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310 Cards in this Set
- Front
- Back
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What are the domains of nursing?
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Education, Administration,Research, Practice
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What are examples of education category in the domain of nursing?
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university/college programs
facility nurse educators |
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What are examples of administration under the domains of nursing?
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Unit managers
Vice presidents, CEO |
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what are examples of research under the domains of nursing?
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career researchers
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What are examples of practice under the domains of nursing?
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Rn, CNS, NP
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What are the roles of students in practice?
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Maintain safe practice
practice within limits of education reflection identify when you need assisstance or supervision awareness of specific areas requirements(ie meds and who is allowed to administer them) |
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Graduate nurses are EXPECTED to?
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Have entry level competencies met and pass the national exam
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A graduate nurse must PRACTICE within?
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Set standards, the code of ethics, registration and licensure requirements, certification requirements, knowledge and application of knowledge
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A graduate nurse must PROVIDE what?
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Leadership
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What kind of relationships must a graduate nurse MAINTAIN?
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professional and therapeutic realationships
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Continuing competencies is the role of who?
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the graduate nurse
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What is meant by RN scope of practice?
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A range of services that a profession is authorized to provide
Ex. drsg changes, IV and IV therapy |
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What is the rationale for scope of practice?
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Promotes safe, ethical, high quality care that responds to the needs of patients and public
Enables providers to practice to the extent of their education, skills, knowledge, experience, competence and judgement |
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What is meant by "reserved act"?
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An act done with respect to an individual in the course of providing health care
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What are examples of the reserved act?
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Medical diagnosis
Prescribing a drug or vaccine performing a procedure administering a substance dispensing or selling a drug or vaccine |
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Who can perform these "reserved act" services under the regulated health professions act?
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A person who is a member of a regulated health profession and is authorized by regulation to perform the reserved act
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What is the definition of regulation?
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Set processes through which order, consistency & control are brought to practice or policy
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what is meant by self-regulation?
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It means "nurses regulating nurses in the interest of the public"
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What is the purpose of self regulation?
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"protect the public from practitioners that are unqualified, incompetent, or unethical
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What are the guiding principles of self regulation?
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1.Promote good practice
2.Preventing undesireable practice 3.Intervening in instances of unacceptable practice |
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What is the rationale for scope of practice?
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-Allows practitioners to work collectively and collaboratively with other HC practitioner
-Reflect the extent, depth and relevence of training and education -promote safe, ethical, high quality care that responds to the needs of patients and public |
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scope of practice-why now?
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Advances in HC
Role clarification Ensure most cost effective and appropriate staff mix Emphasis on health maintenance, health promotion and illness prevention Shift from institutional care to community care |
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What are the requirements of a profession standards of practice?
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Represents the accpetable requirements for determining the quality of nursing care clients receive
Standards are the yard stick used to measure acceptable practice Proves to the public and govenrment what is acceptable practice of a nurse |
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What are standards?
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Objective guidelines for nurses to provide practice and evaluate care
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How many standards of practice are there?
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5
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What is the 1st standard of practice? Give an example
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Professional responsibily and accountability
Ex. Reports med error |
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What is the 2nd standard of practice? Give an example
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Competent application of knowledge
Ex.Gathers and analyzes pt. assessment data to develop a nursing dx and a plan of care |
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What is the 3rd standard of practice? give an example
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Competence in nursing practice
Ex.Graduate RN is able to start IV safely and efficiently |
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What is the 4th standard ot practice? give an example
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Communication and collaboration
ex. RN regularly records patient data and evaluations in the chart |
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What is the 5th standard of practice? give an example
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Nurse develops a therapeutic relationship with client and family
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What is a Clinical Nurse Specialist(CNS)?
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A masters prepared nurse who practices at a high level in a certain specialty. Within the scope of practice of an RN
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What are 5 key components of a clinical nurse specialist?
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Clinician (in depth knowledge)
Consultant (complex and challenging situations) Educator ( Preceptors,mentors,client and staff educators) Researcher (Strenghten the link btw research & practice. Transforms research in to practice) Leader ( promoting quality patient care) |
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What is a Nurse Practioner (NP)?
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Expanded scope of RN nursing practice governed by special legislation
Can prescribe certain drugs, order and interpret lab and diagnostic tests -Provide primary care: wellness care, diagnose and treat minor illnesses and injuries, screen for the presence of chronic disease and monitor patients with stable chronic disease Practice autonomously and in conjunction with other practitioners |
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What is it called when you challenge theory and practice?
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critical inquiry
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What is evidence informed practice?
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Clinical decision making informed by best available research and clinical considerations
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What does evidence informed rituals de-emphasize?
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rituals, opinions and traditions
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How can you maintain competencies?
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Read publications regularly (journals)
Attend professional development |
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What does maintaining competencies include?
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Advocating for quality care
Promoting healthy public policy Working to create and sustain practice environments that support safe, competent, and ethical nursing care Advocating for social justice |
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What is social justice?
