NUR1023 Unit 2

Developmental Tasks

A unique set of skills and competencies to be mastered at each developmental stage across the lifespan in order for the individual to cope with the environment. Broad in scope and are determined by culture. They may relate to individual or family. Ex. stepping up unassisted or coping with the loss of a spouse.

comprehensive functional assessment

time-intensive, interprofessional effort requiring use of multiple assessment tools. Indicated under specific circumstances

Ethical question

a question that challenges you to consider a particular ethical concept, principle, or perspective in your analysis. Ex. Do i have to tell the truth? What is the greater harm? To whom is my primary loyalty? What are the best interests of my patient?

Organizational Ethics

a set of formal and informal principles and values that guide the behavior, decisions, and actions taken by members of an organization as well as the organizational structures, systems, practices, policies, and procedures developed to ensure ethical operation.

Research ethics

a specialized field within bioethics that examines the ethical conduct of research using human subjects and animals

Health IT is viewed as

the most promising tool for improving the overall quality, safety, and efficiency of the health delivery system

Disability

the negative aspects to a person's health condition and social or physical limitations

Impairment

the physical abnormaility that underlies disability limitations and is caused by some type of disease process

Functional Ability

the physical, psychological, cognitive, and social ability to carry out the normal activities of life. The continuum from full function to disability

Function

the positive or neutral interactions between a person's health condition and ability to perform social or physical activities

Latent condition

the potential contributing factors that are hidden and lie inactive in the health care delivery system, originating at more remote aspects of the health care system, far removed from the active end. A flaw in a system that does not immediately lead to an acident but establishes a situation in which a triggering event may lead to an error

Safety

the prevention of health care errors and the elimination or mitigation of patient injury caused by health care error

Differentiation

the process by which initially formed cells and structures become specialized. Both a quantitative and qualitative change from simple to a complex

Diagnostic error

the result of a delay in diagnosis, failure to employ indicated tests, use of outmoded test, or failure to act on results of monitoring or testing

Informatics

the science that encompasses information science and computer science to study the process, management, and retrieval of information

Development

the sequence of physical, psychological, and cognitive developmental changes that take place over the human lifespan

Ethics

the study or examination of morality through a variety of different approaches. The concepts of right and wrong.

American Medical Informatics Association noted

"the term health informatics to refer to applied research and practice of informatics across the clinical and public health domains

Safety - Human Factors

- study of the interrelationships among people, technology, and the work environment. - consider the ability or inability to perform tasks while attending to multiple things at once. - Work of nurses in acute care environment is very complex. - Focus is on supporting health professionals and eliminating hazards

Maturation

the emergence of personal, behavioral, or adult-like physical characteristics. Enables the individual to function in a fully developed and optimal way.

Professional Ethics

the ethical standards and expectations of a particular profession. A fundamental element to one's professional identity.

ANA Code of Ethics

"The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems." Professional ethics

Functional Ability - Lifespan considerations

1) Developmental stage. 2) physical health 3) psychosocial health 4) cognitive abillity 5) social and cultural factors

Principles of Intervention - development

1) Early identification and early intervention are critical. 2) specific interventions are dependent on the category and type of developmental delay, as well as the age. 3) Management always requires interdisciplinary collaboration

Risk factors for impaire abililty

1) developmental abnormalities; 2) advanced age; 3) cognitive function; 4) mental health issues; 5) trauma; 6) illness

12 ADLs

1) maintaining a safe environment; 2) breathing; 3) communication; 4) mobilizing; 5) eating and drinking; 6) eliminating; 7) personal cleansing and dressing; 8) maintaining body temperature; 9) working and playing; 10) sleeping; 11) expressing sexuality; 12) dying

Crew Resource Management

1. situational awareness. 2. problem identification. 3. decision making by generating acceptable solutions. 4. appropriate workload distribution 5. time management 6. conflict resolution

Contemporary Theories

3 main aspects: Does the theory suggest that development is continuous or discontinuous? Does the theory suggest that there is only one path of development for all children? and What is the relative influence of nature and nurture accoridng to the theory being discussed?

Erikson's theory of psychosocial development

8 stages of psychosocial development that occur between birth and death. Identified by the conflict confronting the individual. 8 stages: trust vs mistrust, autonomy vs shame and doubt, initiative vs guilt, industry vs inferiority, identify vs role confusion, intimacy vs isolation, generativity vs self-absorption and stagnation, and integrity vs despair. Stagewise philosophy in which each stage had a particular task, identified in the form of a conflict, that must be resolved to progress to the next developmental level.

