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90 Cards in this Set
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- Back
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Nursing Theory
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a supososition or system of ideas that is proposed to explain a given phenomenon. The purpose of theory in nursing is to provide new possibilities for unaderstanding the practice of nursing.
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Theory in education
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to establish itself in universities Nursing had to demonstrate a unique body of theoretical knowledge. Once used to provide a framework for nursing education many programs have moved away from theoretical framework.
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Theory in research
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provides a foundation and direction for research
-identifies gaps in the way we approach specific fields of study such as symptom management or quality of life |
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Theory in practice
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-facillitates reflection, questioning and thinking about what nurses do.
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Grand theory
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a group of related ideas that articulate a broad range of significant relationships among the concepts of a discipline
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Midlevel Theory
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focus on exploration of concepts such as pain, self-esteem, learning and hardiness
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Critical theory
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help elucidate how social structures effect a wide variety of human experiences. In nursing it helps explain how these structures such as race, gender, sexual orientation and economic class affect a patient's experiences and health outcomes
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Peplau's Interpersonal relations model
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-nurses enter into an interpersonal relationship with an individual when a need is present creating a therapuetic nurse-client relationship
-develops in 4 phases: orientation-the client seeks help and the nurse assists the client in understanding the problem and the extent of the need for help identification:the client assumes a posture of dependence, iterdependence or independence in relation to the nurse exploration: the client derives full value from what the nurse offers. The client uses available services based off self-interest and need. Power shifts from nurse to client Resolution:old needs and goals are put aside. As old goals are resolved newer more mature goals are adopted |
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Henderson's definition of Nursing
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Conceptualizes the nurses role as helping the sick and healthy obtain independence in meeting 14 fundamental needs:brathing normally, eating and drinking adequately, eliminating body waste, moving and maintaining a desired position, sleeping and resting, selecting suitable clothes, maintaining body temperature by adjusting clothing or modifying the environment, keeping the body clean and well groomed to protect the integument, avoiding dangers in the enviroment and avoid injuring others, communicating with others in expressing emotion, fears, needs or opinions, worshiping according to one's faith, working in a such a wa as one feels a sense of accomplishment, playing or participating in various forms of recreation, learning, discovering or satisfying the curiosity that leads to normal development and health using various health facilities
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Leininger's cultural care diversity and universality theory
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-care is the essence of nursing and the dominant, distinctive and unifying feature of nursing
-human caring varies among cultures in its expression, process and patterns; it is largely culturally derived -Sunrise model: -healthcare is influenced by social structures such as technology, religious and philosophical factors, kinship and social systems, cultural values, political and legal factors, economic factors, and educational factors -social factors addressed within environmental contexts, language expressions and ethnohistory -to assist people of varied cultures 3 models are used: -cultural care preservation and maitanence -cultural care accomidation, negotiation or both -cultural care restructuring or repatterning |
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Orem's self care theory
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-based on 4 concepts:self-care, self-care agency, self-care requisites and therapuetic self-care demand
-3 catagories of self-care requisites:environmental, developmental and health deviation -self care deficits result when self-care agency is not enough to meet self-care demand -people can be helped through 5 methods: acting or doing for, guiding, teaching, supporting, providing an enviroment that promotes the individual's ability to meet current and future demands -identifies 3 types of nursing systems: wholly compensetory, partially compensetory, supportive-educative |
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Roger's Science of unitary beings
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-view of the person as an irreducible whole, the whole being greater than the sum of its parts
-humans are dynamic energy fields in continuous exchange with enviromental fields both of which are infinite and characterized by pattern, a universe of open systems, and four demensionality -application in practice includes focus on the persons wholeness, seek to promote symphonic interactions between person and environment, coordinate human with enviromental rhythm, direct and redirect patterns of interaction between human and environment -use of non-contact therapeutic touch is based off this theory |
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Roy's adaptation model
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-defines adaptation as the process and outcome whereby the thinking and feeling person uses conscious awareness and choice to create human and envinmental integration
-individuals resond to need in 1 of 4 models: -physiological model:involves the body's basic needs and ways of adapting -self-concept model:involves the physical and the personal self -role function mode: determined by need for social intergrity and refers to performance of duty based on position in society -interdependence mode: involves relationships with significant others and support system |
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Watson's Human Caring theory
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-10 factors refered to as the core of nursing:
