LPD Finals

5 Rights of Delegation

Right task; right circumstance; right person; right direction and communication; right supervision and evaluation

Supervision

Directing; monitoring; evaluating task performance

Assistive Personnel Tasks

Condom catheter application; vital signs on stable clients

Assistive Personnel Restrictions

Cannot perform invasive procedures

Licensed Personnel Tasks

RNs/LVNs may perform invasive procedures within scope and competence

RN to LVN Delegation

RN transfers responsibility and authority for medication administration to LVN but remains accountable for outcome

Prioritization

Airway; breathing/oxygenation; circulation; potential disability before shelter; ABCs before pain

Laissez-Faire Leadership

Staff freedom to make decisions; staff expected to solve problems independently; leader responsible for staff decisions

Situational Leadership

Focuses on short-term goals; flexible; adjusts quickly to circumstances

Client Advocacy

Verify understanding; communicate client wishes/status to healthcare team; act as client voice, protector, supporter; nurse does not make decisions for client

Advanced Directives

CPR; durable power of attorney; feeding tubes; documents end-of-life wishes; only client can change directive

Informed Consent

Provider obtains consent; nurse witnesses signature; verifies voluntary consent and apparent competence; verifies client understands information provided

Client Refuses Treatment

Notify provider; document refusal and reason; inform client of right to refuse; ask reasoning

Client AMA

Notify provider; educate about risks of leaving; request AMA signature

Advocacy Situations

End-of-life decisions; healthcare access; privacy protection; informed consent; substandard practice

Who Can Sign Consent

Parent of minor; legal guardian; court-appointed representative; healthcare proxy; durable POA for healthcare; spouse depending on state; closest available relative depending on state

Language Barriers

Use trained medical interpreter for informed consent when language barrier or hearing impairment prevents communication

Patient Self-Determination Act

Clients must be informed of right to accept/refuse care on admission; competent adults may refuse treatment and leave healthcare facility

Texas Board of Nursing

Issues/revokes nursing licenses; defines scope of nursing practice in Texas

HIPAA

Protects privacy and confidentiality

Professional Accountability

Responsibility for actions, decisions, and outcomes

LPN Education

Certificate; diploma; associate degree

RN Education

Diploma; ADN; BSN

RN Education Requirement for Nurse Administrators

BSN

Compact License

Multistate license allowing practice in participating states

Magnet Recognition

Awarded by ANCC; lasts 4 years

Licensure

Minimum legal requirement to practice

Certification

Demonstrates excellence/specialization in an area

Assault

Threatening harm; no touching required; may involve threatening medical treatment/procedure

Battery

Unauthorized physical contact/touching

False Imprisonment

Holding a competent adult against their will

Libel

Written defamation

Slander

Spoken defamation

Scope of Practice

Never perform skills outside legal scope or competence

Mandatory Reporting

Child abuse; elder abuse; vulnerable adult abuse; communicable diseases

Autonomy

Client's right to make personal healthcare decisions

Nonmaleficence

Do no harm; avoid harm

Fidelity

Keep promises

Uniform Determination of Death Act

Death = irreversible loss of circulation and breathing OR irreversible loss of all brain function including brainstem

Federally Defined Minority Groups

Asian American; Black/African American; Hispanic/Latino; Native Hawaiian/Pacific Islander; American Indian/Alaska Native

Factors Affecting Health

Homelessness; unemployment; lack of insurance; limited healthcare access

Social Determinants of Health

Income; housing; education

Nurse Retention Strategies

Flexible scheduling; safe staffing; positive work environment; better ergonomics; fair hiring; reduce implicit bias

Evidence-Based Practice

Better patient outcomes; lower healthcare costs; higher quality care; safer nursing practice

Benefits of EBP

Better patient outcomes; lower healthcare costs; higher quality care; safer nursing practice

Strategies to Promote EBP

providing education and training on how to find and evaluate research, encouraging nurses to ask questions about current practices, providing access to current research and clinical guidelines, using EBP mentors or champions, encouraging interdisciplinary collaboration, supporting quality-improvement projects, providing leadership support and resources, and evaluating patient outcomes to determine whether evidence-based changes improve care.

Barriers to EBP

Barriers to EBP include lack of time, limited access to research and resources, insufficient knowledge or skills in finding and evaluating evidence, lack of support from leadership, resistance to change, inadequate staffing, limited funding, and difficulty applying research findings to clinical practice.

Culturally Congruent Practice

Reduce health disparities; improve health outcomes; individualized care

Disasters

Natural disasters and human-made events can occur without warning

Emergency Preparedness

Food; water; clothing; communication devices; extra medications; personal documents

Incident Report—Medication

File for medication errors

Incident Report—Procedure

File for procedure/treatment errors

Incident Report—Equipment

File for equipment-related injuries/errors

Incident Report—Needlestick

File for needlestick injuries

Incident Report—Falls

File for client falls/injuries

Incident Report—Visitor

File for visitor/volunteer injuries

Incident Report—Threats

File for threats made to clients/staff

Incident Report—Property

File for lost property such as dentures, jewelry, personal wheelchair

Mass Casualty Triage—Red

Emergent/immediate; highest priority; life-threatening injuries with high possibility of survival after stabilization

Mass Casualty Triage—Yellow

Urgent/delayed; major injuries not yet life-threatening; treatment generally within 30 min–2 hr

Mass Casualty Triage—Green

Nonurgent/minimal; minor non-life-threatening injuries; can wait hours to days

Mass Casualty Triage—Black

Expectant; not expected to survive; comfort measures; no restorative care

Thunderstorm/Tornado—Windows

Draw shades; close drapes; protect from shattering glass

Thunderstorm/Tornado—Beds

Lower beds; move beds away from windows

Thunderstorm/Tornado—Doors

Close all doors

Thunderstorm/Tornado—Ambulatory Clients

Move to hallways away from windows or designated secure locations; do not use elevators

Thunderstorm/Tornado—Monitoring

Turn on severe weather channel

Code Red

Fire

Code Pink

Newborn/infant/child abduction

Code Orange

Chemical spill

Code Blue

Medical emergency

Code Gray

Tornado

Code Black

Bomb threat

Active Shooter—Running

Evacuate if clear path; leave belongings; encourage others to follow but do not wait; prevent others from entering danger area

Active Shooter—Hiding

Hide out of view; lock/block entry; remain quiet; silence cell phones

Active Shooter—Fighting

Last option when running/hiding unavailable and danger is imminent; take aggressive action to stop shooter

Active Shooter—General Measures

Call 911 when safe; do not move wounded until scene is safe; remain calm/quiet; keep hands visible and cooperate with police