PNLE NP1

Types of leadership styles

Autocratic (Authoritative)

Democratic/paticipitative

Laissez-faire/permissive

Multicratic/Situational

Charismatic

Transformational

Transactional

Autocratic (Authoritative)

-Strong control over the group or directive approach

-Concern w/ task accomplishment

-Autocratic involves centralized decision making, with the leader making the decision & using power to command & control others.

Democratic/Participative

-Encourages staff participation

-Involves staff in planning

-Believes in the best people

-Communicates effectively

-Builds responsibility in people

-Works well with competent, highly motivated people

Laissez-faire/permissive

-No supervision/Delegating approach

-Is passive & submissive, non directive, inactive.

- Chaos is most likely to develop because members may work independently.

-Suitable only if the members are responsible & mature enough.

-Leader function as monitor only.

Multicratic/Situational

The leader identifies which styles of leadership a particular situation requires.

charismatic/inspirational leadership style

-Obtains emotional commitment from followers & by arousing feelings of loyalty & enthusiasm.

-inspire employees to transcend self-interest; self-confident and strong conviction in the righteousness of beliefs

Transformational Leadership

leadership that, enabled by a leader's vision and inspiration, exerts significant influence

Transactional Leadership

focusing on clarifying employees' roles and task requirements and providing rewards and punishments contingent on performance

functional nursing model

licensed and unlicensed staff member performs specific tasks for a large group of patients/mass casualty event.

Primary Nursing Model

A nurse is accountable for planning, evaluating, and directing the care of a pt 24/7 throughout stay.

- was designed to put the nurse back at the bedside; allows the nurse to provide care to a small # of clients for their entire stay.

-Extension of principle of decentralization

-Nursing process driven.

-Primary Nurses & associate nurses

-24 hr coverage

-greater pt & staff satisfaction.

Advantage-

1.Pt & family are able

to develop trust to Rn

2.Defined accountability & responsibility

3.Holistic/continuity of care.

Disadvantages

1.high cost bec. there is a higher RN skill

2.Proximity of patient assignment

3.Overlapping of staff functions

4. Nurse pt ratio must be realistic.

Case Method

-1:1/pt ratio

-Ex.private duty, ICU, CHN

-Nurse is responsible for the total care of the pt. for the shift she's working.

Advantage;

1.Consistency of one individual caring for the pt for the whole shift.

2.More opportunity to observe & monitor the pt.

Disadvantages

1.Nurse may not have the same pt the next day.

2. Does not serve the purpose of decentralization.

Functional Nursing

-Psychological & sociological needs of the pt is neglected.

-Divides the specific task to be done & every member is responsible for his/her actions

-Best system that can be used if there are many pt & professional nurses are few.

Advantages;

1. Work is done fast

2. Workers learn to work fats

3. Gain of skill is faster in that particular task.

Disadvantages;

1. Fragmentation of Nursing care

2. Pt cannot identify

3.Nurse-pt relationship is not fully developed.

4.evaluation of Ng care is poor & outcomes are rarely documented, &

5. Difficult to find a specific person to answer the relative's question.

Team Nursing/Joint Practice/Modular Ng

-More than modality

-involves nurses & physicians collaborating as colleagues

-Agreed upon protocols to manage care in primary settings.

-Modular Nursing is a kind of team Nursing that divides the area into modules of pt, S each module cared by a team Nurses.

Advantages;

1.Work is shared S others

D/A

1.Pt's received fragmented, depersonalized care;

2.Communication is complex

3.accountability & responsibility

Case Management

-Clinical system C accountability for individual or group through continuum of care

-Negotiating, procuring, & coordination of services & resources.

Expanded Nursing Roles

advanced practice nurse (APN), clinical nurse specialist (CNS), nurse practitioner (NP), certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), nurse educator, nurse administrator, nurse researcher.

nurse anesthetist

A nurse who completes a course of study in an anesthesia school; carries out preoperative visits and assessments; administers and monitors anesthesia during surgery; and evaluates postoperative status of patients

Primary Prevention

1. Health Promotion

2.Disease Prevention

Health Promotion Methods

Activities directed towards increasing the level of well being & actualizing the health potentiall of I, F, C & societies.

-Health education

-Nutrition

-Personality development

-Adequate housing, recreation, agreeable working condition

-Genetic Counseling

-Periodic selective examination

disease prevention

activities directed towards decreasing probability of specific illness or dysfunctions in individuals, F, & communities.

Through people;

-Immunization

-Chemo prophylaxis

-Nutrition

-Personality development

-personal hygiene

-child spacing

-protection against carcinogen & allergen

Environmental control

-Safe water supplies

-good food hygiene

-safe excreta & rubbish disposal

-disinfection & sterilization

-vector & animal reservoir control

-good living and working condition

secondary prevention

Aka "Health Maintenance".

