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245 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Illness-Wellness Continuum |
No one is ever stable on this continuum unless they are dead. Constantly changing.favtors |
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Factors that disrupt health |
-physical disease -injury -mental illness -loss -impending death -competing demands -the unknown -imbalance -isolation1st |
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5 stages of illness behavior |
1) experiencing symptoms 2) sick role behavior 3) seeking professional care 4) dependence on others 5) recovery |
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Factors that influence illness behavior |
Age Family patterns Culture Nature of illness Hardiness Intensity, duration and multiplicity of the disruption |
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________ needs are just as important at physiological needs. |
Psychosocial |
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No matter the age, _______ identity is very important. |
Sexual |
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Body image can be _______ and _______. |
External; internal (e.g. functioning of lungs) |
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Gradual vs. sudden body changes (example) |
Mastectomy vs loss of limb |
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Components of self-concept (2, plus definitions) |
Personal identity- your view of yourself as a unique human being, relatively constant and consistent.
Self esteem- how well a person likes one's self. |
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What is the silent killer (psychosocially speaking)? |
Depression |
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Depression in older adults |
Under/misdiagnosed Mistaken for dementia/delirium "Expectation of aging"- FALLACY! |
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Who defines wellness? |
The patient! |
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Different kinds of nursing knowledge (4) |
Theoretical Practical Self (values/beliefs/biases) Ethical |
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Define "nursing process" |
A systematic problem-solving process that guides all nursing actions. |
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What is the purpose of the nursing process? |
To help the nurse provide goal-directed, patient-centered care. |
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What is the purpose of the nursing process? |
To help the nurse provide goal-directed, patient-centered care. |
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What are the phases of the nursing process and a brief description of each? |
Assessment: data gathering Diagnosis: identification of the patient's health needs Planning outcomes: goals and interventions: strategies to help patient achieve goals Implementation: action phase Evaluation: degree of goal attainment |
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Define assessment |
Systematic gathering of information r/t all aspects of individual, group, or community. Focuses on responses to illness. |
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Types of assessments (4) |
Initial Ongoing Comprehensive Focused |
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Types of assessments (4) |
Initial Ongoing Comprehensive Focused |
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Types of special needs assessments |
Nutritional Functional ability (ADL's) Pain Cultural Spiritual health Psychosocial Wellness (sports physical) Family Community (lead poisoning) |
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Assessment techniques (2) |
The nursing interview Physical assessment |
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Assessment techniques (2) |
The nursing interview Physical assessment |
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Documenting data (important tips) |
-Document ASAP -Write legibly without using acronyms -Avoid using inferences "just the facts" -Use the pt's own words -Record only pertinent, important and relevant data |
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Diagnosis |
Includes strengths, problems, and factors contributing to the problem. |
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Diagnosis |
Includes strengths, problems, and factors contributing to the problem. |
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A ________________ is a contract with the pt to help them get better. |
Plan of care |
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Problem urgency (three priority levels) |
High priority- life-threatening (not breathing) Medium priority- not a direct threat to life, but may cause destructive physical or emotional changes (pulse in feet getting weaker) Low priority- requires minimal supportive nursing intervention (pts can usually take care of themselves) |
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Problem urgency (three priority levels) |
High priority- life-threatening (not breathing) Medium priority- not a direct threat to life, but may cause destructive physical or emotional changes (pulse in feet getting weaker) Low priority- requires minimal supportive nursing intervention (pts can usually take care of themselves) |
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Nursing Diagnoses: The problem suggests the ______ |
Goal. |
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Nursing diagnoses: The etiology suggests the _____ |
Interventions. |
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Writing quality statements tip: |
State the problem as a patient response |
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Writing quality statements: Common errors |
-Be sure that the etiology does not merely restate the problem -Avoid using medical dx and tx as etiological factors -Use nonjudgmental language -Avoid legally questionable language |
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Collaborative problems |
ALWAYS a potential problem FOCUS of nursing interventions is monitoring for and preventing the complication (not the disease, test or medical tx) |
