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81 Cards in this Set
- Front
- Back
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What are the major societal influences of nursing
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-The national economy
The role of healthcare consumer -Patients have access to vast ammounts of medical information -Direct to consumer marketing -Consumer intrest has generated legislation -The womans movement -Collective bargaining |
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What is the definition of a profession
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-The knowledge of the group must be based on techinal and scientific knowledge
-The knowledge and competence of members of the group must be evaluated by a community of peers - The group must have a service orientation and a code of ethics |
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Is nursing a profession? Why?
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YES!
-Entry level nursing education requires coursework in basic and social sciences -Nursing education and practice are increasingly based on research from nursing and related fields -State or provincial regulatory bodies have defined the criteria that nurses must meet to practica and they monitor members for adherence to standards - Nursing is clearly foculed on providing service to others - The major professional orginizations have developed eethical guidelines to guide the practice of nursing |
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Define Nursing according to the ANA
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The protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of juman response, and advocacy in the care of individuals, families, communities, and populations.
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What are the roles and responsibilities of a nurse?
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-Direct care provider
-Communicator -Client/ Family educator -Client advocate -Counselor -Change agent -Leader -Manager -Case manager -Research consumer |
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Describe Direct care provider
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Addressing the physical, emotional, social, and spiritual needs of the client
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Describe Communicator
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Using interpersonal and therapeutic communication skills to adress the needs of the client, to facilitate the communication in the healthcare team, and to advise the community about health promotion and disease prevention
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Describe Client/family educator
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Assessing and diagnosing the teaching needs of the client, group, family, or community. Once the diagnosis is made nurses plan how to meet these needs, implement the teaching plan, and evaluate its effectiveness
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Describe client advocate
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Supporting clients right to make healthcare decisions when they are able to voice their opinions and protecting clients from harm when they are unable to make decisions
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Describe counselor
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Counseling clients on health-related issues through the use of therapeutic communication skills.
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Describe Leader
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Inspiring others by setting an example of positive health, assertive communication and willingness to improve.
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Describe Manager
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Coordinating and managing the activities of all members of the team
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Describe Case Manager
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Coordinating all care deliverd to a client
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Describe research consumer
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Incorporating research into practice to provide the most appropriate care, to identify clinical problems that warrand research, and to protect the rights of research subjects.
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What are the different practice settings for a registered nurse?
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-Hospitals
-Extended care facilities -Ambulatory care -Home care -Community health |
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What are some issues that affect nursing and the quality of patient care in the current healthcare environment?
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-People with no health insurance (Delay getting help, get sicker)
-Increase in aging population (Baby boomers) -Less funding -Alternative medicine -Informed consumers (internet) -AIDS -High tech vs. high touch |
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What are the different levels of healthcare?
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-Preventative care
-Primary care -Secondary care -Tertiary care -Restovative care -Continuing care |
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Descrive preventative care
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Education, Diet, nutrition, nursing succation, wellness care, vaccinations, weight intervention
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Describe primary care
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Health promotion and prevention, school health, wellness care (doctors office.)
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Describe secondary care
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Hospitals
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Describe tertiary care
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Specialty hospital care
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Describe restoritave care
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Nursing home
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Describe continuing care
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Skilled nursing facility, home, daycare center, hospice
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DRG
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Diagnostic related group: fixed reimbursement for an illness
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Case managers
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Moniter progress, RN's
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Describe Discharge planning critical pathway
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Plans for clients needs outside the hospital
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Capitation
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Fixed ammount paid per client
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RUG
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Resource utilization group: used in LTC, managed costs
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PSRO
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Professional standard review orginization
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UR
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Utilization Review: audit charts
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Medicare
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Over 65 or disabled
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Medicade
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Injured or no healthcare
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What is JHACO
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The Joint Commission of Accreditation of Healthcare Oganization, monitors saftey and set standards
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What is evidence based practice?
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the use of firm data rather than anecdote, tradition, intuition, or belief in making decisions about medical and nursing practice
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What is needed to carry out Evidence based practice?
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-Sufficent research must have been published on the specific topic
-The nurse must have skill in assessing and critically analyzing research. |
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Give examples of evidince based practice
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(fill in)
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Describe what is meant by standards of care
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The legal definition of a standard of care looks to what a reasonable and prudent nurse would do in the same or similar situation.