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A concern for the equitable distributions of benefits and burdens in society
Changing social relationships and institutions to promote equitable relationships |
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What are examples of people nurses advocate for?
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Vulnerable populations such as: poor and homeless, People with chronic conditions/disabilities, people in precarious circumstances
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What can nurses do to advocate for health policy change?
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Be aware of public issues that pertain to health
Volunteer at community agencies Vote Involvement in nursing or community organizations |
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What is relational practice?
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A dynamic approach which acknowledges and responds to how "in the moment" people situations, environment and processes are connected to and influence each other in terms of client health
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The circumstances in which situations occur is called what?
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Context
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What is it called when nurses critically examine their practice by reflecting continually on experiences and having a perspective that "reads the world"?
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Reflection
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What is reflexivity?
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An action that requires that a nurse acts on reflective awareness and in that moment knowledge
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Being open, caring, mutually responsive and non directive are characteristics of what?
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A collaborative partnership with the patient
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What are barriers to relational nursing?
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Technology driven HCS that pulls nurses away from the bedside
When a perspective outcomes approach is used Standardized care Patients are viewed as ...... |
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What are the essential elements of relational practice?
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Respect, Trust, Mutuality, Collaboration
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Respect has 5 characteristics. What are they?
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Treating others as inherently worthy & equal
Acceptance of others Willingness to listen Genuine attempts to understand Sincerity |
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What is trust built on?
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Trust is built on the foundation of respect
The patient trusts that nurse will assist in promoting positive outcomes for the patient Eg.If you say you're going to do something make sure you do it |
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What is mutuality?
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A negotiated, collaborative process where both parties participate, choose, and act
(The give and take between nurse and patient) |
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What challenges are faced with relational nursing?
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Workload, Staffing ratios, Supportive (or unsupportive) collegial relationships
Nurses personal identity |
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Nurses are ethically, and morally obligated to provide what?
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Responsive, compassionate, therapeutic relationships and ethical competent nursing practice
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What obligations does relational nursing have?
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To be reflexive and intentional
To open the relational space for difficulty To act at all levels to effect the potential for health and healing |
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To be reflexive and intentional and to open the relational space for difficulty and to act on all levels to affect the potential for health and healing are all what?
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Obligations to relational nursing
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What is an obligation to relational nursing?
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To be reflexive and intentional
To open the relational space for difficulty To act at all levels to effect the potential for health and healing |
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What would working together with other health care providers for a better healthcare system and health care consumers(clients, patients, families, communities) be called?
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Collaboration
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What are the 2 main categories of collaboration?
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Intra-disciplinary collaboration and inter-disciplinary collaboration
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Collaboration within the nursing profession to solve patient issues is called what?
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Intra-collaboration
Ex. Unit conferences, nurse interest groups |
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What is Inter-disciplinary collaboration?
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Collaboration between defferent professional groups with differing education, values, socialization, identity
Ex. Discharge planning conferences, emergency/ICU/palliative care |
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Why is collaborating important?
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-Gives the best possible outcomes for: The patient. the organization, the healthcare team
-Recognizes divesity of backgrounds and viewpoints -Fosters commitment to common goals contributes to enduring and effective collaborative partnerships |
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What is the act of working jointly?
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collaboration
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What are the 3 attributes of collaboration?
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Problem focused process:Centered around patient
Sharing: Equal involvement of all disciplines Working together: Sense of cooperation |
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what is the collaboration tool we use?
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SBAR
S=Situation-What happened B=Background A=Assessment R=Recommendation |
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what does the SBAR do?
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Increases patient safety
Provides a standard approach to information sharing Increases personal clarity/power for caregivers to make requests for changes in patient care, or to pass on critical information Improve team effectiveness |
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Collaborative team consists of?
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Professionals(regulated have self governing body)
Non-professionals(Non-regulated have no regulated standards to meet. |
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What is conventional medicine?
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Also known as traditional, mainstream, or orthodox
It is when you we diagnose a health problem, treat pre diagnosed health problems with scientifically proven therapies, medication & surgery |
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What is reffered to as alternative medicine?
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Support and complement conventional medicine, provides an option.
eg. Massage therapist, herbalist, acupuncture |
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Name the elements of collaboration success
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1. Inter professional education
2. Role awareness 3. Interpersonal relationship skills(mutual trust & respect) 4. Deliberate action (team building) 5.Support-creating a culture |
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What are some benefits of interprofessional collaboration?
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It is essential for improvement in patient/client/family and community health outcomes
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Define patient/client/family/community centered care
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-Patients are seen as experts in their own lived experiences
-Is critical in shaping realistic plans of care -collaborative care -health care team provides knowledge/skill |
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What is the purpose of patient/family/community centered care?
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The patient has control and can make informed decisions.
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what is technology in nursing practice?
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-nurses work in an information intense environment
-as knowlege workers, information is used to make decisions that foster quality nursing practice -nurses must integrate nursing information competencies into their practice |
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Nursing informatics, dianostic technology and recording, technology used in the provision of direct patient care, and patient as a seeker of health information via the internet are all examples of what?
