Fundamentals Week 1 Objectives

Front 1

Civility

Back 1

is the art of treating others, as well as ourselves, with respect, dignity, and care. Civility is apparent when we are sensitive to the impact that our communication, practices, and behaviors have on others, and when we acknowledge each person’s self worth and unique contributions to the community as a whole.

Front 2

Nursing as an art

Back 2

is characterized by delivery of care artfully with compassion, caring and a respect for each client's dignity and personhood. Art is the deliberate arrangement or product of organizing something to affect the senses and/or emotions. Nursing as a science includes the process of gaining knowledge and is based on a body of knowledge that is continually changing with new discoveries and innovations

Front 3

Role of the Professional Nurse:

Back 3

Presentation: Standards for appearance & behavior
Responsible (accountable)
Open to change (adaptable)
Follows defined scope & standards of practice
Extensive Education—exhibits intellectual curiosity
Scientific—provides evidence-based practice
Sensitive & Skillful
Integrity is above reproach/Honest
Outcome-driven
Non-Judgmental & open to diversity
Advocate—anticipates needs of clients/populations
Listens actively

Front 4

Professional RN Education

Back 4

• RN (Registered Nurse)- Must have an Associates or Bachelors degree and must take NCLEX in state in which they will practice

Front 5

Graduate Education

Back 5

• RN with master’s degree in nursing.
• Valuable for roles in advance practice nurse, nurse educator, and nurse administrator

Front 6

Doctoral Preparation

Back 6

• Prepares graduates to apply research findings to clinical nursing or emphasizes more basic research and theory
• Need for doctoral degrees is increasing for teaching purposes of new and advanced academic/clinical nurses

Front 7

Continuing education

Back 7

formal educational programs offered by universities, hospitals, state nurses associations and professional nursing organizations

Front 8

In-service education programs

Back 8

Instruction of training provided by a health care agency or institution.

Front 9

Benner’s Classification of Nurses

Back 9

Novice-Beginning nursing student
Advanced Beginner-Some level of experience
Competent- 2-3 years experience
Proficient-greater then 3 years experience
Expert-large experience base and able to apply to scenarios

Front 10

Nursing Practice Act (NPA)-

Back 10

Regulate nursing practice and protect public health, safety, and welfare. Overseen by the State Boards of Nursing.

Front 11

Licensure

Back 11

RN must pass the NCLEX-RN exam of the state in which they will practice

Front 12

Certification

Back 12

After passing an exam, an RN maintains certification with ongoing education

Front 13

Health

Back 13

The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being, and does not consist only of the absence of disease or infirmity.” Many things need to be considered to define health in relation to one’s values, personality, and lifestyle.

Front 14

Health Promotion

Back 14

WHO defines this as the process of enabling people to increase control over their health and its determinants, and thereby improve their health

Front 15

Variables affecting and individual’s or family’s health beliefs

Back 15

o Age, race, gender, culture
o Mental, social, and spiritual well-being
o Life conditions and socioeconomic variables such as environment, diet, and lifestyle practices and choices as well as many other physiological and psychological variables.

Front 16

Internal variables

Back 16

developmental stage, intellectual background, perception of functioning, emotional factors, and spiritual factors

Front 17

External variable

Back 17

family practices, socioeconomic factors, and cultural background

Front 18

Passive strategies of health promotion

Back 18

individual’s gain from the activities of others without acting themselves. The fluoridation of municipal drinking water and the fortification of homogenized milk with vitamin D are examples of this

Front 19

Active strategies of health promotion

Back 19

individuals are motivated to adopt specific health programs. Weight reduction and smoking cessation programs require clients to be actively involved in measures to improve their present and future levels of wellness while decreasing risk of disease.