Developmental arrest

a plateau of developemental change in some category and is noted when chronological age continues to progress but developmental change does not.

Functional ability - attributes and criteria

Capacity: ability to perform a task Antecedents: amount of assistance neeed, amount of time needed, level of performance

Computer Science

a branch of engineering that studies compution and computer technology, hardware, and software as well as the theoretical foundations of information and computation techniques

Health informatics

a discipline in which health data are stored, analzyed, and disseminated through the application of information and communication technology

Bioethics

Ethical questions surrounding the biological sciences, emerging health care technologies, and health policy.

Ethical dilemma

a problem for which in order to do something right you have to do something wrong. Ex. determining whether aggressive treatment at the end of life will cause more harm than benefit.

4 class theories for neurocognitive development

Freud's theory of psychosexual development. Erikson's eight stages of psychosocial development. Piaget's theory of cognitive development. Kohlberg's theory of moral development

Developmental stages across the lifespan

Infant, toddler, preschool, school age, adolescent, young adult, middle adult, older adult

Development - interrelated concepts

Influencers: functional ability, nutrition, and culture. Reciprocal relationship: family dynamics & mood and cognition. Impacted: maldaptive behavior, sexuality & reproduction, resilience, protection & movement, and homeostasis & regulation

Ethics of duty

Is it the right thing to do? based on the ethical approach of deontology, in which moral duties are seen as self-evident, needing no further justification. Consequences of our actions are secondary to duty and our intention of doing the right thing

Ethics of consequence

Is the greatest good for the greatest number? based on teleogical view that moral actions are defined entirely on the basis of the outcomes or consequences. Reaching a goal regardless of your sense of duty or moral intent

Ethical Problem

a problem with an ethical dimension. Have a reasonably clear solution

Justice

Particularly complex. Concerned with treating people equitably, fairly, and appropriately. Each patient is entitled to the same level of care and consideration

Physical growth

a quantitative change in which an increase in cell number and size results in an increase in overall size or weight of the body or any of its parts

Developmental regression

The loss of developmental milestones. Very subtle and parents often miss this occurring in their children. The underlying cause must be idenitified

Cognitive development - Risk recognition - definition

These concepts are discussed in terms of pediatric populations (infancy through adolescence) because change in all categories of development is occuring rapidly. Development in all areas is interdependent, a delay, arrest, or decline during a period of rapid developmental change may place an individual at risk

Sources of ethics

family, peers, religion, culture, society, profession, & personal experiences. Family is most powerful

Ethics of Relationship

What is the caring response? focused on the nature and obligations inherent in human relationships and community. Preserving relationships, improving communication, enhancing cooperation, and minimizing harm to everyone involved while promoting an ideal of caring.

Ethics of Character

What is the wise action to take? Rely on the character of the individual as the primary source of moral action. A moral act must both promote good and intend good

Clinical ethics

involved primarily with decision making at the bedside and other patient-specific issues

Culture of safety

acknowleges the influence of complex systems and human factors that influence safety. The focus is on teamwork to accomplish a goal of safe, quality care. *The focus is on what went wrong rather than on who committed the error*

Nonmaleficence

act in ways that avoid harm to others, including even the risk of harm. Harm and perceived harm.

Developmental Milestones

an ability or specific skill that most individuals can accomplish in a certain age range. Typically refers to changes that involve motor, social, emotional, cognitive, and communication skills.

Near miss

an error of communication or omission that could have harmed the patient, but serious harm did not occur as a result of chance, prevention, or mitigation

Adverse event

an event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient

Electronic Health Record

an individual's official, digital health record and is shared among multiple facilities and agencies

Personal ethics

an individual's own ethical foundations and practice. Perhaps most important. Change over time.

Beneficence

an obligation to do good by acting in ways that promote the welfare and best interests of others

Period of exuberance

an outward demonstration of frontal lobe development and typically occurs in children 18 months to 3 years. Communication development

Sentinel event

an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. They signal the need for immediate investigation and response..

Frued's theory of psychosexual development

at different ages, particular areas of the body provide the chief source of sensual pleasure and that experiences with these pleasure centers significantly impact the development of personality. 5 stages: oral, anal, phallic, latency, genital

BADL

basic activities of daily living, or just ADL.

AMIA's three domains of informatics

clinical, public health, translational

Personal Health Record

consumer health informatic

Technology & Informatics used by groups

consumers, patients and their families, caregivers, health care professionals, administrators, and any personnel supporting the delivery of health care.

