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117 Cards in this Set

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Health is a state of complete ______, ______, and _______ well-being, not merely the absence of disease or infirmity (WHO, 1986).
mental
social
physical
Person is an _____, ________, or ______ who is a multidimensional being with intrinsic worth and free will.
individual
family
community
Nursing metaparadigm
person, health, nursing, and environment (through education)
Nursing
the diagnosis and treatment of human responses to health and illness.
Environment
all internal and external variables that influence the health of persons.
education
life-long interactive process between educator and student including the acquisition and application of knowledge, skills, and understanding relative to nursing.
Maslow's hierarchy of needs
1. physiological
2. safety
3. love and belongingness
4. esteem
5. self-actualization
Nursing roles
care provider
care manager
member of healthcare team
educator
8 core components of nursing practice
1. professional behaviors
2. communication
3. assessment
4. clinical decision making
5. caring interventions
6. teaching & learning
7. collaboration; and
8. managing care
The nurse assists persons to meet their needs through the interactive process and the application of the ______ _____.
nursing
process
Who was the founder of modern nursing?
Florence Nightingale
When was the historical turning point of nursing?
Crimean War (1853)
What were Nightingale's 2 main foci?
Sanitation
hygiene
Before Nightingale, nursing was closely associated with what other profession?
prostitution
Clara Barton founded ________.
Red Cross (1881)
Dorothea Lynde Dix (1802 - 1887)
improved sanitarium conditions
Civil War Superintendent of Union Army Nurses
Henry Street Settlement (1893)
1. opened by Lillian Wald and Mary Brewster
2. beginning of community nursing
Mary Mahoney
1st professional black nurse (1905)
Mildred Montag
Founder of Associate Degree Program in nursing (1942)
Mary Brewster
opened Henry Street Settlement (1893) with Lillian Wald
Linda Richards
1st graduate of 1st nurse training program founded by Nightingale (1879)
Florence Nightingale
founder of modern nursing
lady with the lamp
first to use EBP
reformed hospitals and infirmaries & workhouses by implementing sanitation and hygienic procedures and standards
Societal influences on nursing
demographics
women's health care issues
human rights issues
medically underserved populations
threat of bioterrorism
2 health goals of Healthy People 2020 are ______ and _______.
illness prevention
obesity prevention
Every healthcare encounter should be ________.
educational
The main nursing challenge is how to do ______ with _____.
more
less
5 characteristics of nursing as a profession
1. requires extended education
2. requires a body of knowledge
3. provides a specific service
4. has autonomy
5. incorporates a code of ethics
Scope and Standards of Practice
GOAL OF NURSING: to improve health and well-being of persons through significant and visible contributions of registered nursing using standards-based practice (ANA, 2004)
The Nursing Process
continuous process of:
1. assessment
2. diagnosis
3. planning
4. implementation; and
5. evaluation (of client, not nurse!)
Code of Ethics: philosophical ideals of _____ and _____ that define principles of nursing.
right
wrong
4 nursing ideals
1. advocacy
2. accountability (for self and others you manage
3. responsibility
4. confidentiality
Ways to become RN
ASN
BSN
diploma
What can you do with MSN degree?
nurse educator
nurse administrator
Certified Nurse Specialist
Advanced Practice Nurse
CRNA
What are the 3 nursing doctoral programs?
DSN
PhD
DNP
T/F: Every state has its own nursing practice act.
True
The _________ is the nationwide licensing exam for RNs.
NCLEX-RN
What is the purpose for the state board of nursing?
to protect the consumer (not the nurses!)
The professional responsibility of nurses has changed over time. Used to be just to provide care and comfort. Now nurses are to provide care and comfort and emphasize _______ and _________.
health promotion
disease prevention
Nursing roles:
1. caregiver
2. educator
3. manager
4. advocate
5. communicator
Name 6 types of NP specialties
1. Family
2. Women's Health
3. Pediatric
4. Neonatal
5. Acute
6. Geriatric
T/F: Nursing has been voted Most Trusted Profession in Gallup Poll every year.