-forming a human-alttruistic system of values -instilling faith and hope -cultivating sensitivity to one's self and others -developing a helping-trust relationship -promoting and accepting the expression of positive and negative feelings -systematically using the scientific problem solving method for decision making -promoting interpersonal teaching-learning -provide a supportive, protective or corrective mental, physical sociocultural and spiritual environment -assisting with gratification of human needs -allowing for existential-phenomenologic forces |
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King's Goal Attainment theory
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-focuses on 3 dynamic interacting systems:personal, interpersonal and social
-a personal relationship forms between the client and nurse. -the nurse-client relationship is the vehicle for the delivery of nursing care which is defined as the dynamic interpersonal process in which the nurse and client are affected by each other as well as by the healthcare system. The nurse's goal is to assist the client in reestablishing or maintaining a positive adaption to the enviroment |
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Nueman's systems model
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-nursing focuses on variables affectingthe client's response to stressors
-actions include primary, secondary or tertiary levels of prevention -primary prevention focuses on strengthening a line of defense through identification of actual or potential risk factors associated with stressors -Secondary strengthens internal defenses and resourcesby establishing priorities and treatment plans for identified symptoms -tertiary focuses on readaptation and prevention of reoccurence of the stress response |
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ANA Standards of Nursing Practice
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1:Assessment:the RN collects comprehensive data pertinent to the patient's health or the situation
2:Diagnosis: The RN analyzes the assessment data to determine the diagnoses or issues 3:Outcome Identification: The RN identifies expected outcomes for a plan individualized to the patient or the situation 4:Planning: The RN develops a plan that prescribes stratagies and alternatives to atain expected outcomes 5:Implementation: The RN implements the identified plan 5A:Coordination of Care: The RN coordinates care delivery 5B:Health Teaching and Health Promotions 6:Evaluation: The registered nurse evaluates progress towards attainment of outcomes |
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Evidence-based practice guidelines
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-defined as the intergration of best research evidence with clinical expertise and patient values
-critical aspects of evidence-based practice: -client centered -scientifically based -population outcomes based -refined through quality improvement and bench marking -individualized to the client -compatible with system policies and resources |
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Quantitative Research
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investicagation of nursing phenomena that lend themselves to precise measurement and quantification
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Qualitative Research
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investigation of phenomena that are not easily measured, quantified or catergorized.
-uses inductive reasoning to form theories from specific observations |
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Informed Concent in research
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research subjects:
-are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits and alternative methods of treatment -are capable of fully understanding the research and the implecations of participation -have the power of free choice to voluntarily consent or decline participation -understand how confidentiality and anonymity is maintained |
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Critical Pathways
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allows staff from all disciplines to develop integrated care plans for a projected length of stay or number of visits for a client with a specific case type
-recommends day-by-day suggested activities, consults, procedures, educational topics ,and discharge planning activities |
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Nursing Care Plans
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-a guide for clinical care
-communicates nursing care that has been performed to all members of the care team -decrease risk of incomplete, inaccurate or incorrect care |
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Concept Mapping
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-a tool that assists learners in developing a self-appraisal on their own individual thinking process
-it is a diagram of client problems and interventions that show their relationship to one another |
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Quality Improvement
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an approach to the continuous study and improvement of the process of providing healthcare services to meet the needs of clients and others
-achieved through evaluation of meeting client outcomes on a constant basis |
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Risk Management
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-a system of ensuring appropriate nursing care that attempts to identify potential hazards and attempts to eliminate them before harm occurs
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Civil Law
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Protects the rights of the individual persons within our society and encourage fair and equitable treatment
-involve monetary settlements for damage to an individual or property |
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Criminal Law
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-prevent harm to society and provide punishment for crimes
-2 classifications: felony-a crime of a serious nature resulting in greater that 1 year of imprisonment or death misdemeanor-less serious crime with less than 1 year of imprisonment |
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Common Law
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-created by judiciary descicions made in courts based of the decisions of legal cases
-"past precedent" |
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Statutory Law
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-created by elected legeslative bodies
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Torts
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-a civil wrong made against a person or property
-may be intentional or unitentional |
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Negligence
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conduct that falls below the standard of care
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Malpractice
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-professional negligence
