Nursing Exam 2: Research, Theory, Health Care Systems, and Legal Aspects

Comprehensive vocabulary flashcards covering Exam 2 lecture content: Literature Searching, Evidence-Based Practice, Research Design, Nursing Theorists and Metaparadigm, Illness Behavior, Health Care Organizations and Payment, and Legal Aspects of Professional Nursing.

Controlled Vocabulary

Standardized terminology used to index and retrieve articles in electronic databases, such as MeSH in MEDLINE and CINAHL Subject Headings in CINAHL.

Keywords

Natural language terms selected by the researcher to describe a search topic.

Boolean Operator: AND

A search operator used to combine different concepts, which functions to narrow search results.

Boolean Operator: OR

A search operator used to connect similar terms or synonyms, which functions to broaden search results.

Boolean Operator: NOT

A search operator used to eliminate specific terms from search results that must be used with caution.

PICOT Framework

A structured format used to develop a focused clinical research question consisting of Patient/Population ($P$), Intervention ($I$), Comparison ($C$), Outcome ($O$), and Time ($T$).

Pure Science

Scientific knowledge that summarizes and explains natural phenomena without concern for whether the information is immediately useful, focusing on generating new knowledge.

Applied Science (Clinical Science)

The practical application of scientific theory, knowledge, and scientific laws directly to patient care.

Translational Research

Research serving as a conduit between bench research and bedside research, taking laboratory discoveries into clinical practice while using clinical findings to guide new laboratory inquiries.

Nursing Research

Systematic investigation designed to develop knowledge about nursing practice, patient care, and patient outcomes.

Qualitative Research

A research design that explores qualities of human experience through narrative interviews and participant observation without manipulating variables to describe and interpret phenomena.

Quantitative Research

A research design utilizing standardized experimental protocols with hypotheses, measurable variables, statistical analyses, and minimization of subjectivity and bias.

Mixed Methods Research

An investigation that combines both qualitative and quantitative research techniques and data analysis approaches to examine a phenomenon.

Randomized Controlled Trial (RCT)

An experimental research study in which subjects are randomly assigned to either an intervention group or a control group to evaluate treatment efficacy while reducing selection bias.

Systematic Review

A comprehensive, structured method that systematically locates, appraises, and synthesizes evidence from scientific studies addressing a specific clinical question.

Meta-analysis

A statistical procedure that mathematically combines the results of multiple independent studies to determine an overall effect size.

Evidence-Based Practice (EBP)

The integration of the best available research evidence, clinical expertise, and patient preferences and values into clinical decision-making.

Hierarchy of Scientific Evidence

A pyramid framework ranking the quality of scientific evidence from Level $5$ expert opinions and editorials (weakest, no design) at the base to Level $1$ systematic reviews, meta-analyses, and evidence-based practice guidelines (strongest, filtered/pre-appraised) at the pinnacle.

Nursing Theory

More concrete descriptions of concepts embedded in propositions that describe linkages between concepts and guide nursing practice and research.

Nursing Philosophy

A set of broad foundational beliefs about the nature of how the world works that begins linking concepts of the nursing metaparadigm.

Conceptual Model

An organizational structure that provides a more specific organization of nursing phenomena and clearer connections between concepts than a philosophy.

Nursing Metaparadigm

The most abstract structure of nursing knowledge, consisting of four foundational concepts: Person, Environment, Health, and Nursing.

Jean Watson's Philosophy

A nursing theory centered on the human caring process and the nurse-patient relationship, emphasizing holistic care of mind, body, and spirit.

Dorothea Orem's Model

A nursing model focusing on patient self-care deficits, which posits that nursing care is required when patients cannot independently fulfill their self-care needs.

Sister Callista Roy's Adaptation Model

A nursing model that views the patient as an adaptive system and defines nursing as facilitating adaptation to changes in environmental and health stimuli.

Imogene King's Interacting Systems Framework

A nursing theory focusing on mutual goal-setting between the nurse and patient, collaborating to attain identified health outcomes.

Virginia Henderson's Definition of Nursing

A nursing perspective centered on assisting the individual in performing activities contributing to health or recovery that they would perform unaided given necessary strength, will, or knowledge, fostering independence.

Ida Jean Orlando's Nursing Process Theory

A theory focusing on assessing patient behavior to identify and meet immediate patient needs through targeted nursing actions.

Madeleine Leininger's Culture Care Theory

A transcultural nursing theory emphasizing culturally congruent and competent care that aligns with patients' specific cultural beliefs, values, and practices.

Hildegard Peplau's Interpersonal Relations Theory

A relational nursing model emphasizing the therapeutic nurse-patient relationship and interpersonal communication to understand and resolve health difficulties.

Acute Illness

A condition characterized by sudden onset, rapid progression of symptoms, short duration, and typical return to the previous level of functioning without permanent changes.

Chronic Illness

An illness characterized by gradual onset, ongoing medical management, remissions and exacerbations, permanent and progressive structural or functional changes, and lifelong impact.

Five Stages of Adjusting to Illness

The psychological sequence experienced during serious illness: Disbelief and denial, Irritability and anger, Attempting to gain control, Depression and grief, and Acceptance and participation.

Coping

Internal strategies and cognitive or behavioral efforts used to assess and manage internal and external demands perceived as challenging or exceeding resources.

Resilience

An internal psychological quality defined as the capacity to recover quickly and adaptively from difficulties and stressors.

Culture

A pattern of learned behavior, values, and beliefs that are reinforced through social interactions, shared by members of a group, and passed from one generation to the next.

