Foundations of Nursing Practice

Agent-Host-Environment Model

(Leavell-Clark) Interaction between an external agent, susceptible host, environment as cause of disease in a person. Certain factors place some people at risk for an infectious disease.

Health Promotion Model

(Pender) how people interact with their environment as they persue health. Incorporates individual characteristics and experiences, behavior specific knowledge & beliefs, to motivate health-promoting behavior.

Health Belief Model

(Rosenstock) What people perceive or believe to be true about themselves in relation to their health.

Three components of the Health Belief Model

1.) Perceived susceptibility to a disease, 2.) Perceived seriousness of a disease, 3.) perceived benefits of action.

Self-Actualization needs

Acceptance of self & others; Focus on intrests on problems outside oneself, problem solving, pursuing intrests.

ANA

American Nurses Association; Founded in late 1800's, for RN

Application of the nursing process

Assessment, planning, implementation, evaluation

Duvall's Theory

Based on Erickson's but applied to families; all families reguardless of structure, have certain tasks they must accomplish to promote health & well-being with in the family structure. Families who don't meet the tasks experience lack of adapation and growth. They become stagnant, dysfunctional and may even fall apart.

Florence Nightingale

Birth of modern nursing, provided foundation for modern nursing, defined it as an art & science, differentiated it from medicine.

Primary Roles of Nursing

Caregiver, Communicator, Teacher/Educator, Counslor, Leader, Researcher, Advocate, Collaborator

Four Blended Competencies

Cognitive, Technical, interpersonal, ethical/legal

Lillian Wald

Est. a neighborhood nursing service for the the sick poor of the Lower East Side in NYC; founder of public health nursing.

Contributions of Florence Nightingale

Est. standards for hospital management, est. nursing education, two components of nursing: health & illness, Continuing education for nurses, maintained accurate records of patients.

Clara Barton

Established the Red Cross in the US in 1882

Mary Elizabeth Mahoney

First African American nurse

16th Century

Focus on religion replaced by warfare; exploration and expansion of knowledge, shortage of nurses cause recruitment of criminals

Margaret Sanger

Founder of Planned Parenthood

Health & Dignity

Health - promoted in life, Dignity - nurse maintains dignity in death

ICN

International Council of Nurses; Founded in 1899, professional women

Nutrix

Latin, to nourish

Facilitation of coping with disability

Maximize the clients strength and potentials (teaching, support systems)

Harriet Tubman

Nurse, abolitionist; active in the underground railroad.

11-13th Century (early christian)

Nurses began to have a formal and more clearly defined role.

1950's- Present

Nursing broadened in all areas, Growth of nursing as a profession, varied health care settings developed.

Holistic Care

Physical, Emotional, Social, Spiritual; the whole person

5 levels of Maslow's hierarchy of needs

Physiologic needs, Safety/Security, Love/belonging, self-esteem, self-actualization

Beginning of Animism

Priests were seen as physicians, illness was caused by sin & god's displeasure, Nurses were slaves, Nature.

Nursing Aims

Promote Health, Prevent Illness, Restore Health, Facilitate coping with disability and death. Being able to identify, analyze and maximize a patients individual strengths.

Definitions of Nursing

Promotion of health, preventing of illness, collaborative care; central to all definitions of nursing is Holistic Care.

Acute Illness

Rapid onset of a limited duration

Factors that affect self-esteem

Role changes, body-image.

Nursing is a blend of

Science & art

18-19th Century

Social reform began, Nursing as we know it now began.

Factors that affect a communities health

Social support system, community health structure, economic resources, environmental factors

Stages of behaviors of illness

Stage 1: experiencing symptoms; Stage 2: Assuming the sick role; Stage 3: Assuming a dependent role; Stage 4: Achieving recovery and rehab.

Dorothea Dix

Superintendent of the Female Nurses of the Army during the civil war; was a pioneering rusader for the reform of the treatment of the mentally ill.

Nurse Practice Acts and Licensure

Vary from state to state, Defines the legal scope of nursing, creates a regulatory body in each state, define important terms and activities in nursing, Est. criteria for the education and licensure of nurses within the state.

Health care disparities

a particular type of health difference that is closely linked with social, economic, and or environmental dis-advantages

Community

a specific poplualtion or group of people living in the same geographic area under similar regulations and having common values, intrests, needs.

Health

a state of optimal functioning or well-being (includes Holistic Care)

Health-Illness Model

a way to conceptualize a person's health lvl. Health as a constantly changing state with increased levels of wellness and death at opposite ends of a scale.

Teritary Health Promotion & Prevention

after illness is diagnosed and treatment, reversing disability, helping rehabilitate, to maximal level of functioning. (ex. surgery, treatment, meds, PT, OT.)

reciprocity

allows a nurse to apply for and be endorsed as an RN by another state.

Wellness

an active state of being healthy by living a lifestyle that promotes good, physical, mental, emotional, spiritual health

Family

any group of people who live together and depend upon one another for physical, emotional, financial support.