-malpractice established by the presence of 3 criteria -the care provider owed a duty to the client -the care provider did not carry out that duty -the client was injured -the care provider'd failure to carry out that duty caused the injury |
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Assault
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Any intentional threat to bring about harmful or offensive contact
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Battery
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any intentional touching without consent
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Invasion of Privacy
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-protects the rights of the client to be free from unwanted intrusion into his or her private affairs
-4 types of invasion of privacy -intrusion on seclusion -appropriation of name or likeness -publication of private or embaressing facts -publicly placing one in a false light |
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Confidentiality
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-clients are entitled to confidential healthcare
-unauthorized release of a patient's confidential health information is considered one of the invasion of privacy torts |
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Defamation of Character
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-publication of false statements that result in damage to a person's reputation
-in the case of a puplic figure the statements must be published with Malice (intentionally publishing information known to be false or publishing with reckless disregard to the validity of the statement) -If the statement is presented orally it is called slander -if it is written it is called libel |
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Fraud
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an intentional deception made for personal gain or to damage another individual
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False Imprisonment
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restraint of a person in a bounded area without justification or consent. False imprisonment is a common-law felony and a tort
-restraints (physical or chemical) may only be imposed if -the patient poses an immediate danger to himself or others -a written order from a phycisian which specifies duration and circumstance (unless considered emergent in which case the order should be obtained as soon as possible) |
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Abandonment
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occurs when a health care professional (usually a physician, nurse, dentist, or paramedic) has already begun emergency treatment of a patient, and then suddenly walks away while the patient is still in need, without securing the services of an adequate substitute or giving the patient adequate opportunity to find one
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Breech of Duty
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breach is proven when the plaintiff shows that the defendant's conduct fell below or did not reach the relevant standard of reasonable care
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Elements of a valid contract
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A contract is an agreement entered into voluntarily by two parties or more with the intention of creating a legal obligation, which may have elements in writing, though contracts can be made orally
-a party must have capacity to contract; the purpose of the contract must be lawful; the form of the contract must be legal; the parties must intend to create a legal relationship; and the parties must consent. |
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respondeat superior
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-"let the master answer"
-this docterine states that the master (employer or superior) assumes responsibility for for the conduct of the servant (employee) -does not prevent the employee from being held liable for gross misconduct |
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Risk Management
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-a system of ensuring appropriate nursing care that attempts to identify potential hazards and attempts to eliminate them before harm occurs
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Living Will
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Written documents that direct treatment in accordance with a client's wishes in the event of a terminal illness or condition
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health care proxy
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a notorized or witnessed statement appointing someone else to manage health care treatment decisions in the event that the client is unable to do so
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health care records
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-medical records are considered legal documents
-failure to keep proper records can consitute negligence -insufficient or inaccurate assessments and documentation can hinder proper diagnosis and treatment rusulting in injury to the client |
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DNR
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a written order to withhold CPR in the event of cardiac arrest
-should be routinely reviewed by a physician in case a change occurs in the client's condition |
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incident, variance, or occurence reports
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an agency record of an accident or unusual occurrence.
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Consent
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-must be informed:
-purpose of treatment -expectations of what the patients may feel or experience -risks or possible negative outcomes -advantages or disadvantages of possible alternative treatments -Consent must be given voluntarily, consent must be given by a client or individual with the capacity and competence to understand, client or individual must be given enough information to be the ultimate decision maker |
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MInors
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-parents or guardians must give concent for treatment of minors
-some states allow minors to concent for themselves when treatment is for substance abuse, mental health or reproductive health concerns -some minors are able to give concent on their own if they are married, pregnant, parents, members of the military or emancipated(living on their own |
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Assisted suicide
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-providing the terminally ill patient with the means to kill themselves
-illegal in most countries and states -nurses may face criminal charges |
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substance abuse
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Due to high levels of stress associated with the health care profession, there are high incidence of substance abuse associated with nursing
