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47 Cards in this Set

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Accountability
To accept owenership for the results or lack of results or lack of results asociated with a task. Accountability is shared and you can only delegate the tasks for which you are responsible
Accreditation
The process by which an agency or organization evaluates and recognizes an institution or program or study as meeting certain predetermined criteria or standards
Advocacy
The act of standing in for the rights of the patient; The RN, as an advocate and because she has the specific training, has specific responsibilities to and for the patient
American Academy for Nursing (AAN)
An organization for professional nurses in the USA. Focus is on standards of healthcare, nurse professional development, economic and gernal welfare of nurses. The goal is to transform healthcare so as to optimize the well ebing of the Amiocan people and the world.
American Civil War 1861-1865
At the begining, there was no organized system for caring for the wounded or sick; Doctors began developin a short training course for female volunteers. Members of exisitng religious orders began to volunteer and were assigned to larger hospitals; Dorothea Dix was appointed "Secretary of War" to oversee the trained nursing volunteers
American Nurses Association (ANA)
Established in 1897; It's a federation of state associations. Voluntary professional nusring organization; Serves as a spokesperson/agent for nurses and nursing. Publications: American Journal of Nursing (AJN), Nursing Research, International Nursing Index. The American member of the International Council of Nurses (ICN). Membership in the ANA is open to professional nurses with currentl valid license.
Balanced Budget Act (BBA) Public Law 105-33 of 1997
This removed the restrictions on Nurse Practitioner billing. It means that NP's can be independent Medicare providers and can bill Medicare separately. THis law requires a collaborative rather than supervisory relationship between NP's and Drs
Clara Barton 1821 -1912
She was a schoolteacher with no formal nurse training, she served with the German Red Cross during the Franco Prussian Wars and founded the American Red Cross; founded the "Missing Soldier Office" during the Civil War; She and Harriet Tubman tended wounded soldiers; directed relief operations during the war, mobilizing 6000 women for the North and 1000 women for the south; she convinced Congress to ratify the Geneva Treaty which allowed the American Red Cross to act in peacetime
Breach of Contract (Liability Theory)
Contract is a promise or set of promises between two parties; the RN may beasked to witness a one-party dcoument; Elements of a valid contract:
1: Parties are competent to contract
2: The contract must concern a legal subject matter
3. There must be a consideration (without it, the agreement is for a gift)
4. There is a mutuality of agreement
Breach of Warranty (Liability Theory)
these claims are a specified type of contractual claim and are prompted by reprentations from the HMO that its providers will provide "high quality care"; although the HMO may advertise high quality care, the HMO is not simultaneously guaranteeing non-negligent medical care
Brewster, Mary
Worked with Lillian Wald and Lavinia Dock to establisht the Henry Street Settlement; Pioneer in community health nursing
Case Management
a process that is implemented in an integrated health care delivery system; the RN is assigned as the case manager and is responisble for moving the pt throught the continuum of care int he integrated system; the Case Manager secures services that are desired and avialable; Social workers used to be Case Managers but RNs are better suited for the task
Case Method (Delivery of Care)
the total of one pt is assigned to one RN; Case nursing delegates and assigns total responsibility of one pt to one nurse for the duration of the pts' stay; the main nurse assigns assocaite nurses duties to help with pt care but the main nurse is totally responsible and accountable; case nurses are salaried but are definitely a staff position
Certification
Used a tool to measure competence (a measure of TQM or CQI); It's voluntary and signifies competence or specialization; there are 3 criticisms:
1. denial of certificiation may be based on a lack of educational background or failure to pass the exam
2. nurse could be grandfatherered into certification
3. conflict of interest could exist; the agency that confers the certification may also be the agency that accredits the educational program that the candidate must graduate from to qualify
Christman, Luther
a nursing pioneer; the nurse who founded the American Assembly for Men in Nursing; he is the founder and Dean Emeritus of the Rush University School of Nursing in Chicago
Clinical Pathways (aka Outcomes)
