NURS101 Final

QSEN

began in 2005 as a multi-phase project funded by the Robert Wood Johnson Foundation to prepare future nurses with the knowledge and skills necessary to improve patient care and the healthcare environments in which they work.

Core Competencies

leadership, knowledge, skills, attitudes/behaviors

KSA

the model reflects the expectations for initial nursing practice following the completion of a prelicensure professional nursing education program

Orem's Self-Care Deficit

persons can care for themselves

Social Cognitive

explains human behaviors in terms of dynamic reciprocal interactions among cognitive, behavioral, and environmental influences

Roy's Adaptation Model

the aim of nursing is to increase compliance and life expectancy

Benner's Clinical Wisdom Philosophy

practice in an attempt to discover and describe the knowledge embedded in nursing

What are the basic concepts of a Nursing philosophy?

person, environment, health, and nursing

Competence

The ability to demonstrate an integration of knowledge, attitudes, and skills necessary to function in a specific role and work setting

Clinical reasoning

The processes by which nurses and other clinicians make their judgments include the deliberative process of generating alternatives, weighing them against the evidence, and choosing the most appropriate, and those patterns that might be characterized as engaged, practical reasoning.

Clinical judgment

An interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response or the use of the clinician's experience and knowledge in assessment, diagnosis, planning, intervention, and evaluation

Critical thinking

The ability to think systematically and logically, solve problems, make decisions, and establish priorities in the clinical setting. It is the competent use of thinking skills and abilities to make sound clinical judgments and safe decisions.

Intuition

the ability to understand something immediately, without the need for conscious reasoning

Communication

The nurse will interact effectively with patients, families, and colleagues, fostering mutual respect and shared decision-making, to enhance patient satisfaction and health outcomes.

Identify NOF Core Competencies

Patient-centered care, professionalism, leadership, system-based practice, communication, safety, information and technology, teamwork and collaboration, quality improvement, evidence-based practice

Patient-centered care

provide holistic care that recognizes an individual’s preferences, values, and needs and respects the patient or designee as a full partner in providing compassionate, coordinated, age and culturally appropriate, safe and effective care

Professionalism

demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles

Leadership

influence the behavior of individuals or groups of individuals within their environment in a way that will facilitate the establishment and acquisition/achievement of shared goals

Systems-based practice

demonstrate an awareness of and responsiveness to the larger context of the health care system and will demonstrate the ability to effectively call on work unit resources to provide care that is of optimal quality and value

Informatics and technology

will be able to use advanced technology and to analyze as well as synthesize information and collaborate in order to make critical decisions that optimize patient outcomes

Teamwork and collaboration

function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning, and development

Safety

minimize risk of harm to patients and providers through both system effectiveness and individual performance

Quality improvement

uses data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously improve the quality and safety of health care systems

Evidence-based practice

will identify, evaluate, and use the best current evidence coupled with clinical expertise and consideration of patients’ preferences, experience and values to make practice decisions

Know the components of the Nursing Process

The tool by which all nurses can become equally proficient at critical thinking. The nursing process contains the following criteria: (1) assessment, (2) diagnosis, (3) planning, (4) implementation, and (5) evaluation.

What types of programs can assist the nursing student/graduate transition to the role of Registered Nurse?

Nurse orientation and onboarding, nurse residency training, nurse internship program, and NCSBN

Define socialization in the context of becoming part of the profession

a process of adapting to and becoming a part of the culture of the profession. Benner’s Five Stage Model: Movie, Advanced Beginner, Competent, Proficient, and Expert

Define the effects of role conflict as a student nurse transitions to Registered Nurse

when a nurse cannot integrate the ideal, perceived, and actually performed role into one professional role

What things can a Registered Nurse do to manage stress and take care of him/herself?

eating a balanced diet, getting enough sleep, avoiding addictive substances, exercising on a regular basis, paying attention to mental and spiritual health, being vigilant in coping with stress triggers at home and work

burnout

progressive, involves disengagement and withdrawal and is characterized by physical, emotional, or mental exhaustion

compassion fatigue

acute condition resulting from stress that may present itself over involvement in patient care

