Model 1A MF

What is nursing?

A dynamic, evolving profession focused on promoting health, preventing illness, restoring health, and caring for individuals, families, and communities.

What makes nursing a profession?

Formal education, clinical experience, socialization into the profession's values and norms, ethical practice, and a distinct scientific knowledge base.

What are nursing's major aims?

Promote health, prevent illness, restore health, and facilitate coping with disability or death.

Professionalism

Behaviors, values, knowledge, accountability, and ethical standards expected of a member of a profession.

Accountability

Being answerable for one's judgments, actions, and omissions and accepting their consequences.

Credentialing

The process of verifying that a person or program has met established professional standards; includes licensure, certification, and accreditation.

Accreditation

Formal recognition that an educational program or healthcare organization meets established quality standards.

Certification

Recognition by a nongovernmental professional organization that an individual has met specified qualifications in a specialty.

Licensure

Legal permission from a state to practice nursing after required education and examination standards are met.

National Council Licensure Examination (NCLEX)

The standardized examination used by state boards of nursing to determine entry-level nursing competence for licensure.

National Council of State Boards of Nursing (NCSBN)

The organization of nursing regulatory bodies that develops the NCLEX and supports public protection through nursing regulation.

American Nurses Association (ANA)

A professional organization that establishes nursing standards, a code of ethics, and guidance for professional practice.

Nurse Practice Act (NPA)

State law that defines nursing's legal scope of practice, licensure requirements, standards, violations, and disciplinary actions to protect the public.

State Board of Nursing responsibilities

Enforces the Nurse Practice Act, regulates scope and standards, approves nursing programs, authorizes NCLEX eligibility, issues and renews licenses, investigates complaints, and disciplines violations.

Maslow's Hierarchy of Needs in nursing

A framework nurses use to prioritize needs, generally addressing lower-level survival and safety needs before higher psychosocial needs.

Maslow level 1: Physiological needs

Needs necessary for survival, such as airway, oxygen, breathing, circulation, water, food, elimination, sleep, temperature control, and pain relief.

Maslow level 2: Safety and security

Physical and emotional protection, stability, a safe environment, fall prevention, medication safety, abuse or suicide prevention, and freedom from fear.

Maslow level 3: Love and belonging

Relationships, acceptance, affection, family, friendship, trust, inclusion, and emotional support.

Maslow level 4: Self-esteem

Self-respect, confidence, independence, dignity, recognition, and a positive body image.

Maslow level 5: Self-actualization

Personal growth, purpose, fulfillment, reaching one's potential, and pursuing meaningful goals.

What is the basic Maslow priority rule?

Address physiological threats first, then safety, love and belonging, self-esteem, and self-actualization; use clinical judgment because urgent threats override routine hierarchy.

Airway-Breathing-Circulation (ABCs)

A priority framework: maintain a patent airway first, then adequate breathing, then circulation and perfusion.

What findings require high priority?

Red flags such as airway obstruction, respiratory distress, poor circulation, abnormal or worsening vital signs, altered mental status, uncontrolled bleeding, and sudden severe pain.

Acute versus chronic priority

An acute or suddenly worsening problem usually takes priority over a stable chronic problem.

Nursing process (APPIE)

A systematic method of person-centered care: Assessment, Problem identification/diagnosis, Planning/outcome identification, Implementation/interventions, and Evaluation.

Characteristics of the nursing process

Systematic, dynamic, interpersonal, outcome-oriented, universally applicable, and continuously adapting.

Why is the nursing process systematic?

It follows an organized, step-by-step method for identifying and addressing patient needs.

Why is the nursing process dynamic?

The patient's condition and needs can change, so the nurse continually reassesses and modifies care.

Why is the nursing process interpersonal?

It depends on communication and collaboration among the nurse, patient, family, and healthcare team.

Why is the nursing process outcome-oriented?

Care is directed toward specific, measurable patient outcomes.

Why is the nursing process universally applicable?

