Turn Into Quiz
burnout: (1) cumulative state of frustration with the work environment that develops over a long time; (2) behaviors exhibited as the result of prolonged occupational stress
compassion fatigue: loss of satisfaction from providing good patient care
health: an infection that was not present on admission to a health care institution and develops during the course of treatment for other conditions (nosocomial)
healthy nurse: ANA defines a healthy nurse as one who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional well-being. Healthy nurses live life to the fullest capacity, across the wellness/illness continuum, as they become stronger role models, advocates, and educators, personally, for their families, their communities and work environments, and ultimately for their patients.
licensure: to be given a license to practice nursing in a state or province after successfully meeting requirements
mindfulness: capacity to intentionally bring awareness to present-moment experience with an attitude of openness and curiosity; mindfulness promotes healing as you pause, focus on the present, and listen
nurse practice acts: law established to regulate nursing practice
nursing: any action performed by a nurse to assist patients to meet health goals: promote wellness, prevent disease or illness, restore health, or facilitate coping with altered functioning nursing process: five-step systematic method for giving patient care;involves assessing, Diagnosing, planning, Implementing,and evaluating
profession: an occupation that meets specific criteria including a well-defined body of specific and unique knowledge, a code of ethics and standards, ongoing research, and autonomy reciprocity: process allowing a nurse to apply for and be endorsed as a registered nurse by another state
resilience: hopeful attitude, utilizing healthy internal coping mechanisms and external resources, such as supportive work environments, mindfulness-based stress reduction training, and assertive communication skills training
secondary traumatic stress: feeling of despair caused by the transfer of emotional distress from a victim to a caregiver, which often develops suddenly
standards: clear, precise, specific, accurate, relevant, plausible, consistent, logical, deep, broad, complete, significant, adequate (for the purpose), and fair
Pg.10 Table 1-1: Important People of Nursing (Red and bolded = important to know; red = most important to that person/way of remembering; Just bold = may be one of the options seen on a question)
1. Florence Nightingale- Defined nursing as both an art and a science, differentiated nursing from medicine, created freestanding nursing education.
a. Published books; founder of modern nursing.
b. Crimean war
c. Conceptualized nursing in terms of manipulating the environment
2. Clara Barton- Established the RedCross in the US in 1882.
a. Volunteered to care for wounds and feed Union soldiers during the Civil War b. organizing hospitals and nurses.
3. Dorothea Dix- Served as superintendent of the Female Nurses of the Army during the Civil War; was given the authority and the responsibility for recruiting and equipping a corps of army nurses; was a pioneering crusader for the reform of the treatment of the mentally ill
a. Main concern was mental health
4. Mary Ann Bickerdyke- Organized diet kitchens, laundries, and an ambulance service,and supervised nursing staff during the Civil War
5. Louise Schuyler- Charities: organized the
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NY Charities Aid Association; recommended standards for nursing education.
6. Linda Richards-Graduated in 1873 from the New England Hospital for Women and Children in Boston, Massachusetts, as the first trained nurse in the United States; became the night superintendent of Bellevue Hospital in 1874 and began the practice of keeping records and writing orders.
7. Jane Addams- Provided social services within a neighborhood setting; a leader for women’s rights
8. Lillian Wald (was on a quizizz question) -Established a neighborhood nursing service for the sick poor of the Lower East Side in New York City; the founder of public health nursing.
9. Mary Elizabeth Mahoney- Graduated from the New England Hospital for Women and Children in 1879 as America’s first Black nurse.
10. Harriet Tubman- A nurse and an abolitionist; active in the underground railroad movement before joining the Union Army during the Civil War.
11. Nora Gertrude Livingston- Established a training program for nurses at the Montreal General Hospital (the first 3-year program in North America).