False: the year after 9/11, firefighters were most trusted. It's been nursing every other year.
Name 4 professional nursing organizations
1. National League for Nursing
2. American Nurses Association
3. International Council of Nursing
4. National Student Nurses Association
4 types of nursing theories
1. grand (abstract)
2. middle-range (more limited)
3. descriptive (cause & effect)
4. prescriptive (actual consequences)
4 types of interdisciplinary theories
1. basic human needs (Maslow)
2. developmental theories (Erikson)
3. psychosocial theories
4. systems theories (open or closed)
What is a closed system?
limited to the individual
What is an open system?
individual + environment
8 stages of Erikson's theory of development
1. infant (trust v. mistrust)
2. toddler (autonomy v. shame & doubt)
3. pre-schooler (initiative v. guilt)
4. school age (industry v. inferiority)
5. adolescent (identity v. role confusion)
6. young adult (intimacy v. isolation)
7. middle-age adult (generativity v. stagnation)
8. older adult (integrity v. despair)
Psychosocial & Developmental Theories
Freud (psychosexual development)
Piaget (cognitive development)
5 stages of Freud's developmental theory
1. oral
2. anal
3. phallic
4. latency
5. genital
Piaget's cognitive stages
1. sensorimotor (0-2 yrs)
2. preoperational (2-7 yrs)
3. concrete (7-12 yrs)
4. formal operations (12+ yrs)
Components of Systems Theories
1. input
2. system
3. output
4. feedback
NURSING THEORY:
Nightingale (1860)
body repair through manipulation of environment
NURSING THEORY:
Peplau (1952)
significance of nurse/patient relationship
NURSING THEORY:
Henderson (1955)
14 principles of nursing care (revised & more detailed than Nightingale's theory)
NURSING THEORY:
Rogers (1970)
maintain and promote health & prevent illness
NURSING THEORY:
Orem (1971)
client self-care
NURSING THEORY:
Neuman (1972)
systems model: attaining & maintaining maximal level of wellness and reduce stresses
NURSING THEORY:
Leininger (1978)
transcultural caring
NURSING THEORY:
Watson (1979)
philosophy & science of caring
NURSING THEORY:
Roy (1979)
adaptation model: help client assess and adapt to stressors
7 aspects of environment which Nightingale (1860) said could be manipulated to promote health
1. noise
2. light
3. sanitation
4. hygiene
5. comfort
6. socialization
7. hope
14 basic principles of nursing care according to Henderson (1955)
1. breathing normally
2. eating and drinking adequately
3. body waste elimination
4. moving & positioning
5. sleeping & resting
6. suitable clothing
7. maintaining proper body temp
8. skin care
9. avoiding environmental dangers to client and others
10. communicating with others
11. worshipping according to one's faith
12. work resulting in sense of accomplishment
13. recreation
14. learning
Goal of nursing according to Orem (1971)
for client to attain total self-care
NURSING THEORY:
Jean Watson (1979)
carative v. curative
NURSING THEORY:
Sister Callista Roy (1979)
adaptation model of nursing - nursing care needed when individual can't adapt to internal and external environmental demands
The relationship between _____ and _____ builds nursing's knowledge base.
theory
research
Traditional clinical decisions based on _______, ________ and _________.
formal education (changes over time)
experience (varies by the individual)
policies & procedures (may not be up to date)
______ enable clinicians to provide the highest quality of care.
EBP
Key areas of current health care research
chronic illness
quality & cost-effective care
health promotion
disease prevention
symptom mgt
adaptation to new techniques
health disparities
end-of-life palliative care
Clinical Knowledge Gaps
lots of research opportunities!
diagnosis
prognosis
therapy
prevention
education
What does PDSA stand for?
