Online Final L4

Lecture 4 flashcards for vocabulary review

Evidence-based research

Is the integration of the best research evidence with clinical expertise and the patient's unique values and circumstances in making decisions about the care of individual patients

Replicability

Evidence can be repeated

Reliability

Evidence is consistently measured; leads to similar outcomes

Validity

Evidence is measurable

Quantitative research

Focused on the testing of a hypothesis through objective observation and validation. Supply the evidence

Qualitative research

Focuses on a person's experience and uses analysis of textual, or non-numeric, data, such as interviews, surveys, or questionnaires

Mixed Methods Research

Features both quantitative and qualitative approaches

P

Population

I

Intervention

C

Comparison

O

Outcome

T

Time frame the population is observed

Big data analytics

Is a method that can be used in PBE (practice-based evidence) designs. It involves using technology to analyze large data sets to examine patterns and identify new relationships that in turn can be used to make improvements in health care

Bundle

Is a fall prevention bundle which groups several evidence-based practices into a standard protocol, was used along with a TRIP (Translating research into practice) intervention designed to increase the bundle's uptake

Clinical guidelines

A systematically developed statement or recommendations designed to assist health care providers in making decisions about appropriate healthcare for specific clinical circumstances

Comparative effectiveness research (CER)

Examines the evidence for the effectiveness, benefits, and harms of treatment options such as drugs, medical devices, diagnostic tests, surgeries and procedures, or ways to deliver health care

Effectiveness

Intervention effectiveness can aid in determining which intervention is the best one to use for a patient population

Efficacy

Is when an intervention or treatment is tested in a rigorously designed research study such as a traditional randomized controlled trial (RCT)

Internal validity

Is carefully selecting the sample and consistency in delivering the intervention or treatment to determine whether it works

Meta analysis

Is a statistical technique used to combine and synthesize results from multiple independent studies addressing the same research question

Participatory action research (PAR)

Involves members from the community being studied, usually as part of an advisory board for a research project, to identify and refine (1) research questions, (2) strategies for engaging community members, and (3) potential challenges in carrying out the research project

Practice-based evidence (PBE)

Is a research methodology that can help inform practice decisions by examining outcomes in the real world

Translation science

Implementation science

Practice-based research networks (PBRN)

Collaboration can occur not only within an organization but also through PBRN and data warehousing

Randomized controlled trials (RCT)

Include at least two groups and the random assignment of study participants to one group or another, either by a coin toss or by some other strategy, to test a treatment's effectiveness

Research

Is the diligent, systematic inquiry or investigation to validate and refine existing knowledge and generate new knowledge

Systematic review

Is a rigorous and structured approach to reviewing existing literature on specific research questions or topic

Translating research into practice (TRIP)

Consider what types of strategies have been most successful in implementing a practice in one's organization is important

Agency for healthcare research and quality (AHRQ) Evidence-based Practice Center (EPC)

Develops evidence reports and technology assessments that are common, expensive, and/or significant for Medicare/Medicaid populations

Agency for healthcare research and quality (AHRQ) Effective Healthcare Program

Sponsors systematic reviews and translation and dissemination of research. Includes comparative effectiveness reviews and technical briefs on patient-centered outcomes

Agency for healthcare research and quality (AHRQ) Practice-Based Research Networks (PBRNs)

Supports AHRQ in providing support to primary care PBRNs doing clinical and health services research

Center of Disease Control and Prevention (CDC) Advisory Committee for Immunization Practices (ACIP)

Medical and public health experts who develop recommendations on the use of vaccines in the US civilian population

American association of critical care nurses (AACN)

A community of nurses who champion competent and compassion patient-cantered care- and advocate for patients' and families needs. they are role models, coaches, and mentors

Clinical Judgment

Is an interpretation or conclusion about a patient's need, concerns, or health problems, and/or the decision to take an action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response