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What are the different sources from which the standards of care are derived?
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-Nurse practice act
-Professional orginizations -JCAHO -ANA -Medical and nursing literature -Published practice guidelines -expert practitioners |
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Describe nurse practice acts in realtion to the standards of care
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Identifies the minimum level of nursing care for a specific patient in specific circumstances. Standards set forth in nurse practice acts are mandatiory; that is they are set forth in statutes and enforced by athority granted by the state.
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Describe JCAHO in relation to the standards of care
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The JCAHO standards are similar to clinical guidelines, or clinical steps for patient managment
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Describe ANA in relation to the standards of care
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The first six ANA standards of care focus on interventions performed within the nursing process. The ANA standards also focus on professional performance or activities appropriately based on education and position.
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What is the purpose of a living will?
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A living will is an advance directive that declares the patients wishes regaurding future health care, should the patient become unable to give instructions.
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What is the purpose of a durable power of attorney?
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A durable power of attorney identifies a person who will make healthcare decisions in the event the patient is unable to do so.
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Describe the student nurses respponsibility inthe clinical setting for applying HIPPA guidelines
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Confidentiality for patients, initials on charts, do not discuss the health status with othhers.
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What is the definition of an intentional tort?
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Intentional conduct is designed to bring about a specific result inthe mind of a defendant. Intentional torts include assault, battery, false imprisonent, fraud, and invasion of privacy
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Discuss licensure as a legal requirement
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complete a educational program in a state accredited school of nursing, pass the NCLEX-RN, provide evidence of good mental and physical health, statement of good moral character, pay a fee for exam, obtain a temporary license pending outcome of the first exam, competence in English
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Define tort
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civil wrong
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Quasi-intentional torts
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Defamation of character: false communication is made to a person
Slander: orally Libel: in writing |
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Intentional torts
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Assault: person feels threatened by words or actions
Battery: intentional touching wwithout consent False imprisionment: physically or verbally confining somebody against their will Fraud: willing writing or saying something untrue with the intent to cause legal injury or deprive the person of a right Invasion of privacy: violates a persons right to be free from unwanted interference in their private affairs |
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Neglience
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the failure to use ordinary or reasonable care as dictated by the standards of practice and/or by what a reasonable and prudent nurse would do in the same/similiar circumstance (FAILING TO ACT CAUTIOUS)
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most common causes of patient injury due to negligence and how these might be prevented
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fill
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Discuss the nurse’s role in obtaining consents
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witness the client's signature, make sure the client gave voluntary consent, signature is authentic, client appears to be competent, must notify a physician if concerned
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What is an informed consent?
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treatment or procedure explained, name of surgeon, harmful possibilities, alternatives and risk of doing nothing, informed of right to refuse, may refuse even after procedure has begun
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Legal liability of students
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Held to the same standards of care as registered nurses, policies of state as well as facility practicing in, (CAN ONLY PRACTICE IN SCHOOL)
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Issues related to liability insurance
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Transmission of AIDS from nurse to patient, sexual abuse of a patient, injury cause while under the influence, criminal activity, punitive damages (damages awarded to punish the defendant for egregious acts)
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List the criteria used for establishing malpractice and give examples
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1. Existence of a duty-Nurse patient relationship
2. Breach of the duty- demonstrating that the nursing actions failed to meet the standards of care 3. Causation- Must prove nurse's actions or lack there of cause injury, type of injury was forseeable 4. Damages- plantiff must prove that an actual injury or damage |
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Nurse’s legal responsibility in the following situations
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Short staffing:cannot leave until replacement arrives
Floating:if asked to go to another floor do so, but follow intsrutions of head nurse Following physicians orders: follow orders, but double check to make sure correct Delegating to assitive personnel: assign tasks according to skill levels |
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Define basic terms/concepts utilzed in ethical discussion and give examples of how each might be applied in a clinical situation
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Autonomy: person's right to choose and ability to act on that choice
-treat people with consideration, believe people's stories about thier illnesses, protect patients who are unable to protect themselves. Nonmaleficience: to do no harm and to prevent harm -unintentional harm due to lack of careful planning and consideration Beneficence: duty to do or promote good -do no harm, prevent harm when you can, remove harm when it is being infilcted, bring about positive good Fidelity: faithfulness -obligation to keep promises Veracity: duty to tell the truth Justice: obligation to be fair |
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Differentiate between ethical and legal issues.
