A - Foundations Of Professional Practice Chpt 03 & 06 & 08

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Why is it important for nurses to be involved in various nursing organizations?

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Organization helps to further the cause of practice and education and can influence society for health care reform.

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* nurses who are members are called "fellows".
* official journal is Nursing Outlook.

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American Academy of Nursing (AAN).

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* membership is open to deans and directors of baccalaureate nursing programs.

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American Association of Colleges of Nursing (AACN).

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* the largest professional nursing organization in the world.
* the largest labor union for RNs in the U.S. is a branch of this organization.
* this organization's social policy statement defines nursing and the scope of practice.
* its official journal is the American Journal of Nursing.
* its position paper of 1965 has caused controversy among nurses.
* recommended minimal educational preparation standards for professional and technical nursing.
* supports political parties and endorses candidates.
* provides certification for nurses.

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American Nurses Association (ANA).

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* provides certification for nurses.

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American Nurses Credentialing Center (ANCC).

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* national philanthropic organization established by the ANA that funds nursing research.

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American Nurses Foundation (ANF).

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* accredits baccalaureate through graduate degree programs, but not associate degree programs.
* autonomous accrediting agency of the AACN.

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Commission on Collegiate Nursing Education (CCNE).

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* federation of national nurses' associations.
* focuses on health care access for all people.
* founded by Ethel Gordon Fenwick.
* its official publication is the International Nursing Review.

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International Council of Nurses (ICN).

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* is concerned about uniform standards for nursing examinations, education, and practice.
* this organization developed Nursys, which might facilitate mutual recognition of nursing credentials by state nursing boards.
* works with all nursing regulatory bodies to ensure competency in nursing practices.

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National Council of State Boards of Nursing (NCSBN).

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* was formerly the American Society of Superintendents of Training Schools for Nurses.
* Lavinia Cock, Isabel Hampton (Isabel Hampton Robb), and Adelaide Nutting were early nursing leaders in this organization's precursor.
* membership is open to nurses and anyone concerned about nursing education and health care.
* its official journal is Nursing Education Perspectives.
* produces standardized exams to help students prepare for state boards.

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National League for Nursing (NLN).

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* accredits postsecondary and higher-degree nursing programs, including LPN/LVN and associate degree programs.

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National League for Nursing Accrediting Commission (NLNAC).

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* advocates for associate degree nursing education and associate degree graduate nurses.
* associate degree educators are primary members.

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National Organization for Associate Degree Nursing (N-OADN).

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* has a bill of rights for its members.
* its official journal is Imprint.
* organization for student nurses.

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National Student Nurses Association (NSNA).

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* organization that eventually became the ANA.

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Nurses Associated Alumnae of the United States and Canada.

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* bargaining agent for the ANA.

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United American Nurses (UAN).

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* recommended that minimal preparation for beginning professional practice should be baccalaureate degree education and minimum preparation should be associate degree education.

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ANA position paper of 1965.

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* involves negotiations between organized workers and their employers for purpose of reaching an agreement on issues (i.e. wages, hours, conditions, benefits).
* employees may be union members.
* union members may strike if no agreement is reached.
* strikes may create an ethical dilemma for nurses.

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collective bargaining.

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List two specialty organizations that focus on spiritual needs and ethical issues in nursing.

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1. National Association o Catholic Nurses U.S.A. (NACN-USA).
2. Nurses Christian Fellowship (NCF).

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End result that one hopes to attain:

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goal.

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Primary purpose for existing:

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mission.

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Includes information about who will be served and how that service will be provided:

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mission statement.

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Specific goal statements:

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objectives.

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* might be based on a theory.
* sometimes called a worldview.
* system of basic underlying principles.

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philosophy.

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Criteria used as a basis for comparison:

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standards.

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Specific actions to meet goals:

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strategies.

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People in authority are usually managers of the organization who generally have little if any direct contact with patients or their families:

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centralized organizations.

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Decisions are made in practice settings by people who have direct contact with patients and their families:

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decentralized organizations.

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What do accountability and responsibility mean in health care settings?

All members of the health care team:

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* are accountable to someone else.
* are responsible for acting reliably and dependably.
* are responsible for accomplishing assigned work according to expected/anticipated outcomes or standards of care determined by the employing institution as well as by their profession or discipline.

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Why is it important for nurses to know the chain of command?

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A nurse may be the frontline person responsible for activating a sequence of emergency responses in an emergency.

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Two specific ways health care organizations are structured are based on the concepts of:

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1. authority. (centralized)
2. decision making. (decentralized)

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Someone must be able to explain actions and results:

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accountability.

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Reliability, dependability, and obligation to accomplish work at an acceptable level:

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responsibility.

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Which type of facility would be best for:

* a 65-year-old woman who wants to join a seniors exercise program.

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wellness center.

Wellness centers focus on helping people maintain a high quality of life physically, socially, and emotionally.
(i.e. a senior center that includes daily meals and various exercise programs).

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Which type of facility would be best for:

* 34-year-old woman who needs annual physicals with her nurse practitioner.
* a 40-year-old woman who needs mammogram screening.

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ambulatory care clinic.

Ambulatory care facilities provide care to people when they do not require hospitalization. Also called outpatient care.

(i.e. general office visits to physicians, nurse practitioners, and physician's assistants for routine checkups or diagnosis and treatment of more acute problems like the flu).

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Which type of facility would be best for:

* an elderly husband and wife who are in reasonably good health but unable to cook their own meals.

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assisted living facility.

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List the types of ambulatory care facilities.

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* traditional doctor's office or clinic.
* community health centers.
* health maintenance organizations (HMOs).
* wellness centers.

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Which type of facility would be best for:

* a patient with bipolar disorder who lives in the community.