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Nursing process: planning Formal vs informal |
Formal planning is a conscious, deliberate activity involving decision-making, critical thinking and creativity. Informal planning is the making of mental notes and plans to address data found while doing nursing care. |
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Nursing process: planning Formal vs informal |
Formal planning is a conscious, deliberate activity involving decision-making, critical thinking and creativity. Informal planning is the making of mental notes and plans to address data found while doing nursing care. |
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Initial planning |
-Begins with first client contact -Written as soon as possible after initial assessment -Development of the initial comprehensive care plan |
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Nursing process: planning Formal vs informal |
Formal planning is a conscious, deliberate activity involving decision-making, critical thinking and creativity. Informal planning is the making of mental notes and plans to address data found while doing nursing care. |
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Initial planning |
-Begins with first client contact -Written as soon as possible after initial assessment -Development of the initial comprehensive care plan |
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Ongoing planning |
Changes made in the plan as you evaluate the pt's responses to care |
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Discharge planning |
-Planning for self-care and continuity of care after pt leaves health-care setting -Begins with initial assessment -All pts need discharge planning -Requires collaboration |
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Importance of nursing care plans |
-Ensures care is complete -Provides continuity of care -Promotes efficient use of nursing efforts -Provides a guide for assessing and charting -Meets requirements of accrediting agencies |
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Planning pt goals Long term vs short term |
Long-term goal: global goal that reflects the dx (longer period of time) Expected outcomes: (short term goals) the "steps" achieved towards the global goal and reflect the evidence supporting the dx (hours-days) |
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How do goals relate to nursing dx? |
The goal states the opposite of the problem response
The expected outcomes describe "correction" of the defining characteristics |
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How do goals relate to nursing dx? |
The goal states the opposite of the problem response
The expected outcomes describe "correction" of the defining characteristics |
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What are the components of a goal/EOC statement? |
Subject (patient) Action (will ambulate) Performance criteria (Full length of hallway 3x a day) Target time (by 8/24/14) Special condition (w/ walker) |
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5 criteria of EOC |
-stated as pt behavior, not nurse activity -stated in positive terms -measurable/observable -realistic -gives specific & concrete performance criteria |
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5 criteria of EOC |
-stated as pt behavior, not nurse activity -stated in positive terms -measurable/observable -realistic -gives specific & concrete performance criteria |
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Three domains of learning |
Cognitive (thinking) Psychomotor (doing) Affective (feeling) |
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Three classes of nursing interventions |
Independent (education) Dependent (meds, diet orders) Interdependent/collaborative ("consulting" w/ other med. professionals) |
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Three classes of nursing interventions |
Independent (education) Dependent (meds, diet orders) Interdependent/collaborative ("consulting" w/ other med. professionals) |
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What are nursing orders? |
Instructions that describe how and when nursing interventions are to be inplemented |
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Three classes of nursing interventions |
Independent (education) Dependent (meds, diet orders) Interdependent/collaborative ("consulting" w/ other med. professionals) |
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What are nursing orders? |
Instructions that describe how and when nursing interventions are to be inplemented |
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A nursing order contains (5 items) _______ |
Date Subject Action verb Times and limits Signature |
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Pt asks "is this going to hurt?" Nurse response: |
It may be a little uncomfortable |
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Pt asks "is this going to hurt?" Nurse response: |
It may be a little uncomfortable |
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Five Rights of Delegation: |
Right task Right circumstance Right person Right direction/communication Right supervision |
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CNA's can't "EAT" |
Evaluate Assess Treat |
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Documentation: |
Records the nursing activities and the pt's response |
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Documentation: |
Records the nursing activities and the pt's response |
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#1 reason for documentation |
Ongoing plan of care |
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Evaluation, 4 things to look for |
-Pt's progress towards goal -Teaching/learning outcomes -Effectiveness of nursing care plan -Quality of care in the health-care setting |
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Intermittent evaluations are |
Set evaluation times |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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Define data |