12. Mary Agnes Snively- Director of the nursing school at Toronto General Hospital and one of the founders of the Canadian Nurses Association
13. Sojourner Truth- Provided nursing care to soldiers during the Civil War and worked for the women’s movement
14. Isabel Hampton Robb- A leader in nursing and nursing education; organized the nursing school at Johns Hopkins Hospital; initiated policies that included limiting the number of hours in a day’s work and wrote a textbook to help student learning; the first president of the Nurses Associated Alumnae of the United States and Canada (which later became the American Nurses Association)
15. Mary Adelaide Nutting- Became the first professor of nursing in the world as a faculty member of Teachers’ College, Columbia University; with Lavinia Dock, published the four-volume History of Nursing
16. Elizabeth Smellie- A member of the original Victorian Order of Nurses for Canada (a group that provided public health nursing); organized the Canadian Women’s Army Corps during World War II
17. Lavinia Dock- A nursing leader and women’s rights activist; instrumental in the Constitutional amendment giving women the right to vote
18. Mary Breckenridge- Established the Frontier Nursing Service and one of the first midwifery schools in the United States
Promoting Health:
● Facilitates patients’ decisions about lifestyle that enhance the quality of life and
encourage acceptance of responsibility for their own health
● Increases patients’ health awareness by assisting in the understanding that health is
more than just not being ill, and by teaching that certain behaviors and factors can contribute to or diminish health
● Teaches self-care activities to maximize achievement of goals that are realistic and attainable
● Serves as a role model
● Encourages health promotion by providing information and referrals
Preventing Illness:
● Educational programs in areas such as prenatal care for pregnant people, smoking-cessation programs, and stress-reduction seminars
● Community programs and resources that encourage healthy lifestyles, such as aerobic exercise classes, “swimnastics,” and physical fitness programs
● Literature, television, radio, or Internet information on a healthy diet, regular exercise, and the importance of good health habits
● Health assessments in institutions, clinics, and community settings that identify areas of strength and risks for illness
Restoring Health:
● Performing assessments that detect an illness (e.g., taking blood pressure, measuring
blood sugars)
● Referring questions and abnormal findings to other health care providers as appropriate
● Providing direct care of the person who is ill by such measures as giving physical care,
administering medications, and carrying out procedures and treatments
● Collaborating with other health care providers in providing care
● Planning, teaching, and carrying out rehabilitation for illnesses such as heart attacks,
arthritis, and strokes
● Working in mental health and chemical-dependency program
Facilitating Coping With Disability and Death:
● Nurses also facilitate patient and family coping with altered function, life crisis, and death. Altered function decreases a person’s ability to carry out activities of daily living (ADLs) and expected roles.
● Nurses facilitate an optimal level of function through maximizing the person’s strengths and potentials, through teaching, and through referral to community support systems.
● Nurses provide care to both patients and families at the end of life, and they do so in hospitals, long-term care facilities, hospices, and homes.
● Nurses are active in hospice programs, which assist patients and their families in multiple settings in preparing for death and in living as comfortably as possible until death occurs.
Chapter 2 Theory, Research, and Evidence-Based Practice
applied research: research designed to directly influence or improve clinical practice
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basic research: research designed to generate and refine theory; the findings are often not directly useful in practice
concepts: abstract images (ideas) that are formed as impressions from the environment and organized into symbols of reality
conceptual framework or model: set of concepts, along with the statements that arrange the concepts into an understandable pattern
data: grouping of patient data or cues that points to the existence of a patient health problem deductive reasoning: cognitive process in which one examines a general idea and then considers specific actions or ideas (begins with theory—- arrives at confirmation) evidence-based practice (EBP): nursing care provided that is supported by sound scientific rationale
evidence-based practice guidelines: guidelines written by a panel of experts that synthesize information from multiple studies and recommend best practices to treat patients with a disease, a symptom, or a disability
inductive reasoning: cognitive process in which one identifies a specific idea or action and then makes conclusions about general ideas (begins with observation —- arrives at a hypothesis)
informed consent: knowledgeable, voluntary permission obtained from a patient to perform a specific test or procedure
nursing research: encompasses both research to improve the care of people in the clinical setting and to study people and the nursing profession, including education, policy development, ethics, and nursing history
nursing theory: differentiates nursing from other disciplines and activities by serving the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices
research: process that uses observable and verifiable information (data), collected in a systematic manner, to describe, explain, or predict events
research utilization (RU): is a process of transforming research knowledge into practice, with knowledge referring to both conducting and analyzing research. It enables nurses to improve patient care by informing practice on interventions that may no longer be useful.
