Foundations of Nursing: Exam 2

What are Standards of Practice and what is their function?

The standards of practice are explanatory statements that describe a competent level of care for all registered nurses

What is the Standards of Practice function?

Held accountable by the state to the standards of practice of their specialty and as defined within that scope of practice, nurses graduate with a standard set of skills that deem them competent to perform at entry-level nurses, following code of conduct and upholding ethical values, and establish expectations for professional behavior and to protect the nurse, the client, and the facility, where the client care is practice

What is the state Nurse Practice Act (NPA)?

A state law that explains the functions and responsibilities of the professional nurses (by each state)

What is the function of the Nurse Practice Act?

NPA identifies what conditions must be met for licensure

Duty of each state to protect all clients who are receiving care, which is the rationale for requiring a professional nurse to have a license

Specifies that all RNs and LPN must adhere to the prescribed scope of practice to provide safe and competent client care

How Nurse Practice Act is developed?

First, they need to identify as a NPA by the state legislature to regulate nursing practice in the state 

State legislature identifies a regulatory body, such as the BON

NPA provides the general guidelines, and the state BON overviews it; to make further rules and regulations to the NPA guidelines be more detailed 

Who governs the NPA

State BON

NPA defines the Scope of Nursing Practice

NPA varies from state to state, however have the same definitions of terms and phases used regulatory statuses

Allow other adminstration agency to enforce rules and regulation as seen fit… to uphold the rights of the nurse and protect the health and welfare of the public

NPA rules and regulations MUST align with what?

the nursing process

What specific nursing titles did NPA identify?

RN, LPN, LVN, and APRN

NPA requires of all nursing title to examine for licensure as a RN,

background checks and violations related to substance abuse

NPA can penalize if a nurse fails to report what?

any abuse to client, fraud, positive background check, crime related, and so on

How are nursing education programs regulated?

All education program standards and curriculum rules and clinical learning experiences, must be approved by the BON 

Nursing programs set their guidelines and meet in front of the state board of nursing, and justify their rules and regulations 

Quality and Safety Education for Nursing (QSEN)

set of nursing competencies and proposed targets for the knowledge, skills, and attitudes that all prelicensure nursing student should have attained for entry to practice 

Who formed the QSEN

National Academy of Medicine for their core competencies for all health clinicals

What does KSA mean?

Knowledge, Skills, and Attitudes

What are the 6 QSEN compentencies 

Patient-centered care, teamwork and collaboration, EBP, QI, Safety, and Informatics

Patient-centered care

Nurse provides care, compassion, and culturally sensitive care that address a client’s physiological, psychological, sociological, spiritual, and cultural needs, preferences and values (Asking a patient their pov on their provison of care and any suggestions)

Teamwork and collaboration

involves nurses being aware of their strengths and limitations (asking another team member for assistance of inserting a peripheral intravenous device)

Evidence-based practice (EBP)

nurses’ ability to analyze the difference between evidence-based care v. the normal way of providing client care; could result in undesirable client outcomes 

Quality Improvement (QI)

entails the application of care-related and organizational processes to develop and implement a plan to improve health care and needs for the client (Changing the discharge process or incident report following a patient’s fall; easier for the patient and the nurse) 

Safety

minimizing risk factors that could cause injury to harm while promoting quality care a secure environment for the patient. (Never recap a needle, implement suicide precautions for an at-risk client, and good hand hygiene)

Informatics

nurse’s ability to utilize technology as a communication and information- gathering tool that supports clinical decision-making (Nurse being able to document patient’s education and care and use new technological devices, such as an IV pump)

What are the four NLN Integrating Competencies?

Human Flourishing, Nursing Judgment, Spirit of Inquiry, and Professional Identity

What is the purpose of the NLN?

The purpose of the NLN is to foster excellence in nursing education “to build a strong and diverse nursing workforce to advance the health of our nation and global community”

These NLN competencies are for ________ ______ ______ to learn and be able to apply them when they graduate nursing student and start working as a RN

prelicensure nursing students 

What is the purpose of the AACN BSN essentials

American Association of College is an organization that represents schools of nursing throughout the US

AACN BSN serves as the voice of what?

nursing education: to form quality standards for nursing education and implement and guide nurses to improve health care. Gain community support, research, and practice

What are the educational paths for the RN?

