NURS 2730 Quiz 2

Diversity

being different or unique

Race

common biological attributes shared by a group, such as skin colour

Ethnicity

-geographic and national affiliation
-group of individuals who share the same social and cultural heritage

Health equity

absence of avoidable or remediable differences

Enculturation

socialization into one's primary culture as a child

Acculturation

process of adapting to and adopting characteristics of a new culture

Assimilation

when people give up their ethnic identity in favour of the dominant culture

Multiculturalism

appreciation, acceptance, and promotion of many cultures

Culture

traditions, customs, beliefs, and values

Cultural competence

-demonstrating attitudes and an approach that allows you to work effectively cross-culturally
-valuing and adapting to diversity
-being aware of your own identity and biases

Cultural humility

-ongoing process involving a life-long commitment to self-evaluation and self-reflection
-a desire to fix power imbalances

Cultural safety

-an environment that is safe for all people
-takes into consideration power differentials

Cultural responsiveness

-the ability to communicate between and among cultures and demonstrate skills outside of one's own culture
-willingness to ask questions while being respectful

Cultural intelligence

-three components: cognition, motivation, and behaviour
-cognition: developing patterns from cultural cues
-motivation: the desire and skill to engage others
-behaviour: acting with cognition and motivation

Cultural awareness

-being aware of your own cultural beliefs and expectations helps you understand how cultural values affect your thinking

FICA self assessment

-faith
-importance
-community
-address in care

Spiritual counseling

value of spirituality and faith practices used by clients to cope with the events of daily living

Fundamentals of care framework

-nurse-patient relationship is at the core
-integration of care is in the middle (relational, physical, and psychosocial FOC)
-context of care is on the outside

Relational fundamentals of care

-active listening
-empathy
-engagement
-compassion
-supporting families and caregivers

Physical fundamentals of care

-personal cleansing
-toileting needs
-eating and drinking
-mobility
-comfort
-safety

Psychosocial fundamentals of care

-communication
-privacy and dignity
-respect
-education and information
-emotional wellbeing
-choice
-values and beliefs
-expression of one's self
-interests and priorities

Collaborative practice

multiple healthcare workers from different professional backgrounds providing comprehensive services by working with patients their families, their caregivers, and their community

Interprofessional education

two or more professions learn from and about each other to improve collaboration and quality of care

Interprofessional collaboration competencies

-role clarification
-team functioning
-patient centred care
-collaborative leadership
-professional communication
-interprofessional conflict resolution

Relational inquiry

-focusing attention and acting in a more conscious and intentional manner
-provides tools for uncovering the blind spots that may limit a clear view of the picture
-involves relational consciousness and inquiry as a form of action
-includes nursing obligations and ontological capacities necessary for effective nursing care

Relational consciousness

requires nurses to look beyond the surface of people, situations, and relationships to recognize interpersonal, intrapersonal, and contextual factors that may shape the nurse-client reaction

Inquiry as a form of action

inquiry requires critical examination of the relational experiences of people, the situational context, and any pertinent information so as to bring about more effective outcomes

Ontological capacities

-compassion
-curiosity
-commitment
-competence
-correspondence

Nursing obligations

-being reflective and intentional
-opening one's relational space for difficulties
-acting at interpersonal, intrapersonal, and contextual levels to affect health and wellbeing

Hermeneutic phenomenology

-method of reflection based on the lived experience

The 6 Cs of caring

-developed by roach (the human mode of being)
-compassion
-confidence
-conscience
-commitment
-comportment

Ethics of care

moral obligation to respond with empathy and compassion

Guidelines for tuning in

-S: face patient squarely
-O: open posture
-L: lean toward the other
-E: eye contact
-R: relaxed and natural

Phases of a healthy relationship

-pre-interaction phase
-introductory phase
-working phase
-termination

Pre-interaction phase of a relationship

-reviewing pertinent assessment data and knowledge
-considering potential areas of concern
-developing plans for interaction

Introductory phase of a relationship

-sets the tone for the rest of the relationship
-closely observing each other to form judgements about the other's behaviour
-getting to know the client and develop trust

Working phase of a relationship

-stage 1: exploring and understanding thoughts and feelings
-stage 2: facilitating and taking action

Termination phase of a relationship

-accepting feelings of loss
-summarizing and reviewing the process to produce a sense of accomplishment
-termination discussions need to start in advance of the termination interview

Disruptive behaviours

-incivility
-lateral violence
-bullying

Incivility

rude, discourteous, or disrespectful behavior that reflects a lack of regard for others

Bullying

abusive, intimidating treatment of someone who is in a vulnerable position or position with less power

Lateral violence

physical, verbal, or emotional abuse or aggression directed at coworkers at the same organizational level

Health literacy

-ability to access, comprehend, evaluate, and communicate information as a way to promote, maintain, or improve health
-requires communication, math, and reading skills, as well as the ability to navigate forms and health systems
-may have access to information but not the capability to understand the information

Nursing theory

-body of knowledge that describes or explains nursing
-developed out of a need to be taken seriously as a profession
-provides the principles that underlie nursing practice

Evidence-informed decision-making

a continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care

Sources of evidence

-the client
-the healthcare professional
-research

Research evidence

-scientific evidence in research journals
-randomized control trials are the gold standard

Core skills of clinical decision-making

-pattern recognition
-critical thinking
-communication skills
-evidence informed approaches
-teamwork
-sharing and reflection

Steps to evidence-informed practice

-ask a clinical question
-collect the best evidence
-critique the evidence
-integrate the evidence
-evaluate the practice decision or change

Empirical knowledge

-the scientific method
-systematic, orderly procedures intended to limit the possibility of error and minimize bias