Expert Clinician

An advanced practice RN prepared at the graduate level (MSN or DNP)

Clinical Nurse Leader

Guides nurse colleagues and interdisciplinary teams in direct patient care situations to implement clinical practice guidelines and to achieve positive outcomes

Nurse Executive

directs the infrastructure of the practice of nursing within an organization and advocated for nursing within the context of business of health care

Nurse Educator

Works in academic settings guiding students to deepen and broaden their knowledge

Nurse Researcher

Dedicated to executing and translating evidence-based research into practice

Define factors that contribute to a shortage of nurses

Sentinel events

Unexpected occurrences involving death or serious physical or psychological injury or the risk thereof.

Describe a culture of safety

An atmosphere in which the focus is on what went wrong rather than on who made the error. It is characterized as being trusting, reporting, and improving.

Just Culture

Approach to errors that balances not blaming individuals and not tolerating careless or egregious behavior.

Evidenced-based practice (EBP)

The provision of high-quality patient care based on research evidence and knowledge rather than on tradition, myths, hunches, advice from peers, outdated textbooks, or even what the nurse learned in school 5, 10, or 15 years ago. According to the Nurse of the Future: Nursing Core Competencies, the Nurse of the Future will identify, evaluate, and use the best current evidence coupled with clinical expertise and consideration of the patient's preferences, experiences, and values to make practice decisions.

Promoting EBP

educating yourself and share evidence with peers

PICOT

An acronym that assists in the formatting of clinical questions: P \= Patient, Population, or Problem; I \= Intervention or Exposure or Topic of Interest; C \= Comparison or Alternate Intervention (if appropriate); O \= Outcome; T \= Time or Time Frame. Using this format helps the nurse to ask pertinent clinical questions, focus on asking the right questions, and choose relevant guidelines.

Evaluating research

Levels of evidence

Clinical practice guidelines

Standards developed to guide clinical practice and to represent an effort to put a large body of evidence into a manageable form.

Patient-Centered Care (PCC)

According to the Nurse of the Future: Nursing Core Competencies, the Nurse of the Future will provide holistic care that recognizes an individual's preferences, values, and needs and respects the patient or designee as a full partner in providing compassionate, coordinated, age and culturally appropriate, safe, and effective care.

Strategies that support PCC

JCAHO standards for PCC

Family-Centered Care (FCC)

An extension of patient-centered care that widens the circle of concern to include those persons who are important in the patient's life.

Patient education

Any set of planned educational activities designed to improve patients' health behaviors, health status, or both.

Patient teaching

Activities aimed at improving knowledge.

Teaching/learning patient process

Social Learning Theory

If a person believes that he or she is capable of performing a behavior (self-efficacy) and also believes that the behavior will lead to a desirable outcome, the person will be more likely to perform the behavior.

Self-Efficacy

An individual's belief that he or she is capable of performing a behavior.

Andragogy

Learner-focused education for people of all ages. It was initially defined as "the art and science of helping adults learn."

Health Belief Model (HBM)

This model was originally developed to predict the likelihood of a person following a recommended action and to understand the person's motivation and decision regarding seeking health services.

Communication strategies

defined in nursing is “acting effectively with patients, families, and colleagues, fostering mutual respect and shared decision making, to enhance patient satisfaction and health outcomes

Informatics and its uses

Nursing Informatics (NI)

The synthesis of computer science, information science, and nursing science in the organization and comprehension of data that direct nursing practice.

Electronic Health Record (EHR)

This represents multiple systems that are interfaced to share data and networked to support information management and communication within a healthcare organization.

Search engines

They assist in finding specific topics on the Web by compiling a database of Internet sites.

Database

A collection of electronic data of individual records that are systematically organized, indexed, and cross-referenced. It allows for the rapid collection, organization, manipulation, and analysis of data.

