Foundations of Professional Nursing: Theory, Research, Critical Judgment, and Communication

Flashcards covering nursing research and evidence-based practice (EBP), critical thinking and the nursing process, clinical judgment models, therapeutic communication and professional boundaries, and foundational nursing philosophies, conceptual models, and theories.

What is the scientific method?

A systematic way of thinking used to investigate phenomena and build scientific knowledge.

What are the three research designs used in scientific inquiry?

Quantitative Research, Qualitative Research, and Mixed Method Research.

How is nursing research defined?

The systematic investigation of phenomena related to improving patient care.

Why is Institutional Review Board (IRB) approval required prior to conducting nursing research?

To ensure human subjects are protected and prevent unintentional violations of human rights.

What three core components are integrated in evidence-based practice (EBP)?

The best scientific evidence from research studies and patient care data, clinical expertise, and patient values and preferences.

What does each component of the P-I-C-O-T framework represent?

P stands for Patient/Population/Problem; I stands for Intervention (variable); C stands for Comparison; O stands for Outcome; T stands for Time.

How do Paul and Elder define critical thinking?

That mode of thinking about any subject, content, or problem, in which the thinker improves the quality of their thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them.

What is the difference between reflective thinking and reflective practice?

Reflective thinking is an active process necessary for learning, whereas reflective practice is an ongoing process of self-evaluation and reflection.

What is the nursing process?

A universal standard, method of critical thinking, and conceptual framework that enables practicing nurses to think systematically, solve patient problems, and process patient information.

How does a nursing diagnosis differ from a medical diagnosis?

A nursing diagnosis focuses on the patient's human response to illness, injury, or threat and varies as responses change, whereas a medical diagnosis focuses on the disease or condition and remains constant while it persists.

What key activities occur in Phase 1 (Assessment) of the nursing process?

Collecting subjective and objective patient data through patient interviews, physical examinations, and consultation, while maintaining confidentiality under HIPAA of $1996$.

What processes occur during Phase 2 (Analysis and Identification of the Problem) of the nursing process?

Validating and clustering patient data to identify and prioritize NANDA nursing diagnoses representing human responses to health conditions.

What are the three domains of learning from Bloom's taxonomy applied when establishing patient goals in the Planning phase?

Cognitive, Affective, and Psychomotor domains.

What distinguishes independent, dependent, and interdependent (collaborative) nursing interventions?

Independent interventions allow autonomy without orders; dependent interventions require provider orders; interdependent (collaborative) interventions require teamwork and coordination with other healthcare professionals.

What actions are performed during Phase 4 (Implementation) and Phase 5 (Evaluation) of the nursing process?

During Implementation, planned interventions are carried out with continual assessment and documentation; during Evaluation, patient progress is examined against expected outcomes to determine if problems are resolved, in progress, or unresolved.

What constitutes clinical judgment in nursing practice?

Informed opinions and decisions based on empirical knowledge and experience, including knowing the limitations of one's own expertise and consulting appropriate standards and resources.

What are the six clinical judgment cognitive skills in Layer 3 of the NCSBN Clinical Judgment Measurement Model (NCJMM)?

1. Recognize cues; 2. Analyze cues; 3. Prioritize hypotheses; 4. Generate solutions; 5. Take action; 6. Evaluate outcomes.

What are the three phases of the traditional therapeutic nurse-patient relationship?

Orientation phase, Working phase, and Termination phase.

What occurs during the Orientation phase of the nurse-patient relationship?

The nurse and patient develop trust, view each other as individuals, identify the patient's perceived major problems and needs, and estimate the length of the relationship.

Why is nurse self-awareness essential for maintaining professional boundaries?

It helps nurses recognize their own emotions, prejudices, and personal needs so they meet those needs privately, remaining in the zone of helpfulness and preventing under-involvement, over-involvement, and role confusion.

What is the definition of communication according to Ruesch (1972)?

All the modes of behavior that one individual employs, conscious or unconscious, to affect another: not only the spoken and written word, but also gestures, body movements, somatic signals, and symbolism in the arts.

What percentage of communication is typically nonverbal versus verbal?

Nonverbal communication accounts for approximately $65\%$, while verbal communication accounts for $35\%$.

What are the five essential elements of the communication process?

Sender, Message, Receiver, Feedback, and Context.

What three operational processes occur during communication?

Perception, Evaluation, and Transmission.

What are the four major criteria required to achieve successful communication?

Feedback, Appropriateness, Efficiency, and Flexibility.

How does empathy differ from sympathy in therapeutic nursing?

Empathy is active, involves understanding another person's feelings as if they were one's own, and offers comfort at the root of the problem; sympathy is passive, involves pity from one's own point of view, and often leads to unsolicited advice or judgment.

What is the clinical distinction between an interpreter and a translator?

An interpreter mediates spoken or signed language in real time, whereas a translator works with written text.

What is the purpose of the SBAR communication framework, and what does each letter stand for?

SBAR is a standardized tool designed to structure clinical handoffs and relay critical information safely; it stands for Situation, Background, Assessment, and Recommendation.

What are the four levels of theoretical works in nursing?

Philosophies, Conceptual Models, Theories (Grand Theories), and Middle-Range Theories.

What is the foundational question and focus of Florence Nightingale's philosophy of nursing?

It focused on the relationship between the patient and the environment, asking: 'What needs to be adjusted in the environment to protect the patient?'

What central question guides Virginia Henderson's nursing philosophy?

'What can I help this patient do that they would do for themselves if they could?'

What is the core focus and guiding question of Jean Watson's philosophy of nursing?

The transpersonal caring relationship and the 10 Caritas Processes, guided by the question: 'How can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting their needs?'

What is the central premise of Dorothea Orem's Self-Care Deficit Model?

Nursing care is needed when a patient exhibits self-care deficits, guided by the question: 'What deficits does this patient have in providing their own self care?'

What three interacting systems form the basis of Imogene King's Conceptual System?

Personal System, Interpersonal System, and Social System.

What is the central concept and question of Sister Callista Roy's Adaptation Model?

Biopsychosocial adaptation in response to environmental changes, asking: 'How can I modify this patient's environment to facilitate their adaptation?'

What is the focus of Hildegard Peplau's Theory of Interpersonal Relations in Nursing?

The therapeutic interpersonal relationship between nurse and patient, asking how the nurse can best help the patient understand health problems and develop healthier behaviors.

What is the core focus of Ida Jean Orlando's Nursing Process Theory?

How nurses observe and process patient behavior in deliberate nurse-patient interactions to determine the patient's immediate needs for help.

What model did Madeleine Leininger design to guide the discovery of culturally congruent nursing care?

The Culture Care Sunrise Model (Sunrise Enabler), which explores cultural and social structure dimensions to guide generic and professional nursing decisions.

What five caring processes comprise the structure of caring in Swanson's Caring Theory?

Maintaining belief, Knowing, Being with, Doing for, and Enabling.

What are two examples of middle-range nursing theories in addition to Swanson's Caring Theory?

Mishel's Uncertainty in Illness Theory and Jezewski's Cultural Brokering Theory.