concepts in nursing - midterm

What is professional identity in nursing?

a sense of oneself and in relation to others, that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.

What are some aspects to professional identity in nursing?

collaboration, community, growth mindset, humility, moral courage, clinical judgment, civility, respect, accountability, reflection, etc.

What are some things that can be done to build professional identity?

hear expectations clearly, value feedback from role models, reflection, actively adopt a professional identity, understand responsibilities for learning and be accountable, build relationships with peers, develop personal self care habits

What are the Nurse Practice Acts (NPAs)?

regulate the scope of nursing practice, protect public health, safety, and welfare from unqualified/unsafe nurses.

How do you become an RN?

1. 2 years associates or 4 years bachelors degree

2. pass state exam (NCLEX)

3. Board of Nursing grants license after passing NCLEX (license can be revoked!)

What is the Code of Ethics for Nurses?

1. nurse practices with compassion and respect

2. commitment to the patient

3. promotes, advocates, and protects the rights, health, and safety of the patient

4. nurse has authority, accountability, and responsibility for nursing practice (decisions and taking action for optimal care)

5. nurse owes the same duties to self as to others ( promote health and safety, wholeness of character and integrity, competence, personal and professional growth)

6. Nurse maintains ethical work environment

7. nurse advances profession through research and scholarly inquiry

8. collaborates with other health professionals to protect human rights, promote health diplomacy, and reduce health disparities

9. profession must articulate nursing values, maintain integrity, and integrate principles of social justice

What are the 6 Quality and Safety Education for Nurses (QSEN) competencies?

patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

What is clinical reasoning?

thinking process by which a nurse reaches a clinical judgment

What is clinical judgment?

requires the nurse to apply knowledge to the unique client situation to make sense and respond in context

What is critical thinking?

cognitive process used for analysis of a problem - knowledge based, same across all situations, context unimportant

How do nurses make judgments?

- inferences + interpretations = influence actions

- tasks constantly restacked

- dynamic, ever-changing process

- influence of nurse knowledge, experience, ethics, patient background

What is Tanner's Model?

1. Noticing: using patterns and cues to find information

2. Interpreting: make a hypothesis and test

3. Responding: respond using 1 or more actions

4. Reflecting: determine patient status and adjust

What is ADPIE?

1. Assessment

2. Diagnosis

3. Planning

4. Implementation

5. Evaluation

What are the 6 steps to the NCSBN Clinical Judgment model?

1. Recognize cues

2. Analyze cues

3. Prioritize hypothesis

4. Generate solutions

5. Take action

6. Evaluate outcomes

What is communication?

The act of sending information from one person or group to another. exchanges varies depending on the needs of the situation.

What are the 6 types of communication?

- assertive: positive and negative ideas and feelings expressed openly

- intrapersonal: self-talk

- intraprofessional: communication between individuals in the same profession (nurse to nurse)

- interpersonal: communication with others

- interprofessional: communication between members of the healthcare team. (nurse to doctor)

- therapeutic: process where words and actions are used between clinicians and patients to achieve healthcare outcomes

What are the 5 non-verbal skills that facilitate active listening?

- sit facing the client

- open position

- lean towards client

- eye contact

- relax

What are the 10 therapeutic communication techniques?

acceptance, confrontation, doubt, interpretation, observation, open-ended statements, reflection, restatement, silence, validation

What are 5 non-therapeutic communication techniques?

advice, agreement, challenging, false reassurance, disapproval

What are the 4 phases to nurse-client communication?

1. pre-interaction: occurs before meeting the client

2. orientation: getting to know eachother

3. working: solving problems and establishing goals

4. termination: planning for the future

What are the 5 legal guidelines for documentation?

Factual, Accurate, Complete, Current, Organized

What is the purpose of a healthcare record?

- interprofessional communication

- permanent legal documentation/legal defense

- reflects quality of care= auditing/ monitoring

- reimbursement

- research and education

What is the concept of patient safety?

"Avoiding injuries to patients from the care that is intended to help them"

What is ISBAR

Introduction, Situation, Background, Assessment, Recommendations

What is ISHAPED

Key elements in a standardized patient hand-off process. introduce, story, history, assessment, plan, error prevention, dialogue.

What is a sharp end (active) error?

unpredictable, immediate effect. providing patient care, responding to patient needs

What is a blunt end (latent) error?

flaw in system, does not immediately lead to error, but a triggering event can cause error

What is a sentinel event?

unexpected death, serious physical or psychological injury or risk

What is an adverse event?

unintended harm by act of commission (gave incorrect care) or omission (did not do something, but should have)

What is a near miss error?

no result in patient injury, illness, or damage as a result of chance

What is a diagnostic error?

diagnosis delay, not using correct tests, or acting on monitoring

What is a treatment error?

wrong performance of skill/test, wrong dose/method of med, delay of treatment, ignoring abnormal result

What is a prevention error?

not giving prophylactic treatment, inadequate monitoring, follow-up

What is a communication error?

lacking or unclear... leads to many types of errors

What is a Just Culture?

seeks to find balance between disciplinary measures and learning from mistakes.

What is Reason's swiss cheese model?

Errors occur despite multiple layers of safeguards

What are the 6 domains of healthcare quality?

safe, effective, patient-centered, timely, efficient, equitable