Nurs 285 final exam

continuity of care

a process by which health care providers give appropriate, uninterrupted care and facilitate the patient's transition between different settings and levels of care. ensures a smooth transition between ambulatory or acute care and home health care or other types of health care settings in the patient's community.

ISBARQ

a revised approach, adding introduction and question and answer components to SBAR I - Introduction S - Situation B - Background A - Assessment R - Recommendation Q - Question and answer

clinical reasoning

a specific term usually referring to ways of thinking about patient care issues (determining, preventing, and managing patient problems); for reasoning about other clinical issues (e.g., teamwork, collaboration, and streamlining work flow); nurses usually use critical thinking

discharge planning

systematic process of preparing the patient to leave the health care facility and for maintaining continuity of care

What is an effective use of the CR model by nursing students and its application in practice by novice nurses directly linked to?

the five rights of clinical reasoning: the ability to collect the right cues and take the right action for the right patient at the right time and for the right reason

What are three helpful guides to facilitate clinical reasoning when prioritizing patient problems?

Maslow's hierarchy of human needs, patient preference, and anticipation of future problems.

secondary prevention

centers on health maintenance and is aimed at early detection, with prompt intervention to prevent or minimize loss of function and independence, including interventions such as health screening

Potential errors in decision making

Bias: Placing excess emphasis on first data received Avoiding information contrary to one's opinion Selecting alternatives to maintain status quo Being predisposed to a single solution Stating the problem in a way to support one's choices Making decisions to support past choices Failure to consider the total situation: Using inaccurate data Not clearly identifying the problem Failing to prioritize or rank the problems in order of importance Using unrealistic goals Impatience: Failing to identify multiple solutions Incorrectly implementing the decision Failing to use appropriate resources

Critical thinking

Includes reasoning both outside and inside of the clinical setting

Critical thinking applied to clinical reasoning and judgment in nursing practice

Is guided by standards, policies, and procedures, ethics codes, and laws (individual state practice acts) Is based on principles of nursing process, problem solving, and the scientific method (requires forming opinions and making decisions based on evidence) Carefully identifies the key problems, issues, and risks involved, including patients, families, and major care providers in decision making Is driven by patient, family, and community needs, as well as nurses' needs to give competent, efficient care (e.g., streamlining paperwork to free nurses for patient care) Calls for strategies that make the most of human potential and compensate for problems created by human nature (e.g., finding ways to prevent errors, using information technology, and overcoming the powerful influence of personal views) Is constantly re-evaluating, self-correcting, and striving to improve

Maslow's Hierarchy of Human Needs

Physiologic needs Safety needs Love and belonging needs Self-esteem needs Self-actualization needs

Assertive Community Treatment (ACT)

community-based programs that provide many of the services that are necessary for successful community living; includes case management, problem-solving, social skills training, support, teaching on a 24/7 basis

The Joint Commission National Patient Safety Goals required hospitals to implement a standardized approach to handoff communications that includes

The handoff situation Who is, or should be, involved in the handoff communication Opportunities for people involved in handoffs to ask and respond to questions An outline for when to use certain communication techniques, such as repeat-back or read-back or the Situation-Background-Assessment-Recommendation (SBAR) technique What print or electronic information should be available during the handoff

Clinical Reasoning and Establishing Priorities

What problems need immediate attention and which ones can wait? Which problems are your responsibility and which do you need to refer to someone else? Which problems can be dealt with by using standard plans (e.g., critical paths, standards of care)? Which problems aren't covered by protocols or standard plans but must be addressed to ensure a safe hospital stay and timely discharge (or simply safe care of high quality)?

primary prevention

focuses on health promotion and prevention of illness or disease, including interventions such as teaching about healthy lifestyles.

tertiary prevention

focuses on minimizing deterioration and improving quality of life, including rehabilitation to assist patients in achieving their maximum potential by working through their physical or psychological challenges.

Factors to assess in discharge planning

health data personal data caregivers environment financial and support services

impediments to successful discharge planning

include alcohol and drug abuse, criminal or violent behavior, noncompliance with medication regimens, and suicidal ideatio

essential components of discharge planning

include assessing the strengths and limitations of the patient, the family or support person, and the environment; implementing and coordinating the plan of care; considering individual, family, and community resources; and evaluating the effectiveness of care.

Important teaching topics about self-care at home

include medications, procedures and treatments, diet, referrals, and health status.

eight main steps or phases in the clinical reasoning cycle/clinical reasoning (CR) model

look, collect, process, decide, plan, act, evaluate, and reflect

decision making

purposeful, goal directed effort applied in a systematic way to make a choice among alternatives,"

clinical judgment

refers to the result (outcome) of critical thinking or clinical reasoning; the conclusion, decision, or opinion a nurse makes

When does comprehensive discharge planning occur in acute care settings?

when the patient is admitted for treatment—or even before admission.