NURSING FINAL PART ONE (Historical perspectives of nursing ,professional socialization, nursing informatics, QSEN)

how did nursing start

• started to keep people healthy and comfort the sick

• goals stayed the same but the science + society changed how nurses work

Egypt

• 1st nurses= women/ called midwives

• doctors special in diseases ex: wounds/broken bones/internal diseases

Greece

• believed in Apollo ( healing god)

• Hippocrates ( 400BC): disease has natural cause not magic

diagnosis

identifying disease scientifically

prognosis

predicting possible outcome

cure

restoration of health

rome

• improved public health

• built on the groundwork on their Egyptian and greek

india

• had male nurses

• need 4 qualifications: drug knowledge, cleverness, devotion, purity

christianity

• nursing become formal and respected

• women and men cared for sick

• caring=important religious for sick

Middle Ages

• more hospitals built

• nurse listened to physicians orders

• midwifery grew

• most care by monks and nuns

crusades

• hospitals built on battlefields

• knights cared for sick this is where Red Cross symbol came from

15th- 19th century

• cities grew → poor hygiene + disease

• religion decline → fewer care givers

• criminal women used as nurses

• only respected nurses that worked in religious orders

19th century

• social reform (prisons, public health, poor care)

• pastor Fliedner creates 1st nursing school (Kaiserwerth)

Florence Nightingale

• went to kaiserwerth

• founder of modern nursing

• 1st epidemiologist + nurse researcher

• changed society view of nurses

• created nursing philosophy on health + restoration ( Nightingale pledge)

James Derham

• 1st black male nurse

Dorothea Dix

fought for the rights of the mentally ill

Clara Barton

founded American red cross

Margaret Sanger

found planned parenthood

Mary Breckinridge

startes 1st US midwifery school

Lillian Wald

started Henry street settlement

Isabel Hampton Robb

• 1st ana president

• helped form National league of nursing and AJN

Susie walking Bear Yellowtail

• improved Native American healthcare

• reduced child deaths

Virginia A. Henderson

• wrote nursing practice book

• “Florence Nightingale of her time”

Florence Wald

started US hospice movement

ANA (American nursing association)

• RNs only

• sets starts and ethics and improves nursing care

• started in 1911

NLN ( national league for nursing)

• identify the nursing needs of society and to foster programs to meet these needs

• open to everyone

• started 1952

national council of state boards of nursing inc (NCSBN)

• makes NCLEX

American Association of colleges of nursing (AACN)

• sets standards for BSN and graduate programs

Sigma theta tau international honor society of nursing

• nursing honor society

• invitation only

• began 1922

National student nurse association (NSNA)

• supports future nurses

• founded 1952

occupation

• manual work

• on the job training

• motivated by money

profession

• requires specialized education/training

• has ideals, ethics, responsibility

• special skill

licensure

• legal authority to practice profession, issued by each state

• based on 10th amendment

• most restrictive form of regulation

• needed when work requires specialized knowledge + independent decisions

certification

• usually voluntary

• shows someone passed exam from private agency

why is nursing regulated

• sets minimum standards for safe practice

• protects public from incompetence/unfit for practice

1903

first nursing boards (NC,NY,NJ,VA)

1938

NY 1st state w/ defined scope of practice and mandatory licensure

state board of nursing

• exist to protecting the healthy, safety, and welfare of public by licensing nursing

• write administrative rules

• disciplines unsafe nurses

• approve nursing schools

who serves on state boards of nursing

• staff hired by board

• board of directors appointed by the governor depending on state

• board meets often to tale disciplinary action on nurse licenses

benefits for regulation of nursing practice

• increase status

• economic benefits

• improved standards of practice

• preventing incompetent nurses from practicing

nurse practice act

• set licensure requirements

• define scope of practice

• authorize the board to enforce rules

licensure requirements

• apply

• graduate from nursing program

• pass NCLEX-RN

• be 18

• pay fees

• good moral character

• no citizenship requirement

what can NYS nurse do

• diagnose and treat patient

• perform health assessments

• teach + counsel patients

• work with HC team

• carry put medical regimens from providers

nursing social policy statement

• social context of nursing

• definition of nursing

• knowledge base

• scope of practice

• standards of practice

• regulation

• application

Definition of Nursing

the protection, promotion, optimization,of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of everyone

standards of professional nursing practice

• what nurses are responsible for

• nursing values

• framework for evaluating practice

nursing process

• assessment

• diagnosis

• planning

• implementation

• evaluation

what is nursing informatics

specialty that combines nursing, computer science and information science

informatics

information + automation

uses computer science + cognitive science+ info science

nursing informatics 1980

applying computers to all areas of nursing (education, practice, research)

computer in nursing education

• online learning

• NCLEX

• laptops, phones, PDA

computers in nursing practice

• documentation ( status, meds, notes, care plans)

• access to departments

• schedules

Telehealth

assess, diagnose, treat at a distance

biometrics

fingerprints, retina scans, facial patterns = secure access

EMR

• easy data retrieval

• warns about med conflicts/dangerous conditions

management and safety use

• order supplies

• budget + staffing

• trends and outcomes (research + quality improvement)

• HR databases

• facilities (heating and alarms)

• faster billing/claims

quality and safety education in nursing (QSEN)

• purpose: prepares nurses with competencies needed to continuously improve quality and safety in health care

• funded by RWJ foundation

competencies

1. patient/ family centered care

2. teamwork and collaboration

3. safety

4. evidence based practice

5. quality improvement

6. informatics

components

knowledge, skills, attitude

old patient/ family centered care

listen, show compassion, and respect for patients

ex: everyone had to take shower at 10AM

new patient/family centered care

patient and family are in partnered relationship with HC providers

ex: someone wants to shower at 7pm sure why not listen to patient

old collaboration and teamwork

work side with other HC professionals

(physicians on top nurses on bottom)

new collaboration and teamwork

function effectively within nursing and inter professional teams

(collaboration= joint decision making)

old evidence based practice

adhere to internal policies and procedures

(b/c that’s the way its always been)

new evidence based practice

use best current evidence+ clinical expertise, and patient preferences for best care

(best evidence + family values for patient)

old quality improvement

updating policies and chart audits

(manual)

new quality improvement

use data to monitor outcomes of careened test changes to continuously improve systems

(improving patient care)

old safety

focus on individual performance vigilance to keep patients safe

new safety

minimize risk of harm to patient and providers through both systems + individual performance

old informatics

timely and accurate doc

new informatics

use info and tech to communicate, manage knowledge, support decisions, reduce errors

(how to be on comp)

what is your responsibility

• timely acc data

• complete doc

• don’t falsify info write exactly what happened

• keep patient data clear and concise