qualitative research: method of research conducted to gain insight by discovering meanings quality improvement (QI): the commitment and approach used to continuously improve every process in every part of an organization, with the intent of meeting and exceeding customer expectations and outcomes—also known as continuous quality improvement (CQI) or total quality management (TQM)
quantitative research: research involving the concepts of basic and applied research scholarly inquiry: the logical, organized process of searching for answers to questions via research, assessment of findings from literature searches, and examination of other knowledge sources
systematic reviews: summarized findings from multiple studies of a specific clinical practice question or topic that recommend practice changes and future directions for research; one of the strongest sources of evidence for evidence-based practice
theory: statement based on observed facts that explains or characterizes a process, an occurrence, or an event, but cannot be proved directly or absolutely as a fact
Types of Knowledge:
● Traditional knowledge is that part of nursing practice passed down from generation to
generation.
● Authoritative knowledge comes from an expert and is accepted as truth based on the
person’s perceived expertise—for example, when a senior staff nurse teaches a new
graduate nurse a more efficient method.
● Scientific knowledge is knowledge obtained through the scientific method (implying
thorough research).
Nightingale influenced nursing knowledge and practice by demonstrating efficient and knowledgeable nursing care, defining nursing practice as separate and distinct from medical practice, and differentiating between health nursing and illness nursing.
Theories
● General Systems Theory has been used in a wide range of disciplines since it emerged
in the 1920s. Its primary theorist, Ludwig von Bertalanffy, developed the theory for universal application. This theory describes how to break whole things into parts and then to learn how the parts work together in “systems.” It emphasizes relationships between the whole and the parts and describes how parts function and behave.
● Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions.
● Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death.
Types of Quantitative Research
● Descriptive Research: To explore and describe events in real-life situations, describing
concepts and identifying relationships between and among events; often used to
generate new knowledge about topics with little or no prior research
● Correlational Research: To examine the type and degree of relationships between two
or more variables; the strength of the relationship varies from a –1 (perfect negative correlation, in which one increases as the other decreases) to a +1 (perfect positive correlation, with both variables increasing or decreasing together)
● Quasi-experimental Research: To examine cause-and-effect relationships between selected variables; often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes
● Experimental Research: To examine cause-and-effect relationships between variables under highly controlled conditions; often conducted in a laboratory setting
Common Concepts in Nursing Theories 1. The person (patient)
2. The environment
3. Health
4. Nursing
Nursing Theorists:
● Florence Nightingale (1860) Meeting the personal needs of the patient within the
environment.
● Hildegard Peplau (1952) Nursing is a therapeutic, interpersonal, and goal-oriented
process.
● Virginia Henderson (1955) The patient is a person who requires help to reach
independence.
● Faye Abdullah (1960) Nursing is a problem-solving art and science used to identify the
nursing problems of patients as they move toward health and cope with illness-related
health needs.
● Ida Jean Orlando (1961) The nurse reacts to the patient’s verbal and nonverbal
expression of needs both to understand the meaning of the distress and to know what is
needed to alleviate it.
● Ernestine Wiedenbach (1964) Nursing as an art; nursing is providing nurturing care to
patients.
● Lydia E. Hall (1966) Focus is on rehabilitation, encompassing nursing’s autonomy, the
therapeutic use of self, treatment within the health care team (cure), and nurturing (care).
● Myra E. Levine (1967) Emphasis is on the ill person in the health care setting; describes
detailed nursing skills and actions.
● Martha Rogers (1970) Emphasis is on the science and art of nursing, with the unitary
human being central to the discipline of nursing.
● Dorothea Orem (1971) Self-care is a human need; self-care deficits require nursing
actions.