Tanners Model of Clinical Judgment Noticing

Notices various things about the caregiving situation such as clinical assessment findings, lab work, data, patient demeanor, and family situation

Tanners Model of Clinical Judgment Interpretating

Through clinical reasoning patterns, collecting additional clinical data as needed and conferring with colleagues, the nurse develops an understanding of the particular clinical situation

Tanners Model of Clinical Judgment Responding

Once the patient data have been sorted and interpreted, the nurse uses his interpretation to respond to the particular patient issue through one or more nursing interventions

Tanners Model of Clinical Judgment Reflecting in action

Refers to the nurse's understanding of patient responses to nursing actions while care is occurring

Tanners Model of Clinical Judgment Reflecting on action

Is consideration of the situation after the patient care occurs

Critical Thinking

Is a cognitive process used for the analysis of an issue or problem and makes sound decisions based on clinical reasoning

Sepsis

Is a life-threatening syndrome in response to infection. It is characterized by a dysregulated patient response along with new organ dysfunction related to the infection

PRN Orders

no ranges. Must include: -Frequency - Indications * Specific target signs and symptoms *Instructions for use *Parameters - A limit of doses within a certain time frame and/or - When to notify the HCP if signs and symptoms continue

5 rights of medication

Right patient, Right drug, Right dose, Right route, Right time

What can RN not delegate

Evaluate (initial assessment), Assign-cannot delegate the responsibility for tasks, T- teaching

What can an a RN delegate to CNA or patient care tech?

Making occupied or unoccupied beds, Supervising patient ambulation, Activities of daily living (ADLs), Assisting with hygiene, Toileting, brief changes, Feeding meals, Companionship, Re-applying N/C with O2 that has already been ordered, Vital signs, Blood glucose checking

Safe

Healthcare delivery requires interprofessional teamwork and collaboration at all levels of the organization

Timely

Care refers to reducing wait time of healthcare delivery services

Effective

Based on offering evidence- based services, avoid the underuse and overuse of healthcare services

Efficient

Avoids wasting resources of care

Equitable

Is providing care that does not vary in quality because of gender, ethnicity, geographic location, and socioeconomic status

Patient Centered Care

Is responsive to individual patient preferences, values, and needs

New 2020 Magnet Mission

The Magnet Recognition Program will continually elevate patient care around the world in an environment where nurses, in collaboration with the interprofessional team flourish by setting the standard for excellence through leadership, scientific discovery and dissemination and implementation of new knowledge

New 2020 Magnet Vision

The Magnet Recognition Program will transform healthcare globally by bringing knowledge, skill, innovation, leadership and compassion to every person, family, and community.

Errors of omission

Occur as a result of actions not taken

Errors of Commission

Occur as a result of the wrong action taken

Root cause analysis (RCA)

Is a process for identifying the causal factors underlying variations in performance. In the case of medical error, this variation in performance may result in a sentinel event

Health Information Technology (HIT)

Has the potential to reduce healthcare costs, improves efficiency, and enhance patient care safety and quality

Computerized Provider Order Entry (CPOE)

Refers to the process of providers entering and sending treatment instructions - including medication, laboratory, and radiology orders - via a computer application rather than paper, fax, or telephone

Electronic Medical Record (EMR)

Is an individual's health record within a Healthcare provider's facility, and decision support tools to guide practice and decision making

Bar code medication administration (BCMA)

Technology allows nurses to effectively and safely administer medications to patients

Sentinel Events

Is a patient safety event that reaches a patient and results in any of the following: -Death -Permanent harm - Severe temporary harm and intervention required to sustain life

CMS (Centers for Medicare and Medicaid Services) regulatory agency

That licenses healthcare facilities for operation (e.g., specific state licensing regulations) and can fine organizations or restrict services and suspend operations if there is a failure to meet expected standards

Lewin's Theory

Individuals and groups of individuals are influenced by restraining forces or obstacles that counter driving forces aimed at keeping the status quo, and driving forces, or positive forces for change that push in the direction that causes change to happen

