If I am a licensee and see another nurse or a student nurse do somthing wrong, I can only report it to the board of nursing?
No, you can report to chain of command and board however the individual who saw it much be the one to write the report. Your charge nurse cannot write it.
If you recieve disciplinary action against my licences, why does it have to be published in the boards newsletter?
It is public knowledge
What happens after reporting?
- Nursing disciplinary hearing
What is whistleblowing?
It is what protects employees who report in good faith from getting suspended or terminated by their employer
What are examples of actions that could be protected under the whistleblowing if the employee reported in good faith?
- Firing, or laying off
- Blacklisting
- Demoting
- Denying overtime or promotion
- Discipling
- denial of benefits
- Failure to hire or rehire
- Intimidation/harassment
- Making threats
- Reassignments affecting prospects for promotion
- Reducing pay or hours
What is safe harbor?
Can be called prior to taking on assignments if a nurse feels that it unsafe to accept. This is to protect them.
What is civility?
- Having good manners and being polite
- respecting others
- Based on recognizing that all human beings are important
- Protection from discrimination
What is incivility?
- Any type of speech or behavior that disrupts the harmony of the home, work, or educational environment
Civility in nursing….
- The basis for caring
- Promotes emotional health
- Creates a positive environment for learning and the production of healing
- Develops emotional intelligences in nurses
- Transforms negative attitudes
Communication and civility….
- Positive interpersonal relationships are key aspect of civility
- Health and well-being of clients are predicated on excellence in communication and a culture of civility in the work place
Incivility includes:
- Cyber- harassment
- Vicious anonymous emails
- Hate text messaging
- Acts of rudeness
- Social rejection
What is bullying?
- Defined as any behavior that could reasonable be considered humiliating, intimidating, threatening or demeaning to an individual or group of individuals
- can occur anywhere
- Can be habitual, being repeated over and over
- Complex concept that includes physical/emotional and verbal abuse
What is lateral or horizontal violence?
- Has many of the same characteristics as bullying except that it takes place almost exclusively in the work setting among peers.
- Can be either covert or overt
Overt lateral violence includes…
- name calling
- threatening body language
- physical hazing
- bickering
- Fault finding
- negative criticism
- intimidation
- gossip or divulging confidential information
- shouting
- Blaming
- Put-downs
- Raised eyebrow and eye rolling
- verbally abusive sarcasm w/rude tones
- Physical acts such- throwing objects, pounding a table, shoving a chair
Covert lateral violence includes…
More difficult to identify
1. unfair assignment
2. marginalizing a person
3. refusing to help someone
4. ignoring
5. making faces behind someone back
6. refusing to work with certain people
7. Whining, sabotage, exclusion and fabrication
What results from lateral violence?
- Decreased communication
- Poor quality of care
- Reduced safety of clients
- Poor staff morale
- Excessive “sick days”
- high turnover of staff
- Nurses leaving the profession
- Physical symptoms- insomnia, HTN, Depression, GI upset.
Consequences of incivility in the clinical setting.
- Jeopardizes client safety.
- increases medical and nursing errors
- Lowers the overall quality of care
- creates hostile, toxic workplace environment
- Causes high turnover rates of nursing staff
