NUR235 topic 1

List the 5 factors that influences how likely a person is to stay healthy or to become ill or injured. 

• Physical/biomedical factors (e.g. whether or not a person is vaccinated against disease, high blood pressure, chronic illness).  

• Environmental factors (e.g. pollution)  

• Social influences (e.g. income, education, health literacy, employment, housing, social support, access to health services) 

• Behavioural risk factors (e.g. tobacco smoking,  risky alcohol consumption, illicit drugs, poor exercise and eating habits) 

• Genetics 

 

Explain Australia's determinants of health status in 2016. 

• Australians living in the lowest socioeconomic areas live approximately 3 years less than those living in high socioeconomic areas.  

• People in low economic resource households spend proportionally less on medical and health care than other households.  

• People living in the lowest socioeconomic areas are more than twice as likely to delay seeing—or not see—a dentist, than those living in the highest socioeconomic areas 

• Unemployed people were 1.6 times as likely to use cannabis, 2.4 times as likely to use meth/amphetamines and 1.8 times as likely to use ecstasy.  

• Mothers in the lowest socioeconomic areas were 30% more likely to have a low birthweight baby than those in the highest socioeconomic areas.  

• Aboriginal and Torres Strait Islander people born in 2015–2017, life expectancy was estimated to be 8.6 years lower than that of the non-Indigenous population for males (71.6 years compared with 80.2) and 7.8 years for females (75.6 years compared with 83.4). 

• People with low health literacy are at higher risk of worse health outcomes and poorer health behaviours. 

^ poor economic status seems to be Australia's largest determinant of illness 

Explain the 3 processes leading to the development of competent nursing practice. 

• Critical thinking: The cognitive process of analysing thoughts and knowledge.  

• Clinical reasoning: Process of analysing health information and drawing conclusions to identify health issues or problems. Therefore, it is the application of critical thinking to a clinical situation. 

• Clinical judgment: The application of both critical thinking and clinical reasoning in identifying and addressing a patient’s needs.  

Explain the use of critical thinking. 

It helps us assess and modify our thinking, before taking action. 

Critical thinking is… 

• Purposeful 

• Goal orientated 

• Aimed to help you make judgements based on evidence 

• Based on science and evidence; not assumptions and/or conjectures.  

• Helpful for developing strategies to maximise a person’s potential.  

• Not dependant on a specific situation.  

 

Explain the use of clinical reasoning. 

1. It helps us analyse complex info 

2. make accurate and appropriate clinical decisions 

3. solve problems and find solutions  

4. plan care 

5. evaluate and prioritise each problem  

6. seek knowledge - to make clinical decisions and solve problems 

7. think creatively when planning patient care.  

Describe the scientific method clinical reasoning is based on. 

1. Attending to initially available cues 

2. Formulating inferences and making predictions about possible problems 

3. Gathering additional information relative to  the tentative inferences and predictions 

4. Validating each inference/prediction with additional information thus arriving at a final judgement about the health issue(s) /problem(s).

Define cue. 

Piece of information provided by the patient either - in response to the nurse’s question (subjective data) determined by the physical assessments undertaken (objective data).  

 

Define inference/prediction. 

Tentative explanation for a cue or set of cues that can be used as a basis for further investigation.  

Define reflection. 

Discovering the meaning and purpose of an event to make sense of practice and evaluate performance. 

 

Explain the use of a conceptual framework (a nursing model) to guide clinical judgment and nursing practice. 

• provides the framework for determining what to observe, and how to organise and interpret data. 

• used alongside a medical module to focus assessment not only the diagnosis and treatment of disease but on other core nursing concerns (e.g. nutrition, skin integrity, dyscopia, self-care limitations etc.). This shows you what your patient's needs are and how are you to address them. 

• helps nurses to cluster assessment data (subjective & objective information) and to prioritise identified problems.  

Explain the importance of the nursing process. 

The nurse can individualise strategies to ensure the patient has a successful admission. 

Describe the clinical reasoning cycle (6). 

1. Gathering relevant information and data 

2. Making appropriate judgments and decisions 

3. Setting priorities and establishing goals 

4. Preparing for and taking action 

5. Evaluating impacts and outcomes 

6. Learning from the process to inform future practice 

Describe the level 1 (high) priorities.  

• Airway problems (e.g. blockages) 

• Breathing problems (e.g. pain, fluid in lungs) 

• Circulation problems (e.g. active bleeding, spinal problems) 

• Vital signs concerns (e.g. increasing fever, low spO2) 

 

Describe the level 2 (medium) priorities.  