Front 20

1Preventive Care

Back 20

 Disease oriented and focused on reducing and controlling risk factors for disease
 Examples: blood pressure and cancer screening, immunizations, poison control information, mental health counseling and crisis prevention, and community legislation (seat belts, air bags, bike helmets)

Front 21

Primary Care

Back 21

The focus is on health services provided on an individual basis
 Provision of integrated, accessible health care services by health care professionals who address a majority of personal health care needs, develop partnerships with clients, and care for families and communities
 Examples: prenatal care, well-baby care, nutrition counseling, family planning, and exercise classes

Front 22

Secondary Care

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 Involves the early diagnosis and treatment of illness
 Examples: screening for hypertension, emergency care, acute medical-surgical care, and radiological procedures

Front 23

Tertiary Care

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 Care that prevents further progression of disease
 Examples: intensive care and subacute care

Front 24

Acute Care Settings

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 Settings for secondary and tertiary care
 Includes hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units

Front 25

Restorative Care Settings

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 Meant to help individuals regain maximum functional status and to enhance quality of life through promotion of independence and self-care
 Generally in a home or rehabilitation setting
 Examples: cardiovascular and pulmonary rehabilitation, sports medicine, spinal cord injury programs, and home care

Front 26

Long-term Care Settings

Back 26

 Nursing centers (also called nursing homes) are the dominant setting
 Nursing centers provide 24 hour intermediate and custodial care such as nursing rehabilitation, dietary, recreational, social, and religious services for residents of any age with chronic or debilitating illnesses
 Assisted living is a long-term care setting with a homier environment and greater resident autonomy
 Clients in assisted care require some assistance with ADLs but remain relatively independent within partially protective setting

Front 27

Medicare

Back 27

 Designed to cover health care costs of senior citizens
 The program is set up in the same way as a managed care organization
 Factors associated with payment for Medicare services:
o Utilization review (UR) committees review the admissions, diagnostic testing, and treatments provided by physicians who care for clients receiving Medicare
o Medicare patients are grouped into diagnosis-related group and each group has a fixed reimbursement amount with adjustments based on case severity, rural/urban/regional costs, and teaching costs
o Hospitals receive the fixed amount based on DRG regardless of the length of stay or services used

Front 28

Managed Care

Back 28

 Describes health care systems in which there is administrative control over primary health care services for a defined population
 The provider or health care system receives a predetermined capitated payment for each client enrolled in the program
 Referrals are required to see a specialist
 Capitated the providers receive a fixed amount per client or enrollee of a health care plan
 The focus of this type of system is on containing or reducing costs, increasing client satisfaction, and improving the health or functional status of the individual

Front 29

models of managed care organizations

Back 29

a) Staff model: physicians are salaried employees of the MCO
b) Group model: the MCO has a contract with a single group practice
c) Network model: MCO has contracts with multiple group practices
d) Independent practice association: MCO has contracts with physicians that are not part of a group practice and whose practices include fee-for service and capitated clients

Front 30

1. Health Maintenance Organization (HMO)

Back 30

 There are different:
 This is a type of managed care organization
 It can operate under any of the MCO models

Front 31

1. Preferred Provider Organizations (PPO)

Back 31

 Contract agreement between the PPO and a list of preferred hospitals, physicians, and providers
 The enrollees are limited to this preferred list of providers unless they want to pay more out-of-pocket expenses

Front 32

1. Private Insurance

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 Traditional fee-for-service plan
 The clients payment depends on the number of services used
 These policies are expensive and commonly clients must meet a deductible before the insurance company will pay

Front 33

1. Health Disparities

Back 33

 Defined as the differences in measures of health status between different groups of people living in a community, a state, or the entire nation
 Occur when one group of people has a higher incidence or mortality rate than another, or a lower survival rate than another group
 Eliminating health disparities is the number 2 goal of Healthy People 2010
 Factors that contribute to health disparities are race, culture, ethnicity, geographic location, income, education, occupation, health literacy, gender, age, and health care provider attitudes

Front 34

1. Healthcare Disparities

Back 34

 Differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of the intervention but rather are due to stereotyping, biases, and prejudice