Plan
Do
Study
Act
Steps to EBP
1. ask the question
2. collect evidence
3. analyze
4. implement intervention
5. evaluate practice decision
What's PICO?
how to ask the question in EBP:
P = population of interest
I = intervention of interest
C = comparison of interest
O - outcome
Evidence sources
policy & procedure manuals
quality improvement data
clinical practice guidelines
bibliographical databases
Where to find the literature?
AHRQ
CINAHL
MEDLINE
Cochran Database of Systematic Reviews
National Guidelines Clearinghouse
PubMed
How to critique the evidence?
evaluate its value, feasibility & utility
Must have ______ consent to conduct patient research.
informed
Clinical trials do not employ ________ anymore.
placebo
Research is either ______ or _______.
qualitative
quantitative
How to integrate the evidence?
practice guidelines
policies & procedures
staff support
pilot studies
teaching tools
assessment tools
documentation tools
Components of RCT (randomized control trials)
research question
subjects
randomization
treatment group
control group
outcome measure
analysis
What's the purpose of randomization in trials?
to eliminate bias
How to evaluate the practice decision?
collect data to determine whether:
1. practice worked
2. practice was effective
3. practice worked for the client or the situation
Which of the following is the first step of the research process?
a. analyze data
b. identify problem
c. conduct study
d. use the findings
b. identify problem
Every health care organization gathers data on health outcomes. Examples of data include:
a. discharges
b. medications administered
c. healthy births
d. infection rates
d. infection rates
3 levels of critical thinking
1. basic
2. complex
3. commitment
Basic level of critical thinking
1. accepts opinions of experts
2. more worried about performing the intervention correctly than about the client's comfort
Complex level of critical thinking
student begins to analyze and examine choices more independently
Commitment level of critical thinking
1. anticipate the need to make choices without assistance from others
2. accept accountability for every decision made.
paradigm
links science, philosophy and theories accepted and applied by the discipline
nursing paradigm
elements directing activity of nursing profession:
1. person
2. health
3. environment
4. nursing
person
recipient of nursing care
1. individual
2. family
3. community
health
1. depends on client, clinical setting, and health care profession
2. dynamic and continuously changing
domain
the perspective of a profession
environment/situation
all possible conditions affecting client and setting in which health care needs occur
There's a continuous interaction between the client and the _________.
environment
nursing
diagnosis and treatment of human responses to actual or potential health problems
Nurses uses critical thinking skills to integrate what 4 things into each client's plan of care.
1. knowledge
2. experience
3. attitudes
4. standards
theories
designed to explain a phenomenon
nursing theory
conceptualization of some aspect of nursing communicated for purpose of describing, explaining, predicting, prescribing nursing care
Nursing is a ______, _______, and ________.
learned profession
a science
an art
5 components of Swanson's theory of caring
1. knowing
2. being with
3. doing for
4. enabling
5. maintaining belief
phenomenon
an aspect of reality that people consciously sense or experience
assumptions
"taken for granted" statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory
Why is the general purpose of a theory important?
purpose specifies the context and situation in which the theory applies
input
data/info that comes from client's assessment
output
end product of a system - whether client's health status improves as a result of nursing care
feedback
informs system about how it functions.
evidence based practice (EBP)
problem-solving approach to clinical practice that integrates conscientious use of best evidence in combination with clinician's expertise and values in making decisions about client care
EBP is a response to _________.
the broad societal forces with which nurses must contend
EBP is a guide for nurses to structure how to make accurate, timely, and appropriate ______.
clinical decisions
clinical guidelines
systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific client population
National Guidelines Clearinghouse
invaluable when developing a plan of care for a client
nursing research
a way to
1. identify new knowledge,
2. improve professional education and practice, and
3. use resources effectively
nursing-sensitive outcomes
outcomes which are sensitive to nursing practice
performance measurement
what an organization does and how well it does it
performance improvement (PI)
organization evaluates and analyzes current performance to use results to develop focused improvement actions