Unprocessed numbers, symbols, words; no context |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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Define data |
Unprocessed numbers, symbols, words; no context |
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Define information |
Groupings of processed data (clustering cues) |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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Define data |
Unprocessed numbers, symbols, words; no context |
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Define information |
Groupings of processed data (clustering cues) |
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define knowledge |
Meaningful information created by grouping and compiling information |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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Define data |
Unprocessed numbers, symbols, words; no context |
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Define information |
Groupings of processed data (clustering cues) |
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define knowledge |
Meaningful information created by grouping and compiling information |
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Define wisdom |
Appropriate use of knowledge |
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A big legal issue with evaluation |
Failure to use reassessment date to reexamine and modify the care plan |
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Nursing informatics |
Managing and processing info applying to nursing practice, education and research |
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Define data |
Unprocessed numbers, symbols, words; no context |
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Define information |
Groupings of processed data (clustering cues) |
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define knowledge |
Meaningful information created by grouping and compiling information |
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Define wisdom |
Appropriate use of knowledge |
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How informatics is important to the nursing process |
Facilitates evidence-based practice by: -Reducing barriers to information -Allows for rapid access -Enables location of best evidence supporting nursing practice |
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Documentation (pertaining to informatics) |
The act of recording client assessments and care in written or electronic form |
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Purpose of the written record |
Communication b/n providers Educational tool (for other nurses, not for pt's) Legal documentation of care Quality improvement Research Reimbursement Outcomes *should NOT be a communication tool w/ pt, but they are legally allowed to view. |
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Legal aspects of documentaion |
Patient and practice protection |
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Documentation systems (3) |
Source-oriented Problem-oriented Charting by exception (CBE) |
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Source-oriented documentation system (most common) |
Disciplines chart in separate sections Disadvantages: -Data scattered -difficult to track Tx and OCs |
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Problem-oriented documentation system |
Organized around pt problems Allows for greater collaboration Disadvantage: PCP drives problem list |
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Problem-oriented documentation system |
Organized around pt problems Allows for greater collaboration Disadvantage: PCP drives problem list |
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CBE documentation system |
Only significant findings or exceptions to standards and norms of care are documented Clearly documents abnormalities Disadvantage: "If it's not documented, it's not done" |
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Common types of charting (7) |
Narrative PIE SOAPIER Focus CBE FACT system Electronic entry format |
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Narrative charting (most common) |
"Story" of care in chronological format. Tracks the pt changing status. Disadvantage: Can be lengthy and disorganized. |
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PIE charting |
Problem Intervention Evaluation
-used only in problem-oriented charting
Does not document the planning phase of the nursing process |
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PIE charting |
Problem Intervention Evaluation
-used only in problem-oriented charting
Does not document the planning phase of the nursing process |
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SOAPIER charting |
Subjective Objective Assessment Plan Interventions Evaluation Revision
Works well in intermittent visits |
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Focus charting |
Highlights pt's concerns, problems or strengths in 3 columns:
Column 1: time and date Column 2: focus or problem being addressed Column 3: charting in DAR format (data, action, response)
*chronological, 1st entry most important |
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Focus charting |
Highlights pt's concerns, problems or strengths in 3 columns:
Column 1: time and date Column 2: focus or problem being addressed Column 3: charting in DAR format (data, action, response)
*chronological, 1st entry most important |
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CBE charting |
Charts only significant findings or exceptions to the norms Streamlines charting and saves time |
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Guidelines for documentation |
-Document ASAP -Opening shot: 1st evaluation of shift- says you saw your pt -When in doubt, document -Document all attempts to reach PCP -Late entry- try to avoid. Better to document late than not at all. There are time limits. -Do not chart that you have filled out and occurrence report -Chart any refusal of tx or meds -Always use blue or black ink |
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A nursing admission assessment is a record of __________________. |
Baseline data from which to monitor change. |