It can be used with all patients and in every healthcare setting.

Assessment

The first nursing-process step: systematically collect, verify, organize, document, and interpret patient data to determine health needs and establish a baseline.

Subjective data

Information reported by the patient or another person, such as symptoms, feelings, beliefs, and perceptions; it cannot be directly measured by the nurse.

Objective data

Observable or measurable information obtained through examination, vital signs, laboratory results, and other tests.

Sources of assessment data

The patient is the primary source; secondary sources include family, caregivers, health records, other professionals, laboratory reports, and diagnostic results.

Methods of data collection

Observation, interview/health history, physical examination, review of records, and consultation with other healthcare professionals.

Initial assessment

The first comprehensive assessment used to establish a baseline and identify the patient's overall needs and problems.

Focused assessment

A targeted assessment of a specific problem, body system, symptom, or change in condition.

Quick-priority assessment

A brief, focused assessment used to identify the most urgent problem and need for immediate action.

Emergency assessment

A rapid assessment during a life-threatening crisis, with immediate attention to ABCs and survival needs.

Time-lapsed assessment

A reassessment performed after the initial assessment to compare the patient's current status with baseline and identify change over time.

Clinical reasoning

The thinking process used to collect and analyze information, consider alternatives, and determine appropriate nursing actions.

Clinical judgment

The conclusion or decision a nurse makes about a patient's needs and the actions that should be taken.

Critical thinking

Purposeful, reflective reasoning used to interpret evidence, question assumptions, solve problems, and make safe decisions.

Situational awareness

Continually noticing and interpreting what is happening with the patient and environment so changes and risks can be recognized early.

Prioritization

Ranking patient problems and actions according to urgency, risk of harm, ABCs, Maslow, safety, and changes from baseline.

Problem identification/nursing diagnosis

The nursing-process step in which assessment data are analyzed to identify actual or potential human responses that nursing care can address.

Medical diagnosis versus nursing diagnosis

A medical diagnosis identifies a disease or pathology; a nursing diagnosis identifies a patient's response or need that nurses can treat or monitor.

Problem-focused nursing diagnosis

A current problem supported by defining characteristics or signs and symptoms.

Risk nursing diagnosis

A potential problem that is not currently present but is more likely because of risk factors.

Health-promotion nursing diagnosis

A patient's readiness or desire to improve health, wellness, or health behaviors.

Etiology

The cause or contributing factors associated with a problem; in a nursing statement, it explains what the problem is related to.

Outcome identification

Selecting the specific, measurable patient response expected after nursing care.

Expected outcome (goal)

A specific, measurable, patient-centered result that nursing care is intended to achieve.

SMART goals

Goals that are Specific, Measurable, Attainable, Realistic/Relevant, and Time-bound.

How should a patient goal be written?

In patient-centered language, often beginning with 'The patient will,' and including an observable result, measurement criteria, and target time.

Planning

Prioritizing problems, choosing measurable outcomes, and selecting evidence-based nursing interventions to reach them.

Implementation

Putting the plan of care into action by performing, delegating, coordinating, teaching, and documenting nursing interventions.

Nursing intervention

A specific action performed by a nurse to prevent or manage a problem and help achieve an expected outcome.

How should a nursing intervention be written?

Begin with an action verb and state the specific action, relevant details, frequency or timing, and conditions as needed.

Evaluation

Comparing the patient's actual response with the expected outcome to decide whether the goal was met and whether care should continue, change, or stop.

What happens when an outcome is not met?

Reassess the patient, determine why the plan was ineffective, revise diagnoses/outcomes/interventions as needed, and continue the nursing process.

Why is documentation essential to the nursing process?

It communicates care, supports continuity and evaluation, creates a legal record, and promotes accountability and safety.

Nursing research

A systematic process that collects observable, verifiable data to describe, explain, predict, or control phenomena relevant to nursing.

