Med Surg - Focus Notes 1

Front 1

What is the scope of adult health nursing?

Back 1

The scope of the nurse is to promote health and prevent illness or injury in patients from 18 to 100 yo.

Med-surg nurses are generalists who require a broad knowledge base to meet the needs of clients in a variety of health care settings.

Front 2

Why must nurses use clinical judgment to ensure patient safety as the priority in practice?

Back 2

It is an essential competency that all nurses use clinical judgment to ensure patient safety as the priority of practice.

Front 3

What was identified in the 2000 IOM report, To err is human?

Back 3

A substantial body of evidence points to medical errors as a leading cause of death and injury. Between 44,000 to 98,000 patient deaths result from preventable errors in acute care hospitals

Front 4

Who developed the National Patient safety Goals and why?

Back 4

The Joint Commission developed these goals to focus on specific priority safety practices; many of which involve nursing care.

Front 5

What is the 10,0000 lives campaign?

Back 5

The 100,000 Lives Campaign is a nationwide initiative launched by the Institute for Healthcare Improvement (IHI) to significantly reduce morbidity and mortality in American health care.

Front 6

What is the goal of the IHI (Institute for Healthcare Improvement)?

Back 6

There aim was too save 100,000 lives in 18 months with over 3,000 hospitals enrolled. They have reached there goal. The Campaign continues to maintain its focus on significantly reducing morbidity and mortality through the introduction of the existing Campaign interventions. They will also support hospitals in sustaining and spreading their successful work in these areas, asking them to adopt all six interventions throughout their facilities and systems by the end of 2006

Front 7

What key elements made the rapid response team successful and how does it differ from the code team?

Back 7

The rapid response team (aka.MET) save lives and decrease the risk for harm by providing care to patients before a respiratory or cardiac arrest occurs. They are called whenever a patient has a slow or sudden deterioration in clinical condition. The Code team differs in that they respond to patient arrests.

Front 8

What are the five IOM core competencies?

Back 8

 Provide patient centered care
 To collaborate with the interdisciplinary health care team
 To implement evidence based practice
 To apply quality improvement in patient care
 To utilize informatics in patient care

Hint 8

provide, collaborate, implement, apply, utilize

Front 9

Of the five IOM competencies, what is meant by patient centered care?

Back 9

It is to recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient preferences, values, and needs. This is done by the medical surgical nurse functioning in a variety of role, including caregiver, educator, and advocate.

Front 10

Of the five IOM competencies, what is meant by Hollistic?

Back 10

This refers to the approach taken by the med-surg nurse on psychosocial (emotional), cultural, and spiritual needs of the patient.

Front 11

What is the scope of adult health nursing?

Back 11

The scope of the nurse is to promote health and prevent illness or injury in patients from 18 to 100 yo.
These nurses are generalists who must have a broad knowledge base to meet the needs of clients in a variety of health care settings.

Front 12

Why must nurses use clinical judgment to ensure patient safety as the priority in practice?

Back 12

It is an essential competency that all nurses use clinical judgment to ensure patient safety as the priority of practice.

Front 13

What was identified in the 2000 IOM report, To err is human?

Back 13

A substantial body of evidence points to medical errors as a leading cause of death and injury. Between 44,000 to 98,000 patient deaths result from preventable errors in acute care hospitals

Front 14

Who developed the National Patient safety Goals and why?

Back 14

The Joint Commission developed these goals to focus on specific priority safety practices; many of which involve nursing care.

Front 15

What is the 10,0000 lives campaign?

Back 15

The 100,000 Lives Campaign is a nationwide initiative launched by the Institute for Healthcare Improvement (IHI) to significantly reduce morbidity and mortality in American health care.

Front 16

Of the five IOM competencies, what are the human needs within patient centered care?

Back 16

They are the primary concern (concepts) of medical-surgical nursing. The role of the nurse focuses on meeting these physiological needs (biologic, cultural, and spiritual needs) for patients in a mutually trusting, respectful, and caring relationship.

Front 17

Of the five IOM competencies, what are collaborative nursing functions within patient centered care?

Back 17

To function effectively within nursing and inter-professional teams fostering open communication, mutual respect, and shared decision making to achieve quality patient care. Such as:
-Those that are mutually determined by the nurse and the physician or other health care team member, such as setting activity limitations or providing a special diet.
-Those that are directed or prescribed by the health care provider (physician, nurse practitioner, or physician assistant) but require nursing judgment to perform (eg. Administering medication).