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Types of technology seen in practice
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What is nursing informatics?
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the application of computer science and information science to nursing. Promotes the generation, management and processing of relevant data in order to use information and develop knowledge that supports nursing in all practice domains
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what is a key issue for nurses?
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they must be able to retrieve and use data they have collected at the point of care.
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what are some examples of nursing informatics used in hospital?
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electronic patient record (EPR)
lab results pharmacy scheduling |
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What are the 3 building blocks of nursing informatics?
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Data
Information Knowledge |
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define data in nursing informatics and give an example
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observations that are not interpreted
eg. Infant birth weight |
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define information in nursing informatics and give an example
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data that has been interpreted, organized or structured to provide meaning to the data as a larger whole
eg. low infant birth weights are found in families with low socio-economic status |
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define knowledge in nursing informatics and give an example
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the synthesis of information to identify relationship that provide further insight to an issue or subject area
eg. prenatal care that addresses the nutrition need of prenatal women improves birth weights of newborns |
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What are the challenges to maintaining patients rights regarding electronic record keeping?
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Privacy
confidentiality security |
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what is privacy?
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the right of an individual to determine, when how and to what extent they will share information about themselves with others
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what is confidentiality?
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the obligation of the health professional to protect the personal information of a patient. Fundamental principle of the HCS and nurses code of ethics
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What is security?
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refers to procedures and technologies that are put in place to restrict access to, and maintain the integrity of health information (passwords, firewalls, digital signatures)
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what are the benefits to the client of health care data collection?
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Reduced repitition of health info
Accessible personal Hx Reduced duplication of tests and procedures |
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What are the benefits of health care data collection to providers?
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Timely access to health data
More reliable health info Reduced duplication of efforts Shorter response time, better assessment and Tx |
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What are the benefits of health care data collection to service delivery org?
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Data to evaluate outcomes
Benefits from lessons learned Collaboration with other health agencies |
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What are the benefits of helath care data collection to educators?
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Best practice guidelines
Increased data for educational purposes Student understanding of health informatics early |
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What are the benefits of health care data collection to researchers?
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Availability of higher quality data
comprehensive data sets Improved abiltiy to monitor health outcomes |
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What are the 5 main categories of health information?
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Client status
Nursing intervention Client outcome Nursing intensity Primary nurse identifier |
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Describe the client status category of health information
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set of indicators that reflect the phenomena from which nurses provide care
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what is the nursing intervention category of health information?
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purposeful and deliberate health-affecting interventions. Eg. wound care
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Describe the client outcome category of health information
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client status at a defined point following interventions. Influenced by interventions of all care providers
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What is the nursing intensity category of health information?
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The amount and type of nursing resource used to provide care.
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Describe the category primary nurse identifier of health information
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single unique, lifetime ID number for each individual nurse. Independent of geography, practice sector, or employer
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What are key challenges to health information?
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National Involvement
-Standardizing, collecting and exchanging health info across the provinces. -Federal Goverment committed $500 million for the development of e-health initiatives -Development of Canadian health infoway Inc. |
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What are the features of the Canadian Health Infoway?
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-Federal, provincial and territorial partnerships
-Mandate to develop health information standards, create a national EPR, and liaise with interpersonal groups |
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What is another key challenge to health information?
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Ensuring Nurses have access to Information
-Nurses integrate information & communication technologies into their practice -Nurses will have the required information and knowledge to support practice -Human resources planning to facilitate new models of nursing practice and service delivery -Knowledge sharing: connecting nursing groups -ICT will improve the quality of nurses work environments -Canadian nurses will contribute to the global community of nursing |
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What responsibility do health care organizations have to nurses?
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They have a responsibility to provide nurses with connectivity, commputers, mobile technology, PDA, resource data bases, access to internet
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Define electronic health record (EHR)
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EHR integrates information from many sources into a single, lifetime record of an individuals key health history and care.
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What does EHR improve?
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It improves patient safety by reducing errors caused by multiple files and data entry points.
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EHR makes the overall system what?
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It makes the overall system more efficient by reducing duplication and improving the flow of information
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What must EHR include?
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Must include data from all disciplines
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EHR must be designed in collaboration with what?
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With RN's so that clinical data is captured in a standardized way that reflects practice and impact of nursing care
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CNA has been advocating for what?
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for a client-centered, pan-Canadian EHR
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Implementing a EHR network is essential to what?
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An accessible, productive, and high quality care system
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Who is involved in creating an EHR network?
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all levels of government
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Who is responsible for implementing EHR?
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The Canada Health Infoway
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Improved safety, coordination of care for clients and substantial cost savings are benefits of what?
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The EHR network
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What is Telehealth?
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The use of information and communications technology to deliver health and health care services and information over large and small distances.
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Describe the Manitoba telehealth?
