Critical Care Nursing (NCM 118) - Roles, Ethico-Legal Considerations, and Patient Rights

Vocabulary flashcards covering the core concepts, advanced nursing roles, care bundles, ethical principles, and patient rights and obligations from Critical Care Nursing NCM 118.

Care Bundles

A collection of evidence-based interventions implemented to enhance recovery, improve compliance, decrease hospital length of stay, and lower financial expenses (including SABSI, CAUTI, VAP, SSI, and PIP).

SABSI

Central line-associated bloodstream infection.

CAUTI

Catheter-associated urinary tract infection.

VAP

Ventilator-associated pneumonia.

SSI

Surgical site infection.

PIP

Pressure injury protection.

Direct Patient Care

A practitioner role where the critical care nurse detects and interprets indicators of varying conditions, initiates the full nursing process, acts promptly to prevent clinical deterioration, and coordinates with the healthcare team.

Indirect Patient Care

Care focused on the family by understanding their needs, providing information to relieve fears and anxieties, and assisting them in coping with life-threatening situations or impending death.

Extended Roles as Critical Care Nurses

Procedures and therapies beyond traditional professional boundaries normally performed by physicians (e.g., ABG analysis, ventilator weaning, titrating infusions, initiating defibrillation, removing pacer wires and chest tubes) executed under established institutional protocols and training.

Nurse Specialist / Clinical Nurse Specialist (CNS)

An advanced practice nurse supported by graduate study or a master's program with more than 3 years of uninterrupted critical care experience who leads education, clinical research, and the refinement of ICU standards.

Acute Care Nurse Practitioner

An advanced practice nurse who works alongside physicians, taking the lead in developing evidence-based practices to address changing clinical needs and facilitating patient care processes.

Outcome Specialist

A critical care expert and Quality Assurance team member who develops and implements critical pathways, protocols, algorithms, and orders to ensure quality and cost-effectiveness in care delivery.

Nurse Practitioner (NP)

An advanced practice role with an expanded scope of practice that can assess, order, and interpret diagnostic tests, initiate treatments, adjust medication or ventilation settings, and evaluate patient responses.

Republic Act No. 9173

The Philippine Nursing Act of 2002, which defines nursing practice under Article VI, Section 28 (Scope of Nursing Practice).

Autonomy

A core ethical principle centered on identifying and respecting the patient's wishes and choices, fundamentally protected through obtaining informed consent.

Beneficence

The ethical duty of doing good and acting in the patient's best interest, such as giving prescribed analgesics prior to wound dressing, raising bed side rails, and administering medications on time.

Justice

The ethical principle of navigating due process to determine healthcare limits and providing equitable care without discrimination based on socioeconomic status.

Non-Maleficence

The ethical principle to do no harm by identifying potential harms and taking steps to actively avoid them.

Principle of Double Effect

An ethical guideline stating that an action with two foreseen effects (one beneficial and one harmful) is permissible if the intention is good, such as administering opioids for pain relief despite the risk of secondary respiratory depression.

Moral Distress

The distress experienced by a nurse who knows the morally correct action but cannot carry it out, such as when recognizing that continuing specific life support therapies is no longer beneficial to the patient.

Advance Directives

Legal documents outlining specified medical interventions desired should a patient lose decision-making capacity, including DNR/DNAR orders and designation of a Health Care Proxy or Durable Power of Attorney.

Organ Procurement Organization (OPO)

A specialized organization whose coordinators work 24/7 with grieving families to navigate the organ and tissue donation process after cardiac or brain death.

Magna Carta of Patient's Bill of Rights and Obligations of 2017

Legislation introduced by Sen. Bong Revilla and filed on March 16, 2017, by Senator JV Ejercito (updating a 2008 version) establishing rights, obligations, and legal grievance mechanisms for patients.

Third-Party Consent Priority Order

The legal sequence of individuals authorized to grant informed consent when a patient is legally incapacitated: (1) Spouse, (2) Son or daughter of legal age, (3) Parent, (4) Brother or sister of legal age, (5) Guardian.

Right to Self-Determination

The right of an adult of sound mind to execute an advance written directive instructing physicians on the administration of terminal care when facing the end-stage phase of a terminal illness.

Right to Medical Records

The entitlement of a patient to examine the contents of their medical records (with physician explanation) and receive a medical certificate upon request, excluding psychiatric notes.

Right to Leave

The right of a patient to depart from a healthcare facility regardless of medical condition once informed of the consequences, provided it does not prejudice public safety; detention solely for unsettled hospital fees is prohibited.

Exhaust Grievance Mechanism

A patient obligation to report an incident to proper authorities and file a formal written complaint with institution leadership prior to pursuing administrative or legal action.