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Admission database includes (8 items) |
-Chief complaint -Physical assessment data -Vital signs -Allergy info -Current meds -ADL status -Discharge planning needs -Data about pt support system and contact info |
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Medication administration record (MAR) |
-list of all ordered meds -drug allergies -documents scheduled/routine, PRN, STAT, or omitted doses *addt info needed for omitted/nonroutine meds |
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KARDEX/pt care summary |
-demographic data -med dxs -allergies -diet/activity orders -safety precautions -summary of meds ordered -IV therapy orders -ordered Txs (wound care, PT), sx, labs and tests -special instructions such as preferred intensity of care and isolation orders |
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KARDEX/pt care summary |
-demographic data -med dxs -allergies -diet/activity orders -safety precautions -summary of meds ordered -IV therapy orders -ordered Txs (wound care, PT), sx, labs and tests -special instructions such as preferred intensity of care and isolation orders |
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Discharge summary |
-time of departure -method of transportation -name/relationship of those accompanying -condition of pt at discharge -teaching provided -discharge instructions -follow-up appts or referrals given |
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Integrated plans of care (IPOC) |
A combined charting and care plan form -pt OCs, interventions and Txs for a specific diagnosis -lab work, diagnostic testing, meds, and therapies in pathway |
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Long-term care initial assessment |
W/in 24 hours of admission, updated every 3 months |
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Occurrence reports |
For your protection! #1 reason: quality control
On occurrence report: "patient falls downward" or med errors documented
On pt health record: "pt found on floor, assessment" |
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Hand-off/change of shift report |
Verbal/walk-arounds
Includes: -pt demographics, dxs, & relevant med hx -significant assess. findings -Txs -upcoming diagnostics/procedures -restrictions -POC for pt -concerns
Only report what happened from last shift! |
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Transfer reports include: |
-your contact info - pt demographics, dxs, reason for transfer -family contact info -summary of care -current status, including meds, txs, and tubes in pt -presence of wounds or open areas of skin -special directives, code status, preferred intensity of care, or isolation required *always ask receiver if they have any questions |
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Verbal orders are indicated in an __________ situation |
Emergency |
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Telephone orders (common in long term care) guidelines |
-write order only if you heard it yourself -repeat order back to confirm accuracy -spell unfamiliar names; pronounce digits of #s separately -directly transcribe order onto chart: -date/time -text -providers name -your signature *physicians must countersign w/in 24 hrs |
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Telephone orders (common in long term care) guidelines |
-write order only if you heard it yourself -repeat order back to confirm accuracy -spell unfamiliar names; pronounce digits of #s separately -directly transcribe order onto chart: -date/time -text -providers name -your signature *physicians must countersign w/in 24 hrs |
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SBAR |
Situation Background Assessment Recommendations |
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Morals |
Private, personal or group standards of right and wrong |
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Morals |
Private, personal or group standards of right and wrong |
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Ethics |
Systematic study of right and wrong conduct Formal process for making consistent moral decisions |
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Morals |
Private, personal or group standards of right and wrong |
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Ethics |
Systematic study of right and wrong conduct Formal process for making consistent moral decisions |
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Sources of ethical problems in nursing |
Consumer awareness Technological advances Multicultural population Cost containment (cutting healthcare costs) |
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Morals |
Private, personal or group standards of right and wrong |
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Ethics |
Systematic study of right and wrong conduct Formal process for making consistent moral decisions |
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Sources of ethical problems in nursing |
Consumer awareness Technological advances Multicultural population Cost containment (cutting healthcare costs) |
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Moral distress |
Inability to carry out a moral decision Perceived constraints |
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Morals |
Private, personal or group standards of right and wrong |
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Ethics |
Systematic study of right and wrong conduct Formal process for making consistent moral decisions |
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Sources of ethical problems in nursing |
Consumer awareness Technological advances Multicultural population Cost containment (cutting healthcare costs) |
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Moral distress |
Inability to carry out a moral decision Perceived constraints |
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Moral outrage |
Belief that others are acting immorally Powerlessness |
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Whistleblowing- THINK acronym |
Talk with an attorney Have concrete evidence of wrongdoing Institute survival plan Note nature and consequences of the problem Know your reporting options and support systems |