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the use of information technology to connect people to healthcare sevices at a distance. A high speed, secure, video link is used to connect clients to health care providers at different locations in Manitoba
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what are individuals able to do through telehealth?
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Individuals are able to see, hear and talk to care providers on a television screen with providers able to see, hear, and talk to patient/and/or family
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How does it benefits rural areas?
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It provides professional education programs and administrative support to rural health authorities
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What are the advantages to telehealth?
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-improves access to health services that may not be available in every community
-can save the client and the healthcare system the time, money and risks associated with travel -allows for access to care while remaining close to family, friends and community supports -may reduce the hardships of being away from work and home |
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What are the disadvantages of telehealth?
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-not available in every community
-privacy (eg.technical, staff) -cancellations -may not be appropriate for every health condition |
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what are examples of innovative users of ICT in nursing practice?
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VON(mobile wound assessment program)
CNA NurseONE Virtual hospice |
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Technology has the power for what?
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Technology in todays health care system has the power to become the strongest reference point nurses use to inform, direct, interpret, evaluate and understand their nursing care
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being honest, giving clear explanations, keeping family members informed, answering questions open honestly and willingly are nursing behaviors perceived as what?
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caring
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What is a theory?
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A set of statements that tentatively describe, explain, or predict relationships among concepts that represent phenomena
Eg. weather, marketing theory, thrill theory(roller coaster, race cars) |
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What other ways can theory be defined?
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-A purposeful set of assumptions or propositions that identify the relationship between concepts
-Organized information intended to explain phenomena. Greek word theoria to speculate -Consist of concepts organized in a systematic logically connected manner to explain their realtionship |
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What is an obsevable connection or relationship between objects, events or ideas?
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Phenomenon
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What are some examples of phenomena?
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Nature related: rain, earthquakes
Social: All behavior that influences humans; sorrow, divorce, equity Supernatural: miracles, ghosts Nursing: caring, uncertainty, pain, self care |
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What are examples of phenomena of interest to nurses?
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Florence Nightingale-Environment of healing
Self-care-Orem Interpersonal relationships- Peplau Adaptation-Sr.Callista Roy Client as systems-Neuman |
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What is a concept?
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Words and phrases that identify, define, and establish, structure and boundaries for ideas generated about a particular phenomenon
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A theory should be what?
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Logical
Integrated previous research, Testable No contradictory statements |
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Why is understanding theory so important?
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Because it is the foundation of all that you will do as a nurse
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What is the purpose of nursing theories?
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Theories are important because it provides a systematic view for explaining, predicting, and prescribing phenomena of nursing
Also provides focus for professional goals of practice Provides foundations of nursing practice Helps to generate further knowledge through research and future directions for nursing |
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What are the benefits of having a defined body of theory in nursing?
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Better patient care
Enhanced professional status for nurses Improved communication between nurses Guidance for research and education |
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Why does nursing need theories?
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The main component of nursing-caring -cannot be measured, it is vital to have the theory to analyze and explain what nurses do
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Theory means what?
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To speculate
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Knowledge means what?
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To identify and understand
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What are philosophies?
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Broad connected statements about beliefs and values that have potential to guide thinking and behavior
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What is deciding which needs or problems require immediate action and which ones can be delayed until a later time?
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Prioritization
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What is the first level of priority setting?
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Airway, breathing cardiac/circulation, Vital signs(ABC+V), safety
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What is the second level of priority setting?
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Mental status changes, untreated medical issues, acute pain, acute elimination problems, abnormal lab results.
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What is the third level of priority setting?
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Long term issues
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What is knowledge?
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Waht is identified and understood through the integration of education and experience
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what is the difference between understanding and knowing?
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Understanding is to comprehend or grasp the significance
Knowing is to be aware of |
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What is paradigm?
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Patterns or systems of beliefs(worldwide) about science within and accross disciplines
Eg. Humans are bio-psycho-social-spiritual beings responding to or interacting with the environment |
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What is metaparadigm?
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Of nursing is person, enviroment, health and nursing
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What are models?
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Visual representations or digrams that demonstrate theoretical relationships also used to guide thinking and behavior
-mental representation of how things work |
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Models can be what?
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linear and directional or circular models
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Theories explain models what?
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demonstrate
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Research is what?
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dilligent systematic inquiry
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what is reasoning?
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A cognitive process that allows us to think, identify relationships and form judgements about information.
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what are the 2 phases of theory development?
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speculative and established
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what is speculaive theory?
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Limited research has been conducted on topic
Can not make predictions Less reliable and valid Needs to be tested further before it becomes an established theory |
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What is established theory?
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More certain/predictable
Based on a accumulation of facts, principles and laws Based on replicated research and logic over time. |
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Where do the roots of nursing begin?
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With Florence Nightingale in 1800s
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When were many speculative nursing theories establishes?
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between 1950's and 1980's
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Most nursing theories are named after what?
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theorists
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What are some lessons learned about theories?
