CARE - Exam 1

This is all the information from the slideshows

Florence Nightingale

• Pioneered careful data-collection in form of note-taking to illustrate correlation of cleanliness and health

• Provided foundation for current nursing practice in infection control strategies

• Recognized connection of calming fears and instilling hope and impact upon healing

Health Literacy

Refers to clients’ knowledge and understanding regarding their conditionsand the ability to access, comprehend, and use information to make informed health decisions.

Holistic Nursing Care

nurses provide care for whole person: physical, mental, emotional, and spiritual health, whether providing direct care for the client or advocating and arranging for appropriate care to fulfill that client’s needs and concerns

case manager

Nursing role

• conduit b/w clients and health care system

• ensure clients receive care they need

• afford clients the highest level of care through an interdisciplinary care plan

standards

term for what establishes expectation for professional behavior to protect the nurse, the client, and facility where client care is practiced

hold nurses accountable for following a code of conduct and upholding ethical values related to the profession

american nurses association (ANA)

professional organization for registered nurses, has established standards for both nursing practice and professional performance. these standards include the Standards of Nursing Practice and the Standards of Professional Performance

Nursing process

standards of practice correspond to the critical thinking model known as this. RNs use this as the basis for decision making and actions taken

assessment, analysis, planning, implementation, evaluation

the 5 steps of the nursing process

State Nurse Practice Acts (NPAs)

regulate nursing within each state of US

executed by state boards of nursing

identify what conditions must be met for nursing licensure

identify specific nursing titles and definitions of those titles

determine scope and standards of practice based on provisions of the nurse’s professional license

ACEN or CCNE

Schools of nursing become accredited when they meet criteria established by one of two national accreditation organizations. Provide the ACRONYM for these organizations

Quality and Safety Education for Nursing (QSEN) institute

project created in response to identified need for improving quality and safety in nursing

began in 2005 based on Institute of Medicine’s core competencies for all health clinicians to provide safe and quality care

Identified the following six competencies as necessary to have the specific knowledge, skills, and attitudes necessary to maintain quality and safety in health

• patient-centered care

• teamwork and collaboration

• evidence based practice

• quality improvement

• safety

• informatics

National League for Nursing (NLN)

• Purpose: foster excellence in nursing education to “build a strong and diverse nursing workforce to advance the health of our nation and global community”

• Serve as a resource to ensure that all students in prelicensure nursing programs are educated the same fundamental level

• New graduates should demonstrate

  • human flourishing

  • nursing judgement

  • professional identity

  • spirit of inquiry

American Association of Colleges of Nursing

Represents baccalaureate, graduate, and postgraduate schools of nursing throughout US

Consists of nine essentials that outline essential expected curriculum content and required competencies of graduates from a prelicensure baccalaureate program

AACN BSN Essentials

These listed are what?

• Liberal Education for Baccalaureate Generalist Nursing Practice

• Basic Organizational and Systems Leadership for Quality Care and Patient

Safety

• Scholarship for Evidence-Based Practice

• Information Management and Application of Patient Care Technology

• Healthcare Policy, Finance, and Regulatory Environments

• Interprofessional Communication and Collaboration for Improving Patient

Health Outcomes

• Clinical Prevention and Population Health

• Professionalism and Professional Values

• Baccalaureate Generalist Nursing Practice

Nurse Licensure Compact (NLC)

permits nurses to practice in their home state and other compact states under one multistate license

credentialing

a process that provides confirmation of an individual’s abilities to practice as a health professional. requires individual to complete a program of study and demonstrate abilites established as standards of care

communication

the process by which info is transferred from one person to another

can be verbal connection, body language, emotions, and use of technology/other equipment

Shannon-Weaver

Communication Model

One of the first communication models

designed as a technical communication model but laid groundwork for future variations

Six concepts:

• Sender

• encoder

• channel

• decoder

• receiver

• noise

Schramm

Model of communication

Suggests that communication is an engaged process where the sender and receiver send messages back and forth and receive feedback

Berlo

Model of communication

Often called SMCR model for its four components

Sender, message, channel, receiver

sender, receiver, and message

there are multiple communication models, but each has at minimum a ____________________ (3)