Front 18

Of the five IOM competencies, what are the independent nursing functions within patient centered care?

Back 18

This is initiated and carried out without direction from the health care provider. Such as:
-Weighing a patient
-Listening to breathe sounds
-Elevating the head of the bed to facilitate breathing

Hint 18

Think of the health assessment tools we use in accessing patients in clinical setting

Front 19

What are the best practices for teaching older adults?

Back 19

 Ensure that the client wears glasses or hearing aids if needed
 Be sure that the area for teaching has ample lighting and minimal distraction
 Provide most of the teaching in the morning (after breakfast) before the client becomes too fatigued
 Speak slowly and provide small amounts of new information at a time
 Ask the client to repeat the information to make sure that he/she has learned it
 Provide written information so the client can refer to it later if needed
 Provide as much privacy as possible
 Ask the client whether family or significant other should be present during the interview
 Refer to the patient by his/her last name unless he/she prefers another name.
 Provide health teaching when the patient is not experiencing pain and after basic comfort needs have been met.
 Sit at the patient’s eye level during the interview
 Be aware that the patient may not be able to distinguish soft consonant blends such as “sh” or “ch”.
 Teach the patient in the morning, after breakfast, or in the early afternoon, after the patient has rested.
 Whenever possible, use open-ended questions to gather more information; avoid questions that can be answered “yes” or “no”.
 Consider the patient’s education, culture, and age when teaching, especially about sensitive or controversial issues.
 Observe the patient’s nonverbal behavior as well as what he/she says

Front 20

Of the three ethical principles used in guiding decision making, what is self determination?

Back 20

This refers to the patient’s autonomy as being capable of making informed decisions about their care. When they are incapable of making these self determined decisions, we as nurses are ethically obligated to protect him/her as an advocate within the professional scope of practice. This respect given to clients is used by nurses and health care professionals as the basis for clinical decision making.

Front 21

Of the three ethical principles, what is meant by Beneficence?

Back 21

This is the second ethical principle which emphasizes the importance of preventing harm and ensuring the patient's well being. This can be avoided once its causes or possible causes have been identified.

Front 22

Of the three ethical principles, what is meant by Justice?

Back 22

This is the third principle which refers to equality. All patient's should be treated equally and fairly.

Front 23

What is the nurse’s role in collaborating with the interdisciplinary health team?

Back 23

The nurse functions as the coordinator of patient care through effective communication with the nursing and health care team.

Front 24

Who is one of the most important members of the interdisciplinary team to provide patient centered care?

Back 24

The case manager.

The goal of the case management process is to provide quality and cost effective services and resources to achieve positive patient outcomes.

Front 25

What is SBAR and how does it impact communication?

Back 25

SBAR signifies Situation-Background-Assessment-Recommendation. It is a formal method of communication between two or more members of the health care team when there is an unmet patient need or problem.

Front 26

What are the four steps of the SBAR process?

Back 26

Situation: Describe what is happening at the time to require this communication.

Background: Explain why any relevant background information that relates to the situation.

Assessment: Provide an analysis of the problem or patient need bases on assessment data.

Recommendation: State what is needed or what the desired outcome is.

Front 27

What steps are involved in implementing evidence based practice?

Back 27

-Clinical questions
-Access resources
-Critically analyzing
-Integrating evidence
-Implementing change to improve safety and quality

Front 28

Describe in detail each step involved in implementing evidence based practice.

Back 28

-Clinical questions are formulated using critical thinking about nursing or interdisciplinary practices.

-Access resources to retrieve the most relevant and best evidence that may answer the clinical question.

-Critically analyze the evidence for validity, reliability, and utility to answer the clinical question.

-Integrate the evidence findings with one's own expertise and patient preferences and values to make clinical decisions to answer the question.

-Implement the evidence-based practice change or seek appropriate channels for making the change in practice

-Evaluate the practice change for its effectiveness in promoting patient safety and quality care.

Front 29

What is the best source of scientific evidence?

Back 29

RESEARCH!!!

Front 30

How can we use quality improvement in patient care?

Back 30

As nurses, we can become active participants in the systemic quality improvement process by:

-Identifying indicators to monitor quality and effectiveness of nursing care.
-Collecting data to monitor the quality and effectiveness of nursing care.
-Recommending ways to improve nursing care.
-Implementing activities to improve the quality of nursing care.

Front 31

How can informatics impact patient care?

Back 31

By being able to access patient documentation, internet searches, and e-mail communication, health care professionals are able to enhance collaboration and coordination of care.