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Ethics: systematic study of right and wrong, formal process for maikng consistent moral decisions
Legal:laws are sets of enforceable priniples or rules established to protect society |
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Discuss application of the concepts of accountability and responsibility in clinical practice.
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fill
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Delineate the steps used to process an ethical dilemma.
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1. What is the problem?
2. Gather data 3. Values clarification 4. Verbalize problem 5. Consider possible courses of actions 6. Negotiate the outcome (possible compromise) 7. Evaluate the action |
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Identify resources within healthcare settings for assisting healthcare workers with ethical dilemmas.
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Board of Ethics
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Summarize some of the current bioethical issues.
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quality of life, genetic screening. futile care, allocation of scarce resources-medical and nursing
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Describe how personal and cultural values could influence the nurse’s response to clients.
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fill
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Discuss the benefit of personal value clarification in developing effective interactions with clients.
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Will be able to make better decisions, avoid imposing your values on others
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Discuss ways in which patient confidentiality will be maintained in the clinical setting.
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HIPPA
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Components of the chain of infection
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Infectious Agent: pathogens or normal flora tat become pathogenic
Reservior: can be living or nonliving; where pathogns live and multiply Portal of Exit: body fluids, coughing, sneezing, diarrhea, seeping wounds, tubes, IV lines Mode of Transmission: direct or indirect contact, droplet or airbourne transmission Portal of Entry: eye, nostrils, mouth, vagina, cuts scrapes, wounds, surgical sites, bite from vector Susceptible Host: person with inadequate defense |
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Modes of transmission for micro-organisms from the reservoir to the host
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direct contact- touching, kissing, sexual contact indirect contact- contact with a fomite (an object that becomes contaminated)
droplet-cough or sneeze airbourne (via AC or sweeping) |
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Assess the client for factors that influence their susceptibility to infection.
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Person with inadequate defense: immunocompromised, young, old, sick, chemotherapy, organ transplant
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Determining factors for the organism to cause infection
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Virulence, number of organisms, hosts defenses (healthy lifestyle, nutrition, rest, exercise, stress management)
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Characteristics of the stages of infection
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Incubation-time of infection until manifestation of symptoms; can affect others
Prodromal-appearance of vague symptoms; not all disease have this Illness-signs and symptoms are present Decline-# of pathogens declined Convalescence-tissue repair return to health |
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Describe the inflammatory process
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Process that begins when histamine and other chemicals are released either directly from damaged cells or from basophils in response to activation of compliment
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How the nurse would assess for inflammation
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Histamine and other chemicals cause dilation, increased permability of blood vessels, increasing the flow of phagocytes, antimicrobial chemicals, oxygen and nutirents to the damaged area
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Purpose of leukocytosis and state the normal WBC range
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WBC range:5,000-10,000
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Nursing interventions that interrupt the chain of infection
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Medical asepsis
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Most common causes and sites for nosocomial infections
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Lack of handwashing
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Differentiate between medical and surgical asepsis
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Medical = clean
Surgical = sterile |
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Practices for promoting good medical asepsis
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Maintaining a good environment, clean hands, following CDC guidelines
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Prevalent organism causing nosocomial infections in healthcare settings today and how to prevent its spread
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MRSA-Methicillin Resistant Staph. Aureus
-resistant to Beta lactant -now in community -main mode of transmission HANDS! -looks like boil on skin -types of infection:skin, surgical wounds, pneumonia, sepsis, urinary |
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Prevalent organism causing nosocomial infections in healthcare settings today and how to prevent its spread
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VRE-Vancomycin Resistant Enterococus
-origin intestine -significant threat to high risk clients -virulent, hard to kill -mismanagement of antibiotics -transmission: hands, clothing, stethoscope, countertops |
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Prevalent organism causing nosocomial infections in healthcare settings today and how to prevent its spread
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C. Diff- Costridium Difficile
-gram pos. anaerobic bacillus -causes diarrhea, fever, loss of appetite and colitis -most susceptible:illness or condition requiring prolonged used of antibiotics, elderly spread: hands, surface contaminated with feces, mouth mucous membranes |