Diploma, ADN, or BSN

How does the RN become licensed?

The RN becomes license when they pass the NCLEX and the state BON licenses them to practice

What is an APRN?

Advanced Practice Registered Nurse 

Who regulates APRN practice?

State Board of Nursing

What is the Nurse Licensure Compact (NLC)?

An agreement by state licensing boards that allow a nurse to practice in any state that has adopted the compact under one license

Who does the NLC benefit?

traveling nurses, telehealth nursing, nurse educators, who provide online nursing education, and nurses who provide services during disasters in other NLC states

A nurse who applies for a _______ license must hold a valid and active nursing license in their primary state of residence to be approved for a multistate license 

multistate

In order for a nurse who holds a multistate nurse license through the NLC,

that state has to be a member of the compact

What is reciprocity? (basically, the same thing as NLC)

The ability to transfer current state license to another, providing the nurse has an initial nursing license and is in good standing with the state

All 50 states practice reciprocity, but what is different?

the applying process

A nurse with a single-state licensure can practice where?

in the state that it is issued in

For a nurse to transfer their single-state license to another state they have get what done?

a thorough background check, submit an application to the state BON, and pay a fee  

What is a Certification in Specialty Practice?

Provides instructions in a concentrated area or topic of study, usually followed by a test

Nurses can take multiple paths to demonstrate proficiency in their field practice 

What is credentialing?

Process that provides confirmation of an individual’s abilities to practice as a health professional (verify the nurse has the necessary education, training, and experience to practice in the state)

How to write nursing credentials

Should be listed in a specific order… beginning with the highest educational level attained, followed by licensure, state designation/requirement, national certification, honors/awards, and any other certifications 

Care Provider

Assess resources, strengths, weaknesses, coping behaviors, and the environment to assist the client in regaining health and ability to function independently 

Most often associated with the hospital setting 

Coordinating care and helping the client navigate the health system 

Caring is CENTRAL in this role 

Knowledge also is critical to proving safe, quality client care 

Educator

Spend a great time teaching and reinforcing teaching

Focus on health promotion and prevention 

Helping clients cope with and manage acute or chronic conditions 

Assist clients in recognizing choices, evaluating alternatives, develop a sense of control over environment and health

Teaching is planned, and based on the needs of the client

Client Advocate

Promote what is best for the patient, needs are met, and protects client’s legal rights

While promoting in patients’ best interest, do not take away their independence; will be a challenge 

Advocate for individuals, families, communities, and population 

Responsibility to be knowledgeable and active in political processes affecting the safety and rights of patient 

Change Agent

Identify problems in health care delivery that impact client care, safety, access to care, or the work environment 

Assess motivation and capacity for change, in addition to determining alternatives and exploring all possible outcomes

Able to implement change on your own, or may need to approach management with your ideas and recommendations 

Most effective when its evidence-based, carefully planned, implemented collaboratively, and continuously evaluated 

Manager

Plan, direct, monitor, and evaluate the nursing care provided to a variety of client populations

If you don’t have a formal management title; still function in the manager role

Necessary for a change agency to express a positive of changes to enhance the provision of care

Act to accomplish goals in efficient manner with others

What does the Manager role requires?

skill in planning, decision-making, collaboration, communication, and critical thinking

Researcher

Responsible for designing, managing, and publishing studies; basis of EBP

Evaluate research findings and incorporate evidence into practice

Research is critical to providing safe, effective, and high-quality care to clients

Collaborator

Apart of an interprofessional team made up of health care professionals from many disciplines (nurses, physicians, pharmacists, social workers, OT, PT, and so on)

Collaborator plans and coordinate care in cooperation with who?

disciplines

Collaborate with members of the community and government agencies to identify and address issues that impact who?

society

Who does the NLN and AACN focuses on?

nursing education

The ANA and NAPNES promote

generalist nursing practice

The NLN is the professional organization that promotes

“excellence in nursing education to build a strong and diverse nursing workplace”

NLN represents nursing education programs at all levels and offers accreditation process through its

NLN Accrediting Commission

What does AACN represents?