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-Do not try to make a theory fit somewhere it does not
-Ensure that language is clear and meaningful to those who use it -Theories value may lie more in the future than the present |
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A theories value lies where?
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In its ability to answer questions, solve problems, explore phenomena and generate new theory
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establishing knowledge is what?
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Dynamic(constantly changing)
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Can there be new interpretations of well established facts, principles and laws?
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yes
Eg. second hand smoke-effect on society Prior to 1997 it was thought that the flu virus could not be transmitted from bird to humans |
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Operationalize Theory is used in practice to what?
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1.Explain past events
2. Predict future events 3. Develop a sense of understanding 4. Develop a sense of control of the variables (things that are likely to change) and propostitions (direction of relationships) making up the event. |
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What is operationalize?
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To put into use
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What do you call something that is likely to vary or change?
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Variables
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What is an independent Variable?
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It is influenced or cause something to happen to another variable (intervention)
Eg. Handwashing, wound care, ROM excercises |
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What is a dependent variable?
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The variable that has been influenced or changed
Eg. 20 sec hand washing(independent) decreases infection rates(dependent) ROM 3x a day (independent) maintains muscle tone (dependent) |
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What describes the direction relationship between 2 or more variables or concepts?
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Propositions
Eg. sunlight increases plant growth Excercise decreases blood pressure Excercise enhances mobility |
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What are assumptions?
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Accepted as true. Has the potential to influence other concepts or propositions
Eg.Plant flourishes in sunlight(not the case in all plants make sure the assumption is true) Humans strive for independence People are holistic beings |
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Significance is what?
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Meaning or importance.
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Understanding significance assists in what?
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Decision making, priority setting and critical thinking
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determining signifincance is essential to what?
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Safe and effective nursing practice
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Explaning and predicting involve?
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Upper level cognitive skill.
Involved in interpreting information and significance to others Based on past and present (predicting is future) |
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Using knowledge of situations and using language and intellect to predict is what?
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predicting
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What is influencing?
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Altering a situation (indirectly through someone else) by changing one or more concepts or variables to bring about a desireable outcome.
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If influencing is not effective taking what might be necessary?
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Control
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Control is what?
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If patient is "fully capable of making a decision and is responsible, for diong so"
Giving tools to make effective change |
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What influences nursing theory?
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Image of the profession
Funding and government influences Changes in education Economy Development of research activities, demand for a body of knowledge, and changing scope of practice Other disciplines |
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Nursing theories are enhanced and supported by theory form what?
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Arts, sciences, and the humanities(often referred to as borrowed theories)
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What do support nursing theories do?
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Help answer questions, solve problems, explore phenomena, regardless of where is comes from
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Who is Ludwig Von Bertalanffy?
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Biologist from Vienna (General systems theory)
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What does the General System Theory (GST) suggest?
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that there is hierarchical structure, organization and interdependence among living things
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A system is what?
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Connected, interdependent and interacting
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A system is made up of what?
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subsystems
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what is the goal of the open system theory?
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to maintain homeostasis
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wholeness of a system means what?
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together subsystems are greater then the sum of the parts
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What is the phenomena of the open system theory?
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system, subsystem, environments, interact with and inluence each other
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What are the key concepts of a open system theory?
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system, subsystem, environments, hierarchy, wholeness, interaction, feedback
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What are the propsitions of open system theory?
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work to maintain homeostasis and achieve a common goal.
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What are the assumptions of open system theory?
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hierarchical order facilitates goal achievement
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What are the variables of open system theory?
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external environments, inputs/outputs, boundaries
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Which Dr. studied the effects of stress on the human body in 1946?
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Hans Selye
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What is the phenomena of stress adaptation theory?
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Patients under stress have a similar pattern of symptoms
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What are the key concepts of stress adaptation theory?
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Stress, adaptation, GAS(General adaptation syndrome), alarm, resistance, exhaustion
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What are the propostions of the stress adaptation theory?
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Stress causes physiological and psychological symptoms
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What assumptions are made by the stress adaptation theory?
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Stress may be good or bad. Prolonged stress is undesirable
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What are the variables of stress adaptation theory?
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Multiple stressors can occur at the same time
Interventions can influence some of the effects of stress Interpertation of stress affects stress response |
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What is an example of Selye's stress adaptation theory?
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Alarm Phase: H1N1
Resistance Phase: Body fighting virus Exhaustion Phase: Person goes on a respirator |
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Which theory is the grand theory of human motivation and hierarchy of basic human needs?
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Maslow's theory
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What is the phenomenon of Maslow's theory?
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Need motivates behavior
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What are the key concepts of Maslow's theory?
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Hierarchy of human needs, safety, love, self-esteem, motivation
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What are the propositions of Maslow's theory?
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Human need motivates behavior. Human needs are ordered according to survival
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What assumptions are made in Maslow's theory?
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Physiological need must be met first
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What are the variables of Maslow's theory?
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Motivation for a need might outweigh a lower need.
Psychological illness may affect lower needs |
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Which theory has 8 developmental stages?
