AVR Test Review Unit3

176: Rational for theries

anything routine in report does not need to be giving example; ambulation etc

which can be delegated for an unlicensed personal 255

Rational for theories: provide basis for research on the effectiveness of nursing care. 3 concepts of nursing

  • person- recipient of care

  • health - goal of nursing

  • environment - the setting where nursing care takes place

Maslow’s Human needs to nursing process:

Physiological needs: oxygen, food water, elimination , safety, sleep , activity , mental stimulation and sexual procreation

  • ex, nurse collects data on whether patient are eating enough to maintain their strength and health, if they have relief from pain and if interventions are planned with the patient to meet the need

Safety needs: security, freedom from harm and protection

  • data collected on real or imagined safety needs — ex do you need more than one nurse to ambulate patient safety

Love and belongings needs: love affection and companionship

  • ex whether patient has a support system to meet needs post- hospitalization. Engaging the patient’s family in their care and assisting them in understanding the possible behavior changes they will experience.

  • may assist the patient iin feeling loved and or following up in home health

Esteem needs: respect and recognition

  • ex what the patient is doing or can do that will assist in earning a positive sense of self

  • is the person able to do volunteer work any opportunity to help others

Self actualization: highest level of needs not everyone attains this level , involves maximum realization and fulfillment of individuals potential

  • ex Gandhi and Mother Teresa

Peplau’s interpersonal relation theory: basic for developing a therapeutic relationship with patients

Orientation: seeks assistance of a felt need. A problem been identified and the nurse works with the patient to help them recognize the problem. process is often complex but personal and social growth can develop during this stage

Identification: patient understands the situation and responds to the nurse who supplies the needed help

Exploitation: patient begins the depend on the nurse and uses the help offered exploring all possibilities

Resolution: Dependent behavior that developed must now be given up as the therapeutic relationship comes to and end, phase is crucial of how the nurse handle this phase because faulty resolution can possibility end with vague physical symptoms

  • nurse fulfils roles of resource person , teacher, leader, surrogate and counselor

Rosenstock’s Health Belief Theory: tries to explain why or why not a person will take action to prevent or detect illness

  1. Perceptions vary and ,ay have no basis in reality

ex patient comes to ED with complication determined later on its cancer since the patient was shy even though aware of changes hoping it’ll go away. the thought of being examined embarrassed the patient

  1. Beliefs are connected to existing barriers

may see the preventative / treatment as expensive, painful or inconvenient. If there are fewer perceived negative aspects the possibility of doing something is higher. If more negative aspects exist the person is more likely to not to act.

  • EX patient diagnosed with with advance cancer. Had 7 other procedures done already and did not want to put up with any other uncomfortable healing process

  • financial barriers

  1. A cue to action is seen as necessary : pain , news story , a reminder from HCP

  • cue (finally) for the patient in the above scenario was the pain they began to experience, useful using th enursing process to promote health. Can be used to promote yearly examinations , vaccines, also when developing interventions and outcomes to deal with disease process or health problem that has been identified

Sister Callista Roys Adaption Model : describes recipient of care (patient) as a holistic adaptive system. in her adaption both internal (from inside the patient and external (outside) stimuli affect the system — 3 stimuli

  • Focal: meaning something direct like as a patient experiencing pain

  • contextual other factors that affect the focal stimuli such as examined in the area of pain

  • residual both interval and external that may not always be evident such as memory of pervious pain and the effect it has on the patient

Jean Watson of Human care: health is harmony between the body, mind and spirit

Quantitive research study: an objective study. A variable is the event the researcher is trying to measure. Two types

  • one variable is the group receiving the intervention

  • the other does not receive the intervention.

Qualitative research study: a subjective study. data gathered by interviews and or direct observation them are identified. The study can be a narrative description of the lived experience of individuals pr possibility groups ; living with chronic pain or understanding how much nursing students confidence is increased in the clinical settings

NLN excepcts of all levels of nurses in regard to research and evidence based practice

  • nurses with a research doctorate design and implement research studies and publish findings.

  • Nurses at the master level formulate research questions and evaluate the effect of evidence based solutions on nursing problems

  • Nurses with a bachelor’s degree identify questions needed to be studied, critique published research and use evidence as solutions to nursing problems

  • Associate degree/ diploma nurses challenge the status quo, question assumptions and offer new insights to improve the quality of care.