Feedback

allows the sender and receiver to know the message was properly understood

Verbal, nonverbal, electronic, written

Four modes of communication

Passive

Communication Style:

want to avoid conflict, so individual says nothing or simply agrees

Assertive

Communication Style:

honest and clear communication that does not violate the rights of others

Aggressive

Communication Style:

communication that is verbally, and sometimes physically, abusive

passive aggressive

Communication Style:

communication that appears passive on the surface, but often, the individual is demonstrating anger in a subtle, indirect, or secretive way

motivation interviewing

a form of therapeutic communication that allows the nurse and client to develop plans to promote the client’s using several techniques

OARS

open ended questions, affirmations, reflective listening, summarizing

what does OARS stand for?

evidence based practice

client outcomes improved

nurses experience increased professional satisfaction

lowered cost of quality healthcare

provides nurses a framework to execute clinical judgement based on research and quality improvement

spirit of inquiry

desire to clarify complex issues through research and trends that influence client outcomes

scientific literature

peer-reviewed, published scientfic research articles that are examined prior to publication by a panel of experts for accuract, authenticity, and scientific rigor

source

To build relevant evidence-based practice, nurses must first consider the

_____ of their evidence

scientific method

• A systematic research process whereby new knowledge is applied to nursing practice and outcomes are re-evaluated.

• Limits bias while seeking to address a gap in specific nursing knowledge.

• Empirical data is collected through observations, assessments, and measurement.

• Minimizes the opportunities for opinions and bias to affect research

empirical data

assessment and measurements used to discover new knowledge that can be applied to larger groups of clients

specific

the S in SMART goals stands for…

measurable

the M in SMART goals stands for…

attainable

the A in SMART goals stands for…

realistic

the R in SMART goals stands for…

timely

the T in SMART goals stands for…

Situation background assessment recommentation

What does SBAR (the organized handoff tool acronym) stand for

Subjective, objective, assessment, plan

SOAP

Nursing note that help nurses organize thoughts and activities in factual manner

client acuity

the complexity of a client’s condition

calculation tool helps ensure client assignments are consistent and fair

very by facility

discharge planning

what is the acronym IDEAL used for?

• Include client and caregivers

• Discuss 5 key areas: meds, home life, warning signs, test resutls, follow up

• Educate client: condition, discharge process, next steps

• Assess effectiveness of education

• Listen to the client’s goals and preferences

delegation

one person assigning tasks to another person

task, circumstance, person, directions and communication, supervision and evaluation

the five rights of delegation

team nursing

pairs two or more nurses together as a team to care for a group of clients

utilizes nurses’ various experiences levels and skills while sharing the responsibilities

increased teamwork results in more effective and safer client care

noncompliance

defined as failure to act in accordance with a plan

interprofessional collaboration

due to ever increasing complexity of client health conditions and treatments, the need for _________________ and communication has never been greater

silos

One important element perpetuating the problem of medical errors is that healthcare professionals are often educated within “_______,” meaning solely within their own professional discipline.

Team STEPPS

Team Strategies, Tools to Enhance Performance and Patient Safety

consultation

when one provider formally requests another provider’s input or advice as to how to approach or treat a condition

referral

one provider is delegating responsibility for management of a client’s specific condition to another provider.

transfer

systematically turn care over to another provider.

interpersonal communication

building strong relationships helps to improve performance, job satisfaction, and social skills, also known as interpersonal communication skills

Joint Commission

the ____________ recognizes that communication plays a major factor in client safety-related events. studies have found that breakdowns in transference of info occur during hand-offs, staff/shift changes, and by fialing to establish clear-cut responsibilities in continuity of care, thus jeopardizing client safety

Introductions, situation, background, assessment, recommendation, readback

ISBARR → standardized communication tool to establish uniform delivery of info from one provider to another during transfer of care

receive, record, read back

when receiving a perscription, use these three Rs

Interprofessional Education Collaborative (IPEC)

developed a core competency to provide structure to teamwork to acoomplish client centered care.