The Art of Nursing

application of scientific knowledge, the skilled application of knowledge to help others reach maximum health & quality of life.

Independence & Dependence

are always to be balanced during an illness

Factors affecting health and Illness

basic human needs, human dimensions, self-concept, risk factor

Basic Human Needs

behaviors, feelings about ourselves/others, values, priorities that relate to our physiologic and psycohosical needs

Ethically & legally responsible skilled nurses

can be trusted to act in ways that advance interests of the patient, be accountable for their practices, act as effective patient advocate, mediate ethical conflicts, use legal safeguards, conduct themselves morally and professionally.

Critically Skilled Nurses

can select the correct nursing interventions and use thinking to solve problems.

Current trends in nursing

changing demographics/diversity; technology; educated consumer, genomic & palliative care; shift to population based care, cost of health care, nursing shortage, advances in nursing science & research

Components of the nursing process

cognitive, technical, interpersonal, ethical/legal

Mortality

death

Standards for nursing practice

define the activities of nurses, allow nurses to carry out professional roles, serve as protection for the nurse, patient and insitution

Morbidity

disease

Secondary Health Promotion & prevention

early detection screening, yearly exams, papsmears, mammograms, etc.

Preventing Illness

educational programs (pregnant, stop smoking), community programs (aerobics, literature, tv, etc.), health assessments Healthy lifestyle info.

Interpersonaly Skilled Nurses

elict the personal strengths and abilities of patients, provide the healthcare team with knowledge about the patients valued goals and expectations, work collaboratively, est. and maintaining caring relationships that facilitates the achievement of value goals.

Self-esteem Needs

feelings of self-worth, pride, sense of accomplishment, respect, appreciation. (Emotional dimension)

Factors that affect level of health

genetics, cognitive, abilities, educational lvl., race, ethnicity, culture, age, gender, developmental lvl., lifestyle, environment, socioeconomic status

Nursing Process

guideline for nursing practice, helps nurses implement their roles, critical thinking and clinical reasoning, defines areas of care with in the domain of nursing.

The nurse uses the nursing process to....

identify the patients healthcare need and strengths, to establish and carry out a plan of care to meet those needs and to evaluate the effectiveness of the plan.

Nurses promote health by

identifying, analyzing, maximizing each patients own individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death.

Primary Health Promotion & Prevention

immunization clinics family planning poision control accident prevention

Influences of health care disparities

impoverished, women, children, older Adults, Rural/Inner city, people with disabilities, people with special needs, access to health care.

The patient

is the central focus. includes physical, emotional, social, and spiritual dimensions.

Caring

is the essence of nursing and the most central & unifying focus of nursing practice

Nurse Practice acts

laws established in each state in the US to regulate the practice of nursing. Protect the public by excluding untrained persons. Create state board to enforce rules. Define important terms. Establish criteria for education and licensure.

Technically skilled nurses

manual dexterity, hand-eye coordination, ability to troubleshoot equipment problems.

Types of Risk Factors

modifiable: Things that people change; Non-modifiable: things people can not change

Restoring Health

monitoring signs and symptoms of a disease, referring questions to healthcare providers, Illness detection through assessment, Direct patient care

Physiologic needs

must be met to sustain life. Water, Oxygen, food, elimination, temp, sexuality, physical activity, rest. (Physical dimension)

ICN's definition of nursing

nursing is the promotion of health, prevention of illness, collobrative of care; Advocacy, promote safe environment, research in shaping health policy & health system management. (Policies)

Safety & Securrity needs

protection from potential or actual harm; trust, free from fear, anxiety, apprehension (Environmental dimension)

Facilitation of coping with death

provide compassionate end of life care (Hospice)

What is a nurse?

someone who nourishes, fosters, protects; cares for the sick, injured, and aged

Three main guidelines for nursing practice

standards of nursing practice, nurse practice acts & licensure, nursing process

Health Promotion

the behavior of a person who is motivated by a personal desire to increase well-being and health potential.

The science of nursing

the knowledge base for the care that is given

ANA's definition of nursing

the social context of nursing, a definition of nursing, the knowledge base for nursing practice, the scope of nursing practice, standards of professional nursing practice, the regulation of professional nursing. (Practices, Scope & Standards)

Illness

the unique response of a person to a disease; an abnormal processing involving changed levels of functioning.

Love & Belonging needs

understanding & accepting of others in both giving and receiving love; belonging to a group (families, peers, etc.); unmet meeds produce feelings of loneliness and isolation. (Sociocultural dimension)

Chronic Illness

unusually slow onset typically. with peroids of remission and exacerbation. Permanent changes that is caused by irreversible alterations in normal anatomy and physiology

Criteria for nursing as a professional discipline

well-defined body of specific and unique knowledge, Strong service orientation, Recognized authority by a professional group, Code of ethics, Professional orginizations (set standards), Ongoing Research, Autonomy and self regulation.