-most disciplinary actions relate to substance issues -rehabilitation programs available that allow nrses to continue to work with compliance to program as a condition of employment with restriction to day shift, no overtime and inability to administer or access narcotics |
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Licensure
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-legal permit that a government agency grants to individuals to engage in the practice of a profession and to use a particular title
-must meet 3 criteria: need to protect public welfare or safety, occupation is a clearly delineated seperate distinct area of work, a proper authority exists to assume obligations of the licensing process, in the case of nurse this is done by the state board of nursing -may be revoked for just cause |
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Licensure by Examination
(NCLEX-RN) |
nurses upon completion of their educational program must take the National Council Licensure Examination. Even though the test is nationally based it is administered by the state boards and only provides licensure in the home state. Nurses from other countries are granted registration by endorsement after successfully completing the NCLEX
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Nurse Practice Acts
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-each state has a nurse practice act that protects the public by legally defining and describing the scope of practice and by controlling practice through licensure requirements
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Multistate licensure
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-to practice in another state a nurse must apply for reciprocity
-some states are recognizing a mutual recognition that allows nurses to practice in multiple states under one license |
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Unlicensed assistive personnel
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-nurses must know not only their scope of practice but that of the UAP prior to delegation
-the nurse is ultimately held responsible for the actions or inactions of the UAP concerning his/her patients -UAPs more common due to nursing shortages to help manage understaffing |
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Sunset laws
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a measure within a statute, regulation or other law that provides that the law shall cease to have effect after a specific date, unless further legislative action is taken to extend the law
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Good Samaritan Acts
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laws designed to protect heath care providers who provide assistence at the scene of an emergency against claims of malpractice unless a gross departure from the normal standard of care or willful wrong doing on the part of the provider are proven
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Mandatory Reporting of abuse
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when an identified instance of injury appears to be present and the result of abuse, neglect or exploitation, the mandatory reporter must report the situation to the appropriate authority
-since the nurse is often able to identify and assess cases of violence against others they are often included as mandatory reporters |
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Americans with Disabilities Act
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-prohibits disrimination on the basis of disability in employment, public services, and public accommodations
-provide a clear and comprehensive national mandate for eliminating discrimination against individuals with disabilities -provide clear strong consistent enforceable standards addressing discrimination against individuals with disabilities -to ensure that the federal government plays a central role in enforcing standards under this act |
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Patient Self-Determenation Act
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legislature requiring every competent adult be informed in writing on admission to a health care institution about his or her rights to accept or refuse medical care and to use advanced directives
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Health Insurance Portability and Accountability Act
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requires that information about a client be secured in such a way that only those with right and need to aquire information are able to do so.
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Omnibus Budget Reconciliation Act
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list requirements for assuring quality of care in SNFs
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Family Medical Leave Act
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federal law requiring covered employers to provide employees job-protected and unpaid leave for qualified medical and family reasons. Qualified medical and family reasons include: personal or family illness, family military leave, pregnancy, adoption, or the foster care placement of a child
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Occupational Safety and Health Act
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the primary federal law which governs occupational health and safety in the private sector and federal government in the United States
-Its main goal is to ensure that employers provide employees with an environment free from recognized hazards, such as exposure to toxic chemicals, excessive noise levels, mechanical dangers, heat or cold stress, or unsanitary conditions |
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Legal process of a lawsuit
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-a document called a complaint is filed by a person called a plantiff who claims that his/her legal rights have been infringed upon by one or more persons refered to as the defendants
-a written response called an answer is made by the defendants -both parties engage in pretrial activities refered to as discovery in an effort to obtain all facts of the situation -in all trial of the case, all relevant facts are presented to a jury or only a judge -the judge renders a decision or the jury renders a verdict -the plantiff must offer proof of the defendant's wrong doing. The duty of proving the assertion is called burden of proof -nurses may be asked to testify based off their skill, expertise or special training in a relevant area. The nurse would be considered an expert witness. |
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Whistle Blowing
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a person who tells the public or someone in authority about alleged dishonest or illegal activities (misconduct) occurring in a government department, a public or private organization, or a company. The alleged misconduct may be classified in many ways; for example, a violation of a law, rule, regulation and/or a direct threat to public interest, such as fraud, health/safety violations, and corruption.