Lewin's Step 1 Unfreezing

The goal of the unfreezing stage is to break down the existing status quo before you can build up a new way of operating

Lewins Model Step 2 Changing

This is where the actual transition occurs implementing new strategies

Lewin's Model Step 3 Refreezing

Focuses on solidifying the changes made during the changing phase and ensuring that they become part of the organizational culture

Purpose of HCOs

Is to help others by providing healthcare services

HCOs Internal Environment

Organizational Environments The internal environment of the HCO consists of an integrated web of factors such as organizational culture (where culture is defined as a set of values, beliefs, and practices), systems such as information systems or the human resources management system, and structural elements such as role responsibilities, rules, and practices

Care Coordination Key Attributes

-Patient-centered/individualized plan of care, Evidence-based care, Efficiency, Improved health outcomes, Value-based care delivery, Interprofessional team-based care

Incivility

Is one or more rude, discourteous, or disrespectful actions and can range from gossiping to refusing to assist a co-worker

Lateral Violence

Is aggressive and destructive behavior or psychological harassment of nurses against each other

Horizontal Violence

Bullying

What must nurses do to eliminate bullying and lateral violence?

Nurses must enhance their knowledge and skills in managing conflict and promote workplace policies

Ethical Principles Autonomy

Freedom or independence to make own decisions

Ethical Principles Beneficence

Actions guided by compassion/kindness

Ethical Principles Veracity

Telling the truth

Ethical Principles Fidelity

Keeping promises or commitments

Ethical Principles Justice

Actions are fair and equitable

Values

What we believe to be important, good, and meaningful drives our behavior

Altruism

To do something or act for the sake of benefiting someone

Dignity

Implies that everyone, regardless of race, religion, sex, gender, or other individual identification, has value and should be respected simply because human beings are all equal

Integrity

The quality of being honest and having strong moral principles or moral uprightness

Malpractice

When nurses act in a manner that is not consistent with best-practice standards and harm is caused to a client as a result, they may be charged with malpractice

Tort Law

If an individual carries out an act or fails to carry out an act and that results in injury or harm to a client—a tort has been committed

Implied Consent

Consent that is implied by actions

Whistleblowing

An act when a person formally reports on illegal, wrongdoing, or unethical practice

Mandating Reporting

Legislation mandates that certain officials have a legal duty to report information that can prevent maltreatment and provide safety to another individual(s)

Safe Harbor

In Texas, Safe Harbor can be invoked when a nurse believes they are being asked to perform an assignment that violates the Nursing Practice Act (NPA) or Board rules

How does Safe Harbor protect nurses?

Protects nurses from retaliation, suspension, termination, discipline, discrimination, and licensure sanction

Peer Review

The nursing peer review process is one of fact-finding, analysis, and study of events by nurses in a climate of collegial problem solving focused on obtaining all relevant information about an event

Professional associations (organizations)

Are groups of people who share a set of professional values and who decide to join their colleagues to effect change

An umbrella organization that represents all nurses throughout the United States?

Is the American Nurses Association (ANA)

State level organization?

Is the Texas Nurses Association

Unions

A group of workers who pay dues to be represented by leaders outside of the workforce in exchange for positive employment changes

Collective Actions

Defined as activities that are undertaken by a group of people who have common interests

Workplace strategies Step 1

Maintain current knowledge and changes being discussed regarding nursing in the state of Texas including, but not limited to, staffing, patient care to nurse ratios, grievance process (including bullying and abuse of nurses)

Health Policy

Actions and decisions by government bodies or professional organizations that influence the actions and decisions of individuals within the health care system

Primary Care Organizations Purpose

Entry into system, Health maintenance, Chronic care, Treatment of temporary nonincapacitating malfunction

Secondary Care: Purpose

Prevention of disease complications, Screenings

Tertiary Care Purpose

Rehabilitation, Long-term care