nurs 320 midterm

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145 Terms

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Florence Nightingale

founder of nursing theory and pushed nursing into professional atmosphere:

  • allowed nursing to be respected, under positive light

  • advocated for public health and new sanitation measures

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Nightingale’s changes

  • prejudices against women and elevated status of all nurses

  • developed the first training school

  • established standards

  • defined role of nurse

  • believed it was important to know the why

  • occupational/recreational therapy for patients

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role of the nurse

to meet personal and basic human needs

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Nightingale’s established standards

  • cleanliness

  • fresh air

  • clean bandages

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Nightingale’s nursing research

developed the first nursing theory (Environmental Nursing Theory)

  • focused on the environment for patients and how they can heal

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ICN nursing defintion

nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings

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International Council of Nurses

ICN

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autonomous

making decisions for oneself

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ANA nursing definition

  • the protection, promotion, and optimization of health and abilities

  • prevention of illness and injury

  • alleviation of suffering through diagnosis and treatment of human response

  • advocacy in the care of individuals, families, groups, communities, populations

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patient

central focus of all nursing defintions

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goal of nursing

provide safe/effective care + prevention/promotion of health

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holistic

the field of nursing is ____; encompasses mind, body and spirit

  • medicine is focused on body (diagnosis, treatment, cure)

  • look at the psychosocial aspect → mind and spirit

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interrelated roles of nurses

  • caregiver

  • communicator

  • teacher/educator

  • counselor

  • leader

  • researcher

  • collaborator

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nurses as caregivers

  • provide care needed for patients

  • range from basic care (hygiene, bed bath) to administering medications/treatments

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nurses as communicators

  • therapeutic communication

  • how to address patients/families?

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nurses as teachers

  • teach patients about condition, treatment, medication

  • age appropriate teaching

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nurses as counselors

  • therapeutically interacting with patient → help patient through difficult time

  • bad diagnosis → devastating news that requires counseling

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nurses as leaders

  • fight/advocate for best care and patient

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nurses as researchers

  • evidence based practice

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nurses as collaborators

  • engage in interprofessional collaboration

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nursing’s aims

  • promote health

  • prevent illness

  • restore health

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KSA

  • knowledge

  • skills

  • attitudes

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critical thinking

looking at all potential outcomes → quickly, prioritize, decision making, reflection

  • recognizing that there’s a problem

24
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four blended competencies

  • cognitive

  • technical

  • interpersonal

  • ethical/legal

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cognitive competency

consists of knowledge

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technical competency

involves hands on skills and hand-eye coordination

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interpersonal competency

includes attitude and caring/affirming patient centeredness

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ethical/legal competency

consists of deep knowledge of the legal aspects of nursing

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QSEN competencies

  • patient-centered care

  • teamwork and collaboration

  • quality improvement

  • safety

  • evidence based practice

  • informatics

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quality improvement

  • systematic and continuous actions that lead to measurable improvements

ex:

  • getting better at skills/techniques

  • looking at new research

  • patient satisfaction score

  • implementing policy changes

  • reflection

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factors affecting health

  • genetic inheritance

  • cognitive abilities

  • educational level

  • race/ethnicity: culture

  • age and gender

  • developmental level

  • lifestyle and environment

  • socioeconomic status

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genetic inheritance

predisposition to certain illness/condition

  • ex: diabetes, breast cancer, sickle cell, certain autoimmune disorders

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cognitive abilities

ability to think/take care of yourself/make decisions

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educational levels

nurses will not make assumptions; affects literacy and ability to follow medical advice

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race and ethnicity

  • are all people getting the same level of care?

  • cultural beliefs can change treatment plan

  • different races have hereditary disease

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modifiable aspects

can be changed; if they can make changes, do they have the desire to make the change

ex: lifestyle and environment, preventions to limit genetic inheritance’s effects

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non-modifiable aspects

cannot be changed

ex:

  • not everyone has the means to getting higher education

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promoting health

identifying, analyzing, maximizing each patient’s individual strength as components of preventing illness, restoring health and facilitating coping

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health

state of optimal functioning (holistic)

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wellness

active state of being healthy

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healthy people 2030 guidelines

  • health conditions

  • health behaviors

  • populations

  • settings and systems

  • social determinants of health

goals that are set to reach by the end of decade

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social determinants of health

  • education

  • healthcare and quality

  • neighborhood and built environment

  • social and community context

  • economic stability

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primary prevention

prevent illness from HAPPENING

  • immunizations, helmet, strength training, seatbelts, educational programs

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secondary prevention

early detection for best favorable outcome

  • screenings, blood work, BP checks

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tertiary prevention

restoring health (AFTER person has illness/injury/disease)

  • trying to get back to pre-illness status or recovers as many abilities as possible

  • referrals and collaboration focused

  • ex: mental health and chemical restoring programs

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palliative care

  • improving the quality of life that patient can possibly have

  • diagnosis of something incurable

  • comfort care

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hospice care

  • patient has <6 months of remaining life; terminally ill

  • comfort care w/o curative intent

48
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nursing as a profession

  • well defined body of specific and unique knowledge

  • strong service orientation

  • recognized authority by a professional group

  • code of ethics

  • professional organization that sets standards

  • ongoing research

  • autonomy and self-regulation

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LPN

licensed practice nurse

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RN

registered nurse

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graduate education in nursing

  • masters

  • APRN (advanced practice)

    • NP, midwife

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national standard of nursing practice

set by the ANA

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nursing practice and licensure

handled by each state

  • ex: NYS nursing laws are handled by DOE

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nurse practice acts

  • define legal scope of nursing practice (LPN vs. RN)