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Erickson's theory
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Which theory has a goal to complete one stage before moving on to the next?
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Erickson's theory
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Which theory focuses on the importance of achieving G&D tasks and is used extensively in nursing?
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Erickson's theory
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What is the phenomenon for Ericksons theory?
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Humans have a common pattern of growth and development
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what are the key concepts of Ericksons theory?
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Personality develpment, developmental stages, progression through stages
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what are the propositions of Ericksons theory?
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Humans develop psychologically progressing through specific stages. Developmental stages correspond with chronological age
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Waht assumptions are made with Ericksons theory?
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Accomplishing developmental tasks in order is necessary for health development
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What are the variables for Ericksons theory?
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Developmental stage of others(parents)
Presence of long term illness |
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What are the classifications of theory?
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Grand, Middle range, Speculative, Established
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Broad in scope is what?
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Grand
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Can be tested through research is?
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Middle range
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Continue to search for facts is?
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Speculative theory
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Ann established theory is what?
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able to explain the facts
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Grand theories are what?
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Abstract and broad in scope
Structural framework and guidance for broad ideas Are used to develop(narrower) mid range theories |
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What are mid range theories developed from?
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Practice observations and research
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Mid range theories are what?
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Less abstract
Examine phenomenon more limited in scope Address specific phenomena or concepts Useful in researching clinical practice questions Can be used to develop clinical practice guidelines |
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Merle Mishel's uncertainty in illness theory is an example of what?
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Mid range theory
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Uncertainty in illness theory states what?
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Measure the degree to which an individual is experiencing uncertainty during illness or an acute injury
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What assumptions are made with the uncertainty in illness theory?
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Uncertainty is a cognitive state(interpretation of illness-related events)
Uncertainty is a neutral experience until it is apprised as desireable or aversive |
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What are the concepts of the uncertainty in illness theory?
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Uncertainty, Cognitive, Interpretation, Symptom pattern, Event familitarity, Structure providers, cognitive capacities, adaptation
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What is the descriptive theory?
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Describes the phenomena (coping patterns in illness)
Speculates why phenomena occur Describes the consequences of phenomena Explain and in some cases predict Guide further research |
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What is perspective theory?
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Guides nursing interventions
Predicts the consequences of specific interventions Outlines conditions under which certain nursing interventions should occur Are action orientated |
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What are patterns or systems of beliefs (worldviews) about science within and across disciplines?
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Paradigm
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What are the metaparadigms of nursing?
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Person: The individual, the nurse is interacting with in a therapeutic manner
Environment:Place where the therapeutic encounter occurs Health:Optimal level of health for that individual Nursing: Uses the 5 steps of the nursing process to plan for and deliver care to the client/patient |
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What is nursing as a science?
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Use of theory and research to understand phenomena of interest (knowing what to do is science)
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What is the art of nursing?
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Way in which knowledge is applied (knowing how to do it is art)
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Who was the first modern nursing theorist?
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Hildegard Peplau (interactive model)
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What did Hildegard Peplau do?
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Wrote the first nursing textbook
First "modern" nurse theorist since Nightingale Phenomena of interest was: interpersonal relationships occur between the patient and nurse Believed there were 3 phases of the helping relationship; orientation, working, termination |
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Who was the first lady of nursing?
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Virginia Henderson AKA mother of modern nursing
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what did Virginia Henderson do?
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-Created the first definition of nursing
-Adopted by ICN and used in nursing curriculum around the world -Her textbooks offered nurses with understandable and coherent philosophy -Nurses first obligation was to the patient |
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What was the significance of virginia Henderson?
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Her definition of nursing was one of the first staements clearly delineating nursing from medicine
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What was the first definition of nursing?
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The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible
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What was Betty Neumans model?
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Systems model
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what was the systems model influenced by?
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a variety of sources
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What is the systems model?
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Clients are systems (wholistic) whose parts are in constant dynamic interaction
The person is layered & multidimensional layers of various circles make up a person |
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What is the person component of Betty Neuman systems model?
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Based on the philosophy that each human being is a total person as a clietn system the person is a layered multidimensional being
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What is the environment component to Betty Neuman systems model?
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Is the totality of the internal and external forces which surround a person and with which they interact at any given time
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What tis the health component of Betty Neuman systems model?
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Equated with wellness. Defines health/wellness as "the condition in which all parts & subparts are in harmony with the whole of the client
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what is the nursing component of Betty Neuman systems model?
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Is concerned with all of the variables which influence the response a person might have to a stressor.
The nurse sees the person as a whole it is the task of nursing to address the whole person |
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What is the assumption component of Betty Neuman systems model?
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Clients are dynamic with unique & universal characteristics
Clients respond to the environment The person's normal lines of defense, enables a return to a state of wellness |
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What is the proposition component of Betty Nueman systems model?
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(demonstrates direction)
Nurses increase the clients level of wellness supporting the clients strengths |
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What model did Calista Roy follow?