● Imogene King (1971) The patient is a personal system within a social system; the nurse
and the patient experience each other and the situation, act and react, and transact.
● Betty Newman (1972) Humans are in constant relationship with stressors in the
environment.
● Sister Callista Roy (1974) Humans are biopsychosocial beings existing within an
environment. Needs are created within interrelated adaptive modes: physiologic
self-concept, role function, and interdependence.
● Madeleine Leininger (1978) Caring is the central theme of nursing care, knowledge,
and practice.
● Jean Watson (1979) Nursing is concerned with promoting and restoring health,
preventing illness, and caring for the sick.
● Margaret A. Newman (1979) Nursing interventions are purposeful, using a total-person
approach to patient care to help people, families, and groups attain and maintain
wellness.
● Dorothy E. Johnson (1980) Nursing problems arise when there are disturbances in the
system or subsystem, or the level of behavioral functioning is below an optimal level.
● Rosemarie Parse (1981) The person continually interacts with the environment and
participates in maintaining health.
● Nola Pender (1982) The goal of nursing is the optimal health of the person, with a focuson how people make health care decisions.
● Patricia Benner and Judith Wrubel (1989) Nursing practice occurs within a context of caring and skill development. Caring is a common bond of people situated in a state of being that is essential to nursing.
● Katherine Kolcaba (2003) Patient comfort exists in three forms: relief, ease, and transcendence. If a patient is comfortable, they will feel emotionally and mentally better which will aid in recovery.
Remember the acronym PICOT:
● Patient/Population/Problem ● Intervention of Interest
● Comparison of Interest
● Outcome of Interest
● Time
Chapter 3 Health, Wellness, and Health Disparities
acute illness: rapidly occurring illness that runs its course, allowing a person to return to one’s previous level of functioning
antiracism: requires everyone to engage in a daily practice of actively combating racial structures, institutions, and practices
chronic illness: irreversible illness that causes permanent physical impairment and requires long-term health care
disease: pathologic change in the structure or function of the body or mind
diversity: welcoming individuals of different race, religion, nationality, culture, age, sexual orientation, and identity
equity: equity ensures that individuals are provided the resources they need to have access to the same opportunities as the general population. While equity represents impartiality, that is, the distribution is made in such a way to even opportunities for all the people. Conversely equality indicates uniformity, where everything is evenly distributed among people. exacerbation: period in chronic illness when the symptoms of the disease reappear
health: an infection that was not present on admission to a health care institution and develops during the course of treatment for other conditions (nosocomial)
health disparity: a specific difference that is closely linked to social, economic, and/or environmental disadvantage
health equity: attainment of the highest level of health for all people
health promotion: behavior of an individual motivated by a personal desire to increase well-being and health potential
holistic health care: health care that takes into account the whole person interacting in the environment
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illness: abnormal process in which any aspect of the person’s functioning is altered (in comparison to the previous condition of health)
inclusion: giving everyone a sense of purpose and belonging, a feeling of being valued institutional or structural racism: the systematic distribution of resources, power and opportunity in our society to the benefit of people who are white and the exclusion of people of color
morbidity: frequency that a disease occurs
mortality: number of deaths
racism: a belief that race is the primary determinant of human traits and capabilities and the racial differences produce an inherent superiority of a particular race; racial prejudice or discrimination
remission: period in a chronic illness when the disease is present, but the person does not experience symptoms of the disease
risk factor: something that increases a person’s chance for illness or injury
social determinants of health: conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks
unconscious or implicit bias: prejudice in favor or against one thing, person or group as compared to another, in a way that is usually considered unfair. Unconscious bias occurs automatically as the brain makes quick judgments based on past experiences and backgrounds vulnerable population: disadvantaged subsegment of a community requiring utmost care, specific ancillary considerations, and augmented protection in research; includes those living in poverty, women, children, older adults, rural and inner-city residents, new immigrants, the homeless, mentally ill patients, and people with disabilities and special health care needs wellness: an active process in which an individual progresses toward the maximum possible potential, regardless of current state of health
Chapter 4 Health of the Individual, Family, Community, and Environment
basic human needs: something essential to the health and survival of humans; common to all people
blended family: two single-parent families joined together to form a new family unit
climate change/crisis: rising temperatures are fueling environmental degradation, natural disasters, weather extremes, food and water insecurity, economic disruption, conflict, and terrorism. Sea levels are rising, the Artic is melting, coral reefs are dying, oceans are acidifying, and forests are burning