• values and ethics for interprofessional practice

• roles and responsibilities

• interprofessioanl communication

• teams and teamwork

communication

the process by which information is transferred from one person to another

information is shared between the sender and receiver through verbal connection, body language, emotions, and the use of technology or other equpiment

clinical guidelines

methodical statements that focus on a specific plan of care for speciifc client population

stored in the national guideline clearinghouse

used to optimize client outcomes or improve cost effecrtiveness and resource allocation

ethics

making decisions, choosing right from wrong, acting within one’s individual values—each person has their own set of personal ethics and morals

autonomy, beneficence, veracity, fidelity, justice

the 5 ethical principles

autonomy

freedom or independence to make own decisions

beneficence

actions guided by compassion/kindness

veracity

telling the truth

fidelity

keeping promises or committments

justice

actions are fair and equitable

values

what we believe to be important, good, and meaningful drives our behavior. understanding personal values and those of clients provides clarification of each other’s perceptions and plays an important role in professional nursing practice’s ethical compliance

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

social justice

also called distributive justice

in health care, this principle suggests that regardless of societal status, every person has the right to quality health care

malpractice

mistakes can happen in any profession. however, 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 this

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

essentially, this is a civil wrong that has been committed against an individual

torts can be further categorized into intentional or unintentional

implied consent

consent that is implied by actions

informed consent

consent expressed in writing

requires providers to educate clients about the risks, benefits, and alternatives to procedures

must be provided for clients to make well-informed decisions about their health care

good samaritan laws

nurses are not required by law to provide care to clients outside of work. that is up to the ethical discretion of the nurse, and nurse cannot be held liable if deciding to not provide care

protect nurse from being held responsible for harm as long as there was no willfull negligence

whistleblowing

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

can result in punitive actions against the accused, but can also cause stress, fear of repirsal, and retaliation for the whistleblower

fear of reporting is a huge obstacle and many laws exist to protect whistleblowers

mandatory reporting

legislation mandates that certain officials have a legal duty to report information that can prevent maltreatment and provide safety to another individual(s). licensed nurses are mandatory reporters

professionalism

the actions, behaviors, and attitudes of an individula that are reflective of the core values, ethical principles, and regulatory guidelines of the profession

a committment to self and the profession, an obligation to practice with integrity and honesty, and an unselfish devotion to the welfare of others

unprofessionalism

Refers to conduct that does not adhere to the standards of practice or the code of ethics.

Misconduct often cited as “conduct unbecoming of a nurse,” which means to dishonor, disgrace, or harm the standing or reputation of the profession in the eyes of the public

stage 1 novice

beginner with little or no experience

stage 2 advanced beginner

demonstrates basic skills but continues to need the support and guidance of a mentor

stage 3 competent

indiviudal can plan, make decisions, and perform job responsibly and efficiently

stage 4 proficient

demonstrates advanced decision making, knowledge, resourcefulness, flexibility, and problem solvings

stage 5 expert

role models deep knowledge and skills, teaches others, and multitasks efortlessly and fluently

professional identity

a nurse’s sense of self as influence by the values, beliefs, and attirbutes associated wit hthe nursing discipline

accountability

a legal obligation with a moral and ethical commitment to do the right thing, every time, and in every situation

taking ownership of decisions and actions, and further, being responsible and answerable for actions and the consequences of those actions

responsibility

an obligation to perform work, duties, or tasks using sound professional judgment

means being reliable, dependable, and persistent in following through with commitments

involves thinking things thorugh, completing tasks at an acceptable level, and accepting the consequences for what has been done or said

transactional leaders

• establish standards, highlight obligations, concentrate on monitoring behaviors, and use rewards or punishments based on how tasks are completed

• encourage compliance with rules by getting others to focus on their responsibilities and doing what is expected of them

• do not encourage creativity or motivate followers to find solutions to existing problems

transformational leaders

• establish a common mission and vision and, in turn, encourage employees to heighten their level of performance

• relay trustworthiness, voice an attractive and hopeful future, provide meaning, and challenge the best within people

• passionate about causes

• display compassion and a sense of understanding toward team members

laissez-faire leaders

• hands-off leaders that oversee and encourage their team to work independently, providing little direct control over decision making

• relinquishes power and responsibility to others, facilitating independent decision-making goal setting, and solutions

• makes minimal decisions yet provides the necessary resources and tools needed for employees to self-sufficiently demonstrate their knowledge and accomplish tasks

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situational leaders

• transition or move from one leadership style to another depending on the circumstances

• style chosen depends on the situation, the task, the nature of the group, and the requirements of the organization

chain of command

an organization hierarchy identifying the lines of authority within an organization

confirms that appropriate leaders, beginning with those closest to the level of an event, are notified and involved in problem solving

shared governance

• A shared-decision structure that gives nurses control over their own practice.

• Based on the premise that nurses will have access to resources, information, data, and growth opportunities by being a contributing partner in the decisions that impact nursing practice.

• Promotes collaboration, autonomy, professional development, accountability, and empowerment for nurses