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Adaptation model (1970)
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What was the person component of the adaptation model?
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Bio-phsyco-social being in constant interaction with a changing environment (uses innate and acquired mechanisms to adapt)
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What is the health component of the adaptation model?
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Represented by a health-illness continuum
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what is the nursing component of the adaptation model?
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promotes adaptation in the four adaptive modes. Physiological/physical, role concept, inter-dependence and role function
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What is the environment component of adaptation model?
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All conditions, circumstance and influence surrounding and affecting the development and behavior of persons and groups
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What is the assumptions component of the adaptation model?
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Adaptation occurs when a cient responds positvely to environmental change.
Positive adaptation promotes the clients return to health |
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What is the propositions component of the adaptation model?
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Nursing actions promote positive adaptive responses by the client
Nursing actions improve patient environment interactions |
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what philosophy is associated with Jean Watson?
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Nursing Human Science and Caring
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What did Jean Watsons theory believe about the core of nursing?
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That there were 10 carative factors
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What is the person component of the Jean Watson Nursing human science and caring philosophy?
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A valued person to be cared for, respected, nurtured, understood and assisted
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What was the philosophy of the nursing human science and caring Jean Watson?
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A philisophical view of a person as a fully functional integrated self, human is viewed as greater than and different from, the sum of his or her parts
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Waht is the health component of the Jean Watson Nursing human science and caring philosophy?
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A high level of overall physical, mental and social functioning
A general adaptive-maintenance level of daily functioning The absence of illness (or the presence of efforts that leads itf absence) |
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What is the environment component of the Jean Watson Nursing Human science and caring philosophy?
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Caring is transmitted by the culture of the profession as a unique way of coping with its environment
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What is the nursing component of the Jean Watson Nursing human science and caring philosophy?
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nursing is concerned with promoting health, preventing illness, caring for the sick and restoring health
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Jean Watson believes nursing focuses on what?
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Health promotion and treatment of disease. she believes that holistic health care is central to the practice of caring in nursing
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Jean Watson views the nursing process as containing what?
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The same steps as the scientific process. Both try to solve a problem. both provide a framework for decision making.
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What nursing philosophy did Patricia Benner believe?
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Model of skill acquistion in nursing (1984)
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What was the Model of skill acquisition in nursing philosophy?
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-Students pass through 5 levels of skill acquisition: novice, advanced beginner, competent, proficient, and expert
-Practice based model -Used by educators & practitioners for understanding the knowledge of practice and how it should be taught |
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What is meant by novice in Patricia Benners Model of acquisition in nursing philosophy ?
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Beginner with no experience
Use rules to perform tasks Rules are: context free, independent of specific cases and applied universally Rule-governed behavior is limited and inflexible Eg.Tell me what you need and I'll do it |
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What is meant by advance beginner in Patricia Benners Model of skill acquisition in nursing philosophy?
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Demonstrates acceptable performance
Has gained some experience in actual situations to recognize recurring meaningful components Principles based on experience, begin to be formulated to guide actions |
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what is meant by competent in Patricia Benners Model of skill acquisition in nursing philosophy?
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typically 2-3 yrs experience on the job in the same area or in similar day to day situations
Plans actions based on conscious, abstract, and analytical thinking and helps to achieve greater effciency and organization |
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What is meant by proficient in Patricia Benners Model of skill acquisition in nursing philosophy?
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Precieves and understands situations as whole parts
More holistic understanding improves decision-making Based on experience know what to expect in certain situations and how to moidfy plans |
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What is meant by expert in Patricia Benners Model of skill acquisition philosophy?
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No longer relies on principles, rules or guidelines to connect situations and determine actions
Much more experience Has intuitive grasp of clinical situations Performance is now fluid, flexible, and highly proficient |
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Which theory did Madeleine Leininger believe?
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Culture care:diversity and universality theory
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How does Leininger define culture?
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set of values, beliefs and traditions that are held by a specific group of people and handed down from generation. Culture is also bliefs, habits, likes, dislikes, customs, and rituals learned from ones family
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What are learned, shared, and transmitted values, beliefs, norms, and life way practices of a particular group that guide thinking, decisions, and actions in patterned ways?
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culture
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What are some of the main points of the Madeleine Leininger Diversity and universality model? otherwise known as the sunrise model
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-Cultural beliefs may result in people choosing not so seek modern medical treatment
-Many Eastern(and others) believe the locus of control for disease causality is outside the individual -western cultures, the locus of control tends to be more internally oriented -Certain cultures might not follow through with health promoting or treatment recommendations |
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Define helath?
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Refers to a state of well being or restorative state that is culturally constituted, defined, valued and practice by individuals or groups that enable them to function in their daily lives
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What is transcultural nursing?
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Refers to a formal area of humanistic and scientific knowledge and practices focused onholistic cultural care(caring) phenomena and competencies to assist individuals or a group mantain or regain their health or well being and to deal with disabilities, dying or other human conditions in culturally congruent and beneficial ways
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As a student nurse you are expected to develop and build upon your what?