community: regionalized service for vulnerable geographic populations with an emphasis on primary care and education, established to ensure that everyone who needs care has access regardless of ability to pay
environmental health: that aspect of human health determined by physical, chemical, biologic, and psychosocial factors in the environment
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extended family: nuclear family and other related people
family: any group of people who live together and depend on one another for physical, emotional, or financial support
love and belonging needs: understanding and acceptance of others in giving and receiving love
nuclear family: family unit, family of marriage, parenthood, or procreation, and their immediate children
physiologic needs: need for oxygen, food, water, temperature, elimination, sexuality, activity, and rest; these needs have the highest priority and are essential for survival
safety and security needs: person’s need to be protected from actual or potential harm and to have freedom from fear
self-actualization needs: highest level on the hierarchy of needs, which include the need for individuals to reach their full potential through development of their unique capabilities self-esteem needs: need to feel good about oneself and to believe others hold one in high regard
Chapter 5 Culturally Respectful Care
cultural assimilation: process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different
cultural blindness: the process of ignoring differences in people and proceeding as though the differences do not exist
cultural competence: care delivered with an awareness of the aspects of the patient’s culture cultural diversity: (1) coexistence of different ethnic, biologic sex, racial, and socioeconomic groups within one social unit; (2) diverse groups in society, with varying racial classifications and national origins, religious affiliations, languages, physical size, biologic sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location cultural humility is the recognition of diversity and power imbalances among individuals, groups or communities, with the action of being open, self-aware, egoless, flexible, exuding respect and supportive interactions, focusing on both self and other to formulate a tailored response. Cultural humility is a process of critical self-reflection and lifelong learning, resulting in mutually positive outcomes.
cultural imposition: tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group cultural respect: enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients; critical to reducing health disparities and improving access to high-quality health care
culturally competent care: care delivered with an awareness of the aspects of the patient’s culture
culture: situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values
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culture conflict: situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values
culture shock: those feelings, usually negative, a person experiences when placed in a different culture
ethnicity: sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns
ethnocentrism: belief that one’s own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one’s cultural norms as the standard to evaluate others’ beliefs
implicit bias: prejudice in favor or against one thing, person or group as compared to another, in a way that is usually considered unfair. Unconscious bias occurs automatically as the brain makes quick judgments based on past experiences and backgrounds
intersectionality: occurs when race, sex, gender, class, and other individual characteristics intersect and overlap with one another, often leading to an increased burden of discrimination on several fronts and other negative outcomes
linguistic competence: ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter personal space: external environment surrounding a person that is regarded as being part of that person
stereotyping: assigning characteristics to a group of people without considering specific individuality
subculture: group of people with different interests or goals than the primary culture transcultural nursing: providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society
Chapter 6 Values, Ethics, and Advocacy
NOT BORN WITH VALUES THOSE ARE DEVELOPED
advocacy: protection and support of another’s rights
autonomy: self-determination; being independent and self-governing
beneficence: principle of doing good
care-based approach: approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative
code of ethics: principles that reflect the primary goals, values, and obligations of the profession
conscientious objection: refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse’s personal and professional ethical beliefs and standards
ethical dilemma: situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action
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ethics: system dealing with standards of character and behavior related to what is right and wrong
feminist ethics: type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor
fidelity: keeping promises and commitments made to others
justice: process that distributes benefits, risks, and costs fairly
moral agency: ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do
moral distress: developed capacity to respond well to morally distressing experiences and to emerge strong
moral injury: an injury that occurs when there has been: (1) a betrayal of what is right, (2) by someone who holds legitimate authority, or by oneself, (3) in a high-stakes situation.
