fundamentals exam 1

*nurse practice act (NPA)

set of laws that establish terms, rules, and regulations to guide a nurse

what conditions must be met for licensure (what is a nurse legally allowed to do?)

*ANA’s (american nurse’s association) scope of nursing practice

guidelines that define the complex and dynamic roles of a nurse

*florence nightindale

known for her work towards nursing in the 19th century. created evidence-based practice and is regarding for creditation towards modern nursing.

clara barton

founder of the American Red Cross

Iidauro Murillo

founded National Association of Hispanic Nurses

Eddie Bernice Johnson

the first nurse elected to congress, created the term STEM

*novice to expert model

1. Novice

2. Advanced beginner

3. Competent

4. Proficient

5. Expert

(Nena Always Cooks Papas Early)

*ANA

professional organization of RN’s

code of ethics

describes the expectations for nursing practice as well as standards for nursing practice and professional performance

*scope of nursing practice

the services that licensed professionals are permitted to perform; each state adds their own rules

1. state legislature passes NPA to regulate nursing within state

2. Legislature identifies regulator body (BON) to enforce regulations

standards of practice

statements describing competent care level for RN’s; every nurse is held accountable

standards of professional performance:

nurses evaluate their own performance

QSEN (quality and safety education for nursing)

the core skills needed to provide safe and quality care

American Association of College of Nursing (AACN)

represents nursing schools in the US.

*National Council of State boards of nursing (NCSBN)

ensures safe and competent care delivered by nurses

nurse licensure compact (NLC)

allows nurses to practice in any state under one licnese

health literacy

clients knowledge and understanding about their conditions

case manager

ensures that clients receive the care they need once they leave the hospital

*nursing process steps

1. assessment

2. analysis

3. planning

4. implementation

5. evaluation

(ally always poisons izzy everyday)

“What is happening? → What does it mean? → What should we do? → Do it → Did it work?”

Accreditation can occur via the _________ or the _________

Holistic nursing care

a nurse caring for the whole person (physical, mental, emotional, spiritual)

standards of professional practice

establishes expectations for professional behavior to protect the nurse

affordable care act (ACA)

“obama care”; intended to improve health care quality by lowering costs and increasing care access, expanding medicaid program, and focusing on disease prevention

-american rescue plan strengthened this by lowering care costs even more

State board of nursing (BON)

determines eligibility requirements, issues licenses, governs policies, and reviews disciplinary cases for all nurses.

*the joint commission (TJC)

publishes national patient safety goals (NPSG) based on requirements and outcomes

-they also publish sentinel events

*sentinel event

an event resulted in a client’s death or harm

-tracked to help health care orgs improve care and care quality

pathway to excellence:

notices healthcare orgs that demonstrate commitment to providing a healthy workplace

*hospital consumer assesment of healthcare providers and systems (HCAHPS)

measures client satisfaction via standardized questions

-can be between 40hrs-6wks

*press ganey survey:

evaluates health care delivery and client satisfaction

-administered via a 3rd party vendor and emailed at the end of a visit

medicare

client must be aged 65+

-could be younger but with a disability

-A: hospital insurance B: medical insurance C: advantage plan D: medication coverage

medicaid

clients younger than 65 with a disability or socioeconomic hardship

children’s health insurance program (CHIP)

coverage for children who do not meet medicaid requirements

healthy people program:

highlights issues that affect health promotion and disease prevention

*acute care

illness requiring treatment with brief or short admission

-ex: overnight stay at hospital

*long-term care facility

cares for clients who don’t need specific nursing skills

*skilled nursing facility (SNF)

like a nursing home that provides short-term rehabilitation care

-ex: physical therapy

*long-term care hospital

cares for clients who require hospitalization for long-term illnesses

ex: burns

*assisted living

care provided for clients who are mainly independent but choose to live in a facility for daily assistance

*hospice care

care for clients that have less than 6 months to live

*palliative care:

helps clients feel comfortable during illness

*respite care

allows caregivers a break for a short time

fee for service (FFS):

when providers and orgs receive payment based on volume of services

diagnosis-related groups (DRGs)

given to clients based on their diagnosis, age, and gender; the healthcare place then receives cost based on DRG and health care centers are awarded if quality care was provided

*near miss:

an error almost reaches the patient but was caught

-requires report

*occurence/incident:

something unexpected or outside normal care occurs

-requires report

-ex: client falling

*expected/normal event:

something occurred that’s apart of a patient’s condition or expected care. is not a safety even

-chart documentation

-ex: patient with pneumonia having a fever

telehealth

use of technology to deliver nursing care remotely

nurse staffing

number of nurses to acuity of patients

-california has set nurse-patient ratios

acuity

amount of nursing time required to provide nursing services for each client

health insurance portability and accountability act (HIPAA)

protects health insurance coverage through portability and prioritizes privacy for clients

emergency medical treatment and active labor act (EMTALA)

prevents “patient dumping” and requires for clients, at a minimum, a health screening until stabilized regardless of insurance coverage

modifiable risk

factors that could be modified (weight)

nonmodifiable risk

beyond the client’s control (ex: race)

primary prevetion

decreasing the risk for development

-ex:vaccine

*think- primary→prevent

secondary prevention

early screening to detect disease for progression

-ex: colonscopy

*think: secondary → screen

tertiary prevention

controlling chronic effects of health issues that have already occurred and working towards returning to optimal function

-ex: physical therapy

*think: tertiary→ treat

quaternary prevention

protects client from excessive medical interventions that may cause more harm than good

-ex: medical treatment that do not benefit the client

public health policies

influences the health of a nation through health promotion and disease prevention programs

public health policies are influenced by

patient self-determination act (PSDA)

requires all health orgs to inform clients of their right to make decisions regarding their care

-clients have the right to refuse treatment

-advance directives

advance directives

written documents outlining wishes of person in case they can’t make the decisions for themselves

informatics

the use of info and technology to communicate, manage knowledge, mitigate error, and support decision making

nursing informatics

integration of nursing science to manage and communicate data, info, knowledge, and wisdom in nursing practice

-was designated as a specialty practice in 1992 by the ANA

client education

providing clients with new info; promotes skill building and assists clients to be accountable for their self care

-goals: health promotion, health restoration, adaptation to permanent illness/injury

cognitive domain

“thinking domain”

-knowledge, comprehesion, application, analysis, synthesis, evaluation

affective domain

based on emotions and feelings of the client

psychomotor

based on action

-movement, skills, coordination, senses

-ex: practicing skills

regulatory agency:

enforces standards and practice requirement

assessment part of nursing process

collecting info/data about the client

-key words: assess, collect, obtain, ask, observe, measure, inspect, listen, monitor

-gathering info

analysis part of nursing process

analyzing data; interpreting the data you have collected

-key words: interpreting, analyzing, connecting, determining, identifying

planning part of nursing process

what are you going to do about the client’s problem?

-key words: goals, outcomes, plan, expected outcome, prioritize, performed interventions

implementation part of nursing process

putting the plan into action; actually doing something about the situation

-key words: administer, provide, perform, position, teach, assist, give, implement, encourage

evaluation part of nursing process

determining if the interventions were effective