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Ethical Dilemma
ask
gather info relevant to case
identify ethical elements
name the problem
identify possible courses of action
create and implement action plan
evaluate action plan
autonomy
decision making
beneficence
patient's best interest when making decisions
-promoting good
-maximizing good
-promoting positive outcome
nonmaleficence
healthcare provider will cause no harm when taking action
justice
health care providers will make fair decisions
dignity
patients should be treated with respect and honor
fidelity
faithfulness or agreement to keep promises
spirituality
often defined as an awareness of one's inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself
religion
associated with the "state of doing" or a specific system of practices associated with a particular denomination, sect, or form of worship
true or false: spirituality is synonymous with religion
false
true or false: nurses should place higher priority on spiritual health rather than physical or mental health
true
true or false: having knowledge about different religions and spiritual health practices improves communication with patient/families
true
self-transcendence
sense of authentically connecting to one's inner self
connectedness
being intrapersonally connected within oneself, others and the environment, God, or unseen higher power
FICA
F: what is your FAITH or beliefs
I: is it IMPORTANT in your life?
C: are you apart of a spiritual or faith COMMUNITY
A: how would you like me to ADDRESS issues in your healthcare
possible FICA questions
do you belong to a faith community?
do you follow special diet bc of spiritual beliefs?
are any members of faith community able to assist you at home?
HOPE
H: sources of HOPE where patient finds relief
O: ORGANIZED religion
P: PERSONALIZED beliefs
E: EFFECT of spiritual belief on medical decisions
Therapeutic Communication
open-ended questions ask relevant q's summarize confrontation self-disclosure
-what are your thoughts about the new diagnosis?
true or false: you should share your passwords with anyone
false
why do nurses use standard nurse terminology?
it facilitates measuring the impact of nursing interventions on patient outcomes
To Err is Human
described the extent of medical errors
revealed significant issues in quality of care in hospitals
Crossing the Quality Chasm
framework for improved patient care and quality
beginning of informatics in healthcare
The Future of Nursing
addressed nursing workforce
HITECH
stablished provisions to promote meaningful use of health info technology
Electronic Health Record (EHR)
an individuals LIFETIME computerized record
Electronic Medical Record (EMR)
record for an INDIVIDUAL healthcare visit
Nursing Clinical Information System (NCIS)
facilitates nursing activities and sharing info
nursing model (nursing process) and critical pathway
Clinical Decision Support System (CDSS)
aids and supports clinical decision making
the RN documenting in a paper charting system recognizes she documented on the wrong patient. The RN should:
draw a line through the wrong text and initial beside the error
what is not a benefit of nursing use of informatics?
reducing the need for decision-making through use of algorithms
what did the HITECH Act provide?
funded incentives for meaningful use of electronic health records
QSEN competencies (6)
patient centered care
teamwork and collaboration
evidence-based practice
quality improvement
safety
informatics
goal of QSEN
meet the challenge of preparing future notions of KSA's
KSA in QSEN
K: Knowledge
understand, describe, examine, explore, demonstrate
S: Skills
asses, recognize, participate, provide, elicit
A: Attitudes
value, respect, recognize, appreciate
nursing process
ADPIE
assessment
diagnosis
planning
implementing
evaluating
assessment
collect comprehensive data pertinent to the situation
diagnosis
analysis of data and determination of a nursing diagnosis
planning
develop a plan of nursing care to achieve the expected outcomes
implementation
coordination of care
education
health promotion
evaluation
what progress has been made?
were goals achieved?