moral resilience: developed capacity to respond well to morally distressing experiences and to emerge strong
morals: like ethics, concerned with what constitutes right action; more informal and personal than the term ethics
nonmaleficence: principle of avoiding evil
nursing ethics: a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments
principle-based approach: an approach to bioethics that offers specific action guides
value system: organization of values ranked along a continuum of importance
values: process by which people come to understand their own values and value system values clarification: process by which people come to understand their own values and value system
virtues: human excellences; cultivated dispositions of character and conduct that motivate and enable us to be good human beings
Chapter 7 Legal Dimensions of Nursing Practice
accreditation: process by which an educational program is evaluated and then recognized as having met certain predetermined standards of education
assault: threat or an attempt to make bodily contact with another person without that person’s permission
battery: assault that is carried out
certification: process by which a person who has met certain criteria established by a nongovernmental association is granted recognition
common law: law resulting from court decisions that is then followed when other cases involving similar circumstances and facts arise; common law is as binding as civil law credentialing: general term that refers to ways in which professional competence is maintained crime: offense against people or property; the act is considered to be against the government, referred to in a lawsuit as “the people,” and the accused is prosecuted by the state
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defamation of character: an intentional tort in which one party makes derogatory remarks about another that diminishes the other party’s reputation; slander is oral defamation of character; libel is written defamation of character
defendant: the one being accused of a crime or tort
*expert witness: nurse who explains to the judge and jury what happened based on the patient’s record and who offers an opinion as to whether the nursing care met acceptable standards of practice
*fact witness: nurse who has knowledge of the actual incident prompting a legal case; bases testimony on firsthand knowledge of the incident, not on assumptions
felony: (1) crime punishable by imprisonment in a state or federal penitentiary for more than 1 year; (2) crime of greater offense than a misdemeanor
fraud: willful and purposeful misrepresentation that could cause, or has caused, loss or harm to people or property
incident report: a report of any event that is not consistent with the routine operation of the health care facility that results in or has the potential to result in harm to a patient, employee, or visitor
law: rule of conduct established and enforced by the government of a society
liability: legal responsibility for one’s acts (and failure to act); includes responsibility for financial restitution of harms resulting from negligent acts
licensure: to be given a license to practice nursing in a state or province after successfully meeting requirements
litigation: process of lawsuit
malpractice: act of negligence as applied to a professional person such as a physician, nurse, or dentist
misdemeanor: crime of lesser offense than a felony and punishable by fines, imprisonment (usually for less than 1 year), or both
negligence: performing an act that a reasonably prudent person under similar circumstances would not do, or failing to perform an act that a reasonably prudent person under similar circumstances would do
nurse practice act: law established to regulate nursing practice
plaintiff: person or government bringing a lawsuit against another
root cause analysis: deep investigation into a sentinel event to determine why the event occurred, and exploring the circumstances that led to it to determine where improvements can be made
sentinel event: an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
statutory law: law enacted by a legislative body
tort: wrong committed by a person against another person or that person’s property whistle-blowing: term generally used to refer to employees who report their employers’ violation of the law to appropriate law enforcement agencies outside the employers’ facilities Whistle-blowing: Speaking up when witnessing actions that place patients at risk
Chapter 11 Health Care Delivery System
accountable care organization (ACO): group of health care entities (e.g., hospitals, primary care settings, and specialty care practices) organized via incentives to deliver the most efficient and high-quality care for the population served
advanced practice registered nurses (APRNs): registered nurse educated at the master’s or post-master’s level in a specific role and for a specific population; examples include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives
ambulatory care: health care settings located in areas that are convenient for people to walk into and receive care; may be provided in hospitals, clinics, or centers
care coordination: deliberate organization of patient care activities between two or more participants (including the patient) to facilitate the appropriate delivery of quality health care services in an efficient person-centered manner; mechanism to make sure that patients get the right care at the right time in the most efficient and cost-effective manner, by the right person in the right setting