Email

A method of composing, sending, receiving, and storing messages over electronic communication systems; the most common use of the Internet.

Listservs

Group emails that provide an opportunity for people with similar interests to share information.

Social media

Internet-based applications that enable people to communicate and share resources and information.

Telehealth

The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, and public health.

Personal health record

Data that conform to interoperability standards and are available via a patient portal. The patient manages, shares, and controls this information.

HIPAA

Enacted by the U.S. Congress in 1996. It was intended to improve the efficiency and effectiveness of the healthcare system by encouraging the development of a health information system. Several areas are addressed by the act, including simplifying healthcare claims, developing standards for data transmission, and implementing privacy regulations.

HITECH

Data capturing and sharing

How do you evaluate a website?

Define the roles of all nurses and be able to provide an example of each

Caregiver

the nurse practices nursing as both an art and a science. The nurse provides interventions to meet the physical, psychosocial, spiritual, and environmental needs of patients and families using the nursing process and skills of clinical judgment

Advocate

As the nurse-patient relationship develops, the nurse uses professional knowledge to assist patients in their decision-making. The nurse assumes the role of patient advocate in healthcare delivery, intervening during times of crises, whether the situation be related to the diagnosis of acquired immune deficiency syndrome, homelessness, drug and alcohol abuse, teenage pregnancy, child and spouse abuse, or increasing healthcare costs.

Manager

They direct the work of professionals and nonprofessionals to achieve the expected outcomes of care

Interprofessional healthcare team

Those who are directly involved in a patient's care, such as physicians, nurses, and family members, but also those who provide support services that contribute to the patient's care.

Communication-handoff (SBAR)

Ethics

The study of ideal human behavior and ideal ways of being. It is a systematic approach to understanding, analyzing, and distinguishing matters of right and wrong.

ANA Nursing Code of Ethics

Patient advocacy

The nurse speaks for the patient or maintains the patient's rights in the face of the healthcare system. An advocate is a person who pleads for the cause of patients' rights.

Patient Self-Determination Act

Legislation is designed to facilitate the knowledge and use of advance directives

Living will

A formal legal document that provides written directions concerning medical care that is to be provided in specific circumstances.

Power of attorney

A written directive provides a designated person with the legal authority to make either general or healthcare decisions for another person.

Advance directive

A written expression of a person's wishes about medical care, especially care during a terminal or critical illness.

Do not resuscitate

A type of advance directive in which a person states that healthcare providers should not perform cardiopulmonary resuscitation (restarting the heart) if his or her heart or breathing stops

Euthanasia

the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma. The practice is illegal in most countries

Palliative care

Providing comfort rather than curative measures for terminally ill patients.

Persistent vegetative state

A clinical condition of complete unawareness of the self and the environment, accompanied by sleep-wake cycles with either complete or partial preservation of hypothalamic and brain stem autonomic functions.

Physician-Assisted Suicide

According to Oregon's Death with Dignity Act, "lethal medications, expressly prescribed by a physician for that purpose."

Medical futility

When a treatment has no physiologic benefit for a terminally ill person

Rule of double effect

Usually defined narrowly in health care as the use of high doses of pain medication to lessen the chronic and intractable pain of terminally ill patients, even if doing so hastens death

Social justice

A virtue that guides us in creating those organized human interactions we call institutions.

Rationing healthcare

denying patients the potentially beneficial healthcare services

Organ transplantation

a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ

Death

cessation of heart-lung function, or of whole brain function, or higher brain function

What was an important focus of Healthy People 2020?

What is health disparity?

Are preventable differences in the burden of disease, injury, violence, or opportunities to reach your best health that are experienced by socially disadvantaged populations

Beneficence

The actions taken by nurses to benefit patients and facilitate their well-being

Non-maleficence

Refraining from actions that might harm others. The injunction to "not harm" is often paired with beneficence, but a difference exists between the two principles. Beneficence requires taking action to benefit others.

Justice

The fair distribution of benefits and burdens. Regarding principlism, it most often refers to the distribution of scarce healthcare resources.