university-level nursing education program

AACN activities include

educational research, governmental advocacy, data collection, publishing

AACN establishes standards for what types of degrees in nursing program

baccalaureate and graduate degree

ANA differs from most professional nursing associating by what?

also functioning as a labor union

The ANA seeks to influence ____, ____, and _____ conditions affecting nursing practice

social, political, and economic

ANA establishes statements to inform what?

decision-making, guide practice, and influence quality

ANA represents all ______ _____ in the US

registered nurses

NAPNES

multidisciplinary association that promotes practice and education of LPNs

NAPNES advocates for regulation of what?

practical nursing practices

Altruism

selfless concern for the well-being of others, or placing the needs of others first

Altruism is also acting as a client _____

advocate and mentor to provide guidance to novice nurses

Incorporating altruism in your practice, ensures as a provider; you are striving to protect who?

individuals who are most vulnerable in society

Respect for Autonomy is supporting the freedom of clients have to make what?

their personal decisions

Clients should decie their own future, even if, the decision creates risk that who do not argue with?

the nurses

Human dignity respect for the uniquness and worthiness of each who?

person

Repect human dignity by incoporting what?

empathy, kindness, and respectfulness in your practice

Providing the same quality of care to all clients, regardless of their

background, social standing, or level of alertness

Integrity

actions align with nursing’s code of ethics and standards of practice

True or False: Embrace high standards for moral, ethical, and legal behavior, and incorporates accountability, responsibility, and honesty

True

Social Justice

upholds the morals and legal principles, such as allocating resources fairly and reporting incompetent, unethical and support fairness

What is health policy?

Determines who provides health care, who pays and gets paid for health care

Also determines what kinds of care health professional provides, where, how, and when they provide it 

The political process of healthy policy as a nurse is

part of your role as a nurse to advocate for patients, society, and profession 

What are ethical comportments

your ethical behavior and being responsible incorporating it into your practice

The Code of Ethics provides direction in ethical comportments. However, they do not have provide what?

code/rules for instructions 

In difficult situations, nurses are going to have to make unpleasant choices; demonstrating what?

ethical behaviors 

Ethical comportment is the primary commitment to who?

the client, having accountability, self-respect, healthy environment, advance the profession, ethical issues, and more 

Social justice in broad health issue

Support efforts to improve conditions for vulnerable populations and improve conditions for vulnerable population. Also promote public awareness

What are standards of care

Legal basis upon which the minimum level of acceptable care of nusing practice is determined 

Health care institutions create internal standards of care, for instance….

education, policies and procedures, and job description required for a particular role 

Legal written guidelines for nursing practice

What are the roles of state Nurse Practice Acts

Protect the public by legally defining the boundaries of the scope of nursing practice pertaining to licensure

NPA governs individual practice by determining what?

permissible functions and activities of the nurse

Although NPA varies from state to state, what are they still responsible of following?

the scope of practice in the state

What is the Affordable Care Act?

A law enacted in 2010 to improve health care quality while lowering costs and expanding the Medicaid program.

What is accreditation of health care facilities?

an outside organization that assures they have policies and procedures in place to maintain the quality of services and the safety of clients

What are The Joint Commision (TJC)

a nonprofit organization that accredits health care organizations in multiple types of health care settings, ranging from an inpatient hospital to pharmacies

Accreditation visits consist of documentation/policy review, observation, and interviews with who?

administration and staff members to ensure quality care of the client and need for improvement

How long is TJC valid for?

three years

Health care facilities must meet the standards outlined in the?

TJC book

TJC also provides guidance on how to change and improve what?

facilities practices

National Patient Safety Goals

are based on current client safety issues to its website

NPSG establishes for each type of care setting:

ambulatory, behavioral health, critical access, home care, hospitals, laboratory services, national care center, and office-based surgery

When new trends in patient safety are identified, TJC develops new what?

requirements or modifies current NPSG requirements

What is an Hospital-acquired infections (HAI)

hospital will receive less reimbursement money for poor outcomes than for good outcomes

What is a sentinel event?

Results in a client’s death or harm that is determined to be permanent or serve (administering a wrong blood type into a patient, infant death, surgical procedure performed to an incorrect arm or leg)