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Values |
-Belief about the worth of something -Highly prized ideals, customs, conduct, goals |
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Values |
-Belief about the worth of something -Highly prized ideals, customs, conduct, goals |
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Attitudes |
-Feelings toward person, object, idea -What a person thinks |
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Values |
-Belief about the worth of something -Highly prized ideals, customs, conduct, goals |
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Attitudes |
-Feelings toward person, object, idea -What a person thinks |
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Beliefs |
-something that one accepts as true |
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Ethical frameworks |
Consequentialism -teleology -utilitarianism Deontology -formalism -categorical imperative Feminist ethics Ethics of care |
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Ethical frameworks |
Consequentialism -teleology -utilitarianism Deontology -formalism -categorical imperative Feminist ethics Ethics of care |
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Consequentialism |
The rightness or wrongness of an action depends on the consequences rather than the act itself |
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Ethical frameworks |
Consequentialism -teleology -utilitarianism Deontology -formalism -categorical imperative Feminist ethics Ethics of care |
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Consequentialism |
The rightness or wrongness of an action depends on the consequences rather than the act itself |
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Utilitarianism |
The value of an action is determined by its usefulness. For the greater good. |
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Deontology |
An action is wrong or right regardless of its consequences |
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Deontology |
An action is wrong or right regardless of its consequences |
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Categorical inperative |
One should only act if they believe everyone should act in the same way in.a similar situation |
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Deontology |
An action is wrong or right regardless of its consequences |
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Categorical inperative |
One should only act if they believe everyone should act in the same way in.a similar situation |
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Feminist ethics |
Uses relationships and stories rather than universal principles for ethical reasoning |
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Ethics of care |
Nursing's responsibility to care in ethical situations Principles+feelings |
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Ethics of care |
Nursing's responsibility to care in ethical situations Principles+feelings |
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Fidelity (faithfulness) |
Duty to keep promises |
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Ethics of care |
Nursing's responsibility to care in ethical situations Principles+feelings |
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Fidelity (faithfulness) |
Duty to keep promises |
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Veracity |
Duty to tell the truth |
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Ethics of care |
Nursing's responsibility to care in ethical situations Principles+feelings |
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Fidelity (faithfulness) |
Duty to keep promises |
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Veracity |
Duty to tell the truth |
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Justice |
Obligation to be fair |
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Values clarification |
The process of becoming conscious of and names one's values |
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Moral dilemma |
Problem that poses a question between competing and equally valuable interests are true dilemmas |
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Moral dilemma |
Problem that poses a question between competing and equally valuable interests are true dilemmas |
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MORAL acronym (decision making model) |
Massage the dilemma Outline the options Resolve the dilemma Act by applying the chosen option Look back and evaluate |
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Law |
Binding practice, rule or code of conduct that guides a community and is enforced by controlling authority |
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Statutory law |
A statute is a law passed by congress. For the benefit of society as a whole. Nurse Practice Act (NPA) is a statutory law. |
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Statutory law |
A statute is a law passed by congress. For the benefit of society as a whole. Nurse Practice Act (NPA) is a statutory law. |
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Administrative law |
Laws that govern activities of administrative agencies. Each state has a Board of Nursing that creates rules and regulations under NPA |
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Statutory law |
A statute is a law passed by congress. For the benefit of society as a whole. Nurse Practice Act (NPA) is a statutory law. |
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Administrative law |
Laws that govern activities of administrative agencies. Each state has a Board of Nursing that creates rules and regulations under NPA |
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Common law |
Based on customs and traditions |
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Emergency Medical Treatment and Active Labor Act |
Requires healthcare facilities to provide emergency medical treatment to pts regardless of their ability to pay, legal status or citizenship status. |
