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NURS 428: Evolution > Week 1: Overview of Critical Care Nursing > Flashcards

Week 1: Overview of Critical Care Nursing Flashcards

Exam 1

1
Q

What is Critical Care Nursing?

A

AACN defines progressive or critical care nursing as the speciality that manages the human responses to actually or potentially life threatening problems.

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2
Q

Evolution of Critical Care:

How did it begin?

A

Began with polio units (1950s), recovery rooms, and coronary care units (1960s)

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3
Q

Evolution of Critical Care:

How did patient outcomes improve?

A

Patient outcomes improved with specialty care

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4
Q

Evolution of Critical Care:

When were ICUs made?

A

Intensive Care Units (1970s)

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5
Q

Critical Care in the 21st Century

What are examples of specialization?

A

Cardiovascular,

neurological,

trauma,

burn units

Pediatric

Neonatal

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6
Q

Critical Care in the 21st Century

Variety of settings like?

A

Inpatient
Outpatient
Home care

EICU

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7
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

A
  1. Promote
  2. Intervene
  3. Ensure
  4. Serve
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8
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

Promote: What should nurses promote amongst patients?

A

Autonomous decision making

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9
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

Promote: What should nurses respect?

A

Respect & represent patient and family wishes

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10
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

INTERVENE: What should they intervene in? What should they provide education for?

A

in patient/family best interests

intercede for those who cannot advocate for themselves

educate patients access care resources

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11
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

Ensure: What should nurses ensure?

A

safe, competent, & high-quality care

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12
Q

Nurse as Patient AdvocateAt the bedside 24 hours a day, so we can…

Serve: Who should nurses serve?

A

as liaison between patient, family & providers

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13
Q

The Synergy Model

The underlying premises of the Synergy Model are:

What are a concern to the nurses?

A

Patients’ characteristics are of concern to nurses.

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14
Q

The Synergy Model

The underlying premises of the Synergy Model are:

What is important to patients?

A

Nurses’ competencies are important to patients.

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15
Q

The Synergy Model

The underlying premises of the Synergy Model are:

What drives nurses competencies?

A

Patients’ characteristics drive nurses’ competencies.

(How stable a patient is and the complexities of their illness). The ability of the patient to participate in their care matters to the nurse?

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16
Q

The Synergy Model

The underlying premises of the Synergy Model are:

When patients’ characteristics and nurses’ competencies match and synergize,
What happens?

A

When patients’ characteristics and nurses’ competencies match and synergize, outcomes for the patient are optimal.

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17
Q

The Synergy Model: What is it?

A

A framework that can be used as a basis for work to be done by facilities seeking Magnet designation.

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18
Q

What is synergy?

A

Synergy- collaboration, cooperation, working hand in hand. Things work better together then working separate.

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19
Q

Magnet Hospital?

A
20
Q

Patient Characteristics include?

A

Resiliency

Vulnerability

Stability

Complexity

Participation in care

Participation in decision making

21
Q

Slide 9

A
22
Q

Standards of Practice: What does it do?

A

Guide evidence-based clinical practice

Establish goals for patient care

Provide assessment of outcomes

23
Q

AACN Standards for Acute and Critical Care Nursing Practice:

A

Describe level of performance

Describe expected roles and responsibilities of critical care nurses

24
Q

Value of Certification

(examples: CCRN, CNRN, SCRN, ACLS)

A

Value to the patient and family

Value to employers and nurses

25
Q

Value of Certification

Value to the patient and family: What does it validate to people? What does it demonstrate to people?

A

Validation of experience and knowledge

Make decisions with greater confidence

Demonstrates commitment to continual learning

26
Q

Value of Certification:

Value to employers and nurses

A

Knowledge and expertise to promote optimal patient outcomes

Commitment to quality

Workplace empowerment

Enhanced communication and coordination of care

Remain employed in an area where they can apply the knowledge

Sense of professional pride and achievement

27
Q

Evidence-Based Practice in Critical Care Nursing

What is it?

A

“The process of shared decision making between practitioner, patient, and others significant to them based on research evidence, the patient’s experiences and preferences, clinical expertise or know-how, and other available robust sources of information”

28
Q

Evidence-Based Practice in Critical Care Nursing

What does it do?

A

EBP takes what is known and uses it to guide patient care to achieve the best possible outcomes.

29
Q

Importance of Evidence-Based Practice

A

Evaluate research

Hierarchy of evidence

Implement practice based on evidence

30
Q

Barriers to Implementation of EBP:

How long does it take to translate research findings into clinical practice?

A

17 to 20 years to translate research findings into clinical practice

31
Q

Barriers to Implementation of EBP:

A

Lack of knowledge of the research process

Limited access to literature

Lack of confidence in ability to critique research

Limited interest in scientific inquiry

Limited power to change practice

Time factors

Lack of organizational support and commitment

32
Q

Future Challenges in Critical Care Nursing

Having to do with cultures?

A

Increase ability to deliver evidence-based care
that is culturally congruent and relevant

Have a multilingual, culturally diverse workforce

Recruit and retain diverse professionals

33
Q

Future Challenges in Critical Care Nursing

What are other challenges?

A

Expand the skill set of today’s already experienced critical care nurses

Critical care nurses must be prepared to identify, manage, and treat unknown threats.

Prepare to handle an actual or potential bioterrorism threat

Continued expansion of skills and evidence-based interventions

34
Q

Focus on Quality & Safety

What must be prevented?

A

Errors and harm must be prevented

35
Q

Focus on Quality & Safety

What are nurses challenged to do?

A

Nurses are challenged to reduce errors and promote a safe environment

36
Q

Focus on Quality & Safety

What are several initiatives?

A
  1. Joint Commission National Patient Safety Goals
  2. Institute for Healthcare Improvement
  3. Quality and Safety Education for Nurses (QSEN)
37
Q

Harms Targeted for Reduction include:

A

Adverse drug events

Infections

Injuries from falls and immobility

Prevention of venous thromboembolism (VTE)

38
Q

Harms Targeted for Reduction include:

Infections: What are examples?

A

Catheter-associated urinary tract infections (CAUTI)

Central line-associated bloodstream infections (CLABSI)

Surgical site infections

Ventilator-associated pneumonia (VAP)

39
Q

Trends and Issues:

What is important to reduce errors?

A

Communication important to reduce errors

40
Q

Trends and Issues:

What is a communication strategy?

A

SBAR communication strategy

Situation
Background
Assessment
Recommendation

41
Q

Trends and Issues:

What should be done to reduce issues?

A

Handoff at bedside

Rapid response team (RRT)

42
Q

Trends and IssuesInterprofessional Collaboration

A

Daily rounds with multidisciplinary team

Implementation of “bundles” of care to promote evidence-based practices and prevent complications

43
Q

Trends and IssuesInterprofessional Collaboration

Culture of collaboration includes what?

A

Mutual respect

Mutual recognition

44
Q

Bundled CareA “bundle“: What are they?

A

group of interventions related to a disease process that, when executed together, result in better outcomes than when implemented individually.

Institute for Health Care Improvement (IHI)

45
Q

Bundled CareA “bundle“: What does it include?

A
  1. Head of the Bed 30O      
  2. Daily sedative interruption       and daily assessment of
    readiness to extubate
  3. PUD Prophylaxis      
  4. DVT Prophylaxis      
  5. Daily Oral Care      
    with chlorhexidine
46
Q

Other Trends and Issues include:

A

Reducing hospital readmission rates

Increasing use of technology

Ethical issues associated with prolonging life and futile treatment

Telemedicine and eICU

NURS 428: Evolution (13 decks)

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