-whistleblowers are protected from reprisal under federal law |
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Staffing
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-due to increasing nursing shortages may facillities may be understaffed
-Assistive staff may be used to supplement staffing -the nurse should never abandon his/her assignment due to under staffing as he/she may be held liable and instead should report concerns to the nurse manager |
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Acountability
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ability to answer for one's own actions
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altruism
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a concern for the welfare of others
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autonomy
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-a person's independence
-represents an agreement to respect another's right to determine a course of action. |
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human dignity
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a being has an innate right to respect and ethical treatment
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ANA Code of Ethics for Nurses
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-practice with compassion and respect regardless of social or economic status, personal attributes or nature of health problem
-primary commitment is to the patient -the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient -nurse is responsible and accountable for individual nursing practice -owes the same duty to self as to others, including the responsibilty to preserve integrity and safety, to maintain competence, and to continue personal and professional growth -participation in establishing, maintaining and improving health care environments -participation in the advancement of the profession -collaborates with other health care professionals and the public in promoting community, national and international efforts to meet health needs -responsible for articulating nursing values for maintaining integrity of the profession |
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International Council of Nurses Code of Ethics
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4 fundemental responsibilities: to promote health, restore health, to prevent illness and alleviate suffering
-inherent to nursing is respect for human rights including right to life, dignity and respect --promote an enviroment in which the human rights, values customs and spiritual beliefs of individuals, family and community are respected -nurse holds in confidence personal information -carries personal accountability and responsibilty for the nursing practice -takes action to safegard the individual when their care is endangered by another person |
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veracity
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-accuracy or conformity to the truth
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beneficence
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taking positive actions to help others
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nonmaleficence
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-avoidance of harm or hurt
-"do no harm" |
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justice
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-fairness
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abortion
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-pits principles of sanctity of life vs. autonomy and the woman's right to control her own body
-still extremely controversial |
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organ donation
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-involve ethical issues such as allocation of organs, selling of body parts, involvement of children as donors, consent, conflicts of interest between donors and recipients, clear definition of death
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euthanasia
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-greek meaning "good death", known as "mercy killing"
-active euthanasia involves actions to directly bring about a client's death. -Forbidden by law and could result in charges of murder -assisted suicide included in active euthanasia -pasive euthanasia involves withdrawl of extraordinary means of life support |
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Human genome project
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an international scientific research project with a primary goal of determining the sequence of chemical base pairs which make up DNA, and of identifying and mapping the approximately 20,000–25,000 genes of the human genome from both a physical and functional standpoint
-failure to address the conditions raised by population-based research, especially with regard to unique processes for group decision-making and cultural worldviews -new avenues for advances in medicine and biotechnology -genetic tests that can show predisposition to a variety of illnesses and possibly may lead in the long term to significant advances in their management. -may determine new therapeutic procedures |
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genetic screening
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Some advertising for direct-to-consumer genetic testing has been criticized as conveying an exaggerated and inaccurate message about the connection between genetic information and disease risk, utilizing emotions as a selling factor
-possibility of genetic discrimination in employment or insurance is also a concern. Some individuals avoid genetic testing out of fear it will affect their ability to purchase insurance or find a job |
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eugenics
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the "applied science or the bio-social movement which advocates the use of practices aimed at improving the genetic composition of a population", usually referring to the manipulation of human populations
-some elements of the scientific community have associated eugenics with Nazi abuses, such as enforced "racial hygiene", human experimentation, and the extermination of "undesired" population groups |
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Stem Cell research
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-two broad types of stem cells: embryonic stem cells, which are isolated from the inner cell mass of blastocysts, and adult stem cells, which are found in various tissues
-ethical debate primarily concerning the creation, treatment, and destruction of human embryos incident to research involving embryonic stem cells. Not all stem cell research involves the creation, use, or destruction of human embryos. For example, adult stem cells, amniotic stem cells and induced pluripotent stem cells do not involve human embryos at all. -Treatments that have been proposed include treatment for physical trauma, degenerative conditions, and genetic diseases (in combination with gene therapy). Yet further treatments using stem cells could potentially be developed thanks to their ability to repair extensive tissue damage -motivated and reinvigorated the pro-life movement, whose members are concerned with the rights and status of the embryo as an early-aged human life. They can believe that embryonic stem cell research instrumentalizes and violates the sanctity of life and some also view it as tantamount to murder.[8] The fundamental assertion of those who oppose embryonic stem cell research is the belief that human life is inviolable, combined with the belief that human life begins when a sperm cell fertilizes an egg cell to form a single cell. |
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Right to Die
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the ethical or institutional entitlement of the individual to commit suicide or to undergo voluntary euthanasia. Possession of this right is often understood to mean that a person with a terminal illness should be allowed to commit suicide or assisted suicide or to decline life-prolonging treatment, where a disease would otherwise prolong their suffering to an identical result
-sometimes associated with the idea that one's body and one's life are one's own, to dispose of as one sees fit -A debate exists within bioethics over whether the right to die is universal, or only applies under certain circumstances—such as terminal illness |
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Allocation and access to health care resources
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--allocation of limited supplies and services such as organs, artificial joints and special services has become a major issue in healthcare
-many institutions have been using more unlicenced care givers and reducing RNs to reduce costs causing concern for the maiting of standard of care |