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Mandatory reporting laws (2) |
Abuse/neglect (children, elderly, mentally ill Communicable diseases |
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Mandatory reporting laws (2) |
Abuse/neglect (children, elderly, mentally ill Communicable diseases |
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Good Samaritan laws |
Protect from liability those who provide emergency care to someone who has been injured |
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Nurse practice acts are designed to |
Protect pt's or society Define scope of nursing practice Identify minimum level of nursing care that must be provided to pts |
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Standard of care |
What a reasonable and prudent nurse would do in the same or similar scenario |
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Standard of care |
What a reasonable and prudent nurse would do in the same or similar scenario |
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Patient care partnership (PCP brochure) |
Explains to pts that during hospitalization they should expect high-quality care, a clean and safe environment, involvement in care, protection of privacy, help when leaving the hospital, and help with billing claims |
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ANA's nurses' bill of rights |
Framework for employers to understand what nurses need for a safe work environment and to support nurses as they address such issues as unsafe staffing, workplace violence, and mandatory overtime |
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Patient self-determination act |
Recognizes the pt's right to make informed decisions regarding their own healthcare |
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Patient self-determination act |
Recognizes the pt's right to make informed decisions regarding their own healthcare |
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HIPAA |
Health Insurance Portability and Accountability Act
-Protects health insurance benefits for workers who lose or change jobs -Protect coverage to persons with preexisting medical conditions -Establish standards to protect the privacy of personal health information |
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Contract Law |
Dealing with agreements between individuals |
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Contract Law |
Dealing with agreements between individuals |
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Tort Law |
Dealing with duties and rights among individuals Involves claims for damages |
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Three types of tort law |
Quasi-intentional Intentional Unintentional |
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Quasi-intentional torts (3) |
Defamation -false communication to a third person Slander -oral defamatory statements Libel -written defamatory statements |
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Quasi-intentional torts (3) |
Defamation -false communication to a third person Slander -oral defamatory statements Libel -written defamatory statements |
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4 essential elements of defamation of character (written or oral) |
All must be present: -was false -was made to another person or persons -caused the defamed person to experience shame and ridicule and had a negative impact on the persons reputation -was made as a statement of fact rather than as an opinion |
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Intentional torts (4) |
Assault and battery Performing a procedure without consent False imprisonment Restraining a pt against their will Fraud Failing to provide essential info for informed consent Invasion of privacy Breach of confidentiality |
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Non-intentional tort (1) |
Negligence Failure to perform as a reasonable, prudent person would Failure to follow standards of practice |
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Non-intentional tort (1) |
Negligence Failure to perform as a reasonable, prudent person would Failure to follow standards of practice |
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Malpractice (4 elements) |
Existence of duty Breach of duty Causation Damages |
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Non-intentional tort (1) |
Negligence Failure to perform as a reasonable, prudent person would Failure to follow standards of practice |
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Malpractice (4 elements) |
Existence of duty Breach of duty Causation Damages |
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Common malpractice claims (4) |
Failure to assess and diagnose Failure to plan Failure to implement POC Failure to evaluate |
Think nursing process |
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Minimizing malpractice risk |
Proper documentation Observe standards of practice Use nursing process Avoid med/tx errors Report/document accurately Obtain informed consent Attend to client safety Maintain pt confidentiality Provide education Delegate, adding, supervise properly Accept appropriate assignments Participate in continuing education Observe professional boundaries Observe mandatory reporting regulations Be aware of legal safeguards for nurses |
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What is "just culture"? |
Places focus on evaluating the behavior and choices made by an individual, not on the outcome of the event |
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Reportable events to NCBON |
Human error -single med error -failure to implement tx due to oversight At risk behavior -exceeding scope of practice -pre-documentation -minor deviations from established practice Reckless behavior -leaving workplace before completing all assigned pt care for trivial reason -observing pt starting to climb over bedrails but walks away without intervening bc it's not your pt -serious med error, realizes it when pt has adverse reaction, tells no one, denies knowledge of reason for change in pt, documents to conceal error |
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Non-reportable events to NCBON |