Used to make nursing knowledge manageable, define standards and maintain quality; standardized tools used for measuring outcomes are also known as Critical Paths, Care Maps, Care Protocols, Practice Guidelines, CLinical Outcomes, Collaborative Paths or Anticipated Recovery Paths; they define and describe the optimum progression of the patient through the system and are specific to health problems or issues
Community College Education for nursing (a study published in 1959)
Conducted by Montag and others; a two part report sponsored by the Institute of Research and Service in Nursing Education at the Columbia University Teachers College in NY; "Action Research" was the evaluation of effectiveness that was built into the planning and design of the research; the study showed that Associate Degree (AD) nurses could carry on intended nursing functions and programs could be set up in community colleges; it recommended that more AD programs be developed
Continuous Quality Improvement (CQI)
a tool used to measure efficiency, satisifaction and quality
Corporate Negligence (Liability Theory)
Says that the hospital may be held liable if it fails to uphold the proper standard of care owed to the pt; it's a non-delegatable duty owed directly to the pt; Two elements have to be proven
1. the pt must prove that the hospital knew of the defect in its procedures
2 the defect was a substantial factor in bringing about the injury to the pt
it is the duty of the HMO to monitor the doctors' performance for competence
Crimean War 1854
Florence Nightingale became involved and helped the English Secretary of War clean up terribly unsanitary conditions in the hospitals; she started programs of social welfare and helped radically improve the sanitary levels which dropped the mortality rates to 1% . In 1860, she established a nursing school in London's St Thomas Hospital
Critical Path
This defines standards and outcomes; it creates a multidisciplinary approach and reduces the bruden of documentation; the analytical component provides multiple opportunites such as variance analysis, trending and modification of paths; It is used to progress pts and evaluate care as effective or determine whether other measures are required
Critical Thinking
The process of identifying underlying assumptions, interpreting and evaluating arguments imagining and exploring alternatives and develop a reflective criticism to attain a logical and justifiable conclusion
Decision Making
There are three levels:
1. Immediate: there is no time for reflection. action is automatic or immediately responsive
2. Imtermediate: there is time for reflectionbefore acting
3. Deliberate: Information acquisition precedes thinking, consulting and reflection with the objective of making a rational decision. Delibrate decison making is the most common
Defamation of Character
The publication of anything injurious to the good name or reputation of another; Slander is when it's spoken or oral. Libel is when it's written; The best defense against defamation is the TRUTH
Delegation
Defined as transferring authority to a competent individual to perform a selected nursing task in a selected situation; it depends on a balance of responsibility, accountability and authority.
Six Factors:
1. know yourself
2. know your world and organization
3. know your practice
4. know your delegates' strengths/weakness
5. Know what needs to be done
6. know how to communicate, resolve conflict and give
Delegation Process
Five Steps:
1. Define the task, you can delegate a task that you have authority over, you must define the task in terms of performance requirements and must determine which of the five levels of delegation to use
2. Determine to whom to delegate, give the task to the lowest appropriate person
3. Provide clear communication about expecations regarding the task
4. Reach a mutual agreement about the task
5. You must monitor and evaluate the results and provide feedback to the individual regarding the performance of the task
Differentiated Practice
This builds on primary nursing but decentralizes all management functions usch as staffing and scheduling; it is the structuring of roles and functions of nurses according to their expertise, education and competence; it is believed that education is the best basis for practice. Clinical Ladder: competence demonstrasted and categorized in levels
Direct Liability:
3 theories: Corporate Negligence, Breach of Contract/Breach of warranty and Intentional Misrepresenation or Fraud
Dix, Dorothea 1802-1887
She was the Superintendent of Nursing during the Civil War; Also called the "Secretary of War". She insisted that nurses be "plain looking women over the age of 35, moral with common sense". She fought with chauvinistic military surgeons who did not want women there. the nurses were employed as civilian employees of the Army and were pain 40cents and one meal ratio per day. After the war she was credited with helopin to developed state psychiartic instituations