Expanded Role Of LPN: has the responsibility of supervising the care given by nursing assistants and other UAPs

Motivation: organization of all care required of patients in a healthcare settings for specific period

  • focus is planning and directing to meet patient and istitional outcomes

Leadership: is how a person empowers and develops a team to meet and exceed patient and institutional outcomes

  • inspire trust

  • work in and on the buesnniess ‘informal role that is given to a person by group if workers

  • produce changes in the workplave that will meet the goals of the employing agency

  • ask what and why keeps eye on the future

LPNs behaviors based on the four I”s of transformational leadership that will improve patient outcomes

Idealized influence: the leader will act as a charismatic role

  • model a high level of ethical and moral conduct

  • act confident and optimistic

  • lead by example

  • avoid using power for personal gain

  • use teamwork language as “we, us “ together we will meet them”

Inspirational Motivation: leader establishes a clear focused vision and creates collective pursuits of this vision.

  • review mission statement of unit/facility with team

  • assist team to see value of their work

  • model and set high standards of care visible by team

  • be optimistic and enthusiastic in the clinical area showing the behavior

  • highlight and reward positive outcomes

  • highlight benefit of change

Individualized consideration: leader communicates genuine concerns for all followers , providing personal attention and individualized coaching and mentoring supporting developing

  • encourage politeness, cooperation , trust and respect , honest feedback among techs

  • model active listening

  • be open to hear concerns and collaborate identifying solutions

  • provide opportunity to share ideas among techs / ask how to do unit task more effectively

Intellectual stimulation: leader encourages creative thinking and problem solving is supportive of taking risk based on knowledge

  • prove opportunities for UAP to participate in training / contribute to patient plan of care

  • provide evidence for design making

  • ensure fair workload distribution

Motivation Drive: comes within an individual and is intrinsic — known as motivating factors or satisfiers

Howlett hierarchy: used to encourage meeting needs on NA at each level

level 1 : salary, benefits, working conditions, supervision, policies of agency

level 2: safety in the workplace, job security

level 3 affiliation , interpersonal relationships

level 4 : recognition, growth, responsibility , nature of job

level 5: achievement, advancement

Communication of LPN: when talking to NA deliver your message with clear, specific language, spell out objectively what they’ve done for the patients, use I instead of you messages

  • communicate clearly with time frames/reasoning of why

Data collection : involves identifying the problem and recognizing why its happening

Stress management: stress and anxiety in the clinical area can result in dysfunctional behaviors

  • decreased performance of na

  • negative interaction with na

  • ineffective communication

  • inappropriate body cues, as in a sharp tone of voice

  • high staff turnover

  • unhappy residents, families and staff

How to manage as LPN

  • display ability to cope with stress as it affects you

  • create work environment with decreased stress levels

  • guide and support na when they experience stress

controlling stress by altering how you think , stress is the body’s reaction to the minds analysis of a situation. Not the situation but reaction to the situation created stress

Irrational thinking: self talk in a situation , often irrational its based on judgements we make about the situation , judgements are subjective no bearing facts. Then causing negative emotions and stress results

rational thoughts: objective facts , do not cause emotion the situation is” just is “

OBRA: ensure that residents of nursing homes receive quality care that will result in their achieving or maintain their highest reasonable physical , mental and osycolgisoal well being

continuous Quality Improvement: program found in all healthcare facilities, focus is quality of care indicated by patient outcomes - observable , measurable results of nursing activities

COnflict resolution: involves people settling their differences. an exercise in problem solving

Performance evaluation: main purpose is to encourage personal and career growth.

if you received complaint from family members: collect data to determine the real problem , identify and correct it . Be honest and apologize appropriate

chain of commands:

  • NA

  • charge nurse/LPN

  • supervisor

  • Nurse manager/RN

  • DON

  • boards of directors of nursing home '

  • owner of the nursing home

Leadership styles:

Autocratic: does not share responsibility and authority with employees

  • emphasis on policies , tells what task to do; does not seek input

  • may reach goals

  • used in crises situations: code situations , emergencies

Democratic: shares responsibility and authority with employees

  • enforces policies but with concern with employees

  • seeks input and encourages problem solving

  • used in daily nursing care citation , meeting , committees, review of care plans

Laissez faire : gives away responsibility and authority to employees

  • puts employees before polices

  • pleases everyone

  • uses when agency goals/policies are not a consideration or when staff are highly autonomous/ goal oriented in function