Purposes of nursing research

Improve care and outcomes, expand nursing knowledge, study clinical problems and interventions, guide education/administration/policy, and strengthen nursing as a scientific profession.

Why is research important to nursing practice?

It identifies safe and effective care, explains the rationale for nursing actions, challenges routines, supports quality improvement, and improves outcomes.

Basic research

Pure or laboratory research conducted primarily to generate or refine scientific knowledge without an immediate clinical application.

Applied research

Research designed to solve an immediate clinical problem and directly improve nursing practice.

Quantitative research

Research using numerical data, measurement, and statistics to test relationships, differences, or cause and effect; often uses larger samples.

Descriptive research

Quantitative research that describes events or variables as they naturally occur and answers 'What is happening?' without manipulating variables.

Correlational research

Research that examines relationships between variables; correlation shows association but does not prove causation.

Causality

A relationship in which one factor produces a change in another; it requires stronger evidence than simple correlation.

Quasi-experimental research

Research that tests a possible cause-and-effect relationship using an intervention but lacks full control, randomization, or both.

Experimental research

A controlled study that manipulates an independent variable and usually uses random assignment and control/comparison groups; strongest design for testing causation.

Qualitative research

Research using words, interviews, observations, stories, or documents to explore people's experiences, perceptions, culture, and meaning.

Phenomenology

A qualitative approach that describes the lived experience of a phenomenon from the participants' perspective.

Grounded theory

A qualitative approach that studies people's actions and beliefs to develop a theory grounded in collected data.

Ethnography

A qualitative approach that studies the behaviors, beliefs, practices, and experiences of a cultural group.

Historical research

Systematic examination of past events to understand their meaning and influence on current or future nursing practice.

Florence Nightingale's contribution to nursing research

She used observation and statistics to connect sanitation, nutrition, ventilation, and environmental changes with decreased mortality.

Evidence-based practice (EBP)

Making clinical decisions by integrating the best available evidence, clinical expertise, and the patient's preferences and values.

Why use evidence-based practice?

To improve outcomes and safety, support quality care, provide a scientific rationale for actions, reduce ineffective care, and keep practice current.

Six steps of the EBP process

1) Ask a focused clinical question; 2) search for the best evidence; 3) critically appraise it; 4) integrate evidence with clinical expertise and patient preferences; 5) implement and evaluate outcomes; 6) disseminate results.

PICOT

A format for a focused clinical question: Patient/Population, Intervention, Comparison, Outcome, and Time.

P in PICOT

Patient or population of interest.

I in PICOT

Intervention being considered.

C in PICOT

Comparison intervention or current practice.

O in PICOT

Desired or measured outcome.

T in PICOT

Time frame for the outcome, when applicable.

Evidence-Based Practice versus research utilization

Research utilization applies findings from research to practice; EBP is broader and integrates evidence with clinical expertise and patient values.

Nursing informatics

A nursing specialty combining nursing science with information and analytical sciences to identify, manage, communicate, and use data, information, knowledge, and wisdom in practice.

Informatics

The use of information, processes, and technology to support communication, decision-making, care delivery, safety, and outcomes.

Electronic health record (EHR)

A digital longitudinal patient record used to document, retrieve, and share health information across care settings.

Examples of nursing informatics

Electronic health records, clinical information systems, barcode medication administration, clinical decision support, patient portals, telehealth, and digital care plans.

How nurses use informatics

To document care, find and analyze information, communicate with the team, support decisions, reduce errors, educate patients, and evaluate outcomes.

Communication

The exchange of information, thoughts, feelings, or meaning through verbal, nonverbal, written, and electronic methods.

Intrapersonal communication

Communication within oneself, such as self-talk, reflection, and thinking through decisions.

Interpersonal communication

Direct communication between two people, such as a nurse and patient or two team members.

Small-group communication

Communication among several people working toward a shared goal, such as a care-planning team.

Organizational communication

Communication among people and groups within an organization using formal and informal channels.