Dock, Lavinia
She worked with Lillian Wald and Mary Brewster to establish the Henry Street Settlement in New Yor city; a pioneer in communicty healt nursing
Eight Ethical Principles:
Justice: is the right to be treated equally
Beneficence: is the obligation ot do good and avoid harm
Autonomy: is the right to self determination, freedom and independence
Nonmaleficence: is the obligatio to not create or inflict harm on others
Veracity: is the obligation to be honest and not deceptive
Fidelity is the obligation to be faithful to the commitment
Confidentiality: is owed to the patient; it's an obligation as well as a right
Ethics: is the obligation that the nurses' personal beliefs not interfere with patient care
Emergency Medical Treatment and Active Labor Act (EMTALA)
This act prevents patient 'dumping" (primarily from for-profit hospitals) and enial of emergency care when a patient does not have the ability to pay
ERISA Act of 1974
This is designed to provide consistent application for employee benefits which would include health care benefits
Fabiola
A wealthy first century Christian convert who founded the first free hospital for the poor; she was in a group of other notable woman; Empress Helena, Olympias, Paula and Marcella; Most of them built churches, hospitals, orphanages
Freedom of Information Act (FOIA)
This act was passed into law in 1966 followed by the Privacy of 1974; The FOIA gives people the right to obtain inforamtion form public and governmental entities by requesting it in writing
Four Elements That Comprise Malpractice (or Negligence)
Duty, Breach of Duty, Proximate Cause (causation), Damages
Functional Nursing
This bundles pt care care tasks and assigns them; tasks are grouped to save time and to comply with legal requirements; the obvious disadvantage is that there is minimal, if any, continuity of care and the care is fragmented; this isn't good for the pt; the object is to get the work finished without regard to the nurse's or the pt's satisfaction
Gras, Louise de - Sisters of Charity 1633
This religious order was founded by St Vincent de Paul; Louise de Gras was the first Superintendent; She established the first nursing education program
Group Process
This is collaborative decision making; the group process seeks to involve everyone and conveys responsiblity and accountability on all group members; there are seven ways of group decsion making:
1. Majority rule
2. Minotiry rule
3. Augocracy
4. Autocracy with polling
5. Consensus
6. Unanimity
7. Decision by non-decision (motion tabled after discussion)
Health Care Financing Administration (HCFA)
This agency determines the reimbursement for service to Medicare beneficiaries; it administers the Medicare and Medicaid programs
Health Care Quality Improvement Act of 1986 (HCQIA)
An efffort to control various components of the health care delivery arena; it gave rise to efforts that provided and managed information on health care providers who had been a party in litigation
Health Insurance Portability and Accountability Act of 1996 (HiPPA)
This act addresses electronic pt information; it developed standards for health information systems for the electronic transmission of health care information
Health Maintenance Organization (HMO)
Several types; most are the Staff model, the Network model, and the Independent Practice Association model; HMO's are the most common type of managed care plan with the highest number of people enrolled; HMO's provide services for enrollees with a fixed fee mostly through affiliated providers
Health Professions Education For the Future: Schools in Service to the Nation 1993
A Study sponsored by Pew Health Professions Commission; it was funded by Pew Charitable trusts; it followed up on the 1991 report; it found that education and training of health professionals were not adequate to meet the health care needs in America; the professional education was out of synch with the changing health care system; it proposed seven competencies
Healthy People 2010
This study augments the Healthy People 2000 study; HP 2000 developed surveillance and monitoring patterns in health and living; HP 2010 provides more emphasis to individual communities to strengthen their own capabilites to promote and protect health and assure access to health services
Heide, Wilma Scott 1966
Was the National Organization for Women (NOW) first president; now was formed in 1966; she was a nurse and a feminist
Henderson, Virginia 1961
She created the Developmental Model; she was influenced by Orem and Maslow. She based her theory on the assumption othat the pt is a person who needs help moving toward the goal of independence; she saw a nurses' role as an advocate where the nurse would act on the behalf of the pt for those things that the pt would be able to do for themselves if they had the strength, knowledge and willingness to do so