-no call-no show -failure to complete 2week notice -refusal to accept an assignment -rudeness -malfunctioning equipment -Staffing issues -outdated policies/procedures -inappropriate assignment practices |
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QSEN acronym |
Quality and Safety Education for Nurses
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QSEN acronym |
Quality and Safety Education for Nurses
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Components of QSEN |
Pt centered care Teamwork/collaboration Evidence-based practice Quality improvement Safety Informatics |
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3 aspects of components of a quality and safety |
Knowledge -human factors -unsafe practices -errors/hazards of care Skills -valuing reporting process is a skill! Attitudes -hardest to change -once one starts to change, others follow |
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3 aspects of components of a quality and safety |
Knowledge -human factors -unsafe practices -errors/hazards of care Skills -valuing reporting process is a skill! Attitudes -hardest to change -once one starts to change, others follow |
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Human error-what is it and what to do about it |
"Honest mistake"; console |
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3 aspects of components of a quality and safety |
Knowledge -human factors -unsafe practices -errors/hazards of care Skills -valuing reporting process is a skill! Attitudes -hardest to change -once one starts to change, others follow |
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Human error-what is it and what to do about it |
"Honest mistake"; console |
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At risk behavior- what is it and what to do about it |
Behavioral choice that increases risk, deviation from a standard; coach. |
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Reckless behavior- what is it and what to do about it |
Disregarding standards, putting own self interest above that of the pt, organization or others; punish. |
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#1 cause of death in children ages 0-18 |
Motor vehicle accident |
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Developmental factors affecting safety Infants/toddlers Preschoolers School-age Adolescent |
Infants/toddlers Totally dependent Tactile exploration of environment Preschoolers More adventurous School-age Stranger danger Adolescent Feels indestructible Risk taking behaviors Lacking judgment |
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Most important pt education for adolescents |
Driver safety education |
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Developmental factors affecting safety Adults Older adults |
Adults Workplace injury Lifestyle choices Older adults Loss of strength, joint mobility Slowing reflexes Sensory loss |
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#1 cause of death in adults |
Unintentional poisoning |
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#1 cause of death in adults |
Unintentional poisoning |
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#1 cause leading to death in older adults |
Falls |
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Children 0-4 are at great risk for what? |
Suffocation/asphyxiation |
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4 types of pillution |
Air Water Noise Soil |
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Some never events |
Air embolism Administering wrong blood Items left in pt after sx Severe pressure ulcers Falls/trauma Injuries from restraints UTI from catheter Symptoms from poorly controlled blood sugar Infection at sx sites |
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Some never events |
Air embolism Administering wrong blood Items left in pt after sx Severe pressure ulcers Falls/trauma Injuries from restraints UTI from catheter Symptoms from poorly controlled blood sugar Infection at sx sites |
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RACE acronym |
Rescue Alarm Contain Extinguish |
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Get up and go test |
Can pt get up w/out arm rest Walk 8-10 ft Sit down w/out assist |
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Prevention of restraints |
-keep pt occupied -keep environment and caregivers consistent -frequent assessment/surveillance -"gentle reminder" -ask pt what they need every time they get out of bed -bed alarm |
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Restraints tips |
-Pt needs to be checked every 15 min -need very specific provider orders -orders need to be renewed every 24 hrs -in emergency situation, use restraints and notify PCP right away |
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Ambulation safety- if a pt has any significant weakness... |
You need a second person for transfer |
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Donning PPEs |
1) gown 2) face mask 3) gloves |
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Donning PPEs |
1) gown 2) face mask 3) gloves |
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Removing PPEs |
1) gown 2) gloves 3) mask
Always remove in pts room! |
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Temperature of bed bath |
105 degrees |
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IV tubing and bed bath |
Never disconnect! Work around it! |
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Bed bath tips |
Wash inner to outer Wash head to toe Distal to proximal |
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Bed bath tips |
Wash inner to outer Wash head to toe Distal to proximal |
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Pts w/ dementia bed bath |
Stick to strict routine Remain calm Stop if they become agitated |
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Perform oral care on pts side if... |
There is any risk for aspiration! |
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Before oral care, assess: |
Level of consciousness Presence of dentures Gag reflex |
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