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critical thinking skills in order to make sound nursing judegments
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As an RN you will be knowledge worker with a specific knowledge base that is vital to keeping patients what?
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safe and helping them achieve or maintain wellness
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Critical thinking is what?
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Intentional/purposeful and reflective
Drawing on knowledge and experience Use of logic and reasoning Asking questions Intentional Goal directed Multi-step process Modus Operandi (detective work) Humility |
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Nurses must be able to what?
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Be proactive and think ahead
Think in action Thinking back (reflection) |
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An active, organized cognitive process used to careful examine one's thinking and the thinking of other is called what?
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critical thinking
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The ability to solve problems by making sense of information using creative, intuitive, logical and analytical mental process is called what?
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critical thinking
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Critical thinking is a what?
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process
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Clinical judgment is the result of what?
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The critical thinking process. It is the conlcusion nurses come to, the decision nurses make , the options nurses form
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Critical thinking distinguishes the professional nurse from who?
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Technical personnel
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What are the 4 components of critical thinking?
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Noticing or grasping the situation
Interpreting the situation Responding or deciding on a course of action Reflecting on or reviewing the actions taken and their outcomes |
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What are the 3 levels of critical thinking?
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Level 1 Basic
Level 2 Complex Level 3 Commitment |
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What are some characteristics of a Basic level (level 1)of critical thinking?
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Learner trusts that experts have the right answer to every problem
Concrete thinking based on principles & rules Belive there is one right answer for questions/problems |
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What are some characteristics of Complex level (level 2) of critical thinking?
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Begin to seperate thinking process from those of authorities and analyze and examine choices more independently
Realize alternatives and sometimes conflicting solutions to a problem exists |
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What are some characteristics of Committment level (level 3) of critical thinking?
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anticipate the need to make choices without the assistance from other professionals
Assumes responsibility and accountability for choices |
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What is reasoning?
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Use of reason, especially to form conclusions, inferences, or judgments
The act or process of drawing conclusions from facts, evidence,etc. deductive, Inductive, Abductive |
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Deductive reasoning starts with what ?
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Broad establised/accepted facts, principles, laws or theories and use them to address narrower yet related phenomena, concepts
(starting big and going small) Eg. Growth and development chagnes in the older adult that lead to an increase in risk of falling |
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Inductive reasoning starts with what?
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A concept, variable, proposition leads to the development of new facts, laws, theories
(starting small and going big) Eg. children on the pediatric ward eat better when mothers are present |
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What are some factors that influence reasoning?
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You have to have knowledge to apply knowledge
You have to have: Skill:Requires cognitive and psychomotor domains Ethical and moral values: competence the ability to think and act effectively and safely Meanings of symbols& terminology Experience (evolving personal and professional knowledge) |
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To develop critical thinking skills what questions must be asked?
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Who, What, When, Where, Why
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To develop critical thinking what answers must be searched for?
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define, describe, clarify, relate, explain, justify
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Critical competencies scientific method is what?
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systematic data collection looking for patterns
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To be open minded- look for patterns, examine options is what?
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analysis
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Gathering information to look for solutions is what?
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problem solving
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Decision making is what?
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choosing between various options and/actions. Forming informed conclusions based on evidence and reasoning
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What is based on assessment data, looks for meanings and significances of findings
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Diagnostic reasoning/inferences
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Clinical decision making means defining what?
|
the clients problem and selecting the appropriate interventions
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Evaluation means what?
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assessing outcomes based on criteria
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What are some factors what interfere with critical thinking?
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Lack of experience & knowledge
Lack of confidence in nursing process Complacency VS curiosity Close minded Rituals Acceptance without question |
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what is meant by reflection?
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purposely thinking back or recalling to discover purpose and meaning
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Scope of practice promotes what?
|
Safe, ethical, high quality care that responds to the need of patients and the public
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Scope of practice enables providers what?
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To practice to the extent of their education, skills, knowledge, experience competence and judgement
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The requirements of a professions standard of practice represents what?
|
The acceptable requirements for determining the quality of nursing care clients receive
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A professions standard of practice is what?
|
A yard stick used to measure acceptable practice
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Standards of practice proves what?
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Proves to the public and government what is acceptable practice of a nurse
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Standards are objective guidelines for nurses to provide practice and evaluate what?
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care
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What can a NP do?
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Prescribe certain drugs, order and interpret lab and diagnostic tests
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What kind of care do NP provide?
|
Primary care: wellness care, diagnose and treat minor illnesses and injuries, screen for the presence of chronic disease and monitor patients with stable chronic disease
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NP practice autonomously and in conjunction with other what?
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practitioners
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Maintaining competencies means advocating for what?
|
quality care
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Maintaining competencies means promoting what?
|
healthy public policy
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Maintaining competencies means working to create and sustain practice environments that what?
|
Support safe, competent and ethical nursing care and advocate for social justice
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Trust is built on the foundation of what?
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respect
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