Ethical knowledge

-informed consent
-respect for persons and dignity
-concern for welfare
-respect for privacy and confidentiality

Personal knowledge

-clinical judgement
-includes life experiences

Aesthetic knowledge

-the art of nursing
-perceiving, interpreting, and evaluating the nature of a clinical situation

Emancipatory knowledge

recognizing social and political problems of injustices or inequities

Knowledge translation

-dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system
-actual use of knowledge

Concept

-an abstract idea or mental image of phenomena or reality
-building block of theories

Phenomenon

what we are interested in understanding

Conceptual model

-diagram or illustration showing graphically how concepts within a particular cluster are related to each other
-less formal than theories

Theory

-offers ways of looking at a discipline
-comprises several concepts to explain a phenomenon
-helps us organize knowledge and make sense of ideas

Framework

a cluster of related concepts around a particular topic

Deductive reasoning

-top down
-works from the more general to the more specific

Inductive reasoning

-bottom up
-moves from specific observations to broader generalizations and theories

Metaparadigm

describes a global way a professional discipline looks at the world

Nursing paradigm

-involves person, nursing, environment, social justice and health
-"nursing is the human response to health and illness"

Florence Nightingale theory

-four theoretical assumptions about nursing and healthcare
-nurse and patient relationship is important
-environment has a direct effect on patient's wellbeing
-environmental factors can contribute to good health and recovery
-nurse can modify environment to influence patient outcomes

Novice to Expert Theory (Benner)

-stage 1 (novice): nursing student in their first year of clinical education
-stage 2 (advanced beginner): new grads in their first jobs
-stage 3 (competent): has some mastery and can rely on advance planning and organization skills
-stage 4 (proficient): see situations as wholes rather than parts
-stage 5 (expert): intuitive grasp of the situation based on their deep knowledge and experience

Canadian Health Care System

-provides health coverage to all Canadian citizens
-determines what services must be provided.
-includes basic services: primary care and hospitalizations

Canada Health Act

-guides the Canadian healthcare system
-sets out criteria for the administration of insured health services in order to receive federal payments
-only essential services
-does not emphasize health promotion or prevention

Canada Health Act criteria

-public administration
-accessible
-comprehensive
-universal
-portable

Primary healthcare

-accessible, acceptable, and affordable health care

Principles of primary health care

-accessibility
-public or community participation
-health promotion
-appropriate use of technology
-intersectoral collaboration

Primary care

-first point of contact
-focuses on health services, such as health promotion, illness prevention, and the diagnosis and treatment of illnesses

Secondary care

-diagnosis and treatment of health challenges of varying complexities by specialists
-care from a specialist after referral

Tertiary care

-highly specialized skills, technology, and expertise

Quaternary care

-extension of tertiary care
-highly specialized and unusual
-i.e. experimental medicine and procedure

Healthcare reform

discussion about, changes to, and creation of health policies that affect healthcare delivery

Primary healthcare reform

-shift from individual health providers to teams of health providers who can provide comprehensive services for better results

Incident

events, processes, practices, or outcomes that create hazards or potential harm

Domino safety theory

-the safety event takes on the form of a falling domino
-if the domino effect isn't stopped, it can eventually cause harm or death

Iceberg safety model

-we must look deeper than the surface or visible factors and consider invisible factors
-contributing factors and system failures

Canadian Patient Safety Institute (CPSI) domains

-contribute to a culture of patient safety
-work in teams
-communicate effectively
-manage safety risks
-optimize human and environmental factors
-recognize, respect, and disclose adverse events

Culture of safety

-organization needs to be structured with safety in mind
-everyone needs to be on board
-reporting, informed, flexible, and learning culture

Reporting culture

reporting should be the norm

Informed culture

outcome of a reporting culture

Flexible culture

evident by the processes that demonstrate teamwork using shared accountability principles, open communication practices, and reflect shared power among members

Learning culture

the end result of a culture of safety

Risk management

a practice to minimize untoward events by planning for their occurrence by placing safeguards to offset the danger

Adverse events

results in harm to a patient that is unrelated to their medical treatment, but directly related to the care or services provided

Critical incident

adverse event that results in significant physical impairment or death

Good catch/near miss

event that is caught before it reaches the patient

No harm incident

incident that reached patient but caused no discernible harm

Regulation

-establishing and enforcing rules to govern behaviour of people or groups
-intended to safeguard the public in some way

Self-regulation

-ensures the wellbeing of the public interest by assuring safe, competent, and ethical care
-profession is granted the right to regulate its own members
-health professional regulation is a provincial/territorial matter

Regulatory bodies

-control entry into the profession
-set the standards of practice
-establish continuing competence and education
-maintain quality assurance programs
-provide governance of the profession

Nova Scotia College of Nursing (NSCN)

-nursing regulatory body
-promotes good practice and prevents poor practice
-intervenes when practice is unacceptable
-approves and promotes standards for nursing practice and code of ethics

Nursing licensure and education

-protects the public from unsafe practitioners
-assures employers that nurses have met minimum requirements for entry to practice
-registration occurs every year
-to be registered, nurse must complete program and pass national licensure exam

CNA Code of Ethics

-provide safe, compassionate, competent and ethical care
-promote health and well being
-promoting and respecting informed decision making
-preserving dignity
-maintaining privacy and confidentiality
-promoting justice
-being accountable

NSCN Standards of Practice

-responsibility and accountability
-knowledge based practice
-client centred relationship
-professional relationships and leadership
-individual self-regulation

Professional presence

-demonstration of respect, confidence, integrity, optimism, passion, and empathy in accordance with professional standards, guidelines, and code of ethics
-leads to trusting relationships

Scope of practice

-activities a nurse is educated and legally authorized to perform
-defined in legal legislation
-forms the foundation of competencies and standards of practice