Technology is the product of

creative human action, and it is sustained by human action

Technology

describes knowledge and use of tools, machines, materials, and processes to help solve human problems

Developmental Assessment

determine goals for rehabilitation and strategies to compensate and thus optimize function and overall health when limited progression is identified and/or following illness or injury. These critical assessments require focused attention and intervention, particularly when working with preverbal or young children and older adults with limited abilities to articulate accurate information, in situations with an absent primary caregiver, or in chaotic living situations in which limited historical data are available

Development - clinical exemplars

developmental concerns can be diagnosed at birth- neuromuscular immaturity, downs. Or they may become evident with age and ongoing development - autism, leg length discrepancy

Categories of error

diagnostic, treatment, preventive, and communicative

Health information technology (Health IT)

essential antecedents for health informatics

Kohlberg's Theory of Moral Development

expands on Piaget's cognitive theory to address the development of an individual's moral reasoning across their lifespan. When a conflict in the universal values occur, a moral choice must be made. 3 levels: preconventional, conventional, and postconventional. The development of moral reasoning is dependent on cognitive skills and neurologic maturation, but it is not definitively linked to specific developmental stages

Technology & Informatics - Scope

idea that health IT and health informatics intersect with the science of health to provide powerful tools and processes for advancing health practices and serve as an infrastructure to support and promote a continuously learning health care system

IADL

instrumental activities of daily living. More complex skills that are essential to living in the community. Example: cooking, shopping, managing money

Gross motor skills

involve the use of large muscles to move about in the environment. Ex. sitting, standing, walking

Fine motor skills

involve the use of small muscles in an increasingly coordinated and precise manner. Contingent upon cognitive and neurologic development. Ex. holding a pencil, batting an objet

Communicative failure

lack of communication or a lack of clarity in communication can lead to many types of errors

Active errors

made by those providers who are providing patient care, responding to patient needs at the "sharp end", which is the point of care

Respect for persons

maintains that human beings have an unconditional moral worth that requires us to treat each individual with great value, dignity, and respect.

Stressors as perceived by children

may differ greatly from the stressors that cargivers may sense exist for a child. Example: loss of a pet, moving, new school, new baby, illness of family members

Treatment error

occur in the performance of an operation, procedure, or test; in administering a treatment; in the dose or method of administering a drug; or in avoidable delay in treatment or in responding to an abnormal test

Preventive error

occur when there are failure to provide prophylactic treatment and inadequate monitoring or follow-up of treatment

Normal human development is

organized, progressive, and follows a predictable sequence across the life stages

Safety - interrelated concepts

overlapping: health care quality reciprocal relationships: communication, collaboration, and care coordination

Examples of cognitive development risks

prenatal, birth risk, individual risk, family risk, situational risk, social determinants of health, toxic stress, and health status

Fidelity

principle that requires us to act in ways that are loyal. Keeping promises, doing what is expected of you, performing your duties, and being trustworthy.

Ethical principles

respect for persons, nonmaleficence, beneficence, and justice. Also fidelity

Just Culture

seeks to balance the need to learn from mistakes and the nee to implement disciplinary action

Clinical Health Informatics

seeks to transform health care and enhance human health through a creative and innovative use of informatics

Societal Ethics

serve the larger community. Provides a strong normative basis for ethical behavior through the legal and regulatory systems. Law.

Developmentally delayed

signifying that an essential element of neutologic and/or cognitive maturation has not occurred within an age range and should be investigated.

Piaget's theory of cognitive development

sought to explain how children innately organize their world and learn to think. Cognitive development is views as progressing from illogical to logical, from concrete to abstract, and from simple to complex. 4 periods: sensory motor, preoperational, concrete operational, and formal operations

Adaptive development

the acquisition of a range of skills that enable

Functional performance

the actual daily activities carried out by an individual's inability to perform the tasks required to complete normal life activities without assistance

Public Health Informatics

the application of information, computer science, and technology to public health science to improve the health of populations.

Translational Bioinformatics

the development of storage, analytic, and interpretive methods to optimize the transformation of increasingly voluminous biomedical and genomic data into proactive, predictive, preventive, and participatory health

Health informatics broad term

the discipline of informatics as applied to clinical care and public health

Health IT provides

umbrella framework to describe the comprehensive management of health information and its secure exchange between consumers, providers, government and quality entities, and insurers.

Functional impairment and disability refers to

varying degrees of an individual's inability to perform the tasks required to complete normal life activities without assistance

Cognitive development

working memory capacity, cognitive self-regulation, and the processing and use of information about the environment and objects in the environment, as well as understanding the relationships between self and this information. The development of critical thinking and executive functioning