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community mental health center.

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Which type of facility would be best for:

* a 96-year-old woman with advanced Alzheimer's dementia but no acute medical problems who is unable to live alone or with her family.

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custodial care unit in a nursing home.

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Which type of facility would be best for:

* a 75-year-old woman with early-stage dementia who is unsafe alone and who lives with a daughter who works during the day.

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adult day care.

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Which type of facility would be best for:

* a resident of a nursing home with end-stage renal disease and a shunt.

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dialysis center.

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Which type of facility would be best for:

* a 35-year-old man with terminal cancer who wishes to die at home.
* a 75-year-old woman who is discharged home after a knee replacement.
* an 88-year-old woman in good health who wants to live in her own home but needs help with meal preparation.
* an elderly husband and wife who are in reasonably good health but are unable to cook their own meals.

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home care agency.

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Which type of facility would be best for:

* a 35-year-old man with terminal cancer who wishes to die at home.

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hospice.

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Which type of facility would be best for:

* a 30-year-old woman with acute appendicitis.

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hospital (inpatient).

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Which type of facility would be best for:

* a 30-year-old woman with acute appendicitis.
* a teenage boy who sprains his ankle during a sports event on the weekend.

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hospital ER (outpatient).

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Which type of facility would be best for:

* a 78-year-old man with type 1 diabetes who is discharged from the hospital following knee amputation;
he is currently unable to care for himself at home.

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skilled nursing facility.

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Which type of facility would be best for:

* 40-year-old woman who needs mammogram screening.
* a 66-year-old woman who has been exposed to tuberculosis while working in another country and wants to be screened.

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public health department.

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Which type of facility would be best for:

* a 30-year-old man recovering from a diving accident and in need of intensive physical therapy for two months.

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rehabilitation center.

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Which type of facility would be best for:

* an 80-year-old man living with his son, who needs to be out of town for a week.

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respite care.

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Which type of facility would be best for:

* a 50-year-old office worker with a sore throat and fever whose family physician is on vacation.
* a teenage boy who sprains his ankle during a sports event on the weekend.

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urgent care facility.

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* given by hospice nurses.
* type of care that alleviates symptoms.
* providers can be family members, friends, nurses, physicians, social workers, dietitians, chaplains, or trained volunteers.
* it often occurs at home.
* it can be given in hospitals, nursing home units, or freestanding buildings in the community.

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palliative care.

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List the 3 primary types of ownership and funding designations for health care agencies and facilities.

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1. government.
2. proprietary.
3. voluntary.

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Government-funded health care facilities are owned and operated by:

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the government at the federal, state, or local level.

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List the classifications of citizens that receive health care at no cost.

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1. veterans.
2. military personnel.
3. prison inmates.

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Veterans Administration hospitals and Veterans Administration nursing homes are owned by:

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the federal government.

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* for-profit institutions.
* usually owned and operated by tax-exempt organizations like churches, religious, or humanitarian groups, community agencies, or fraternal organizations.
* can include hospitals, nursing homes, and home care agencies.

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voluntary health care agencies.

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People with chronic conditions like asthma, congestive heart failure, or diabetes may need hospitalization for:

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exacerbations of their diseases.

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The nursing level of care in hospitals is generally considered:

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skilled care.

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Skilled care includes:

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skilled nursing services provided by RNs and rehabilitative efforts provided by P.T.s and O.T.s.

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What level of care are the following?

* medication administration.
* tube feedings.
* dressing changes.
* administration of intravenous fluids.
* tracheostomy care.
* frequent and thorough assessments.
* patient teaching.

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skilled care.

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An RN that is responsible for the overall management of patients on a hospital unit, including comprehensive care planning is often called a:

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unit manager.

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Nurses who work on various units in hospitals are called:

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staff nurses.

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Community-based health services include:

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* public health departments.
* home care agencies.
* community mental health centers.
* ambulatory care facilities.
* dialysis centers.

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Baccalaureate degree is the minimum requirement for _____ nursing, but nurses with diplomas and associate degrees may be hired for specific activities like administering immunizations.

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public health

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* primarily involved in prevention programs related to communicable disease.
* also provide mammogram screening for breast cancer, HIV testing for people at risk for AIDS, and testing for tuberculosis.
* an important focus is health care delivery for infants and children.
* can inspect facilities to ensure they meet food safety standards.

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public health departments

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* can include nursing homes, assisted living facilities, retirement communities, and rehabilitation facilities.
* can also be care facilities for the mentally ill or developmentally disabled.
* also known as long-term care facilities.

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extended care facilities

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Two primary designations for nursing care that can be provided in nursing homes are:

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1. custodial care.
2. skilled care.

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Custodial care is:

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* nonskilled care.
* includes help with basic A.D.L.s for people with some degree of physical or cognitive impairment.
* generally rendered by unlicensed personnel under the supervision of professionals.
* not covered by Medicare or most insurance plans.

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Residents on SNFs who are age 65 or older are Medicare eligible as long as they receive skilled care and they were hospitalized for:

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at least 3 inpatient days prior to their nursing home stay.

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The primary population served in nursing homes is:

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men and women over the age of 80.

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The word "hospice" means:

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a place of shelter or a homelike facility to provide supportive care.

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The type of care given by hospice nurses is called:

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palliative care.

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* care that alleviates symptoms such as pain, nausea, or constipation.
* the focus is always on symptom management rather than on disease cure.
* primary goal is to help patients die a good and comfortable death while surrounded by family and friends.

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hospice.

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* focus is on safety and group socialization.
* specific services at each center vary considerably and are often dependent on the center's budget.
* can be especially valuable for people with dementia.

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adult day care.