NURSING FINAL PART 3 (Globalization of nursing, core competencies, political advocacy and involvement, ethics, IOM)

The universal declaration of human rights

“Everyone has the right to a standard of living adequate for the health and well being of himself and of his family” UN 1948

What is health

A state of complete physical, mental, and social well being and not merely the absence of disease or infirmity

Global health

The area of study reseach and practice that places a priority on improving health and achieving equity in health for all people

Objectives of global health care

• high life expectancy and aging populations

• Expansive health and medical care system

• Rapidly growing private health market

• Health as a dominate theme in social and political discourse

• Heath as major personal goal in life

Measurement of health status

• cause of death

• Life expectancy at birth

• Maternal mortality rate

International health agencies

World health organization (WHO) most widely recognized international governmental health organization

US department of health and human services (USDHHS)

Deals with health issues in US

National institutes of health (NIH)

Disease research

Center for disease control and prevention (CDC)

Deals with spread cause and control of disease in US

Epidemic

Rapid spread of a disease though a population in a relatively short amount of time

Pandemic

Is an epidemic that has spread over a large region of the world

Global health priorities

Control of:

Non communicable diseases

Communicable maternal perinatal and nutritional conditions

Injuries

Sustainable development goals

Patient centered care

Give care that respects each patient’s needs, values, culture, and preferences. Treat them as partners in their care.

Professionalism

Act responsibly and ethically. Follow nursing standards, laws, and moral principles.

Leadership

Guide and influence others to reach shared goals and improve patient care.

Systems based practice

Understand how the health care system works and use its resources to give the best care.

Infomatics and technology

Use computers, charts, and technology to communicate, find information, prevent errors, and make decisions.

Communication

Communicate clearly and respectfully with patients, families, and the healthcare team to improve care.

Teamwork and collaboration

Work well with other nurses and professionals using open communication and shared decision-making.

Safety

Protect patients and healthcare workers by reducing risks, preventing mistakes, and promoting safe practices.

Quality imporvement

Use data to spot problems in patient care and help make changes that improve safety and outcomes.

Evidence based practice (EBP)

Use the best research, your clinical skills, and patient preferences to make care decisions

the executive branch

governor Kathy Hochul: submits budget, execution and enforcement of laws, commander in chief

attorney general ( enforces state laws)

Letitia James

comptroller (oversees financial operations)

Thomas DiNapoli

nursing ethics

a system of principles concerning the actions of the nurse in his or her relationships with patients

ethical principles

• autonomy

• nonmaleficence

• beneficence

• justice

• fidelity

• confidentiality

• veracity

• accountability

autonomy

the freedom to make decisions about oneself

ex: nurses need to respect clients right to make choices about health care 

nonmaleficence 

Requires that no harm be caused to an individual either unintentionally or deliberately 

ex: nurses protect individuals who are unable to protect themselves 

beneficence

doing good for others

ex: nurses need to assist clients in getting all their needs ( biological, psychological, social)

justice

everyone must be treated equally

ex: nurses are required to be nonjudgmental

fidelity

loyalty

confidentiality 

anything stated to nurses/HCP by clients must remain confidential 

may be violated when: clients may be a harm to themselves or others or if they give permission for info to be shared 

veracity

truthfulness

accountability

individuals need to be responsible for their actions

ethical codes 

formal statements of the rules of behavior for a particular group of individuals 

To Err is Human 1999

Too many people die from medical mistakes—more than from car crashes, breast cancer, or AIDS. The goal is to make health care safer so patients aren’t harmed by the system meant to help them.

aims

1. Make patient safety a national priority.

2. Find and learn from errors through reporting systems.

3. Improve safety standards across health care.

4. Build safer systems inside hospitals and clinics.

what is an error

• A planned action not done correctly OR using the wrong plan.

what is an adverse event

• Injury caused by medical care, not the illness.

Preventable Adverse Event

An injury that could have been avoided.

why do errors happen

Health care tasks are complicated—hard actions are harder to repeat perfectly every time.

Recommendations

• Create a Center for Patient Safety.

• Use a national reporting system for errors.

• Focus performance standards on safety.

• Build a no-blame culture so workers feel safe reporting mistakes.

how to improve safety

• Standardize and simplify processes.

• Use checklists and protocols.

• Protect worker safety.

• Improve teamwork.

• Involve patients.

• Plan ahead for mistakes and recovery.

• Give workers accurate, timely info.

Crossing the quality chasm 2001

The whole U.S. health care system needs improvement in quality, safety, and how care is delivered.

aims for 21st century health care system

1. Safe

2. Effective

3. Patient-centered

4. Timely

5. Efficient

6. Equitable (fair for all)

collaborative relationship between clinicians and patients

• Ongoing healing relationships

• Care tailored to patient needs

• Patients have control

• Shared information

• Decisions based on evidence

• Transparency

• Prepare for patient needs ahead of time

• Reduce waste

• Strong teamwork among clinicians

final recommendations preparing the workforce

• Teach health workers using 21st-century standards.

• Focus on evidence-based care, teamwork, safety, and informatics.

• Update education from nursing school through continuing training.

• Change regulations to allow health professionals to work effectively.

• Improve the liability system to support safer care.

health professions education: bridge to quality focus

Health care education must teach skills that improve patient safety and quality.

5 core competencies

1. Patient-centered care

2. Interdisciplinary teamwork

3. Evidence-based practice

4. Quality improvement

5. Informatics

recommendation

All health professionals should be trained to deliver safe, evidence-based, team-based care using technology and continuous quality improvement.

goal Future of Nursing (2010)

Improve nursing and health care so patients get high-quality, accessible, affordable care.

4 recommendations

1. Nurses should work to the full level of their education and skills.

2. Nurses should continue their education through easier, seamless programs.

3. Nurses should be equal partners with doctors in improving the health care system.

4. Better data and workforce planning are needed to guide policy and staffing decisions.