  • defines legal requirements

  • establishes criteria for education and licensure of nurses

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nursing process

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trends in nursing education

  • changes

  • technology

  • globalization

  • educated consumer

  • complexity of care

  • collaborative practice

  • shortage

  • significant advances

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early signs of fatigue in nurses

  • compassion fatigue

  • burnout

  • secondary traumatic stress

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social contract

between society and profession of nursing

  • nurse have autonomy → expected to act responsibly and remain mindful of public trust

  • assuring quality, safety, performance

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SMART goals

  • specific

  • measurable

  • attainable

  • realistic

  • timely

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emotional intelligence components

  1. self awareness

  2. self regulation

  3. internal/intrinsic motivation

  4. empathy

  5. social skill

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profession

  • body of knowledge

  • scope of practice

  • agreed upon values, ethics

  • oath or code

  • accountability to society (patients, peers, self)

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how is professionalism judged?

  • against a set of expectations or standards

  • from our own personal values set and understanding of what “professionalism” means

  • may be situational in nature

  • strongly influenced by culture

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professionalism is determined by

  • our image

  • our communication

  • our competence

  • our demeanor

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unprofessional behavior perceived by patient

  • non-therapeutic relationships

  • inappropriate communication

  • inappropriate self-disclosure

  • exploitation (money, gifts)

  • breaches of HIPAA

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unprofessional behavior perceived by coworkers

  • inappropriate relationships

  • disengagement

  • provision of misleading information

  • disrespect

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professional organizations

  • American Nursing Association (ANA)

  • National Council of State Boards of Nursing (NCSBN)

  • National League of Nurses (NLN)

  • Sigma Theta Tau International

  • American Association of Critical-Care Nurses (AACN)

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traditional source of knowledge

information passed down generation to generation (unreliable compared to other sources)

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authoritative source of knowledge

information from expert (less confident than scientific)

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scientific source of knowledge

information derived from research (most reliable)

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types of nursing knowledge

  • science

    • knowledge in/of nursing

  • philosophy

    • study of wisdom

  • process

    • conceptual framework

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influences of nursing knowledge

  • historical (Florence Nightingale)

  • societal (changes influence knowledge nurses have to know)

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concept

abstract impressions organized into symbols of reality

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theory

group of concepts that describe a pattern of reality:

  • explain, predict, understand a certain phenomenon

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deductive reasoning

builds from general ideas

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inductive reasoning

builds from specific ideas/actions

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general system theory

theory for universal application → break whole things into parts to see how they work together in systems

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adaptation theory

adjustment of living matter to other living things and environment

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development theory

orderly and predictable growth/development from conception to death

  • ex: Erikson’s developmental theory

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benefits of nursing theory

  • directs nurses toward common goal 

  • leads to improved patient care 

  • provides rational + knowledgeable base necessary for appropriate actions 

  • give nurses knowledge base necessary for appropriate actions 

  • help resolve current nursing issues 

  • prepare nurses to question assumptions + values 

  • serves research, education, and practice

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goals of theoretical frameworks

  • holistic patient care

  • individualized care to meet patient needs

  • promotion of health

  • prevention/treatment of illness

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nursing theory concepts

  • person/patient

  • health

  • environment

  • nursing

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environmental nursing theory

define nursing as “the act of utilizing the environment of the patient to assist him in his recovery”

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Nightingale’s concepts of environmental sanitation

  • proper ventilation

  • adequate lighting

  • cleanliness

  • adequate warmth

  • quiet environment

  • diet

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general research’s goal

to find solutions to problems

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nursing research’s goal

  • find solution to problems that affect people in nursing care

  • develop greater autonomy, provide EBP, affect policy development

  • keeps the discipline a profession

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national institute of nursing research goals

  • build scientific foundation of clinical practice

  • prevent disease and disability

  • manage and eliminate symptoms caused by illness

  • enhance end of life and palliative care

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MOLST form

patient state their desires at the end of their life

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quantitative research

involves concepts of basic/applied research; uses surveys and valid data

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types of quantitative research

  • descriptive

  • correlational

  • quasi-experimental

  • experimental

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steps of quantitative research

  1. state the research problem

  2. define purpose of study

  3. review related research

  4. formulate hypotheses and variables

  5. select population and sample

  6. collect data

  7. analyze data

  8. communicate findings and conclusions

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qualitative research

conducted to gain insight by discovering meanings; belief that perceptions differ for each person and change over time

  • more subjective, no hypothesis

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qualitative research methods

  • phenomenology (lived experience)

  • grounded theory

  • ethnography (culture)

  • historical

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ethics of clinical research studies

  • value

  • scientific validity

  • fair subject selection

  • favorable risk-benefit ratio

  • independent review

  • informed consent

  • respect for enrolled subjects

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evidence based practice

comes from conducted research

  • problem solving

  • specific nursing interventions

  • mandates analysis/review of research findings

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implementing EBP

  • cultivate spirit of inquiry

  • ask question in PICOT format

  • search/collect relevant best practice

  • critically appraise evidence

  • integrate

  • evaluate

  • disseminate

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PICOT

  • patient

  • intervention

  • comparison

  • outcome

  • time

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nursing research impediments

  • limited time to participate in research

  • restricted access to resources

  • lack of education preparation

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parts of communication

  • stimulus/reference

  • sender/encoder

  • message

  • medium/channel of communication

  • receiver/decoder

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factors influencing communication

  • perception

  • cultural context

  • time

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intrapersonal communication

within self, communication that happens in your own head