intrapersonal communication
self-talk
interpersonal communication
one-on-one interaction
small-group communication
family meetings
public communication
audience, classroom
electronic communication
technology, patient portals
referent
the incentive or motivation for communication to occur between one person and another
sender
one who encodes the message
receiver
one who decodes the message
message
content of communication
channels
means of conveying and receiving messages
feedback
response to message
interpersonal values
factors within both the sender and receiver that influence communication
verbal communication
vocabulary
denotative and connotative meaning
pacing
tone
clarity and brevity
timing and relevance
nonverbal communication
personal appearance
posture
facial expressions
gestures
sounds
personal space
metacommunication
all factors that influence communication
active listening
S - sit at angle facing patient
U - uncross arms and legs
R - relax
E - eye contact
T - touch
Y - your intuition
lateral violence
verbal, emotional, or physical abuse of a RN toward another staff member
workplace bullying
moral distress
occurs when a nurse knows the ethically correct action to take but is constrained from taking it
proportionate
preserving someones life
disproportionate
patient's judgment
do not offer a reasonable hope of benefit
entail an excessive burden
imposed excessive expense on family or community
malpractice
professional negligence that causes injury or harm to patient
negligence
unreasonable conduct under a given set of circumstances
Emergency Medical Treatment and Active Labor Act (EMTALA)
can't transfer patient to another facility without screening and stab
Health Insurance Portability and Accountability Act (HIPAA)
right of the patient to confidentiality; protects patients and employees
Americans with Disabilities Act (ADA)
protects right of people with physical or mental disability
Mental Health Parity & Addiction Equity Act
insurance companies must provide coverage for mental health and substance use treatment disorders
Affordable Care Act and Revisions (ACA)
consumer rights and protections
affordable health care coverage
increased access to care
care that meets the needs of patients
Spiritual Assessment Tools
assessment of their spiritual and religious beliefs, especially as they relate to illness, injury, or disability
spiritual distress
a disruption occurs when there is a conflict in benefits with others
can lead to people questioning their beliefs
spiritual sensitivity
using more of your mind to sense what's going on in and around you
self-care
the process of taking steps to and engagement in activities to establish and maintain health
needing permission
the experience of self-care and self-compassion in nursing
a constructivist grounded theory study
international journal of nursing study
self-compassion
the ability turn compassion inwards and to kind to the self
to acknowledge our humanity, imperfect and fragility
compassion fatigue
loss of satisfaction from providing good patient care
work-related fatigue
avoidance or dread of working with certain patients
reduced ability to feel empathy towards patients and families
frequent use of sick days
lack of joyfulness
physical fatigue
headaches
digestive problems, diarrhea, constipation, upset stomach
muscle tension
sleep disturbances
fatigue
cardiac symptoms (chest pain/pressure, palpitations, etc.)
emotional
QSEN phase I
(2005 - 2007)
defined 6 competencies
QSEN phase II
(2007 - 2009)
pilot schools integrated the competencies in their nursing programs
QSEN phase III
(2009 - 2012)
RWJF provided funding to UNC SON and AACN to continue the project
patient-centered care
recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, needs
EX:
involve family and friends in care
teamwork and collaboration
function effectively within nursing and inter-professional teams
fostering open communication, mutual respect, and shared decision-making to achieve quality patient care
EX:
discuss effective strategies for communicating and resolving conflict
evidence-based practice
integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care
EX:
demonstrates knowledge of basic scientific bases for practice
quality improvement
use data to monitor outcomes of care processes and improvement methods to design and test changes to continuously improve the quality and safety of healthcare system
EX:
tools such as flow charts and diagrams to make process of care explicit
safety
minimize risk of harm to patients and providers through both system effectiveness and individual performance
EX:
value own role in preventing errors
informatics
use information and technology to communicate, manage knowledge, mitigate error, and support decision making
EX:
navigate electronic health record
primary care
keep illness or injury from occurring
secondary care
detect and treat existing disease
tertiary care
reduce the extent and severity of a health problem to its lowest possible level to minimize disability and restore or preserve function
primary prevention
avoids development of disease
immunization programs
healthy nutrition programs
smoking cessation programs
secondary prevention
focus on early disease detection, protecting progression of disease
colonoscopies
mammograms
hearing and vision screening
tertiary prevention
reduces the impact of an already established disease by minimizing disease-related complications
cardiac rehab
physical rehab programs
administrative law
established through executive branch of government
EX:
regulation of nursing profession by state boards of nursing
tort law
prosecuted through civil court system, can be a criminal offense
EX:
lawsuits brought against nurses by patients
constitutional law
originates from federal and state constitutions
EX:
rights and privileges inherent to Bill of Rights
Statutory Law
established from legislative branch of government
EX:
HIPAA and ACA
Note 
Flashcard (69)