community health centers: regionalized service for vulnerable geographic populations with an emphasis on primary care and education, established to ensure that everyone who needs care has access regardless of ability to pay
consumer: the person who uses health care services (the patient)
diagnosis-related groups (DRGs): classification of patients by major medical diagnosis for the purpose of standardizing health care costs
entitlement reform: proposed legislation making changes in entitlement benefits, such as Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation’s budget
extended-care services: organizations, family members, and other caregivers that provide medical and nonmedical care for people with chronic illnesses or disabilities who are physically or mentally unable to care for themselves independently
fee-for-service: system in which a bill is generated and a fee is paid every time a provider does something for a patient
Health Insurance Marketplace: federal and state system designed to help people more easily find health insurance that fits their budget and needs with a plan offering comprehensive coverage, from doctors to medications to hospital visits; insurance options can be compared based on price, benefits, quality, and other features described in plain language
health maintenance organizations (HMOs): prepaid, group-managed care plan that allows subscribers to receive all the medical services they require through a group of affiliated providers; there may be no additional out-of-pocket costs, or subscribers may pay only a small fee, called a copayment
high reliability organizations: organization that operates in a complex, high-hazard domain for an extended period without serious accidents or catastrophic failures
hospice: a type of end-of-life care for persons who are terminally ill, characterized by the following:
(1) patients are kept as free of pain as possible so that they may die comfortably and with dignity;
(2) patients receive continuity of care, are not abandoned, and do not lose personal identity;
(3) patients retain as much control as possible over decisions regarding their care and are allowed to refuse further life-prolonging technologic interventions;
(4) patients are viewed as individuals with personal fears, thoughts, feelings, values, and hopes
inpatient: person who enters a health care setting for a stay ranging from 24 hours to many years
managed care: an organized, high-quality, cost-effective system of health care that influences the selection and use of health care services of a population
Medicaid: Title XIX (Social Security Act, 1965) to make health care available to those people with less than the minimum income who do not qualify for Medicare
medical home: an enhanced model of primary care that provides whole-person, accessible, comprehensive, ongoing, and coordinated patient-centered care
medical neighborhood: a patient-centered medical home and the constellation of other clinicians providing health care services to patients within it, along with community and social service organizations and state and local public health facilities
Medicare: Title XVIII (Social Security Act, 1965) to provide a measure of health coverage to all Social Security recipients
multipayer system: a health care system in which care is paid for by both private insurance companies and the government
multispecialty group practice: organization of physicians from different specialties joined to share income, expenses, facilities, equipment, and support staff; the group practice can better provide comprehensive care
outpatients: person who requires health care services but does not need to stay in an institution for those services
palliative care: hospice care; taking care of the whole person—body, mind, spirit, heart, and soul—with the goal of giving patients with life-threatening illnesses the best quality of life they can have through the aggressive management of symptoms
Patient Protection and Affordable Care Act (PPACA):
pay for performance: a strategy using financial incentives to reward providers for achieving a range of payer objectives, including delivery efficiencies, submission of data and measures to the payer, and improved quality and patient safety
preferred provider organizations (PPOs): a prepaid group practice that allows a third-party payer (such as an insurance company) to contract with a group of health care providers to administer services at a lower fee in return for prompt payment and a guaranteed volume of patients and services
quality: ongoing evaluation program designed and implemented to secure the excellence of health care; may involve an assessment of structure, process, and outcome standards
respite care: a type of care provided for caregivers of homebound ill, disabled, or older adult patients
single-payer system: health care system in which the government collects all health care fees via taxes and pays out all health care costs
value-based purchasing: program that measures, reports, and rewards excellence in health care delivery, taking into consideration access, price, quality, efficiency, and alignment of incentives
Chapter 12 Interprofessional
Collaborative Practice and Care
Coordination Across Settings
advocacy: protection and support of another’s rights
care coordination: deliberate organization of patient care activities between two or more participants (including the patient) to facilitate the appropriate delivery of quality health care services in an efficient person-centered manner; mechanism to make sure that patients get the right care at the right time in the most efficient and cost-effective manner, by the right person in the right setting