Seeks to identify specific illnesses or conditions at an early stage with prompt intervention to prevent or limit disability; to prevent catastrophic effects that could occur if proper attention and treatment are not provided

-Early Diagnosis and Prompt Treatment

-Disability Limitation

-Screening method

Early Diagnosis and Prompt Treatment

-Adequate treatment to arrest disease process and prevent further complication and sequelae.

-Provision of facilities to limit disability and prevent death.

Screening method

-Mass screening

-case finding

-contact tracing

-multiphasic screening

-surveillance

Characteristic of an ideal screening test

-High sensitivity

-High specificity

Disability limitation

-Adequate treatment to arrest disease process and prevent further complication and sequelae.

-Provision of facilities to limit disability and prevent death.

Tertiary Prevention

Occurs after a disease or disability has occurred and the recovery process has begun; Intent is to halt the disease or injury process and assist the person in obtaining an optimal health status. To establish a high-level wellness. "To maximize use of remaining capacities'

Restoration and Rehabilitation

-Work therapy in hospital

-Use of shelter colony

Methods of Tertiary Prevention

-Diagnosis

-Treatment

-management

-Rehabilitation

3 way bottle system (CT drainage)

simply reconnect the tube, continuous bubble is a sign of leakage, no bubbling is obstruction [in the waterseal and you should palpate the surrounding area for subcutaneous emphysema

-Drainage

-Suction control

-Water seal

Drainage

Receives initial inspiratory air & collects drainage

Suction control

Control the amount of suction that goes to the pt defending on the amount of water; gentle bubbling.

Water seal

Does not allow air to go back to the pt but lets it continue to the suction control;

-Normally fluctuating & gentle bubbling upon inhalation & exhalation.

Constant bubbling in a water seal chamber (of a chest tube) is an indication of

Air leak

intermittent bubbling

Pneumothorax

No fluctuations

Tube obstruction

Care of clients with tracheostomy tube and suctioning a tracheostomy tube [sterile technique]

know the functions of the cuff, obturator and the tie. care of clients with pooling of secretions.

Postural drainage:

Do this before meals, the positioning depending on the location of secretion, POPEVICO [arrangement] that is positioning, percussing, vibrating and coughing etc. study suctioning.

independent variable

variable that is manipulated

dependent variable

The measurable effect, outcome, or response in which the research is interested.

Pure (Basic) Research vs. Applied Research

Pure/BAsic Research-generate new knowledge to test new theorist

Applied Research-To use knowledge/research findings to solve immediate problems.

Experimental Research

-concerned with cause & effect relationships

-Highly respected in the scientific world..

-Must have manipulation,/ control of independent Variable, randomization of subjects and present of control group.

non-experimental research

Is research that lacks the manipulation of an independent variable, control of extraneous variables through random assignment, or both. ... Correlational and quasi-experimental research focus on a statistical relationship but lack manipulation or random assignment.

Qualitaive research

-Subj.

-rich & deep

-In depth description of people or events

-Data gathered through interviews & partgicipants observation concerned c patterns & themes.

-Inductive

-must be open to new theories

-does not have a clear-cut guidelines, & are actually harder to do for novice researchers.

-Neutral

focusing on gaining insights & understanding of events.

Quantitative Research

-Obj.

-replicable, reliable

-Manipulation & control phenomena

-Verification of results using empirical data

-Testing of hypothesis

-Deductive

-Limited by existing theories.

Research that provides data that can be expressed with numbers, such as ranks or scales.

IV fluid tonicity

Hypotonic-

-0.23 Nacl

-0.33 Nacl

-0.45 Nacl

Isotonic

-0.9 NSS

-LR

-5% H2O

Hypertonic

-5%Nacl

-5% LR

-10% H2O

Complication of IV therapy

infiltration

FLUID OVERLOAD

PHLEBITIS

INFILTRATION.

Blood transfusion

Complication of immobility

-DECUBITUS ULCER,

-HYPO PNEUMONIA,

-ATELECTASIS,

-DEEP VEIN THROMBOSIS

Virtue Ethics Approach

ETHICS

Teaching and learning steps:

Man initially needs information and MOTIVATION is needed for adherence to teaching. First step in teaching is to ASSESS LEARNING NEEDS before planning what to teach.

SAFETY: Causes of injuries according to age

elderly = falls,

infant = suffocation and aspiration,

adolescence = suicide and homicide.

Intervention in an elderly client who falls frequently = keep the bed at the lowest possible position. etc

BON RESOLUTION 220 (CODE OF ETHICS )

RA 9173

Philippine Nursing Act of 2002

R.A 7164

Philippine Nursing Act of 1991