Note: there can be cases where a level 2 can be a level 1. Priorities change depending on the seriousness of issue. 

• Disability - mental status change (e.g. decreasing alertness, dose of medications) 

• Acute pain 

• Acute urinary elimination problems 

• Abnormal pathology results 

• Risk - of infection, safety or security 

• Untreated medical problems requiring immediate intervention (e.g. diabetic patient requiring insulin dose) 

 

Describe the level 3 (lower) priorities. 

Other health problems (e.g. knowledge deficit, activity intolerance, family coping) 

 

Define acute care. 

• “Health system components, or care delivery platforms used to treat sudden, often unexpected, urgent or emergent episodes of injury and illness that can lead to death or disability without rapid intervention”  

• It usually follows initial contact with the primary healthcare setting. 

Explain the purpose of acute care. 

Purpose: To provide treatment for acute a chronic illnesses that require immediate intervention.  

Goal (according to readings): To establish the patient's normal function, minimise adverse events and promote safe care.  

 

Compare acute and chronic illness. 

• Acute illness: lasts less than 3 months.  

• Chronic illness: lasts more than three months.  

List the types of healthcare services located in acute hospital settings. 

• Emergency care 

• Medical care 

• Trauma and Critical care 

• Surgery  

• Short-term inpatient stabilisation 

• Acute rehabilitation 

Explain the roles and responsibilities of acute healthcare settings. 

• Care for large number of patients with complex or high acuity needs who are at risk of deterioration.  

• Recognise and respond to patient deterioration  

  • Timely recognition and Timely response     =     ↓ patient risk of harm/morbidity  

                                                                                     Improve patient outcomes 

• In order to perform accurate assessments, nurses require sound knowledge of the patient, body systems, disease process (pathophysiology), and clinical reasoning (application of knowledge to nursing practice). 

• Then we record our observations onto the Adult Deterioration Detection System (ADDS chart) - in order to interpret the actions required by the score. 

List the principles of acute healthcare (7). 

• Communication and collaboration.  

• Promoting patient Health, Safety and Security. 

• Client empowerment  

• Equality and Diversity. 

• Dignity and respect 

• Encouraging patient participation in decision-making 

• Client Development.  

 

Describe community healthcare. 

• It encompasses a range of primary health, human services and community-based supports that make up majority of the primary healthcare sector. 

• It places an emphasis on the client's social environment and aims to meet the needs of the local community. 

• It’s primary focus is to promote health, and to prevent and manage diseases. 

 

List the principles of community healthcare (7). 

• Equitable, and Accessible,  

• Health promotion,  

• Appropriate technology,  

• Patient empowerment,  

• Cultural safety,  

• Community self-determination  

• Intersectoral collaboration. 

Describe the primary role of community healthcare nurses. (red (3): most important ones) 

• Patient assessment  

• Patient education 

• Promote patient empowerment 

• Health promotion 

• Illness prevention.  

 

Define health literacy. 

How people access, understand and use health information in ways that benefit their health. 

 

List the two components of health literacy. 

1. Individual health literacy 

2. The health literacy environment 

Explain the benefits of improving health literacy. 

• Increases patient involvement in shared decision making  

• Enables people to partner with health professionals for better health 

Describe the 3 stages of health literacy according to Clendon and Muns (2019). 

1. Functional health literacy 

2. Communicative or interactive health literacy 

3. Critical health literacy 

Define primary healthcare. 

Essential, community-based healthcare focused on prevention, education, and early treatment. 

 

Define secondary care. 

Specialist services for diagnosing and treating conditions typically requiring a referral. 

 

Define tertiary prevention. 

Efforts to manage and reduce complications of established diseases. 

Define discharge planning. 

Coordinated preparation for a patient’s safe transition from hospital to home or another care setting. 

List the factors impeding effective cross-cultural communication. 

• Lack of control (over decisions and discussions) 

• Modes of discourse (e.g. question-answer interview style) 

• Cultural and linguistic distance (complicated terminology and English being a second or third language) 

• Lack of shared knowledge  

• Lack of staff training in cross-cultural communication. 

• Limited use of interpreters. 

List the strategies to improve cross-cultural communication. 

• Informed choice and right of refusal 

• Staff respect, compassion and humility 

• Specific indigenous programs 

• Collaboration and continuity of care 

• Communication resources 

• Tools to measure cultural competence (e.g. reflection) 

• Cultural education programs 

• Cultural specific guidelines