care coordinator: care provider (nurse case manager, social worker, community health worker, or lay person) who is responsible for identifying a person’s health goals and coordinating services and providers to meet those goals
care transition: continuous process in which a patient’s care shifts from being provided in one setting of care to another
collaborative practice: what happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care
community-based care: health care that is provided to people who live within a defined geographic region or who have common needs; designed to meet the needs of people as they move between and among health care settings
continuity of care: coordination of services provided to patients before they enter a health care setting, during the time they are in the setting, and after they leave the setting
discharge planning: systematic process of preparing the patient to leave the health care facility and for maintaining continuity of care
home health care: agency eligible to receive federal funds that provides home-based health care; may be independent, hospital operated, or health department managed
medication reconciliation: process of creating an accurate list of all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing the list to the physician’s admission, transfer, or discharge orders, with the goal of providing correct medications to the patient at all transition points within the hospital
patient handoffs: transferring responsibility for a patient from one caregiver to another with the goal of providing timely, accurate information about a patient’s plan of care, treatment, current condition, and anticipated changes
telehealth: use of electronic information and telecommunication technologies to provide care when the patient and the clinician are not in the same place at the same time
Chapter 42 Self-Concept body image: how a person experiences one’s body
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depersonalization: subjective experience of the partial or total disruption of one’s ego and the disintegration and disorganization of one’s self-concept
false self: a sense of self that might develop in individuals who have the emotional need to respond to the needs and ambitions that significant people, such as parents, have for them global self: term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself
ideal self: self a person would like to be or thinks one should be; includes aspirations, moral ideas, and values
personal identity: an individual’s conscious sense of who they are
role performance: ability to successfully execute societal expectations regarding role-specific behaviors
self-actualization: reaching of one’s potential through full development of one’s unique capabilities
self-compassion: being kind and understanding when confronted with personal failings self-concept: mental image or picture of self; includes body image, subjective self, ideal self, and social self
self-esteem: person’s perception of one’s total being, including self-worth and body image Stages of development of the self:
Self awareness: infancy Self recognition: 18 months Self definition: 3 years
Self concept: 6 to 7 years
Chapter 43 Stress and Adaptation
adaptation: adjustment of living with other living things and environmental conditions allostasis: the process of achieving stability or homeostasis through physiologic or behavioral change
anxiety: vague sense of impending doom or apprehension precipitated by new and unknown experiences
burnout: (1) cumulative state of frustration with the work environment that develops over a long time; (2) behaviors exhibited as the result of prolonged occupational stress
caregiver burden: stress responses experienced during prolonged periods of home care by family caregivers
coping mechanisms: patterns of behavior used to neutralize, deny, or counteract anxiety crisis: (1) point at which body temperature drops rapidly to normal; (2) occurs when coping and defense mechanisms are no longer effective, resulting in high levels of anxiety, disorganized behavior, and the inability to function normally
crisis intervention: five-step problem-solving technique to promote adaptation and improve future coping
defense mechanisms: forms of self-deception; unconscious process the self uses to protect itself from anxiety or threats to self-esteem
fear: a feeling of dread; a cognitive response to a known threat
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fight-or-flight response: the body preparing itself against threat, to either resist (fight) or evade (flight) the danger
general adaptation syndrome (GAS): biochemical model of stress describing the body’s general response to stress
homeostasis: various physiologic and psychological mechanisms respond to changes in the internal and external environment to maintain a balanced state
inflammatory response: localized response of the body to injury or infection; protective mechanism that eliminates invading pathogens and allows for tissue repair to occur
local adaptation syndrome (LAS): localized response of the body to stress, precipitated by trauma or pathology
psychosomatic disorders: physiologic alterations and illness believed to be due to psychological influences
reflex pain response: automatic response of the central nervous system to the stimulus of pain stress: condition in which the human system responds to change in its normal balanced state stressor: anything causing a person to experience stress; change in the balanced state