Ethnocentrism

The inclination to view one's own cultural group as the standard by which to judge the values, behaviors, and worth of other cultural groups.

Cultural Conditioning

The unconscious assumption that one's own innate cultural values and beliefs are natural and universally correct, leading individuals to devalue perspectives different from their own.

Medicare

A nationwide federal health insurance program enacted in $1965$ under Title XVIII of the Social Security Act for persons aged $65$ and older, certain disabled individuals, and patients with permanent kidney failure.

Medicare Part A

The hospital insurance component of Medicare that covers inpatient hospital stays, skilled nursing care, home health visits, and hospice care.

Medicare Part B

The supplementary medical insurance component of Medicare covering outpatient visits, physician services, and preventive care.

Medicare Part C (Medicare Advantage)

Managed care health plans offered by private companies approved by Medicare that combine coverage from Parts A, B, and often D.

Medicare Part D

The prescription drug coverage benefit component of Medicare offered through private insurance plans.

Medicaid

A jointly funded federal-state health insurance program established in $1965$ under Title XIX of the Social Security Act providing assistance to low-income, elderly, blind, and disabled individuals based on state income eligibility.

Health Promotion and Maintenance Services

Healthcare services aimed at assisting patients to stay healthy, prevent risk factors, detect diseases early, and promote healthy lifestyles before risks occur.

Illness Prevention Services

Healthcare services designed to address existing risk factors and stop progression into manifest disease after risk factors have been identified.

Primary Care

Point-of-entry care delivered when a patient first enters the healthcare system, focusing on general health promotion, illness prevention, and routine management.

Secondary Care

Specialized health management provided by specialist clinicians upon referral from a primary care provider.

Tertiary Care

Specialized and acute inpatient healthcare services provided to acutely ill individuals, those requiring long-term rehabilitation, or terminally ill patients.

Quaternary Care

An extension of tertiary care representing highly uncommon, complex, and specialized medical and surgical interventions.

Subacute Care

Goal-oriented, comprehensive inpatient care designed for individuals who have experienced an acute illness, injury, or exacerbation of disease requiring continued treatment.

Team Nursing

A care delivery model in which a Registered Nurse acts as team leader to coordinate and supervise care provided by Licensed Practical Nurses and Unlicensed Assistive Personnel according to skill level.

Primary Nursing Delivery Model

A care delivery approach in which an assigned primary Registered Nurse plans, coordinates, and maintains 24-hour accountability for a patient's care outcomes from admission through discharge.

Case Management Nursing

A care model where a nurse oversees, organizes, and coordinates multidisciplinary care across an illness episode using critical paths to achieve clinical outcomes efficiently and cost-effectively.

Patient Advocate

The nursing role derived from Latin 'advocare' (to call to one's aid) focused on safeguarding patients' legal rights, interests, and autonomy in healthcare decisions.

Common Law (Case Law)

Judge-made, decisional law based on legal precedents derived from judicial decisions interpreting constitutions, statutes, or administrative regulations.

Statutory Law

Formal written legislation enacted by legislative bodies such as the U.S. Congress or state legislatures that must conform to constitutional mandates.

Administrative Law

Rules, regulations, and procedures formulated and enforced by executive branch governmental agencies to implement statutory law.

Civil Law

The branch of law that enforces and resolves private rights and duties disputed between individual citizens or entities.

Criminal Law

The body of law involving unlawful offenses and acts against society that threaten public safety and order.

Nurse Practice Act (NPA)

State statutory legislation that defines professional nursing scope, establishes the Board of Nursing, outlines educational criteria, and sets requirements for licensure.

Mandatory Licensure Law

A statutory regulation that requires any individual engaging in the professional practice of nursing to possess a valid license.

Permissive Licensure Law

A law that protects and reserves a professional title for licensees but does not prohibit unlicensed persons from performing activities of that practice if they do not claim the title.

Licensure by Endorsement

The legal mechanism allowing a Registered Nurse licensed in one state to acquire a license in another state by submitting proof of initial licensure and fee without re-examination.

Nurse Licensure Compact (NLC)

An interstate agreement that allows a Registered Nurse residing in a participating home compact state to practice across other compact states under a mutual recognition model.

60-Day NLC Rule

The requirement stipulating that a compact-licensed nurse changing their primary state of residence must apply for licensure in their new home state within $60\text{ days}$.

Computerized Adaptive Testing (CAT)

The testing technology used by the NCLEX-RN that adapts question difficulty to candidate competence, administering between $75$ and $265$ questions over up to $6\text{ hours}$.

Malpractice

Professional negligence that occurs when a licensed professional fails to act as a reasonably prudent professional would have acted under identical or comparable circumstances.

Act of Omission

A form of professional negligence characterized by failing to carry out interventions or procedures that should have been performed.

Act of Commission

A form of professional negligence involving the execution of an inappropriate, unprescribed, or unsafe act that should not have been done.

Elements of Negligence

The four distinct legal criteria required to establish a cause of action: Duty of care, Breach of duty, Injury/damages, and Proximate Causation.

Delegation

The process of transferring authority and responsibility to perform a specific nursing activity to another individual while the delegating Registered Nurse retains overall legal accountability.

Five Rights of Delegation

The essential legal and clinical standards required for safe delegation: Right Task, Right Circumstances, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.

Informed Consent

The voluntary agreement provided by an individual with legal and cognitive capacity who has received sufficient, comprehensible information regarding a medical procedure, its risks, benefits, and alternatives.

Health Insurance Portability and Accountability Act (HIPAA)

Federal legislation ensuring protected health information confidentiality and establishing patient rights, including access to medical records within $30\text{ days}$ of request.